Iowa Schools Move to Shore Up Student Mental Health Services

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Principal Chris Myers sought to make mental health counseling available to students in the rural district of Graettinger-Terril for nearly four years.

But each time he thought he might be close, money, or lack thereof, got in the way.

Myers’ luck changed in July 2020, when Iowa received $50 million in federal funds through the Coronavirus Aid, Relief, and Economic Security Act, aka the CARES Act. The act passed in March 2020 as a $2.2 trillion relief package to respond to the economic fallout from COVID-19.

Of that $50 million in CARES Act money, $30 million was allocated per capita, at $9.50 per Iowan. The funds went to Iowa’s 14 Mental Health and Disability Services regions. The CARES Act money gave Myers’ effort a boost.

School leaders in the 330 public districts and dozens of private schools across the state are in the same boat as Myers’ — looking to help students with struggling mental health.

IowaWatch reached out to all 14 mental health regions about where funds went and how much was used.

The Need Is Real

Teachers and staff took extra social-emotional training over the summer of 2020 to prepare them for the added demands of the 2020-21 school year, which, at the time, was a question mark. New approaches, such as leading classes in yoga poses, breathing techniques and journaling helped kids and teachers handle the new struggles that come with a pandemic.

“Everybody suffered a trauma of sorts,” said Myers, the principal at Terril Elementary and curriculum director for the Graettinger-Terril and Ruthven-Ayrshire school districts in northwest Iowa.

Consider this scene from Terril Elementary in northwest Iowa.

As winter wound down in March 2021, the lockers belonging to Pennie Klepper’s fourth-grade students started to stink.

Klepper told her students it was time to clean. But the mood shifted before the hum of children sorting through outdoor gear, books and papers could even start. Twenty-four pairs of eyes filled with worry above their facemasks, and then, for some, even tears.

“One kid starts saying something to another kid, ‘oh we’re cleaning out lockers, this is just like last year,’ and then it kind of was the trickle effect,” Klepper said. “It was just so strange, because the whole vibe in the hall got different. … They just instantly went into a panic mode. It was almost like they were starting to re-live the whole pandemic thing all over again.”

Leaving school in March 2020 created an undercurrent of uncertainty. The one-year mark of the pandemic’s onset caused those memories to be even more palpable.

The 2020-21 school year’s fourth-graders were especially good about sharing and talking out problems, said Klepper, who has taught there for eight years. So, that’s just what they did about cleaning out the lockers on that March day.

“We just stopped in the hall and started talking about it right there. And I thought it was the best, at the time, just to let them get their feelings out, and really talk about it. … And they kind of almost consoled each other a little bit, too,” she said. “Some of them really missed each other [last year]. They felt that isolation, and I think that worries them still, and I don’t know how that’s going to affect them going down the road.”

How Did CARES Act Money Get to Schools?

In August 2020, the mental health regions received $30 million in CARES Act funds, with stipulations that they were not allowed to use them on services they had already budgeted for, and that the money could only be spent on services related to the pandemic. Each mental health region invited schools, as well as mental health service providers and other entities such as universities, libraries and daycare centers to apply for funding.

Initially, mental health regions were required to spend each dollar by December 30, 2020, but the deadline was extended until June 2021, said Russell Wood, CEO for the Central Iowa Community Services region.

Regional leaders asked for proposals from providers and school districts they had never worked with. They also reached out to providers they already had relationships with. Within three to four months after receiving the funds, more than $20 million of the $30 million had been allocated. Regional CEOs told IowaWatch they expected all their funds to be spent. If any money is left over, it would go back to the state on July 1.

Nine regions spent all the CARES Act money, with five returning funds. Eastern Iowa MHDS Region sent back $27,712.15; Central Iowa Community Services returned $30,532.04; Rolling Hills Community Services Region returned $160,000; County Social Services returned an unspecified small amount after an organization didn’t use all the funds allocated to it; and the East Central Region sent back $820,777, and is waiting for the Iowa Department of Human Services and the governor’s office to decide if they can have $250,000 of those funds back for a research study to be done with the University of Iowa.

The $30 million was not the only support for Iowa schools’ mental health efforts. Other federal funding, including the Coronavirus Response and Relief Supplemental Appropriations Act, the American Rescue Plan, and funding from FEMA and the Department of Health and Human Services, has been sent to states as the pandemic has persisted. Some of those funds may have gone to schools for mental health services as well.

“The intention in D.C. is to get the money out and provide states with the flexibility on how to spend it” both now and throughout the next six to seven years. How much of that money is funneled to mental health programs is up to state officials, said Taylor Foy, communications director for Iowa Sen. Chuck Grassley.

A spokesman for Iowa Gov. Kim Reynolds did not respond to requests for comment.

‘A Springboard’

An influx of cash through the CARES Act forged new relationships among mental health providers and schools and their mental health regions.

“It’s unfortunate that we’ve limited it to the fact that we have a pandemic, but for us we’re looking at it as a springboard,” said Mae Hingtgen, CEO for Iowa’s East Central Region. “People know who we are as an MHDS region now, [and] we can use that with the ongoing funding that we have all committed in each of our regions to provide support in a little bit more of a comprehensive system for children’s brain health needs.”

