Hawaii has a dearth of school psychologists, prompting some students to seek help from outside mental health providers.
The National Association of School Psychologists recommends a ratio of one school psychologist for every 500 students, but Civil Beat reported in 2021 that Hawaii had just one school psychologist for every 2,800 students.
“We’re woefully short on school psychologists,” said Susan McGovern, National Alliance on Mental Illness HawaiiWalks Big Island manager. “And I think that’s islandwide.”
During the middle of the COVID-19 pandemic in 2021, the state Department of Health reported 11,000 Hawaii youth experienced at least one major depressive episode, an increase of roughly 6,000 from the year prior.
“The pandemic really put a burden on families, especially when students had to stay at home,” said McGovern. “When people became homeless or when students were unable to get to school, that put a lot of stress on families.”
Students have started turning to outside mental health resources like Pau Hana Counseling, which has two clinics on the Big Island.
“There are definitely more adolescents reaching out,” confirmed Erin Gustin, who serves as clinical director of Pau Hana. She added stay-at-home orders probably contributed to an overall increase in social and separation anxiety among youth.
“They got so used to being at home that when they had to go back to school, they had a large increase in separation and social anxiety,” she said. “They missed out on all those years of being socialized in school.”
A drop in the overall stigma related to seeking help for mental health also has encouraged youth to reach out for help.
“There’s a lot more acceptance in our culture now about seeking therapeutic services, and it’s becoming normalized in a positive way,” Gustin said. “I think millennials are a really good example of that, where it’s becoming normal to have a therapist.”
Access became easier for students in 2020 as well when Hawaii passed its minor consent law, or Act 37, which allows those 14 and older to seek outpatient mental health services without the consent of their parents or legal guardians.
Neither the minor, nor their legal guardians, are liable for payments. Instead, licensed therapists receive insurance reimbursements.
“We do have a handful of adolescents that reach out to us in that way,” said Gustin. “But a lot of times, there’s still parental involvement. I think parents have become more accustomed to mental health services, too.”
Gustin recommends therapy and counseling early on when warning signs appear.
“I would recommend parents try to intervene sooner rather than later when they start to notice something is a bit off,” she said, citing withdrawal, depression and acting out in school as early warning signs. “If a kid has a little bit of anxiety about coming in the first time, it’s completely normal that their parents come in with them to start the session.”
Dr. Scott Shimabukuro, acting administrator for the state Department of Health’s Child and Adolescent Mental Health Division, advocated for supportive families and medical resources to help children recover from stress and isolation experienced during the pandemic.
“Parental stress stemming from homeschooling and financial insecurity may negatively affect children,” Shimabukuro said in May in a DOH press release regarding the impacts of COVID-19 on children. “While most parents do not believe their stress affects their kids, most kids when asked say it does.”
The 2022 Kids Count Data Book from the Annie E. Casey Foundation found that from 2016 to 2020, instances of anxiety and depression experienced by children ages 3 to 17 in Hawaii increased by 22.9%.
“I think there’s a crisis among younger people,” said Katherine Goodman, medical assistant and clinical psychology intern on Oahu. “There’s upticks in clients throughout different times of the year, especially in September when school starts.”
With a lack of school psychologists and ongoing wait lists, Goodman has started recommending alternative solutions for her patients.
“A key solution is offering people resources they can use in the meantime when they can’t get services,” she said. “Applications can be helpful. I recommend a lot of apps and websites like the Calm app or Loona, which helps with sleep.”
For those seeking in-person services, Gustin assured patient confidentiality remains an important aspect of counseling.
“A lot of times, kids are really worried that we’re going to go tell their parents everything they say, and that’s really not the case,” she said. “Think of a therapist like a friend. We’re just normal people that are here to help and listen.”
For additional help, students can text ALOHA to 741741 or call Hawaii CARES at 1-800-753-6879.
Email Grant Phillips at gphillips@hawaiitribune-herald.com.
