Mirroring national trends, Pennsylvania is facing a social worker shortage that, if left unaddressed, could keep people from getting the support and care that they need.

To help close that gap, officials at the  say they want to offer $10 million in direct financial aid to social services students — including aspiring social workers.

That money would provide an average savings of about $1,500 a year for each student, the agency said in an April 10 statement. Pell-eligible (high-need) students could receive about $5,000, for an average total of $6,500 per year, according to the state system.

“Social services workers relieve suffering and improve the lives of children, seniors and many other Pennsylvanians,” PASSHE said in its statement. “There’s already a shortage of these workers, and communities will need even more of them to support the state’s aging population and address the impacts of the opioid epidemic and COVID-19 pandemic, the rise in social isolation, and the increase in mental health challenges for students.”

The agency, which has oversight of 10 state-owned universities, has asked the General Assembly to approve a $573.5 million funding request for the fiscal year that starts July 1.

That’s a 3.8% inflationary request, more than 2% increase included in Democratic Gov. Josh Shapiro’s budget proposal, the .

State System officials also are asking lawmakers to authorize an additional $112 million for student aid that would be used to lower the cost of attending a state-owned university, and bolster the system’s ability to produce graduates in high-demand career fields such as nursing, teaching and computer science, the Capital-Star’s Peter Hall reported.

While it’s still possible to find social workers in hospitals and public clinics nationwide, one  that there is a “serious” gap between supply and demand — one that is expected to only worsen in the coming years.

“Our human resources are at the level of a crisis now,” Ron Manderscheid, the executive director of the National Association of County Behavioral Health and Developmental Disability Directors, , an industry trade publication. “About 85% of counties have inadequate or no behavioral health services, and 63% of counties have no psychiatrist.”

A number of factors, including the nation’s aging population, homelessness and incarceration, and the ongoing strain of the opioid epidemic, are helping to drive that demand, , an industry website.

Across the border in Maryland, officials in Anne Arundel County also are contending with a social worker shortage, .

As of mid-March, the county had at least 23 open positions, from entry-level to supervisor roles, the station reported, and was moving as swiftly as it could to try to fill them.

“What we believe is going on is that there is a shortage of people applying at the colleges for the degree programs,” Nicole Fogg, a county social work supervisor, told the station. “We are going to colleges and universities, forming partnerships with them and attending the job fairs. So, we are right there on location trying to entice students to join the profession.”

During an appearance before the House Appropriations Committee last month, state System Chancellor Daniel Greenstein told lawmakers that Pennsylvania’s state-owned universities offer the most cost-effective option for Pennsylvania residents to earn a degree. Over the course of a career, PASSHE graduates see a nearly $1 million increase in earnings, Greenstein said.

“We are an engine of social mobility,” Greenstein said. “We’re not only fueling the workforce, we’re creating ladders of opportunity that people are climbing up and doing really well on and it makes me proud and actually a little bit emotional to be able to say that.”

In its April 10 statement, the state System asserted that its plan for social services workers would allow more people to begin their education in a high-demand field.

“Affordability is especially important for rural and urban students. Increasing financial aid also lowers student debt, another incentive to enter a career field that traditionally has a lower starting wage,” the agency said in its statement.

is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Pennsylvania Capital-Star maintains editorial independence. Contact Editor John Micek for questions: info@penncapital-star.com. Follow Pennsylvania Capital-Star on and .

Between August 2019 and January 2022, only 24% of investigations prompted by calls from school staff found evidence of abuse or neglect compared to a citywide rate of in 2020 — meaning K-12 workers make allegations that do not get substantiated far more often than most other professions.

Teachers, with whom children spend most of their day, misreport more than any other school staff: Two thirds of their calls to the state hotline are unfounded, according to data obtained by ����Ӱ�� through a public records request.

Meanwhile, families say the investigations plunge their lives into deep uncertainty and inflict lasting traumas on their kids. Parents describe children with recurring nightmares, fearing every knock on the door may be a caseworker looking to snatch them from their home.

