By Brenda Ortega
MEA Voice Editor

As a third-year school psychologist in the Eastern Upper Peninsula Intermediate School District (EUPISD), MEA member Cinthia Mendoza-Medina most certainly has not seen it all.

But so far one thing has surprised the early-career educator in her role leading multi-disciplinary teams conducting risk assessments for students feared to be a danger to themselves, others or property.

“When we say, ‘Do you understand why people may be concerned about you?’ most of the students don’t shy away from the tough conversations,” Mendoza-Medina said. “They want to express their frustrations and their needs. They know how their trauma has affected them.

“That has really surprised me because I thought we’d have to spend a long time trying to build rapport with students for them to answer questions – and sometimes we do. But many students are very, very clear about what they want to do and what supports they need, so that’s been eye-opening.”

The EUPISD in Sault Ste. Marie stands at the leading edge of a nationwide movement toward addressing skyrocketing rates of student mental health struggles, teenage suicide, and school violence by intervening with troubled young people before they carry out desperate acts.

Such innovation in the ISD – which services 7,000 students in 19 school districts across a 4,000 square-mile region of Michigan’s Upper Peninsula – is what drew Mendoza-Medina to relocate her young family of four (plus two dogs) across the bridge from Holland to work there.

“As psychs, we are encouraged to not only research the things we’re interested in but to put our ideas into action,” she said. “We are very much supported by our special education department, which is wonderful because then we can come up with really trailblazing types of projects.”

At the request of Special Education Director Rachel Fuerer, the district initiated its first internally driven risk assessment in December 2016 – for a middle school girl who was harming herself and others in a self-contained special education classroom for students with emotional impairment – after an external report proved inadequate.

Since then the process has been refined and formalized, drawing on experience and numerous tools pulled from various professional sources, according to Raquel Fernandez-Earns, Ph.D., an MEA-member psychologist in the ISD from 2013-21, now retired, who led its development.

Private psychological consulting services – contracted to fill in gaps left by understaffed school psychology departments – do the best they can with the information they have, Fernandez-Earns said, adding: “This is not to disrespect the services out there.

“But as soon as we saw the richly detailed picture we could draw by assessing students from within the school setting – being able to access school records in some cases all the way back to kindergarten and having access to school staff where kids spend so much of their waking hours – we thought, Wow, we’ve really got something here in terms of helping our students.”

Today the EUPISD operates among the most comprehensive risk assessment systems in the state, if not the country.

To be clear, the term “risk assessment” is often used interchangeably with “threat assessment.” Both terms can refer to programs like the one at EUPISD, which seek to assess students at-risk of violence or self-harm and intervene to prevent tragic outcomes.

At this time, nine states require schools to implement threat assessment teams, though requirements and oversight can be spotty.

Instead of mandates in the wake of the deadly shooting at Oxford High School in December 2021, in Michigan the focus has been on developing a proven set of guidelines for communities to use in building and refining their approaches.

A national leader is The Comprehensive Student Threat Assessment Guidelines, pioneered for more than 20 years by Dr. Dewey Cornell at the University of Virginia, where training and resources are available and research continues to ensure the safety, effectiveness and fairness of systems.

What makes the EUPISD model exemplary is the depth of the assessment and the encompassing breadth of plans developed to deliver services and supports to students at home, at school, in treatment, and in the community, and then monitor their progress throughout their academic careers.

“What we’re doing here is making a difference,” said Fernandez-Earns, a self-described “inner-city girl, born and raised in Chicago,” who moved to the UP in 2003 after falling in love with its natural beauty. She initially worked in private practice before joining the ISD.

How it works

School psychologists at EUPISD play many roles in addition to leading risk assessments, including overseeing special education assessments, coordinating regional crisis response, and developing Multi-Tiered Systems of Supports to ensure all students have their social, emotional, behavioral and academic needs met.

To keep workloads manageable, requests for risk assessment from school districts in the three-county area served by the ISD must come from administrators and are first screened by a behavior specialist. That person either refers to the team evaluation process or begins an expedited response if a student is at imminent risk – a drop-everything-and-act scenario determined by circumstances.

When cases are referred on, they undergo an Emergency Student Assistance Team (ESAT) evaluation to begin.

The team consists of the psychologist, the student’s parents and teachers, a building administrator and social workers. Some parents of children referred for help may feel overwhelmed by the speed and intensity of the process, said Cinthia Mendoza-Medina.

“But that has been the case much less than the times I’ve encountered parents feeling supported –  because they’re going through a lot of difficulties too, and they’re struggling with everything that’s happening in their families,” she said.

Over two to three hours, the ESAT meeting explores wide-ranging questions on the student’s grades and school attendance, family history, trauma, friendships and social difficulties, mental health issues, suicide attempts or suicidal ideation, self-harm, harm toward others or threats of harm, sleep patterns, and more.

Protective factors in the student’s life also are considered, which are the connected relationships, mental health services, and healthy activities that help young people build self-esteem and resilience.

From there, the student’s level of risk is pegged at low, moderate, high or severe. Regardless of risk level, all students who go through the ESAT process receive a Safety & Supervision Plan, while students determined to be high or severe risk also go on to receive an even more thorough risk assessment.

The Safety & Supervision Plan lays out interventions across multiple environments. At school students could be required to check in each morning with a staff member who makes them feel comfortable and safe. That person might check the student’s backpack and have a chat to see how he or she is doing.

“That person could be a teacher, it could be a janitor, it could be a school secretary – it’s an adult the student gravitates towards when they have needs,” Mendoza-Medina said.

If a student requires breaks throughout the day, or extra supports, or needs to be allowed to leave the room when frustrated to visit the school counselor or trusted adult – a plan is put in place to ensure everyone understands expectations and the student’s well-being is continually monitored.

