HAMPTON — Crystal Sellman spends her days floating in and out of classrooms at Hunter B. Andrews PK-8 School in Hampton.
A mental health counselor, Sellman has six students on her caseload. She spends one to three hours a day assessing and counseling. She might spend an hour observing a child in class, watching for behavior patterns, helping him or her stay on task and collaborating with the teacher. Another hour or two might be used to perform one-on-one counseling or group therapy sessions.
Sellman doesn't work for Hampton City Schools. She's a Therapeutic Day Treatment counselor employed by the Hampton-Newport News Community Services Board.
Calls to improve mental health care for children go out every time a shooting takes place at a school — Columbine, Virginia Tech, Newtown, Conn. Gov. Bob McDonnell's Task Force on School and Campus Safety released its initial report on Thursday and five of its 24 recommendations had to do with mental health care, mostly for young people.
"We've made some strides, but we certainly have a long way to go," said Margaret Crowe, advocate with Voice for Virginia's Children.
Crowe said there's a patchwork of children's mental health services across the state. But communities on the Peninsula – especially Hampton and Newport News – are doing better than most.
Local school divisions use Therapeutic Day Treatment and other outside resources to supplement school psychologists and counselors and provide more intense treatment. Hampton and Newport News are unique because at least one Therapeutic Day Treatment counselor is assigned full-time to every school.
"Providing mental health services in schools makes a lot of sense because that's where they (children) are," Crowe said.
Sellman said working inside the school allows her to easily access students at times of crisis and enables her to build close relationships with teachers.
School psychologists and counselors have seen their duties increase along with a growing need for more mental health and emotional support. Local professionals said they think the increase is partly due to greater academic demands and family financial stress. But they said a growing awareness of mental health and the availability of services appears to have a greater impact.
"The light has been turned on in the areas of children needing help," said Lisa Pennycuff, director of accountability and instructional services for the York County School Division.
Pennycuff said she doesn't think the increase is due to a rise in mental health needs, but that more parents are reaching out for assistance where in the past they might have tried to handle it on their own.
"I think it's positive that families are asking for help," she said.
Pennycuff said she understands that providing help in schools is important because mental health issues can affect students' academic performance.
But, she said, "Schools have never been, and not meant to be, the primary provider for mental health services."
That's why it's important, Pennycuff and others said, for school divisions to have good relationships with outside providers they can turn to for children who need help beyond a school counselor's abilities.
Officials at local school divisions said recent budget cuts and shortfalls have not yet affected the number of school psychologists or counselors employed, but more funding could help.
"I certainly think there's more we could do if there were more of us," said Gloucester County Public Schools psychologist Christina Mahoney.
Mahoney agrees that relationships with outside service providers are important to providing more intensive care, but, she added, Therapeutic Day Treatment isn't available to all students.
"There are other kids who could benefit from that program," she said.
The service only covers students who have Medicaid, leaving parents with private insurance to seek their own care and the uninsured to depend on emergency services, said Chuck Hall, executive director of the Hampton-Newport News Community Services Board.
Hall said another challenge he sees is that Medicaid caps each counselor's case load at six students, leaving excess students on a waiting list.
The Virginia Independent Clinical Assessment Program, or VICAP, added another barrier in 2011. The mandate states that in order to receive Therapeutic Day Treatment, parents must first go directly to the provider for an independent assessment.
Hall said he sees the requirement as a positive move because it prevents students from receiving improper services or inaccurate mental health diagnoses. But he said many parents don't follow through. Hall said the number of counselors at his CSB has fallen from 140 to 100 in the last year, because when students don't complete the assessment, the state doesn't see the need.
When services are available, experts said, a lack of parental involvement and barriers to access pose a challenge. Kaneka Early, a CSB clinical intervention specialist at Andrews PK-8 School, said phone calls home are often not returned.
"One of the major issues is just getting parents to follow through," she said.
David Coe, executive director of Colonial Behavioral Health, the CSB serving Williamsburg, James City County, York and Poquoson, said the collaboration among schools and child-service agencies is what sets the Peninsula apart.
But, he said, reduced state funding over the last four or five years has caused his board to cut staff, and he's concerned future reductions could have a critical impact.
"We have squeezed every penny," he said. "If the cuts come, it's going to go directly into services."
Community Services Boards
Colonial Behavioral Health (Williamsburg-James City Co., York and Poquoson) 757-253-4061
Hampton-Newport News Community Services Board 757-788-0300
Middle Peninsula-Northern Neck Community Services Board (Gloucester and Mathews) 804-758-5314
Western Tidewater Community Services Board (Isle of Wight and Suffolk) 757-255-7126