Urgent action needed for youth in mental health crisis, state teachers union and lawmakers say

The Illinois Education Association and lawmakers want to scrutinize a state program that WBEZ found is failing to support low-income kids.

St. Bernard Hospital on Chicago's South Side, where at least once a week a child in a mental health crisis arrives in the busy emergency room. Manuel Martinez / WBEZ
St. Bernard Hospital on Chicago's South Side, where at least once a week a child in a mental health crisis arrives in the busy emergency room. Manuel Martinez / WBEZ

Urgent action needed for youth in mental health crisis, state teachers union and lawmakers say

The Illinois Education Association and lawmakers want to scrutinize a state program that WBEZ found is failing to support low-income kids.

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The Illinois Education Association, the state’s largest teachers union, is calling on state lawmakers to take urgent action to make sure children experiencing a mental health crisis get the help they need.

Responding to an IEA request, State Sen. Kimberly Lightford is sponsoring a measure calling for hearings to dissect the state’s troubled Screening, Assessment and Support Services program, known as SASS. The measure would create the SASS Program Task Force to analyze whether current funding for the program is enough.

Through the SASS program, children from low-income families in crisis are supposed to be assessed quickly by a crisis worker and connected with treatment.

Illinois mental health providers call SASS an essential lifeline for families, especially during the COVID-19 pandemic as youth have been increasingly showing up in hospital emergency departments with suicidal thoughts. But a WBEZ investigation found the state is failing to ensure thousands of children are getting any follow-up help, let alone the type of intensive behavioral health support many need.

WBEZ found the state is not fully keeping track of what happens to children who are the subject of a SASS call — about 40% of the screening outcome data is missing for cases over the past five years that required a quick assessment from a crisis worker. And there are few places to send kids in emotional distress. There’s a shortage of everything from psychiatric hospital beds to outpatient therapy, especially for children from low-income families. That leaves kids competing across the state for treatment.

IEA President-elect Al Llorens said the WBEZ investigation sounded the alarm, and now lawmakers need to take action. “I don’t think you can over communicate the urgency,” he said.

“Some kind of comprehensive overview of this program is severely needed,” Llorens said. “Since the pandemic, the mental health issue has become something that’s front and center for almost everyone. But when you get down to the point of looking at those living in high poverty, it’s exacerbated.”

State Rep. Lindsey LaPointe, who leads the House Mental Health & Addiction Committee, called WBEZ’s reporting “heartbreaking,” but not surprising given that the mental health system for children and adults has long been fractured.

“At a bare minimum, these are real kids in real crisis, we should absolutely … be tracking outcomes,” LaPointe said. “Part of it is quality, but part of it is just what kind of care kids end up in after a SASS call. So the fact that that is not happening is a problem I will be looking to solve.”

Lightford said she got involved after the IEA approached her last year. The association says school social workers across Illinois are seeing an uptick in students experiencing a mental health crisis “and a failure of the SASS program to address the needs of these students in an appropriate or timely manner,” according to a fact sheet from the association to support Lightford’s proposed task force.

While SASS workers are supposed to screen children in severe emotional distress within 90 minutes — most calls involving SASS are about youth threatening to harm themselves or others — members of the association say they’re waiting hours, sometimes late into the evening, for SASS workers to show up.

“This exacerbates the crisis and limits the ability of the school social worker to provide services to other students,” the association said in the fact sheet. “In addition, our members are reporting a lack of appropriate community-based inpatient and outpatient services for their students.”

Their frustrations mirror what WBEZ uncovered: complaints of children who are waiting hours for what’s supposed to be an urgent assessment, state records show.

“My concerns came over the success of the program,” Lightford said. “Is it actually working? Why aren’t children receiving the supports that they need, and what can we do about it?”

Lightford said the task force would evaluate the program by county and be able to hone in on which counties are being left out when it comes to getting treatment through SASS. The task force would consist of 15 members who would evaluate staffing issues at SASS agencies, response times to crisis calls, and the availability of inpatient and outpatient services, among other elements. The members would include representatives from three state departments involved in SASS: Healthcare and Family Services, which oversees SASS; Children and Family Services; and Human Services.

“There is a strong need to ensure the adequacy of this program, and making sure the funding provisions are met, that they’re in place, and that they’re actually getting to the young people who need the supports,” Lightford said.

Llorens from the IEA said the state has an extra responsibility to make sure students from poor families get intervention because they often attend schools that don’t have the capacity to provide intensive help. He notes that a colleague from northwest suburban Schaumburg told him that a crisis team is available to work with children for an extended period of time.

Llorens, who has taught math for 30 years at Thornridge High School in south suburban Dolton, said his district has one social worker for 800 students and one psychologist for all three district high schools with nearly 4,600 students.

“So you have kids that, because of that lack of resources, fall between the cracks, and it’s a shame,” he said. Llorens said he agreed with a doctor quoted in the WBEZ investigation who said that children who don’t have their mental health needs met, eventually could become troubled adults. “So I think it’s really important to be preemptive about how you deal with this holistically and systemically.”

During WBEZ’s investigation, state officials with Healthcare and Family Services acknowledged they need to do better. But they are just starting to hold insurance companies responsible for making sure children have a follow-up appointment scheduled after a SASS crisis intervention, or after a child is discharged from a hospital. Illinois largely outsources the SASS program to private insurers with Medicaid contracts.

They pointed to a new program called Pathways to Success that’s supposed to provide care coordination and more intensive behavioral health support in communities — some of the work that SASS providers and the private Medicaid insurers are supposed to be doing already. Pathways is estimated to cost around $300 million a year when fully implemented.

State lawmakers must approve creating the task force. Rep. LaPointe emphasized that the state is working hard to build a more robust behavioral health workforce, which ideally would help beef up access to more mental health services for children.

Lightford said she could see improving SASS as a part of Gov. JB Pritzker’s blueprint to transform children’s mental health care. The wide-ranging plan aims to ease the burden on families navigating a difficult and scary moment as their children seek help. The effort includes having state agencies, including the ones involved in SASS, coordinate and share better data.

In an email, a spokeswoman for Pritzker did not comment on WBEZ’s findings, but said she has been told the task force isn’t moving forward because it encompasses work being done by Dana Weiner on behalf of the state. Weiner is a child welfare expert leading Pritzker’s youth mental health transformation. She’s the main author of the blueprint, which generally recommends strengthening the availability of crisis response for youth and says other states use crisis response in lower-risk situations to avert a more serious crisis.

But the report does not address WBEZ’s findings or evaluate how SASS is currently working.

Spokespeople for the Illinois Department of Healthcare and Family Services did not respond to comment.

Sarah Karp covers education for WBEZ. Kristen Schorsch covers public health and Cook County government for WBEZ. Follow them @kschorsch @sskedreporter and @WBEZeducation.