At home, if the student has engaged in self-harm or suicidal ideation, parents or guardians are responsible for ensuring sharp objects are removed from the student’s access and guns are locked in a safe storage unit, which is provided if necessary.

Families also receive direction or supportive services to help them strengthen and maintain communication with their child and the child’s teachers and school. If the student has a probation officer, that person is brought into the conversation.

Needed mental health services are identified in the community, and the student’s priority as part of the ESAT process can sometimes move them to the top of external providers’ (often lengthy) waiting lists. If not, school-based mental health personnel step in to fill the void in the meantime.

The Safety & Supervision Plan also can identify relationship-building interventions, such as extra-curricular activities the student can join, or community recreation opportunities or organizations. Support is provided to help students access music lessons or other personal interests.

“So it’s quite comprehensive and very individualized in terms of the supports that are put in place for the student in school and out of school to address anything they might need, socially, behaviorally, academically, emotionally,” Mendoza-Medina said. “It’s a team effort all the way.”

In addition, those young people identified in the ESAT as demonstrating high or severe risk go through the lengthier process of Student Risk Assessment to better identify needs and build a more detailed Safety & Supervision Plan.

Last year, the EUPISD conducted 40 ESAT meetings and 12 risk assessments – down from 55 and 23, respectively, the year before. The risk assessment stage is where the student becomes involved in the process.

Those students are interviewed for three to five hours or more and assessed using a variety of professional tools, such as a mental status exam, the Kaufman Brief Intelligence Test, Beck Youth Inventories, and the recently updated edition of the Psychosocial Evaluation & Threat Risk Assessment (PETRA), among others.

The conversation begins casually and then delves deeper with genuine concern and empathy. Fidgets and snacks are supplied, and trained school psychologists know and develop instincts about how to leave the script of questions to pursue threads in the student’s story, Raquel Fernandez-Earns said.

“We found again and again from bringing this full circle of people together who are involved in the student’s life – plus interviewing the students themselves, who are usually hungry to tell their stories – that everyone involved had missing pieces of the puzzle,” she said.

“The teacher didn’t know this, or the parent didn’t know that, and suddenly we had all of these ‘Aha’ moments because getting everyone together and sharing information helped us paint a more in-depth picture of the student.”

In some cases, students are identified for the first time as needing special education services, Fernandez-Earns said. She recalled cases where the assessment process revealed students had cognitive impairments or autism and had slipped through cracks in the regular identification systems.

Others have been found to be experiencing psychosis or hallucinations tied to mental illness.

“The fascinating piece about this is that many of these children have – for lack of a better word – a hidden issue of some sort that is connected to their behavior but no one realized,” she said.

In addition to discovering the value of conducting risk assessments internally, Fernandez-Earns gathered several lessons from her experience leading the program at EUPISD.

“For one thing, it can be quite moving and extraordinary to see how much teachers and staff will do to try to help students,” she said. “They will go the extra 10 miles for kids, but they need help. They’re not trained for every situation, and they can’t do it all on their own.”

At a conference presentation by threat assessment experts in Colorado, she learned the importance of maintaining monitoring of students throughout their academic careers in home districts – as needed daily, weekly, monthly or annually – because improvements can erode as circumstances change.

An understanding of the commonalities among at-risk students also emerged from the work, Fernandez-Earns added. These children have suffered trauma, experienced bullying – especially on social media – and isolated themselves, furthering social and academic marginalization.

“Trauma changes the architecture of the brain and it puts the brain in survival mode, which means problem-solving, future planning, none of that is possible,” she said. “But if there is intervention early enough, kids can heal and become resilient and have a more restorative trajectory for their lives.”

What’s next

School psychologists do not have regular contact with students once the Safety & Supervision Plan is in place and being followed, which can be a difficult part of the job, Cinthia Mendoza-Medina said. But they do hear back about students and continue to revise plans to help them, she added.

“Students do want help; they’re just humans who are struggling and don’t know who to turn to or how to ask for it. But they have so much potential… they are amazing.”

Not every student who comes through the program makes a turnaround, although most will learn new coping strategies, develop skills to seek assistance in times of crisis, or emerge from their shells, make friends, find jobs, and plan for the future – all of which is incredibly rewarding, she said.

“It’s not perfect, and there’s always more work to be done to better ensure that our students are safe and have everything they need to be successful,” Mendoza-Medina said. “But this process gives me a lot of hope for our kids, and I’m appreciative to be part of something that I’m so passionate about.”

She has been heartened to see more money allocated in state budgets over the past few years for hiring mental health personnel, as need continues to strain school systems, but shortages in every job category persist.

Mendoza-Medina wants to see risk assessment become a part of every school, which will require ongoing funding and attention to ensure those highly trained, trusted adults are there to deliver the best programming for kids – whatever their needs may be.

“We need more social workers, we need more school psychologists, we need more school counselors, and we need more teachers. And we need people to be paid what they are worth, because every student’s life is priceless.”

WANT TO LEARN MORE?

• A cadre of trainers is available through the Michigan State Police Office of School Safety to deliver workshops on Behavioral Threat Assessment and Management.
• A national leader in the field, University of Virginia offers links to research and free training videos and threat assessment program guidelines.
• The National Association of School Psychologists put together Brief Facts and Tips with an overview of best practices and links to resources.
• For more information about the EUPISD Emergency Student Assistance Team and Risk Assessment Process contact Rachel Fuerer, Director of Special Education, at rfuerer@eupschools.org or Stacey Miller, Behavior Specialist (and MEA-Retired member) at  staceym@eupschools.org.

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