Born and raised in the agricultural foothills of Tulare County in California’s Central Valley, Greg Salcedo attended the only K-8 school and high school serving his rural town of about 3,000 people. Friends and family never spoke about adolescent depression, anxiety, post-traumatic stress or suicide, issues that have, for decades, disproportionately affected rural, high-poverty communities in the United States, according to an article in EdSource.
The Covid-19 pandemic exacerbated a decades-long mental health problem in Tulare County. Psychiatric hospitalization rates for students 9 to 13 years old climbed 23% during the first year of the pandemic. Salcedo decided to pursue a master’s degree in social work. In his first year as a graduate student, he helped shape the county’s emergency response through Rural Access to Mental Health Professionals, a program that placed him as a student mental health support worker in schools serving his community.
“I was able to talk to students and set them up with resources, call parents to set them up for therapy referrals or services with outside agencies [and] do a lot of outreach to promote mental health,” Salcedo says. “Being in this community for so long has helped me have a better sense of empathy and understanding of these kids and what they’re going through.”
The program places early-career mental health workers in 33 of Tulare County’s high-poverty school districts. Through the program, Salcedo served a one-year unpaid internship at an elementary and high school in Tulare, after which he was hired full time as a social worker at a high school in the Tulare Joint Union High School District.
Participants are first- and second-year graduate students in social work who provide education-related services such as interim therapy and student group services, according to Marvin Lopez, executive director at the California Center on Teaching Careers, which helps coordinate the program. Since 2019, the center has supported 50 candidates through a $2.5 million grant from the U.S. Department of Education.
Districts in Tulare County have improved shortages of mental health providers using funds from the state. Tulare Joint Union High School District, for example, reported that the district’s student-to-counselor ratio improved significantly from 300 students per counselor in 2019 to 268 students per counselor in 2021.
Last year, the center secured a $15 million federal grant to develop Preparing Rural Inclusive Mental Health Educators, a program that pays final-year graduate students a $45,000 stipend for a year-long internship and a three-year commitment to remain in the field of school-based mental health care. To date, the center has sponsored 23 interns.
These candidates offer more long-term, advanced care, such as individual student therapy, group therapy, parent and family consultation and school faculty support. The center intentionally recruits from partner universities closest to Tulare County, such as California State University Bakersfield and Fresno State, whose students largely come from the rural communities they will serve.
Jeovany Martin, who completed his master’s in social work at CSU Bakersfield, says, “I’m able to relate to these students. I speak their language, and I’m able to communicate with parents in their language, which goes a very long way in creating a working relationship with them.
The program was also his most realistic path to the field of education-based mental health care. Most providers are overworked and underpaid — with nearly 59% of school counselors leaving their positions in their first two years — and non-white, low-income candidates have much less financial and professional support to enter the field.
Nationally, most school counselors are overwhelmingly white, and they do not represent the backgrounds of the students they serve. For Tulare County’s student population — where nearly 80% of students are Latino — the two programs address a shortage of cultural competence in mental health support available to students, according to program supervisor Rosie Hernandez.
Most children living in rural, low-income households, Lopez says, are also more likely to experience higher rates of anxiety, depression and behavioral problems, often due to stressors such as food insecurity, parental job loss and geographic isolation.
“We’re recruiting, preparing and supporting candidates from our own communities who represent our student population,” Lopez says. “That allows our students to connect at a much higher level with our interns to bring them comfort, a space where they can interact and feel safe.”
The National Center for Youth Law found that across the country’s child welfare, education and mental health systems, providers and educators have routinely over-referred Latino students for behavioral issues and subjected them to harsher disciplinary measures than white children. Black and Latino children were also found to be removed from their families and into out-of-home care at higher rates, while receiving fewer mental health services, such as psychotherapy and counseling, than white children.
To address fears of bias and neglect, which remain the highest barrier for underserved communities to access mental health care, program interns in school counseling work more directly with parents, caretakers and community support systems.
Salcedo, for example, partnered with the local Boys and Girls Club to run a regular backpack drive for students in the neighborhood. He also helped set up a resource closet at his school, where students frequently stop by for necessities such as food, school supplies and personal hygiene products.
“We have this daily check-in routine with our students, where we say, ‘Whether you’re needing to talk to a counselor, or you just need some deodorant, a snack, or pencils, we can provide it’,” Salcedo says. “‘If you’re looking for housing, or babysitting, or transportation to get to an appointment, we can try to help.’”
Martin says that the need for broader support has especially spiked for K-8 students in Tulare County, many of whom lost crucial social and cognitive development to remote learning during the Covid-19 pandemic. Many of Salcedo’s high school students, he says, withdrew from their counseling sessions online — some did not have reliable Wi-Fi or could not use microphones due to disorganized environments at home, for example.
“That’s why it’s important for us to take a holistic approach,” Martin says. “We might be doing an intervention here at the school for the student, but there might be something going on at home that the family needs extra resources for. We’re able to help bridge those gaps, wherever they might be, for the students and their families.”
EdSource
