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Politics

Anne Arundel health department struggles to manage youth mental health crisis

Calls made by children to the Anne Arundel County crisis line have increased sharply since the pandemic began more than two years ago, one of a few troubling trends in youth mental health presented by the county health officer to the Anne Arundel County Council on Monday night.

Members of the council, which sits as the Board of Health twice a year, expressed concern about the data presented by Health Officer Nilesh Kalyanaraman, who noted that children called the county’s crisis phone line about 223 times a month in fiscal 2020, which began about nine months prior to the pandemic. The number of calls rose to an average of 302 a month in fiscal 2021 and increased again to about 352 calls a month in the current fiscal year — a 58% increase over three years.

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“It’s definitely something we’re going to keep our eye on,” Kalyanaraman said. “There is an increase in children’s needs.”

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Kalyanaraman did offer some good news, noting that crisis intervention cases in school health rooms have declined over the last three years. During the 2019-20 school year, there were 6,840 interventions for suicidal threats, substance abuse and social/emotional issues. That number dropped to 5,059 interventions in the 2021-22 school year, Kalyanaraman said, though he said the decrease may be more of a product of changing school protocols than a meaningful decrease in crises.

The school system partnered with the health department to launch the Screening Teens to Access Recovery, or STAR, program in March 2019 to screen high school students for substance abuse or mental health issues. It’s set to launch in middle schools this month.

Students seeking help at school are dealing with increasingly limited resources as schools struggle to maintain health staff, Kalyanaraman said. About 70% of school health workers have turned over since the pandemic began in March 2020 with 125 resignations coming between July 2021 and March 2022.

“That’s astronomical,” Kalyanaraman said of the turnover rate.

Kalyanaraman said the health department planned to tackle the school health staff shortage three years ago with a plan to increase salaries and participate in compensation studies. The pandemic and a resulting nursing shortage threw the plan off course and the county is now turning to the state to help with the retention issue.

The health department should provide some policy proposals for the council to consider to create a more targeted plan to fix the staffing shortage, said Council member Nathan Volke, a Pasadena Republican

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Council member Amanda Fiedler, an Arnold Republican, asked for more data on how these youth crisis numbers compare to pre-COVID levels.

The growing youth mental health crisis is an issue Council member Lisa Rodvien has seen firsthand as an Anne Arundel County middle school teacher.

“I definitely share the concern,” the Annapolis Democrat said. “Obviously there are many, many causes for this but one of the ones we’ve heard a little bit about, and I feel like I observe anecdotally, is the impact of social media and cellphones.”

Rodvien said she’d like to see the health department collect more data on social media and phone usage and devise a plan to combat it. Fiedler agreed, suggesting working with parents to identify warning signs of social media-initiated crises or establishing a panel that presents the information to parents.

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Sarah Lacey, a Jessup Democrat, said she suspected that many of the children in crisis are living in areas of the county like Brooklyn Park, Laurel and Glen Burnie, where people are generally less educated, more diverse and have lower incomes. During the presentation, Kalyanaraman pointed out that the highest average life expectancy is in Arnold at 85.9 years, while the lowest average life expectancy neighborhood was Brooklyn Park at 70.9 years.

“I’m going to bet a lot of those calls and a lot of those visits are happening in areas with lower life expectancy. I have a hypothesis that these children are going into that lower life expectancy pipeline essentially,” Lacey said. “I think you could fairly ask, ‘Are the kids all right?’ Well, it doesn’t really look like they are overall.”

The best approach to the youth mental health issue would be intervening early in the lives of families who may be on the path toward lower life expectancy rates, Kalyanaraman said.

“It’s harder to fix a gap once it manifests itself so I think that our focus really should be on the first few years of life,” he said. “What are the educational opportunities? Where’s the food access?”

The county knows where to look to target these interventions and it’s already working on some, he said. For example, the health department has set up a free weekly healthy food pantry in Brooklyn Park, which is a food desert without easy access to nutritious foods. His department is also exploring setting up a similar food pantry in Lothian.

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The council will continue the discussion Thursday as it debates health investments in the proposed fiscal 2023 budget.


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