County board approves teen mental health funding

The Yamhill County Board of Commissioners approved $75,000 in state funding for youth mental health services in Newberg Thursday.

Several school, county and provider representatives gave the board details on current programs at the schools and their parental notification policies.

Last week, the board delayed a request from Health and Human Services Director Lindsey Manfrin to approve the Oregon Health Authority funding (along with $28,000 for immunization services) to expand services in the Newberg Dundee School District, citing concerns over parental involvement in therapy and counseling services, following the recent suicide of a McMinnville High School student.

The county currently has three School Based Health Centers in McMinnville, Willamina and Newberg. The funding will be used to expand services at the Newberg location and HHS is expecting an additional $75,000 in funding over the next two years for the same facility, according to Manfrin.

The funding can be used for drug and alcohol counseling, mental health therapy and groups and skill building — all services that are currently available but will be expanded, according to Manfrin.

District students can access treatment through school counselors, with the School Based Health Center or through other on site options provided by Providence Health & Services and Lutheran Family Services, but all of those entities follow the same plan related to suicide risk and parental involvement, according to Manfrin.

Under Oregon law, youth aged 14 or older are allowed to enter mental health, drug or alcohol treatment without parental consent; however, the law requires medical providers notify parents if there is an immediate threat of suicide.

“For HHS certainly all of the consent to treatment laws are things that we are obligated to follow and part of those consent to treatment plans include parameters around parental notification. Even in those youth who may be old enough to consent for treatment, there are still guidelines and parameters around when notification is required,” Manfrin said.

Manfrin was joined by Elise Hollamon, Providence Director of Access Strategies; district Director of Special Education Tony Buckner; district Behavioral Health Coordinator Amy Stephens; and district psychologist Jeri Turgesen to explain services at Newberg schools.

The district had taken a hard look at its policies after a rash of six suicides in 2016-17 and teamed with HHS and Providence to identify a solution, according to Buckner. The community started developing standardized evidence-based risk assessments for suicidal youth.

Counselors can give screenings and if they result in moderate of high risk of suicide, a second screening is done by HHS or Providence, which is followed by parental involvement, Buckner said.

“Immediately I’m on the phone with a parent, ‘we need to go do something different because right now your kid’s at a high risk of suicide,’” Buckner said. “In my eight years of doing this work I don’t think I’ve ever had a phone call that I didn’t make to say ‘this is where we’re going and this is what we’re doing.’

“But you have to streamline the whole process. You have to make sure that as they’re seeing a Lutheran provider, as they’re seeing a Providence provider, as they’re seeing their school counselor, everybody is in the loop on that.”

Turgesen said every student in the district who has shown a high risk of suicide in crisis risk assessments has parental or guardian involvement.

“Every single one of those kids who has come in for a crisis risk assessment with high risk suicidality has parental engagement,” she said. “Our goal is truly to provide the highest level of support possible and partner with families or guardians to connect youth to higher levels of care when that is necessary.”

Any student that signs up to receive services is given a form for parents to complete and when they show up without one, staff asks about parental involvement, Turgesen said.

“We are truly asking kids at every point of contact, ‘which safe guardian adult parent in your life can we connect with to make sure that family is involved in these processes?’”

This year there have been 11 risk assessments for students in the district, including five in the last two weeks, according to Turgesen.

She detailed two such cases: in one a student had a “significant” suicide plan and access to a method. A parent was contacted and the district spent four hours developing a safety plan that included moving items out of the home, identifying resources and working with a medical provider.

“It’s not a quick phone call, it’s intentional thorough engagement around ‘this is what we’re seeing, this is the risk factors, here’s how we’re working to support your child and here are what we think would be the appropriate next steps.’”

The other case featured a “very depressed” student who was unable to participate in safety planning so parents were brought in and the student was transferred to a hospital, Turgesen said.

“While it was really difficult and really hard, again we brought that parent in, gave them kind of a voice and choice in how they wanted to navigate that process and also made sure that that kiddo got to that higher level of care,” she said.

Students participating in therapy programs have a similarly high rate of parental involvement, with 90.7% engaged, according to Turgesen. The other 9% aren’t at risk for suicide.

HHS is notified whenever there is a loss of life by suicide or drug overdose and can send a mobile crisis team out immediately for support, according to Manfrin.

The county can also perform psychological autopsies with permission from families of suicide victims, which takes a deep dive into the circumstances that led to death involving multiple district partners, Manfrin said.

She gave an example of another county noting that people turning dogs into a shelter was sometimes a sign of suicide and employees at those agencies can be trained to look for signs and provide resources, Manfrin said.

“Those are the kinds of things we look for when we do those deep dives,” she said.

Turgesen and Buckner pointed out the importance of opening up a dialogue in schools about suicide.

“We are working on not being scared to say the word suicide because we have to be able to talk about it openly to ask the questions, create the space, to be able to get kids and families into the care that they desperately need,” Turgesen said.

“We’re not afraid to talk about suicide,” Buckner said. “We’ve talked about it enough, it’s a lot easier to do it before the student dies.”

Before unanimously approving the funding, board members Mary Starrett and Lindsay Berschauer thanked the speakers for their information and noted the delay in voting didn’t impact programs that are currently available, which Manfrin confirmed.

“I don’t think that there’s a hold up,” she said. “Certainly if it continues we were not able to take our next steps but you’re correct, I didn’t have anyone ready to send to the Newberg school on Friday.”

Berschauer said she asked for the pause for more information because the tenor in the community reminded her of the time in Newberg when the community was reeling from suicide deaths.

“The sentiment right now in the community in McMinnville seems to be tracking along the same level (as Newberg in 2017) and I think that’s why when this came up last week we sort of had that collective reaction, ‘whoa, let’s check in because something’s not right here,” Berschauer said. “For your team to come here within a week and spend two hours almost with us and give us the depth of data and just context and reassure us, we’re all parents and grandparents — some of us — and we take this to heart when this stuff happens and I just am very impressed with your ability to come here … and provide all of this data and knowledge and for director Manfrin to be so responsive.”