Pasadena Bolsters System for Addressing Behavior Problems

As a member of the Pasadena Board of Education, Bonnie Armstrong found the duty of ruling on student expulsions to be onerous and frustrating.

Many of the students, it seemed to her, could have been turned around if someone had paid attention to their problems sooner.

“When I saw kids coming before the board with pages of behavioral problems, I’d ask what happened 18 months ago when it was clear there was a behavior problem here,” Armstrong said.

By the time a student comes to the attention of the board, “I don’t have any choice . . . but to expel,” said Armstrong, expressing a frustration shared by school board members everywhere. “That was a failure of the system to have met the needs of that kid long before that.”

To shore up the system, Armstrong recruited social service agencies in the Pasadena area to provide mental health services to troubled students. To pay for their services, she tapped an unused federal program.

The result is a model for addressing behavior problems. Not only does it seek to help every child in need, the Pasadena system also provides early intervention for that one student who can disrupt an entire class, or worse, pose a threat to the school.

The program, launched in September, has 26 mental health teams in Pasadena schools. Next year, another 26 two-person teams will be added, so there will be at least one for each of the district’s 31 schools.

Social workers and psychologists on the teams step in when teachers spot signs of trouble, such as a student who is aggressive or appears depressed. After receiving the approval of parents, they counsel students individually or with family members, hold group sessions and make home visits.

The program uses a tangle of funding sources, including private insurance, Medi-Cal and county general funds, to reimburse mental health practitioners from community agencies.

Armstrong’s consortium built its program around a Medi-Cal entitlement called Early Periodic Screening, Diagnosis and Treatment. In adopting it a decade ago, Congress declared that every child eligible for Medi-Cal should have access to a full range of mental health services. California lagged behind other states in implementing the law, but was recently pushed along by a successful lawsuit filed by mental health groups.

That program and lawsuit “gave us an opportunity to have a funding stream for children’s mental health services unprecedented in California history,” said John Hatakeyama, deputy director of the Children’s System of Care for the Los Angeles County Department of Mental Health.

The amount has now grown to $200 million annually across the state and should continue to increase as more young people take advantage of the unlimited entitlement, Hatakeyama said.

In Pasadena schools, about half of all students are eligible. But to gain acceptance, Armstrong’s program has to be accessible to all students.

That’s where the county comes in. Hatakeyama’s unit guarantees payment from county general funds for any student who is not covered by a federal program or private insurance.

The county money also allows counselors the flexibility to help privately insured students in emergencies and to follow up to be sure they actually go to appointments.

Hatakeyama said that about 50% of young people who are referred to a counselor never show up.

In its first year, the Pasadena program is expected to generate about $5 million in Medi-Cal billings and $2.3 million from the county, Hatakeyama said.

It is still too early to assess the program’s success, but the providers are confident that the attention to students’ emotional needs will have a positive effect inside the classroom.

“While 20% of the children need our direct help, when those children aren’t being helped, it impacts more children,” said Helen Moran-Wolf, executive director of Foothill Family Services, one of the six social service agencies participating in the Pasadena program.

“If you have one or two children in the class who are very disruptive and take that teacher’s time, [the teacher] is not able to help the other children in the classroom as well.”

Hatakeyama’s unit is also starting mental health teams in several districts including Los Angeles, Long Beach and Compton.

Details will vary from district to district. Los Angeles, for example, has its own mental health unit, and would not need the help of outside agencies. Smaller districts that may be short on mental health agencies could collaborate.

“This will not be the only model,” Armstrong said of the Pasadena plan. “But it will be a model that sorts out some of the issues no matter what kind of structure you want to use.”