Becoming a teenager, learning how to manage a schedule and new social pressures make being in middle school a miserable experience sometimes. These changes can lead to issues with anxiety and other mood disorders.

According to a Center for Disease Control (CDC) study of children between the ages of 3 and 17, anxiety and depression levels among children spike between ages 12 through 17. Rates of anxiety increase from just over 6 percent between ages 6 to 11, to over 10 percent from ages 12 to 17. Rates of depression see a similar increase from those age groups from under 2 percent to nearly 7 percent.

But asking for help or going to a school counselor can be intimidating for middle school students. Some may not even understand how to recognize anxiety or depression symptoms. At the Tahoma School District, the SBIRT program steps in to help students navigate these emotions.

The program, called SBIRT (Screening, Brief Intervention and Referral To services), is funded through King County’s Best Start for Kids program. Tahoma was awarded a three-year grant that began last school year and recently applied for and received additional grant funds, according to a Tahoma press release.

SBIRT pays for two people, one at each middle school, to work with students. The SBIRT coordinators have contacted every eighth-grade student and have screened more than half of them to identify and assess issues or conditions that might be causing anxiety, or could influence students to use drugs or alcohol or to harm themselves.

What is SBIRT?

At Maple View Middle School, students are meeting with SBIRT expert Megan Foreman, who works closely with Betty Bernstein, one of the school counselors. While other districts have school counselors take on the role of SBIRT screeners, Tahoma has created a new position so Foreman can focus solely on screening the thousands of students at Maple View.

“This is my second year in this position,” Foreman said. “It is a three-year grant, and we are hoping to get a fourth year through King County.”

Bernstein has been involved in education and counseling for nearly 20 years. She started as an educator but felt pulled to student counseling early on. She joined the Maple View Middle School team just a couple of years prior. Having Foreman on the team has been a help for counselors who know there are many students flying under the radar, Bernstein said.

“We are really fortunate to have Megan,” Bernstein said. “She’s a great support for us because we have really large caseloads, so it really helps us. The best benefit for our district and our building right now is we can learn about students we don’t really know much about. so we get to understand which kids have needs that maybe weren’t on our radar. And so it helps us identify students, but it also gives us really excellent information in a pretty brief time about the big picture of what’s going on with kids. And so she can screen a student and then we can get general information fairly quickly about what would be a good plan to support that student.”

SBIRT works under two models — the indicated model and the universal model. Foreman said some students are screened under the indicated model, which is when a teacher, advisor or other adult refers them to SBIRT screening. The universal model is when Foreman and other SBIRT experts attempt to screen every student from a specific grade, such as eighth grade, to help collect data on students and make sure no students are possibly suffering from no help.

“This last year we did more indicated and this year we’re focusing on universal for our eighth-graders,” Foreman said. “So we’re kind of doing a blend. That means that every eighth-grader will have the opportunity to start with the screener and do that and for sixth-graders and seventh-graders teachers and counselors can refer them in if there’s something we want more information about.”

This year Foreman has screened 288 students. Since the program has started, more than 200 students have been identified as having needs that were going unmet. In all of Tahoma, nearly half of the eighth-grade students who went through full SBIRT screening and contact had some level of anxiety, with about 11 percent showing severe anxiety. Those numbers include students who were not showing outward signs of anxiety.

“That could be anything from anxiety to potential drug use to suicidal thoughts and ideations or self-harm,” Foreman said. “So being able to catch those kids that nobody was aware of is a huge part for us. Our district is really focused on making sure we’re building connections with the students too.”

After students take the screening test they get a one-on-one conversation with Foreman, whether they were flagged or not. During these conversations, students can open up about issues, what teachers or leaders at school they think they can talk to and how they are feeling about their day-to-day lives.

Bernstein said the numbers seem high but she’s not too surprised.

“Some students are really great at asking for help when they’re going through a hard time, but a lot of kids, not just this age but and probably at any age, are a little shy about asking for help or don’t want to know what’s going on with them,” Bernstein said. “And in a lot of ways, those are the kids we’re most concerned about because if you don’t reach out for help, you might just do something that would be harmful. I’m not really shocked by them but I’m pleased that we were able to connect with them, you know, and fight for them to have some support.”

What happens with the grant expires?

Since SBIRT has been such a success at Tahoma, leaders are looking at new funding mechanisms to keep the program going after the county’s grant expires in a few years.

Tracy Krause, a Health and Fitness Content specialist for the district who helps administer SBIRT, said in the press release the school district will need a new funding source for SBIRT when the grant expires. Local funding would come from the Educational Programs and Operations levy (EP&O levy) since the state does not provide funding for SBIRT or other mental health programs.

“Levy dollars will help sustain this program beyond the grant,” he said.

The EP&O levy passed during the February special election with over 50 percent of the vote. According to the King County Elections Office, the levy was passing with 58.03 percent of the vote, or 6,997 votes, on Wednesday, Feb. 19.

The district also is looking at ways to further expand mental health services to students, such as by adding school counselors. The district and city of Maple Valley plan to co-fund a shared position that would help coordinate mental health services for the city and school district. Levy funds will support the district’s contribution.

David Downing is the chief operating officer for Youth Eastside Services, overseeing clinical counseling, substance abuse and outreach efforts. Downing lives in Maple Valley and volunteers to help Tahoma expand and reshape how it provides mental health services to students.

“Schools are not actually able to educate kids unless these supports are in place,” he stated, referring to mental health support. “We do have an opportunity here,” he said.

Carrie Erickson, a marriage and family therapist who works in Maple Valley and Bellevue, also is working with Tahoma to help improve the district’s mental health services. Erickson got more involved with the district last school year when the community was reeling from the deaths of two students and a former student, each of whom died by suicide, according to the district’s press release.

She said the district has recognized that it must find new ways to identify and assist students who are struggling with mental health issues.

“What we were doing wasn’t working and we had to do something differently,” she said. “Now we move forward to find out what can work better.”

Erickson said the district’s Future Ready initiative provides the academic path for students, but there needs to be recognition and support for what she calls “Now Ready.” Students need social and emotional support to be successful academically, she said.

“These levy funds will help provide the opportunity to help with our kids’ EQ, their emotional intelligence,” she stated.

Bernstein and Foreman said the success of SBIRT in Maple View Middle School has been encouraging. Students tell Foreman they enjoyed being screened and students who have yet to be screened are asking for their chance.

Foreman said students today are more open and honest about their mental health than past generations, and she is seeing many of them take advantage of the private screening test to talk about issues that are bothering them.

“One thing that we know is that the earlier the intervention, the more effective it is,” Bernstein said. “At the middle school level, it’s a really big transition age for kids it’s adolescence, going from an elementary setting and the next stop is high school. There’s so much going on with developing identity and comparing yourself to other people and looking at yourself in the world in a different way than you did as a kid. So, if we can create these interventions and really catch kids before they get too entrenched in behavior that might be risky, we’re doing a lot more good.”