Darcey Merritt, associate professor of social work at New York University, regularly engages with families impacted by the child welfare system in her work and research. She also serves on the Child Maltreatment Prevention Committee of the .

Over the years, Merritt has come to see the system as overly punitive toward poor families who love their children but may struggle to meet their basic needs due to lack of resources. 

The expert believes it’s time to reimagine child welfare to better support those families: “We need to start the whole thing over,” she said.

����Ӱ�� spoke to Merritt to learn what issues she sees in child protective services — and what can be done.

This conversation has been lightly edited for clarity and length.

����Ӱ��: What should people who work in schools understand about the child welfare system?

Darcey Merritt: We can’t disentangle neglect from poverty, it’s inappropriate to do so. 

On any given day, 76% of the children and families that are exposed to child welfare are there because of some form of neglect. And neglect is tethered to poverty: supervisory neglect, physical neglect, which refers to people not having appropriate food, clothing and housing. 

A lot of these issues related to neglect are structural issues that are outside the control of parents. Yet [child protective services] is blaming parents for their unfortunate, involuntary socio-economic statuses. So that’s a problem. 

Teachers are mandated to report out of an abundance of caution if they feel like a child is unsafe for whatever reason. But there’s got to be a way where mandated reporters first figure out how to be more useful in addressing the actual problem. If a child has dirty clothes consistently every day, let’s figure out what to do about that without getting CPS involved. 

I think there needs to be changes in state mandating laws, so [reporters] are encouraged, maybe even required, to first figure out how to address the problem. If they don’t have enough child care, well, then let’s find child care. If they don’t have enough food, let’s find food. Laundry machine is broken and they can’t go to the landlord because they’re behind on their rent? Let’s figure that out. These are all things that are happening. 

What might those changes look like?

We need to start the whole thing over and reserve child protective services for those kids who have been physically and sexually abused. We need to have a separate institution, a separate agency or organization, working with communities and neighborhoods to provide support for all the other kids so that the go-to response isn’t to report a child who’s poor. It all comes down to money and what our society is willing to do to make sure that people have a standard level of resources and support to be able to raise their families.

We need to really have more respect for these parents because they love their children and they are victims of an inequitable society.

To make sure I’m understanding correctly, are you saying child protective services should not be the ones responding to neglect charges?

I do not think they should be handling neglect charges. I think that some other agency that’s not connected to the stigma of having a CPS case should respond. Whatever support we put in place, it needs to be untethered from the institution of child protective services.

I’m not saying we shouldn’t help these families. I’m saying the child protective services is not the agency to handle neglect cases that have to do with poverty.

New York State law, as of 2021, requires implicit bias training for mandatory reporters. Does that rule go far enough to mitigate some of these problems?

I don’t think it goes far enough. You can’t just do a training and call it a day. You have to have something in place so that when people are making decisions, you can check whether or not this decision was made because of some unseen bias. For example, ‘Oh, this child’s parent has been involved with the carceral system. Go ahead and report this one.’ That’s how people continue to cycle in between these harmful punitive systems. 

We have our own Western idea of what safety and family well-being means and it’s all from a deficit lens. Rarely do we look at family dynamics and functioning from a strength-based perspective. I interview a lot of moms for my research and all of them say, ‘We love our children, but we needed help.’ 

It’s a really serious problem and the racial disproportionality is going to continue (because impoverished parents have no choice but to rely on the government for welfare). Black children are highly disproportionately involved with the child welfare system and before Black children, Native kids have the highest disproportionality of involvement. People don’t even pay attention to that.

Interesting. I didn’t know that.

The highest is Native American children, then Black children, then Latino children. White children are not overly represented in the system.

Some parents have told me they can’t help but know about child protective services, or, in New York City, the Administration for Children’s Services, because either they’re personally impacted or they know someone who is. Meanwhile, other families are completely oblivious. Have you seen that difference between communities?