Hingtgen said her region funded 22 of its 39 school districts. Some districts received enough federal dollars directly from the CARES Act and didn’t need any of the funds allocated to mental health regions.

In the Southwest Iowa Region, CEO Suzanne Watson provided funding to 33 of her region’s 36 school districts. Those funds went to helping schools purchase mental health curricula, sensory items such as texturized or brightly colored toys, creating outdoor sensory paths, and quiet, self-care rooms or areas within classrooms to give students feeling anxiety a safe place to go, among other things, she said.

In some of the Heart of Iowa Region’s more rural school districts, region leaders already helped fund therapists in the school, said Darci Alt, the Heart of Iowa CEO. But in larger, more suburban school districts, like those in Dallas County, some district leaders asked for additional funding to increase how frequently therapists or counselors, funded by Employee and Family Resources, visited their school buildings.

But not everything that is tied to children’s mental health starts with therapy or sensory items.

Personal protective equipment and plexiglass dividers helped children’s brain health just by helping to get them back into the classroom, Wood said.

“I think what we’ve learned from this is that kids need other kids. They need to be around each other, and to take them out of that environment is going to cause a significant amount of stress,” Watson said. “So I think any of these supports we were able to provide to keep them in the classroom, and to give them some idea that everything is going to be OK and to provide hope, I think that was one of the biggest things we were able to do for the kids and the teachers.”

Access ‘Makes All the Difference’

A counselor from Plains Area Mental Health began visiting once a week for appointments with Ruthven-Ayrshire and Graettinger-Terril students starting in March 2021, thanks to the CARES Act dollars.

“We literally turned around within a two-week timeframe and set up a space to work and did all of those kind of things, so the person can come in once a week,” Myers said.

Being a rural district is a factor in having such a hard time getting access to mental healthcare, said Marshall Lewis, superintendent of the district and elementary principal at Ruthven-Ayrshire.

“For us, we’re traveling one way an hour sometimes to get the same services, and so you just put a three-hour period of time together, that somebody’s off work, out of school, and [Myers] has been able to bridge that by creating maybe a 30- to 40-minute window for one individual to get a half-hour session out of it, and wow, that makes all the difference in the world. If we were in a community that, 15 minutes or less I’m there, that’s a lot easier,” Lewis said.

Last summer, one family in the district was trying to access a mental healthcare provider for their child, and was on a waiting list for three months, followed by another waiting list for four months.

“I think maybe in January they finally got some connections. And we had to facilitate that a little bit by calling in and pleading, saying ‘hey this is a family that’s really wanting to reach out,’” Lewis said. A few other families connected with another service just before the in-school opportunity was available, which was also a very difficult process. “If it had been a month later that we were looking for these families, I think we would’ve had a lot easier time making it happen.”

The bar for accessing counseling in school buildings is lower in more populous places like Cedar Rapids and the surrounding area, where mental health provider Tanager Place offers counseling and therapy in schools, clinics and even a camp. Tanager Place counselors visit about 60 school buildings in eight districts and a private school in Iowa City, Faith Academy, said Maggie Hartzler, school-based program manager for the organization and a licensed independent social worker.

Tanager Place received CARES Act funds through the region’s MHDS, and used that funding to offer help to children in all Cedar Rapids buildings and Linn County buildings, and offer more support to children and families via virtual care.

Part of clinicians’ roles is to provide therapy for children individually, and the other part of their jobs is prevention. That includes things like sitting in on meetings to offer a mental health perspective, training teachers about mental health and trauma, offering self-care sessions for teachers, and identifying mental health needs for kids, families and educators in each building.

But as more students have access to mental healthcare, that individual support will also help things run more smoothly both in and out of classrooms. Schools that have been able to add counselors, even if it’s only part-time, will start seeing benefits, Peggy Huppert, executive director of the National Alliance for Mentally Ill-Iowa, said. “Once you start something, it’s a lot harder to not do it or to take it away.”

‘It’s Like ‘Field of Dreams’’

In Terril, just having a counselor visiting the school regularly since the second week of March helped to cut through the stigma around mental healthcare. Three families started sessions in March 2021, and several others have shown interest and are working with scheduling issues.

“It’s like ‘Field of Dreams,’ ‘if you build it, they will come,’” Myers said.

And although CARES funding is one-time, and the service is hoped to be perpetual, connecting therapists with clientele means a continuing funding stream that can continue even after federal dollars run out.

“We might come to rely on it in some ways, and it’s a no differencing cost,” Lewis said. “The school would love that, 100 percent, I’m sure that the providers would love that, and I know our families would love that. So beyond a win-win, we’re talking about a triple win here, as well as for our community.”

Iowa’s Mental Health System

Iowa’s 14 Mental Health and Disability Services regions are a setup to distribute mental health services that was created in 2012 and launched in 2014. The regions replaced the 99-county system used for decades. The regions are part of an effort by Iowa’s governor and lawmakers to bolster Iowa’s mental health services for adults and children.

This article originally appeared at IowaWatch.org. Leah McBride Mensching is a freelance reporter for IowaWatch. She has worked as a reporter, editor, photographer and media researcher over the past 15 years, both as an independent journalist and as an editorial manager for WAN-IFRA, the global organization of the world’s press. 

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