Stanford University: Stanford collaborates with local school districts to support mental health and well-being

COVID-19 complicated the rollout of a new collaboration between Stanford University and local school districts to support the mental health and well-being of students and their families – but the pandemic also helped show why such a project is crucial.

The Stanford Redwood City Sequoia School Mental Health Collaborative was established in October 2020 to support the Redwood City School District (RCSD) and Sequoia Union High School District (SUHSD) in building capacity to understand and address the critical mental health needs of thousands of area students and their families.

In the collaborative, Stanford Graduate School of Education’s John W. Gardner Center for Youth and Their Communities and Stanford Medicine’s Department of Psychiatry and Behavioral Sciences’ Center for Youth Mental Health and Wellbeing share expertise on how to strengthen a multi-tiered system of support, including how districts can use data to inform and improve student and staff well-being. In addition to senior faculty and staff, the project team includes three graduate research assistants and two child and adolescent psychiatry fellows.

As Stanford’s presence in Redwood City has grown, it has sought deeper engagement with the local community, especially building on existing collaborations between Redwood City schools and the Graduate School of Education. Support for the collaborative was prompted by newer Stanford facilities that have brought more members of the university community to the city, including the Stanford Redwood City campus, Stanford Medicine buildings, and most recently the addition of The Cardinal Apartments.

Isabelle Stid, a senior at Menlo-Atherton High School, has seen fellow students affected by issues such as anxiety, eating disorders, addiction, and pressure to be the first in their family to go to college or get into top-tier universities.

During the pandemic, students also faced trauma and grief over those lost to COVID, isolation, heightened anxieties, added responsibilities, and more.

“You can’t really focus on learning if your basic emotional needs aren’t met, and you can’t pay attention in math class if you’re trying not to cry,” Stid said. “Students are better able to absorb the information and be present in the classroom and in their own lives when they have mental health support.”

The collaborative also hopes to reduce the stigma around mental health. Stid advocates for her fellow students’ mental health needs as a student member of the Sequoia Union School District’s Board of Trustees.

“Awareness can help remind students that they’re not alone and that what they’re going through isn’t shameful,” she said. “It’s really important because it creates a culture in which we accept that not everyone will be feeling 100 percent all the time and it’s OK if you need the help.”

Increasingly complex needs
The collaborative emerged out of a year of listening conducted before the pandemic as Stanford learned about the districts’ greatest needs at the time. A particular challenge for schools has been cultivating robust well-being and daily education in the classroom, while effectively responding to students in crisis.

“It was really driven by their articulation of what the most complex need was,” said Kristin Geiser, Gardner Center deputy director and senior research associate. “How can we help them develop responses that aren’t reactive but rather build a system of support, so it’s both efficient and effective, and students who need support don’t slip through the cracks?”

The Gardner Center has been working with the Redwood City community for more than two decades, providing a foundation of trust that the collaborative built upon as it focused on immediate support for the districts’ expressed needs and translating them into strategic priorities for the academic year.

The pandemic’s impact complicated the collaborative’s work but also highlighted the demand for it as more students have presented more complex, intense mental health needs in the school setting.

As in-person connections were lost over the course of the pandemic, “those struggling with mental health conditions became more prone to isolation and their symptoms getting worse,” said Dr. Shashank Joshi, professor of psychiatry and behavioral sciences.

Some students pivoted to accessing school-based mental health support via telehealth, but it wasn’t practical for others, he said. Some struggle to find private space for a therapy session while others don’t want to be on video, making it harder for therapists to build connections or read body language.

Additionally, the mental health needs of school staff increased as they faced their own challenges, such as fears about COVID exposure when back on campus, pressures from the community to return to in-person learning, and additional responsibilities in caring for students.

A “true partnership,” the collaborative provides Stanford insight into the challenges school districts face during this unprecedented time, creating the conditions needed for actionable research, Geiser said.

“To navigate this time well, we will be well-served by turning toward each other, learning from and with each other as we go,” Geiser said. “This project feels like an example of doing just that.”

Building capacity
By providing clinical expertise and technical assistance to complement the districts’ own efforts to support students, the collaborative enhances the districts’ capacity to address both routine and more involved mental health needs as well as crises.

“Without the support from Stanford, it would have been hard for us to do this because we are not mental health professionals,” said Redwood City School District Superintendent John Baker. “What is taking place today is phenomenal.”

Many people face difficulty accessing help off campus, particularly for younger age groups, Geiser explained. Placing mental health counseling on campus increases the likelihood that people who need support will get it earlier, which can lead to better outcomes.

Each school site has counselors, and Stanford has provided a school site with a supplemental clinician. Stanford also assists with community communication about why counselors are on campus and the services they provide.

The districts have embarked on some social and emotional learning curricular initiatives, which students are already benefiting from. Stanford serves as a thought partner supporting the districts’ efforts to expand and strengthen their social and emotional curricular initiatives.

Clinicians share coping skills to help students address issues like anxiety, Baker said. For example, when elementary students experience challenging emotions, they’re now given a box with items inside such as toys and crayons that allow them to process and work through their emotions before reengaging with the class.

Shana Karashima, the multi-tiered system of support coordinator for the Sequoia Union High School District, said the collaborative has also helped her district learn how to use data to determine how mental health services are accessed, how effective they are, how often students need additional support, and more.

“Ultimately, the point is to have easier access to mental health care, robust offerings at an earlier level, and access for all students so students don’t have to be referred somewhere,” Karashima said. “That partnership will help us have a really clear picture of our needs.”

Among other efforts, the collaborative has provided information and clinical support to SUHSD teachers and staff about how to reopen schools safely, initiated a mental health-focused youth advisory group, and conducted an initial needs assessment for RCSD’s capacity to support mental health. Team members are in touch with district employees weekly, often adapting their workflow to support changing needs.

Going forward
Joshi, of the Stanford Center for Youth Mental Health and Wellbeing, said district leadership has been very forthcoming and open to suggestions, “allowing for some very good work to be done, and for continuing and sustaining the work for years to come.”

Districts have also set up different listening platforms for all parents, students, teachers, and staff to understand the key issues around school mental health, Joshi said.

“We think we know what some of the issues are but we’re always in learning and investigation mode with the community,” he said. “In doing so, we can continue working together to foster conditions that ensure students are healthy enough to learn and teachers are healthy enough to teach.”