It’s true. Once you’re involved, you know what that looks like. Parents’ language is even institutionalized. Have you heard people who are involved with the carceral system say, ‘Oh, somebody caught a case.’ These ACS-impacted moms literally say, ‘Well, I caught an ACS case.’ That language is a thing. 

And another group doesn’t have any idea what ACS is.

What are the harms of overreporting and what are the harms of underreporting [to child protective services]? 

The obvious harm of underreporting is that we may miss children who are in actual danger from parents that abuse their children. 

This whole issue of, ‘out of an abundance of caution, we need to report anything that we suspect might be problematic,’ that’s where the rub lies. We have to figure out how to pull out those issues that are related to poverty. 

The harm of overreporting is that when CPS comes knocking at your door, you are immediately traumatized. The very minute a child is taken from your home for any amount of time, you are immediately traumatized. They then have workers coming in on a regular basis, they’re being mandated to do certain groups and therapy, all kinds of things that don’t relate to the fact that maybe they need some money.

I personally renamed CPS the ‘child poverty surveillance.’ That’s my own little term I’ve made up for them.

You have to be subjective when you’re making a decision about whether or not a child is in danger. And one needs to be really, really reflective about their implicit biases, because [the worry is] a poor Black child will be treated differently than a poor white child. 

You live and work in New York City. Do mandated reporters, like school staff, lean more toward over or underreporting? 

They lean more towards overreporting. 

What messages are those people receiving when they get trained? Is it ‘When in doubt, report?’ Is it, ‘Take every precaution before you do?’ What are folks hearing?

I think they’re hearing, ‘When in doubt, report.’ I think that’s what they’re hearing. 

For the most part, folks are afraid because if you don’t report something and the child ends up really harmed, then the liability is on the mandated reporter. I think they’re being given a double message: ‘When in doubt, report,’ but on the back end, ‘Be careful, because there might not be a need for CPS to be involved.’ 

In schools, especially those that are under-resourced, they don’t have the means to help a family with their basic needs and their financial needs. [Instead], teachers are by law required to report to child protective services. It just makes no sense. The solution does not match the problem. And it causes harm in the meanwhile.

Given the system as it stands, if you are a mandated reporter in a school setting, how do you respond in a way that both protects a child in real danger, but also won’t jeopardize a family for no reason? How do you weigh that judgment call?

It’s hard. 

I had this conversation with my partner who teaches in Philadelphia. He’s not a social worker. I’m a social worker. But he [has to play the role of] a social worker, because he has to do social work as a teacher. 

When something’s going on with a child, my recommendation is to find out what’s happening from the family first. I recommend taking more caution before making a phone call [to the state hotline]. See if you can come up with a solution first. 

That puts a greater burden on teachers because then they end up being social workers as well. So it’s a very fine line, finding out what resources one has at the school, if the nurses or the climate officers or whoever the people are at the school [can help]. 

I’m only speaking about cases where neglect is related to poverty. Now, there are other cases of neglect where a parent intentionally left the child with a child abuser. All the neglect I’m talking about is unintentional. 

Child protective services should not be the go-to for cases of unintentional neglect related to poverty. That phone call should not be made to CPS but to another agency that we just don’t have yet. 

For five months during her freshman year, Tuli Hannan called New York City mental health providers in her mother’s insurance network after outreach to her school guidance counselor fell flat. In 2016, most therapists she contacted near her Queens home looked to put her on a six-month or longer wait list.

Hannan, who grappled with the will to live at that time, ultimately found a therapist she felt comfortable with at the end of her sophomore year, more than two years after she identified a need for support. Though her search began long before the traumas associated with COVID-19, large numbers of young New Yorkers are facing the same difficulty in accessing mental health support at a time when demand is intensifying.

“You don’t know where to narrow it down, you feel so lost,” Hannan said. “Being the person that’s struggling, you have to keep a stable mind and the patience to look for these services.”

The process led her to become an advocate for expanded mental health support in NYC, where a plethora of services — from community-based organizations, hotlines, in-school clinics and private professionals — left her spiraling and continues to confound her peers, who will return to classrooms next week.

