Yesabel Inga works at Bridges Academy at Melrose in East Oakland, where she is the only therapist for some 400 students, a quarter of them newcomers. The majority are from Guatemala and speak Mam, a Mayan language spoken by some half a million people in that country and Mexico.
“A lot of them, when they first came in, only spoke Mam, they didn't speak Spanish or English,” said Inga. “And so they were just kind of lost, you know?”
As these children and others return to school this month across the Bay Area, one constant is their mental health needs: Reports of increased depression, anxiety, suicidal ideation and emergency hospital visits exacerbated by the pandemic are considered a crisis, according to reports from the CDC, The Annie E. Casey Foundation and Mental Health America.
To meet these needs, California is investing billions of new dollars, on top of state and federal pandemic relief funds. Bridges Academy at Melrose, which is a public school, found a way to leverage the money to maximize impact, pivoting from crisis management to prevention.
The principal at Bridges at the time, Anita Comelo, was having to make tough decisions about which kids would get to see the therapist and which would not.
“So we always have to pick which trauma is the bigger trauma, you know?” said Comelo. “We often end up giving the services to what we call ‘externalizers,’ the kids who end up disrupting class.”
Those students are typically the boys, Comelo said, adding that means other students who tend to internalize the trauma of their anxiety and depression don’t get the help they need.
Because the school therapist, Inga, should only carry a maximum caseload of 15 students at any time, scores of other kids at Bridges who could have used help were not getting it, and the result was a lot of disruption in class and on the playground, says community schools project manager Rosana Covarrubias.
“There was a lot of cyberbullying and so we were seeing it erupt here at school because of what was happening online,” said Covarrubias. “They were needing mental health support for that. We were having some students with suicidal ideation.”
However, when Covarrubias tried to refer students out to other community agencies they partner with, she says every one of them had a waitlist.
“They’ll say, ‘OK, thank you for the referral, we'll get back to you.’ And sometimes it's months before they get matched to an individual who can support them and be their therapist,” Covarrubias said.
And these were the acute cases.
Bridges therapist Inga says what makes matters worse is the lack of health care coverage for preventive care. Currently, Medi-Cal managed-care plans and commercial providers such as Kaiser don’t reimburse counties’ behavioral health departments for children without a clinical diagnosis.
That could change with legislation, namely AB 552, which is now on the governor’s desk. It would nudge private health care plans to work with counties to reimburse community providers such as Seneca, Lincoln Families and East Bay Agency for Children in Alameda County for providing treatment for students with more moderate needs.
“If we were to set up kids with therapy support like preventative, you know, we wouldn't have fifth graders that have suicidal ideation,” said Inga, who works for Seneca.
An investment in mental health
California has begun an unprecedented investment toward meeting the mental health needs of K-12 students.
There is $4.4 billion for a youth and adolescent mental health initiative to reduce structural barriers to kids getting care inside schools; another $4.1 billion for community schools, which includes money aimed at mental health needs; plus billions more in federal and state pandemic relief dollars, some of which is also aimed at helping students recover from depression and anxiety brought on during the pandemic and subsequent school closures.
In the third round of federal pandemic funding to schools, Oakland Unified got over $100 million dollars. According to records filed with the state in May this year, the district only shows spending about $650,000 of that money. And of that, the district reports nearly half went toward mental health.
But by the time the COVID relief money trickled down to Bridges, the school ended up with just $20,000 prioritized for mental health. The money was not enough for even one full-time therapist with benefits, which costs about $160,000.
The district says it hasn’t spent all the resources yet, and is spacing out the investment. It says school sites last year requested the investments they wanted based on their site needs, and that they had flexibility in how to spend the dollars.
Comelo and staff decided to use their $20,000 to hire a part-time clinical therapist for two hours each week. Inga and the part-time clinician decided to start a six-week, group therapy session with eight to nine students, nearly all of whom were native Mam speakers.
