THURSDAY, OCTOBER 29TH, 2020

The Need for Change

Glued to the concrete floor for two hours, a Paly student locked himself into one of the school’s private bathrooms after being denied access to the Wellness Center.

While the center’s staff speculated he was using the center as a means of cutting class, in reality, the student says he was fighting a mental disorder that caused him to feel dissociated from his body and his mind, sometimes forgetting his own name and identity. Minutes later campus security forcefully detached the screws of the door, escorting him to the Wellness Center, only for him to be promptly kicked out verbally again.                                                                                      

The student said that, based on this incident, he lost hope in Paly, the Wellness Center and his future. 

This former student, who agreed to an interview only if he could remain anonymous because of the personal nature of his experiences, represents an extreme of the range of student opinions about the high-profile Wellness Center in Paly’s Tower Building, a place that serves as the front door to the school’s mental health programs. In his case, as in all others, Wellness Center staff do not comment on individual situations. 

Wellness centers at both Paly and Gunn trace their roots to the string of teen suicides between 2009 and 2015. The events prompted serious soul-searching among students, parents and Palo Altans. An array of programs resulted, all aimed at reducing student stress and providing students with broad mental health support. 

The Wellness Center is the most visible. 

As the center approaches its four-year anniversary, The Campanile spoke with students, psychologists, parents and Wellness Center staff in an attempt to assess its effectiveness and reputation. The newspaper found that the center has carved out an important role in supporting many students and that many seek its help — indeed, there’s usually a waiting list for counselor sessions.

From August 2017 to January 2018, the latest figures made available, there were 470 counseling sessions with appointments and 74 drop-in counseling sessions, according to a PAUSD report. PAUSD administrative assistant Betty Muñoz said she did not have the time currently to provide more recent data. 

All of those interviewed said the center represents a good start for mental health support at Paly but sometimes falls short in some ways, including inconsistency in treatment, a distorted reputation, misidentification of some needs, and, at times, insufficient communications. 

Where it All Started

Students who enter the Wellness Center across from the main office are greeted not just by a troupe of staff members, but by plants, tea and a hot water dispenser along with snacks — and the infamous sandbox. If a student can’t meet with a counselor right away, they can have a date with the sand, where they can fiddle with toy shovels and cars to calm their distress. 

First piloted in 2016, the Paly and Gunn High School Wellness Centers provide the necessary support for students struggling with academic stress, anxiety, depression, family issues, gender identity and more.

According to Steven Adelhesim, the director of the Stanford Psychiatric Center, the series of student suicides in Palo Alto from 2009-2015 brought the issue of mental health outreach into the spotlight, prompting the development of a solution: wellness centers and one-on-one onsite counseling and therapy services. 

“I know that there’s a lot of pressure academically,” Adelsheim said. “I think this notion of what success is has really kind of changed and, you know, people worry a lot about whether they’re taking the right Advanced Placement courses. So we need to see these services available.”

Following its inception, the Wellness Center’s primary on-campus counseling provider was Adolescent Counseling Services, a 45-year-old nonprofit serving the Peninsula. According to Paly Mental Health and Wellness Coordinator Elizabeth Spector, ACS provided predominantly unlicensed intern trainees to counsel Paly students. Two years ago, PAUSD switched its provider to Counseling and Support Services for Youth, whose counselors are licensed and more comprehensively trained according to Spector. 

CASSY runs on a “brief therapy” and goal-oriented model where students can receive counseling for up to 12 weeks or 12 sessions, according to Spector. 

Students’ needs differ, so session lengths can range outside of that time frame depending on external factors and their state of mental health.

“If you’re working towards your goals and you’re getting something out of treatment, and you’re still engaged, then we can continue on,” Spector said. “If you feel like you’ve reached your goals, then we close after the session.”

Some students, such as junior Amelia Lagna, utilize the Wellness Center as their only means of mental health support. Strained financially and lacking other support options, Lagna said she purposely tries to use as much time as possible talking during her sessions to avoid having to confront the possibility that the session could be her last. 

“(The therapist) always starts the session saying, ‘What do you want to talk about?’” Lagna said. “I’ll go on for a really long time, so we don’t have enough time to get to the very structural stuff (of scheduling).”

When a student arrives at the Wellness Center, a staff member asks some questions to decide the course of action. Staff can direct the student in a number of possible directions: a 12-week one-on-one session with a CASSY therapist, a drop-in session with a therapist, a period to simply relax in the Wellness Center lobby, or a referable outside program. 

Students with eating disorders and those who are potentially suicidal are classified as referable patients since they require comprehensive care and possible out-patient programs, Spector said. 