A February 2021 survey of about 1,300 New York City youth, aged 14-24, found that who sought mental health support received it. Across the city, 35 percent of young people surveyed expressed a want or need for services; in the Bronx, half of youth surveyed wanted access.

“People my age, my friends, they normalize the fact that we won’t get the help that we need,” said Hannan, who worked with the Citizens’ Committee for Children of New York on the “Voicing Our Future” survey while she was a student at Information Technology High School.

New York’s School Response Clinicians, a group of 85 social workers helping students in crisis to lessen 911 and emergency room outreach, , up from 242 students from July through September.

The data from NYC mirror mental health stories across age groups nationally — from elementary schoolers to . That the pandemic is exacerbating a pre-existing youth mental health crisis is by now well documented.

At least 28 states have pledged to bolster social-emotional and mental health support with pandemic relief funding. Oklahoma, for instance, of licensed mental health professionals. And since 2020, seven more states now allow mental health days as from school.

To help support the 26 New York City neighborhoods most deeply affected by the pandemic, the city’s Department of Education partnered with to establish more mental health clinics in schools.

The DOE has hired at least as a part of its $635 million academic recovery plan. In the city’s 2022 budget, . No line items reference youth mental health specifically. This could be a red flag in an already-murky support area — many providers fit under the same umbrella of “mental health services,” though not all provide services to adolescents.

Jennifer March is executive director of Citizens’ Committee for Children of New York, the nonprofit advocacy group which specializes in research and conducted the February youth mental health survey. March has led campaigns to improve young New Yorkers’ well-being and is .

“While the recent New York City FY22 approved budget takes tremendous steps in New York’s recovery, the level of suffering and trauma the city’s children and families have experienced requires further action to address. The lack of specificity on how the city will ensure access to critical behavioral health supports and how public dollars will be spent to address long-standing racial disparities in access to child mental health care is deeply concerning,” March wrote in an email to ����Ӱ��.

Looking for help and finding the internet wormhole

For students and families looking for mental health support, the first question becomes: Where do I start? In the internet age, they’re likely to find four sites in a quick search: the DOE’s , the for accessing supports at home, the Department of Health’s and , the confidential 24/7 text, chat and call hotline.

The sites link to each other frequently — the first section of the DOE’s page, for example, lists how to contact NYC Well for immediate assistance, and the Office of Community Mental Health site refers anyone looking to support a young person to the DOE. Yet the relationship between the agencies, and which mental health professional might exist at yours or your child’s school, are unclear without spending hours of research or calling a school directly.

The stigma and fear associated with reaching out for mental health support may prevent someone from turning to a school administrator. One Brooklyn student shared in the write-in portion of the mental health survey that they believe support outside of school should be made free to increase accessibility.

“I feel like people are afraid to talk to people in school in fear that someone will tell their parents what they say. Even if it’s just giving special access through an app like BetterHelp or offering phone calls for 30 minute sessions with therapists who will just let people vent about problems. I’m not sure who would organize that or even if this is already a thing. If it is, it should be better promoted.”

Through the end of July, individuals seeking help were likely to encounter at least some broken links, such as those on an directing to a tool on how to start a conversation over mental health concerns with their child’s school, or one at the Mayor’s Office for Community Mental Health that offered resources for teens experiencing abuse. Now, both and resources have been fixed.

Given that each school’s need varies, mental health support systems range from community schools, which offer wraparound health services; to clinics, health centers, specialists and prevention/intervention programs.

For a parent urgently looking through the DOE’s site for the best person to call at their child’s school, the differences between these iterations and the listing what program each school has, without contact information, is not exactly user friendly.

The city’s Office of Emergency Management operates an . ����Ӱ�� could not find a comparable online resource for mental health that lists drop-in youth centers, community-based mental health organizations, and/or school-based mental health services. The closest resource city-wide is  a health and social services directory, though it does not include school-based resources.