“In the beginning, everybody was really quiet and shy,” Inga said. Inga had previously worked with youth in detention camps along the border, and she could relate as an immigrant herself. “My parents brought me here when I was 15, and not having that support … my experiences led me here to this group,” she said.
Among the students joining in the first newly formed preventive therapy group was 10-year-old Heymer Domingo Godinez.
“When I first got here to Bridges Academy, I was afraid. I was crying, because I was scared of the students,” Heymer said in Spanish.
Heymer had arrived from Guatemala with her dad in first grade, screaming, kicking and crying when dropped off at school. She was scared to come to school because back in Guatemala she had been too young to go.
Heymer and her teachers describe having to hold Heymer to calm her and get her to stay in classes. By fourth grade, Heymer says she had just one friend. Inga says kids like Heymer were confused about where they fit in at the school.
“They were not really feeling like they could trust other people,” Inga explained. “Like once they came here, there was no space to really talk about themselves and their culture.” On top of that, the pandemic hit families like Heymer’s living in East Oakland especially hard; her parents lost work and nearly lost their housing, before the school stepped in to help raise money for them.
When Heymer and the other students gathered in the small group therapy session, Inga asked each of them to bring something that represented them. Inga said it was Heymer who asked if she could wear her woven huipil and corte, the traditional Mayan Mam clothing she wore at home.
Heymer was nervous, and a bit afraid of being under the microscope. “Because some people are looking at us and some people are thinking, ‘Why is some girl wearing some corte like that?’” she said.
Inga told her students they could expect to get some attention from their peers, but that they should see it as an opportunity rather than something they’d rather avoid.
"Listen, some other kids might look at you weird, but it's because they haven't been exposed to other cultures," Inga said she told them. "And if they ask you or say something mean, it's like, you know, 'Let me just, let me tell you about my culture, let me tell you what this means.'"
As the group therapy sessions were taking place, other efforts on the part of teachers throughout the school were also unfolding, aimed at creating a greater sense of belonging for the Mam students.
“I know that during parent-teacher conferences, I — and I'm pretty sure other teachers did this as well — explicitly told students in front of their families, ‘Please keep practicing your Mam. We do not want you to lose this language,’” said fourth grade teacher Vivian Yen.
Yen said some teachers began taking Mam language lessons, while others were critically rethinking their curricula.
“I know that my grade-level team, and the fifth grade and third grade, both did this. We were looking at our ELA [English language arts] curriculum because all of the texts are very white-centered,” Yen said.
“I do think the murder of George Floyd did kind of push us to adjust our curriculum and make it a little bit more social justice-oriented and more ethnic studies-oriented. This is so that students would also have time to think about their own identities, thinking about how they fit in and can counter these racist narratives that we're given all the time,” Yen said.
The joy Heymer and the other students felt in wearing their cortes spread — more Mam-speaking students began wearing their traditional cortes on Fridays.
“Even the boys!” Inga said. “It was just beautiful.”
When fifth grade graduation arrived, it was Heymer who welcomed parents to the event in Mam and led the performance. And for the first time, all students who presented recited poems in English, Spanish and Mam.
Teachers point to this as a culmination, and a defining moment, of the culture change they had worked so hard to achieve.
“Honestly I think it was just the buildup of a bunch of tiny little things that led to this movement,” Yen said.
This year, Heymer started sixth grade at Elmhurst United in East Oakland. As she walks the eight blocks to her new school, she likes to sing songs from her church, Iglesia de Dios Evangelio Sana Doctrina in Oakland. She says it makes her happy and calms her.
Heymer scouted the school out before classes began, scrutinizing staff photos on the bulletin board outside the school office, looking for faces and names of teachers she thought might speak Spanish.
She says while she is worried about going to a new school, she is more confident now of who she is and what she can do.
“I want to learn. I don’t care what people say about me. I only care about my mind and achieving my dreams,” she said.
Heymer says if she has to, she’ll call on her old teachers at Bridges Academy for help.
To help a young person who may be struggling with depression or anxiety: