[Congressional Record Volume 147, Number 49 (Thursday, April 5, 2001)]
[Extensions of Remarks]
[Pages E572-E573]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          ELEMENTARY AND SECONDARY COUNSELING IMPROVEMENT ACT

                                 ______
                                 

                           HON. MARGE ROUKEMA

                             of new jersey

                    in the house of representatives

                        Wednesday, April 4, 2001

  Mrs. ROUKEMA. Mr. Speaker, today I am introducing the Elementary and 
Secondary Counseling Improvement Act, legislation to provide for 
elementary and secondary school counseling programs. The epidemic of 
school shootings across the nation exemplifies the urgent need for 
school-based mental health services for our youth. Many youth who may 
be headed toward school violence or other tragedies can be helped if we 
identify their early symptoms.
  The lack of mental health interventions can produce devastating 
results for children, including disrupted social and educational 
development, academic failure, substance abuse problems, or juvenile 
justice system involvement. The bottom line is that we need to identify 
and treat mental illness in youth at its earliest stages.
  In January, Dr. David Satcher, the Surgeon General, released a 
National Action Agenda for Children's Mental Health, in which it was 
found that the nation is facing a public crisis in mental health for 
children and adolescents. According to the report, while one in ten 
children and adolescents suffer from mental illness severe enough to 
cause some level of impairment, fewer than one in five of these 
children receive needed treatment. Dr. Satcher urged that ``we must 
educate all persons who are involved in the care of children on how to 
identify early indicators for potential mental health problems.''
  According to Dr. Satcher, ``the burden of suffering by children with 
mental health needs and their families has created a health crisis in 
this country. Growing numbers of children are suffering needlessly 
because their emotional, behavioral, and developmental needs are not 
being met by the very institutions and systems that were created to 
take care of them.''
  We must ensure that children with mental health needs are identified 
early and provided with the services they so desperately need to help 
them succeed in school and become healthy and contributing members of 
society.
  Providing mental health services in schools is a wise long-term, 
cost-effective approach to reducing youth violence, developing a 
positive school environment, increasing student achievement and 
improving the overall well-being of our nation's youth. Schools provide 
a tremendous opportunity to identify potential mental health problems 
in children. Children spend a high percentage of their time in school, 
especially during their critical years of learning and development.
  Teachers and other school professionals have the chance to identify 
potential problems and get children the help they need. Schools can 
provide underserved youth with or at-risk

[[Page E573]]

of emotional or behavioral problems access to the mental health 
services they need. School-based mental health programs have decreased 
the number of suspensions and referrals to the principal's office, 
decreased the use of force, weapons, and threats, and helped students 
feel safer.
  In a March Washington Post article, columnist Abigail Trafford asks, 
``How many school shootings will it take to focus the nation's 
attention on unmet mental health needs of children and adolescents?'' 
This is exactly what I have been saying for some time.
  The Surgeon General's Report on youth violence cites family 
connectedness, peer group relationships, and success in school as the 
three most significant factors influencing the likelihood of young 
people engaging violent behavior. The Surgeon General describes youth 
violence as an ``epidemic.'' The report identifies effective programs 
as those that provide at-risk youngsters with the necessary physical 
and mental health resources, behavioral interventions, skills 
development, and academic supports.
  Our schools should be equipped to provide early identification, 
assessment, and direct individual or group counseling services to its 
students. Teachers should be adequately trained in appropriate 
identification and intervention techniques. Other solutions being 
proposed, such as increasing the number of campus security personnel or 
installing metal detectors in the schools, are indeed important. 
However, these solutions are merely quick fixes and do not address the 
needs of the troubled child who contemplates bringing a gun to school. 
Similarly, I strongly support character education programs for all 
children. However, it is not enough to teach a child suffering from 
mental illness right from wrong. It is vital that the child's unmet 
medical needs also be addressed.
  The Elementary School Counseling Demonstration Program (ESCDP) within 
Title X of the Elementary and Secondary Education Act directs much-
needed federal resources for school-based mental health programs. 
Research shows school-based mental health services are effective in 
reducing school disruptions and violence. An evaluation of the program 
on which the ESCDP is modeled found that the number of referrals to the 
principal's office decreased by nearly half, the use of force, weapons, 
and threatening of others also decreased, school suspensions were 
reduced, and students felt safer.
  With the increase of violence in our schools, we must reauthorize and 
expand the Elementary School Counseling Program. Our schools must be 
better equipped to identify and help youth possibly headed toward 
school violence or other tragedies.
  I strongly urge my colleagues to support this important legislation 
which ensures that the mental health needs of our nation's children are 
appropriately addressed.
  Mr. Speaker, I submit the text of an article by Abigail Trafford, 
which appeared in the Washington Post on March 7, 2001 concerning the 
need for school-based mental health services to address the problem of 
violence in our schools, to be included in the Record.