The Community Mental Health office does provide a map of programs on its , but that platform is primarily meant to track reach and impact of city services. A parent or student seeking support cannot use it to find location sites, contact information or learn more. For some youth-specific services, map markers do not populate.

Some students or families opt for the NYC Well hotline to streamline understanding of their options and connect with care providers. Of the people who called on someone else’s behalf in 2019, called for their child. NYC Well’s average answering speed or wait time was 33 seconds from July 2020 through June 2021, according to the Office of Community Mental Health.

In the , a number of youth acknowledged that accessing support could be easier if the process and resources were made transparent in school, where they spend so much of their day. Specifically, one Queens student recommended having therapists accessible in schools and dedicating days or weeks to mental health awareness and establishing healthy habits.

In-school mental health supports inconsistent

A number of schools adopted new mental health initiatives because of and during the pandemic to meet student needs. Now 19 and recently graduated, Tuli Hannan was able to see her school partner with a community-based organization to provide more mental health services.

Students at Information Technology High School in Queens can now access on-call therapists during the school day and take online courses related to mental health, including mindfulness, reflective writing and meditation. Having access to those resources when she searched in 2016 could have made all the difference, she said.

“Now it’s easier for us to reach out to our guidance counselors because they email us, letting us know that this is what’s out here, this is what’s accessible to you, and don’t be afraid to reach out to us,” Hannan said. “I wish that that was passed on to all public schools because I know it’s different at each school.”

The New York Foundling, a centuries-old institution providing care for families and children, is one of many community organizations operating in-school mental health services. Through satellite clinics and staffing school support teams, they assist a student population of about 4,000 at 11 K-12 schools in the Bronx, Manhattan and Queens.

The Foundling is also contracted to provide clinical support in school response teams, a mix of providers and school staff that address students in crisis — a group not tethered to a specific school location.

With an end-goal to break the stigma around mental health and sustain a young person’s well-being, they involve the whole school. In practice, that means year-round support is available for students, as are workshops, training or professional development with any of the adults a young person encounters: guidance counselors, teachers, school leadership and their own families.

“We don’t only focus on the students. We believe that in order for mental health services to be sustainable and effective in school, we have to address the entire school as our client, as a community that we’re working with,” said Reïna Batrony, vice president of services for community- and school-based programs.

To get the word out about their services and full-time clinical staff, Batrony’s teams show up. At PTA meetings, afterschool events or summer school launches, staff share contact information and talk about their work, with the added bonus of normalizing the topic of mental health with parents. Students can also self-refer to their services, they don’t require a staff person or parent to make the call.

“I think everyone tends to be hesitant about mental health support. [It] varies based on culture, based on the type of trauma they may have experienced,” Batrony said. “[It] may also vary based on prior providers they may have experienced.”

The Foundling doesn’t maintain a waitlist; at the schools they partner with, a full-time clinician responds to each referral and request, connecting students or families with their services or community-based resources. For therapy sessions, they meet with youth in a confidential school space, in their homes or at one of their borough offices.

Their services and approach to involving everyone in a young person’s orbit in their mental health could have been impactful for a student like Tuli Hannan, who struggled to find support outside of school. The Foundling partners with just a sliver of the DOE’s and the decision about which ones get that level of support is made by its Office of School Health after assessing a school’s need for services, according to Batrony.

The result is inconsistent access to professional mental health support for students. For schools without full-time clinical staff or mental health centers, the baseline is a referral system and access to as-needed crisis response teams.

Guidance counselors, teachers and administrators receive on how to refer or respond in a crisis — according to the DOE, over 75,000 school-based staff were trained in Trauma Responsive Educational Practices since last year — but are not qualified to provide counseling, psychotherapy or act as social workers.

Ife Damon has been teaching New Yorkers for seven years, and says she proactively addresses mental health in the classroom to help students handle emotions and become self-aware. Since the pandemic began, she’s witnessed her English students at Curtis High School express “feelings of anxiety, stress, even depression.”

