HARSH LESSONSUnruly students are hauled away in ambulances instead of getting sent to the principal’s office.
By Michael O’Brien
On Halloween 2013, Amber Decker’s then-8-year-old son was rushed by ambulance to the emergency room. He was not deathly ill, hadn’t broken his arm at the playground or slammed a door on his fingers.
He’d thrown a tantrum.
It started when his teacher asked him to take off his Halloween mask. “He was the Lizard from ‘Spider-man,’” Decker said, “in a little foam outfit with a plastic mask.”
It can take her son, who is autistic, a while to follow directions. But he’s smart and high functioning, Decker said, which is why he was enrolled at Public School 120 in Flushing, Queens, instead of a special education school.
The school was aware of his condition and employed a school psychologist, Decker said. But like many psychologists at New York public schools, he split his time between schools and wasn’t at P.S. 120 that day. Decker said a guidance counselor couldn’t handle the 8-year-old’s outburst.
So someone at the school dialed 911 for an ambulance.
Decker’s son is far from the only city public school student sent to the ER for acting out. Some 1,447 students were taken to the emergency room for an “emotional/psychological condition” during the 2015-2016 school year, according to city data recently made available.
Even the city has cast doubt on whether most of these ambulance calls are necessary. Child psychologist Charles Soule testified in May 2012 before New York City Council that the city’s School Based Mental Health Committee, an advisory body to the city Department of Health and Human Hygiene, found that in 97 percent of such cases the students did not require immediate hospitalization.
The New York Civil Liberties Union concluded in a 2013 report that uniformed school security officers on campus regularly failed to distinguish tantrums from actual emergencies. A year later, a federal judge ordered the city “avoid unnecessary emergency room visits for students experiencing emotional, behavioral or psychiatric events.”
The de Blasio Administration’s mental health plan, launched in November 2015, called for expanding instruction to help officers respond more appropriately to special needs students. This includes fewer 911 calls, fewer suspensions and training on how to de-escalate crises.
A RUSH TO THE ER
Tens of thousands of city students have mental health and behavioral problems. The city Department of Education estimates 9 percent of children ages 6 to 12 have ADHD, depression, anxiety, depression, bipolar disorder and/or other psychological difficulties. Eight percent of the city’s high school students have attempted suicide, according to the city.
Still, it’s difficult to determine how many of the city’s 1.1 million public school students, from pre-kindergarten through high school, are grappling with mental health issues.
About 18 percent of students have an individual education plan on file. This classifies them as students with disabilities, according to the city Department of Education, though the numbers aren’t broken down to distinguish between physical or mental difficulties. City schools are required to integrate all but the most disabled youngsters, who are placed in special schools covered by District 75.
On paper, New York schools appear to have a robust program for addressing students’ mental health needs. But, advocates say, a lack of resources and proper training leads educators and staff to too often rely on punitive measures.
Advocates say city schools began calling more for ambulances for psychologically challenged youth when schools embraced zero-tolerance suspension policies in the 1990s.
In the case of Amber Decker’s son, someone ignorant of his diagnosis might conclude his trouble understanding instructions can make it seem like he’s being “mischievous or not listening,” the mother said. When her son didn’t take off his beloved Halloween mask, the situation escalated. By the time his mother arrived at the school, her son was locked in a room with a security officer.
After an ambulance arrived Decker said she was told by the school her son would not be allowed back in class unless she went with him to the hospital. They spent the day in an emergency room. He was evaluated and sent home with a doctor’s note stating that he was “currently able to return to school at this time.”
This would not be the first time EMS would be called in to deal with her son’s tantrums. It happened again, at another school, she said.
The boy didn’t only lose schooltime: It cost his family money. Parents are expected to pay for for the trip to the hospital – the average cost for an ambulance ride is $800, plus medical fees that range from $700 to $1,700, said Nelson Mar, an attorney with Legal Services NYC.
The NYCLU reported in 2013 that special needs students were suspended twice as often as other students. Over 10 days in 2012, according to the report, one Bronx hospital received 58 emergency psychiatric calls from area public schools.
During the 2011-2012 school year, a 5-year-old kindergartner was sent to the emergency room involuntarily at least five times, according to Legal Services NYC. The group, which lobbied on the boy’s behalf, said the school required a guardian to sit with the child or he would not be allowed in class.
Another kindergartner was banned from school until receiving a “psychological clearance, as well as a neurological and behavioral assessment” for yelling and throwing chairs, according to a letter from the school to the child’s guardian.
In the 2015-2016 school year, police were called to assist with 1,262 suspensions for students with disabilities. This was out of the total 3,437 suspensions involving police.
This data is publicly available largely due to a lawsuit brought by Legal Services NYC, which sued the city on behalf of 11 children with behavioral issues varying from ADHD to autism and their families. Amber Decker and her son were on the list.
“Having these emotional crises in schools has a serious ripple effect. This is part of the reason why we have the achievement gap,” said Mar. “Schools are unable to address it and it spirals out of control.”
REFORM EFFORTS UNDERWAY
An additional $150 million dollars was set to be spent on school children under the de Blasio administration’s Thrive NYC plan between 2015 and 2019, with extra funding proposed afterward, according to the Mayor’s Office of Management and Budget.
This was intended to eventually provide mental health training for 9,000 teachers and staff in classrooms with the youngest students. The city would also train an undetermined number of middle and high school staff. According to the Mayor’s Management Report, as of October 2016, 30 mental health consultants had been hired for 206 schools to identify students most in need of care.
There are still 900 school campuses without additional mental health resources.
Dawn Yuster, an attorney with Advocates for Children of New York, is heartened that the city is attempting to tackle the problem, but noted that too many schools are lagging.
“It’s commendable what the city is doing,” she said. “But it’s just not nearly enough.”
The Office of School Health, run by both the city’s health and education departments, recently implemented a pilot “School Response Team”. These teams conduct mental health assessments, make referrals to health and social services, and “engage parents through outreach,” in 29 schools, officials said. The teams also intervene to “avert unnecessary 911 calls.”
Speaking more broadly, Toya Holness of the Department of Education said in a statement: “Providing all students with a safe, supportive and inclusive learning environment is essential, and we remain dedicated to investing in and expanding successful school climate programs – including restorative trainings, mental health programs and social-emotional supports – that effectively manage behavioral concerns, address underlying issues head-on, and keep students in the classroom where they can learn.”