Therapists, when in a session with students in either a 12-week or drop-in session, ask a range of questions to assess their mental health more comprehensively. Paly CASSY therapist Kate Minutillo said she primarily asks questions concerning academics, family and friends to have an accurate representation of the student’s needs for counseling.

For many students, the Wellness Center has been a haven for relief as it is a space free of judgment. They appreciate its convenience and care. 

“You don’t usually get to talk to someone who’s completely nonjudgmental and their whole job is just to listen to you,” Lagna said. “I feel like with friends, even though they say they’re always listening to you, you can still feel that stress, that burden.”

In contrast to the student who felt rejected by the Wellness Center, Lagna said she is grateful for its services.

“I would find that I would leave and I’d feel way lighter,” Lagna said. “There were times when I would come in and be like, there’s no way I’m feeling better.”

Junior L.J. Vargo agrees.

“If you needed to just rant, they would be there to listen or a room to cry in or just someone to say they are there for you, they would do it,” Vargo said. 

Paly parent Gabriela Buendia, a licensed marriage and family therapist said the Wellness Center’s counseling program was beneficial for her child.

“I was super grateful that it was available because a lot of what was going on for (my child) at that time was stress related to school,” Buendia said. “And so having the convenience of her being able to be on campus and just see someone right then and there and deal specifically with stuff at school, it was very focused towards that.”

While the Wellness Center wins praise from many, others point to what they see as shortcomings. 

Problematic Personalization

When it comes to personalizing the counseling to each student’s needs, the Wellness Center has restrictions that may irritate some students. 

Since the Wellness Center does not encourage or generally permit students to switch to a different therapist, it can be hard for students to find the right counselor match for them. A junior who asked to remain anonymous because of privacy concerns said the therapist provided was not the right fit for her needs or preferred style of therapy.

“You can’t choose your counselors, so if you become upset with yours, or you don’t think they’re best for you, you don’t really have a say,” she said. “I had a very big problem with my counselor because I felt she was very condescending in a way.”

She said the therapist misconstrued her words, leading her to believe that she and her therapist weren’t compatible.

“When I would tell her certain things, she would try to sum up what I was saying in a way that made it sound like she was putting words in my mouth that I never said,” she said. 

“I’ve just had a lot more experience with therapy … so I just see things differently. I noticed things that they shouldn’t be doing.”

But Spector said, regardless of whether a student is compatible with their therapist, they must try to work through their problems and differences.

“In life, we have these messy relationships and we never really get to fully work through conflict, oftentimes,” Spector said. “That’s why we strongly encourage you to talk to your therapist about it if you’re feeling some sort of dissonance because it is therapeutically relevant.”

Lagna, who has met with two CASSY therapists, said the counselors’ methodologies vary despite being guided by the same overarching policies. 

“One is way more solution-oriented,” Lagna said. “The other one is like, ‘Just talk about it.’ I don’t know which one I prefer, but I didn’t really get a choice at the beginning.”

Minutillo, though, said trying different therapists at the Wellness Center does not correlate with its plan. 

“We ask that students stick with a therapist and work through any issues that come up in therapy because we do have limited resources, and you are not really going to get another time like that to work through something,” Minutillo said.

What’s the Feel

Another issue faced by the Wellness Center is that it is a victim of its own success. On the one hand, it has the reputation of helping students with genuine mental health concerns, as well as being a place to hang out and grab snacks. 

On the other hand, some teachers suspect that when a student asks to go to the center, it’s to kick back and relax, not to address a legitimate issue. 

The former Paly student who locked himself in the bathroom said he thinks this reputation is partly why he was denied services. He said while this perspective may help crackdown on students who cut class, it overlooks those using the service with justifiable intentions.

“In their attempt to discourage skipping class for unnecessary reasons, they ended up pushing me away when I needed their help,” he said. “It makes more sense to me to give students the benefit of the doubt and make sure they are mentally all good, instead of making sure that no student uses it for selfish reasons but also denying some students who need support.”

Another Paly junior who asked to remain anonymous said many of her teachers see the Wellness Center as an excuse for students to cut class. 

“In my experience, teachers just see going to the Wellness Center as an attempt to leave class,” she said. “My math teacher last year called my parents and told them I was going to Town & Country’’ because the math teacher thought her call slips were fake.

The junior also said her math teacher violated the center’s confidentiality rules — which represents another challenging aspect of its operations. 

In general, Wellness Center counseling does not require the consent of a student’s parent or guardian. Meetings can be confidential unless the student is being harmed, harming themselves or harming others in the past or present, or they know of others having harmed themselves or others in any way. 

“Only one of my parents consented to therapy, so the teacher broke confidentiality by calling my other parent,” the student said.  “I told my mom I’d talk to my therapist about it, and after I did, nothing happened. I just stopped scheduling my appointments during math to make things easier.”