Damon makes it known to her classes that there is an in-house mental health center, and if they’re interested, they can connect with her, a guidance counselor, social worker or with the center directly. Young people, she says, typically talk openly about their mental health only “when teachers provide opportunities for students to do so.”

Located on Staten Island’s north shore, Curtis High serves predominantly Black and Latino students, who make up about 77 percent of the student body, and is . Their school-based health center provides vision, medical, dental and mental health care, coordinated by community-based organizations.

Damon serves on the community school advisory board, which hosts an annual forum open to students, parents and community members to assess community need and potential expansion. The forums also solicit feedback for the model, as Damon explains, “How can we better support you as a parent? How can we collaborate with you as a stakeholder in order to strengthen our school and help to make sure our students are getting what they need?”

The RAND Corporation’s found that the model boosted high school graduation rates, decreased chronic absenteeism and resulted in fewer disciplinary incidents for elementary and middle schoolers.

Community schools make up about 14 percent of NYC public schools. For students in the 267 schools, the model expands access to having many of their basic needs met; though citywide, . The DOE has plans to add 130 more community schools to support pandemic healing.

“We know that students cannot fully engage in learning unless their social-emotional and mental health needs are being met. Our expansion of successful established a common approach to supporting students through teacher training, resources, and direct clinical help,” DOE deputy press secretary Nathaniel Styer told ����Ӱ�� in an email.

The department’s growing investments in clinical partnerships are “to ensure every student has a caring adult to go to when in crisis.”

More money, a new mayor and a critical moment

While the push to expand affordable mental health support to New Yorkers fosters a moment in which the city may turn its focus to youth and families.

Licensed master social worker Melissa Koppenhafer works with unhoused young people accessing mental health, housing and workforce support in CORE’s for 16- to 24-year-olds. She said that expanding school and community-based services is critical for the next mayor, but the cost must be subsidized to prevent further financial strain on young people. As CORE’s senior program director of youth and family services, Koppenhafer works with young people who are mostly covered by Medicaid or are uninsured.

“Programs that are available to them that accept Medicaid and are completely free, without a copay, are really going to be what’s successful,” she said. “Twenty dollars is a lot to them. If they’re working minimum wage, that’s more than their one-hour right there.”

In order to foster sustained mental health care for young people, Koppenhafer is also calling for the city to recruit and retain more mental health practitioners of color.

“As someone in the field, I find that people in general tend to like to have providers that they feel they can connect to via race, culture, history — any one of those things can help them connect to someone,” she said.

Though the DOE has hired for this school year, it’s unclear whether any efforts are being made to recruit social workers to better match a student population that is . Advocates say that while it’s a welcome expansion, meeting the recommended 250:1 ratio for students to social workers would .

Eric Adams, Brooklyn borough president, former city police captain and the Democratic mayoral candidate poised to win November’s general election, has of expanding mental health support for young New Yorkers. On the campaign trail, he argued in schools.

Police interventions for students in emotional distress , according to a recent analysis by Advocates for Children of New York. Looking into 12,000 incidents where children were transported to hospitals for psychological evaluations, data shows that Black students and students with disabilities were disproportionately affected and handcuffed.

An found that NYC students vastly preferred more guidance and mental health support over police, and more than two-thirds of those surveyed agreed police should be removed completely.

Advocates contend that NYC’s particular context — on the eve of a mayoral shift, with families’ demand for accessible care mounting along with an influx of federal pandemic relief funds — positions city leaders to make lasting change for youth facing mental health challenges.

“There is a critical opportunity in the year ahead,” said the Citizens’ Committee’s Jennifer March, “to invest in place-based preventive and clinical interventions in pediatric settings, child care and pre-K, schools and communities as our children and adolescents are in crisis and their behavioral health needs have skyrocketed.”

Lead image: At I.S. 584 in the Bronx, sisters Melody and Delany received in-school mental health care from the New York Foundling. (Ryan Lash / New York Foundling)