               Answer the Wake-Up Call From Our Children

                         (By Abigail Trafford)

       How many school shootings will it take to focus the 
     nation's attention on unmet mental health needs of children 
     and adolescents?
       No one knows what drove 15-year-old Andy Williams on Monday 
     to allegedly fire 30 rounds from a. 22 caliber longbarrel 
     revolver, killing two students and injuring 13 others in 
     Santee, CA. Or why an eighth-grade girl in Williamsport, Pa., 
     pulled out a gun and wounded her classmate today. But in many 
     instances of juvenile violence, the primary cause is 
     undetected and untreated mental illness. To be sure, there 
     are other factors in this level of violence, such as easy 
     access to guns. And most kids with mental health needs do not 
     become murderers.
       But after the headlines fade and the tragedy at Santana 
     High School in Santee becomes another statistic next to 
     Columbine--after the calls from parents and neighbors are met 
     to put in more metal detectors in schools and establish hot 
     lines to report threats and weird behavior--where is the 
     long-term commitment to protecting the mental health and 
     emotional development of children?
       ``You can make a case that youth mental health is the most 
     neglected area in health care,'' says clinical psychologist 
     Mark Weist, who directs the Center for School Mental Health 
     Assistance at the University of Maryland School of Medicine. 
     ``There's a huge gap between their mental health needs and 
     the resources and services that are available to them.''
       For starters many people still deny that mental illness can 
     occur in children, which increases the stigma. There also 
     aren't enough mental health professionals for young people. 
     Between 12 and 15 million children and adolescents in the 
     United States are in need of mental health services, 
     according to the Surgeon General's Report on Mental Health. 
     There are only about 8,000 child and adolescent psychiatrists 
     in the country. One estimate of the need called for at least 
     30,000 psychiatrists for this population. There is also a 
     shortage of psychologists, social workers and other mental 
     health workers who are trained to address the emotional and 
     developmental needs of the young.
       Services in many parts of the country are fragmented and 
     under-funded. Since the Columbine shootings, the demand for 
     mental health care for children has skyrocketed. With 
     heightened concerns about violence, many schools have adopted 
     a zero-tolerance policy toward disruptive students. In some 
     cities, a typical scenario goes like this: A student makes a 
     threat and is sent by ambulance to a hospital emergency room. 
     There he--usually it's a boy--is diagnosed with a psychiatric 
     disorder but there is no space available in the appropriate 
     level of care whether it's a hospital bed or placement in a 
     special school or residential facility. Either the student 
     ``boards'' at the hospital until a bed in a mental health 
     unit is found, or he is sent home to wait for outpatient 
     services.
       With the move toward zero-tolerance policies, many needy 
     kids are also expelled from school for long periods of time. 
     This often exacerbates their problems and jeopardizes their 
     academic development.
       Yet, the most effective arena for providing mental health 
     services for children is the school. A decade of research 
     into school-based health centers suggests that children are 
     more likely to have a problem detected at a school center 
     than in a doctor's office or outpatient clinic. Advocates of 
     comprehensive mental health services in schools point out 
     that such programs can help promote emotional growth as well 
     as detect psychiatric problems early and monitor treatment 
     with medications or therapy.
       ``There's enough data to suggest that this makes a 
     difference. At the federal level we should look at school-
     based mental health as routinely as curriculum 
     requirements,'' says pediatric psychiatrist Richard D'Alli, 
     who directs child and adolescent community programs for the 
     Johns Hopkins Children's Center.
       In fact, mental health counseling is the leading reason for 
     visits by students to school-based health centers, according 
     to surveys of users of these centers.
       The trouble is that most schools do not have a health 
     center. There are only about 1,400 schoolbased health centers 
     in a country with more than 110,000 schools. About 40 percent 
     of these centers have no mental health services.
       These statistics underscore the general lack of psychiatric 
     help for children. Overall, only about a third of kids with a 
     mental illness get any treatment--and only 10 percent get 
     adequate treatment, according to the Surgeon General's 
     report.
       It's time to address these needs and not wait for the next 
     shooting. A national commitment to bolster mental health care 
     for children cannot guarantee that there will never be 
     another tragedy like Santana and Columbine. As D'Alli says: 
     ``What sets these kids apart? Why are they murderers? We may 
     not have the answer any time soon.''
       But detecting and treating mental illness in children is 
     one way to reduce the risks of school violence. Researchers 
     know that psychiatric disorders in children arise from a 
     complex mix of factors--genetic vulnerability, social 
     environment, history of traumatic experiences, level of 
     psychological and cognitive strength. They also know that 
     intervention as early as elementary school can protect at-
     risk children.
       ``These are troubled kids,'' continues D'Alli. ``The whole 
     concept is to treat [the problem] early. If you don't, you're 
     not sure where it will lead.'' So why isn't there a louder 
     outcry from parents and teachers for mental health services 
     in schools? Part of the answer is money, Good mental health 
     services are labor-intensive and costly. The other part is 
     leadership.
       President Bush was quick to express his sorrow. ``When 
     America teaches their children right from wrong . . . our 
     country will be better off,'' he said. But this problem is 
     not just a moral problem. It's a medical one. And he can do 
     something about it.

     

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