Spector said the Wellness Center does not condone this teacher’s alleged behavior as it goes against the rules and students’ right to confidential counseling. 

“If it’s clinically appropriate to not involve the parents, we do offer minor consent; that’s something that the student and their therapists would discuss in-depth to determine if that’s appropriate,” Spector said. “But still, the limits of confidentiality apply.”

Reading Emotions

Some students say the Wellness Center suffers from a version of the squeaky wheel proverb: it seems to them that outwardly distressed students receive more attention. 

“If the kids coming in are not talking to (the Wellness Center staff), then they had no issues but are using the Wellness Center as a way to pass the time and to not go to class,” said a Paly junior who asked to remain anonymous because he still regularly uses the center’s services. 

He said the center has improved in this respect from last year, now asking questions to those who don’t show their emotions to better assess their intentions. 

That improvement came too late for the former Paly student, however, who said when he entered the Wellness Center, the staff told him since he wasn’t showing any outward signs of distress, he was mentally and emotionally sound in their eyes. 

“According to them, I clearly wasn’t showing signs of stress and was therefore fine, which I was directly told,” he said. “Most of the time I was sitting there quietly with a blank expression on my face, usually because that’s all I could manage.”

This student says the Wellness Center began to limit his time there to 15 minutes and began to call his teachers and parents, saying students without issues couldn’t stay longer than that.

Spector said she couldn’t comment on individual student cases but that, in a scenario where a student is emotionally inexpressive or unwilling to communicate, the Wellness Center will generally ask them to leave after 15 minutes but their response can be subject to change on a case-by-case basis. 

Outreach and Communication

While the Wellness Center was established to make sure it met the mental health needs of Paly students, so far, at least, it has no way of ensuring that some students won’t fall through the cracks given its case-by-case policy as described by Spector. 

Students who are enrolled in Wellness Center counseling receive thorough follow-up communication after sessions, but that cannot be said for those who sporadically or even regularly drop into the Wellness Center in search of support. 

Spector said she may reach out to those who drop in sporadically or regularly depending on their past history or other factors, but insisted that it is case-by-case and that there’s no guarantee of a follow-up. 

The former Paly student was one of those sporadic visitors. He said he dropped by frequently when he was unable to function in class but felt unnoticed and pushed out by Wellness Center staff.

“I didn’t demand attention from the staff or anything. I just thought it was a safe space,” he said. “After a while, however, some of the Wellness Center staff noticed I was a regular and warned me that if I kept using the Wellness Center to skip class, I would have to give up on coming there again.” 

What he really wanted was not just to be noticed, but to be helped. 

But Spector said Wellness Center staff are careful not to make a student talk if they don’t want to.

“If there was someone who was in our presence, and they didn’t want to engage with us right now, we never want to force the student to talk to us,” Spector said. “If you’re not ready or don’t feel like talking to someone, it’s not gonna help.”

Spector said it’s the responsibility of each individual student to seek help if they need it. However, in some situations, Spector said that she will reach out to guidance counselors or others to try to connect with a student who seemingly needs help, describing the approach as case-by-case.

The Mission

Moving forward, Minutillo and Spector have made clear their top priority: destigmatization. Spector and others are striving to further destigmatize mental health problems, allowing students to feel comfortable reaching out for help.

“I think we have helped destigmatize mental health and help-seeking behavior,” Spector said. “That’s one of the biggest and we’ve done that in a number of ways,” 

The center’s staff has made its services well known to teachers and to students, with wellness fairs and meet-and-greet sessions called “Cocoa with Counselors” and through presentations given to teachers.

Moira Kessler, a Stanford child and adolescent psychiatrist, said there is still a stigma around mental health and mental health conditions that needs to be addressed.

“People still have a lot of beliefs based off of myths that are incorrect,” Kessler said. “It takes time for various stigmas to improve and this is one of them that is in the process of improving, but has a way to go.

To further destigmatize mental health in families, Adelsheim said talking within the family is where it all needs to start.

“We as parents need to do a better job of shifting our own expectations for students to be able to help our students shift the expectations,” Adelsheim said. “We’re all stressed and challenged. And I think if we can normalize some of that, that might take off a little bit of pressure.”

At Paly, the Wellness Center staff has worked over the years to improve students’ mental health and believes that an important step in assisting students to feel comfortable even seeking help is to at first help make them feel at home — whether that’s with a smile, soothing words, tea, toys or sand.

 

Suicide: Help is available

Santa Clara County Suicide and Crisis Hotline: 855-278-4204

National Suicide Prevention Hotline: 1-800-273-8255

www.suicidepreventionlifeline.org

Crisis Text Line: Text HOME to 741741

www.crisistextline.org

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