"If we don't act now, I don't know that we're going to be able to cope with what is going to happen in terms of loss," said Dr. Gary Maslow, the director of Child and Family Mental Health and Community Psychiatry at Duke Health. "The youth who die by suicide is one part of it. The providers who leave the workforce because they can't take the distress of being on the frontlines and not having anyone help them."
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Jessica Pendergrass has personally tried to navigate mental health resources for teens and felt the heartache firsthand. Her 13-year-old son, Austin, took his own life at Wendell Middle School last fall.
"There's no easy way to lose a child. There's no word for it; that kind of pain. But to lose a child to suicide, it's a different kind of hurt," she said. "I just want people to know like, don't ever, ever, ever stop fighting for your children."
The Wake County mom said Austin struggled with bullying and other mental health challenges for years.
"It was just progressively getting worse. Instead of better. We tried medicine, we tried different therapy services. We weren't getting anywhere," she remembered.
She said they tried counseling, therapy, and psychiatric services for him for years. He was even hospitalized a few times.
"I mean, it's devastating. It's traumatic for any parents," Pendergrass said. "You wait in the emergency room for a bed to open up because facilities are just full. I mean, he was even hospitalized all the way in Winston Salem, because there were no beds here."
The North Carolina Department of Health and Human Services (NCDHHS) said 350 people are waiting for behavioral health services in emergency departments a day and 50 of those patients are children.
Duke Health shared the number of kids seeking behavioral health help across its three emergency rooms last year was up by 44% or more than 300 patients.
"A year in the hospital, we'd see one or two Tylenol overdoses and now, we may see that in a week, and so it's just that it's a real, real dramatic change in the seriousness of some of the suicide attempts that are occurring for teens," Maslow said.
Pendergrass said it's a similar challenge for extensive care options too. When the family considered a therapeutic home, the nearest one available was in Georgia.
Pendergrass said while they tried so many avenues to get Austin help, she does think having resources available in his schools at an earlier age might have made a difference.
"It's hard when you try to work and schedule these appointments that are really only open during work hours when they're supposed to be in school. I don't know I just think there needs to be some more mental health resources in the school," Pendergrass said.
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This is something school districts have been ramping up over the past few years.
"If you catch them early, you could get treatment and unfortunately, the waitlist for treatment is growing. And so if we do identify that a 12-year-old is having anxiety, the time to get them into care is really long. And so that's sort of what we need to be working on is how to decrease that time," Maslow said.
State data shows around $5.4 million of federal pandemic relief money was spent on school health support. Fifteen percent of that funding was specifically allocated to psychological contracted services.
Both Wake and Durham County public school districts have open bids to expand their in-school mental health providers.
"With school-based services, it's an easy, convenient service that's consistent and is provided right here in the school setting. Parents don't have to worry about after-hours appointments. So it's still, in my opinion, the best sort of setup that you can have for your child," explained Dr. Karen Barbee, the owner of Renaissance Wellness Services.
Her business offers therapy for students in five public school districts.
"I feel like we were absolutely drowning. That is just, you know, the honest truth about it. We definitely have more need than we're able to keep up with right now," she explained.
She said the 'tidal wave' of need is continuing and the number of referrals paired with a shortage of staff is leading to a waitlist.
She said additional funding from school districts would hopefully allow her to increase resources and staff to better meet the needs of students. Barbee said she easily could use around 10 more clinicians as some of the schools they serve have 50 students on the waitlist.
"I want to see their needs getting met and so when I see a waitlist, and I don't see someone there to actually help with that waitlist like that. And so I've been working directly with interviewing and then hiring to, to make sure that we're kind of trying to expedite the process. As much as possible to find qualified staff," Barbee said.
The North Carolina Department of Public Instruction announced an additional $17 million in federal funding for school-based mental health providers in 15 districts.
In yet another effort to expand assistance, NCDHHS partnered with Duke's Department of Psychiatry & Behavioral Science to launch a Psychiatry Access Line, coined NCPAL.
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"The hope is to reduce emergency department visits because the hope is, through the resources and guidance and tools that NCPALS provides school personnel, they have those tools at their disposal for sustainability to refer, to connect with other regions as well who may be the may be experiencing the same issues for continuity to better meet the needs of students," said Anne Odusanya, the assistant director for the NCDHHS Division of Child and Family Well-Being.
The service kicked off earlier this year and provides telephone consultations and educational programs to school staff and administrators at around 100 schools across the state. The initiative helps provide real-time support and assistance from medical professionals to school staff.
"Here in North Carolina, most counties do not have access to a child and adolescent psychiatrist. That's how it helps to fill the gap. Because NCPAL provides psychiatrists that work alongside school personnel to address the behavioral health needs of students," Odusanya said.
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She said the increase in incidents surrounding weapons on campus and school safety is another indicator of why services and resources like NCPAL are needed.
Maslow said while all these efforts are steps in the right direction, they are still only a drop in the bucket.
"There's a lot more that needs to be done, particularly to get it so that if you have a child who is identified as having a need in school, for linking them to care at the school, in the medical system in the mental health system, that should be really easy and right now, it's very complicated and often doesn't happen," he explained.
Maslow also pointed to workforce shortages and coverage being other big barriers for the state to tackle.
"I don't think it's an understatement to say this is a pivotal moment for action. And, you know, inaction is going to have significant consequences for this generation," Maslow said.
In March, Governor Cooper announced a $1 billion plan to tackle mental health and substance abuse in the state. Close to $200 million is targeted at increasing support for mental health resources within schools.
Pendergrass is hoping leaders continue to make mental health funding a priority so other families don't have to endure what they have gone through losing Austin.
"Our family, we have a big hole without him," she said.
If you or somebody you know is struggling with thoughts of mental anguish or suicide, you can call or text 9-8-8, which is the Suicide and Crisis Lifeline, to be connected to help immediately. To learn more about its resources, click here.
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