On-Site Therapists & Other Supports Implemented in 4 Pilot Schools to Meet Students’ Growing Mental Health Needs

Written by Karyn Powers

No parent thinks twice about a teacher sending their child to the school nurse for a bodily health issue in the classroom.

But what if their child is suffering from a mental health issue? What then?

The student’s behavior will likely cause anxiety and disruptions in the classroom…

He or she may spend long periods of time being sent to the school’s front office, falling even further behind in learning…

Eventually, such students may skip or miss multiple days of school because they have no interest in going to a place where they always find themselves “in trouble”…


Some parents are able to find counselling to get their child appropriate treatment, but that takes time and costs money. And at the same time, parents are losing income by missing work for such appointments.

Without treatment, a young troubled child usually continues to fail and becomes the teenager who cuts classes and lands in Marathon County’s Truancy Court.

Becky_Bogen-MarekAccording to Becky Bogen-Marek, Juvenile Justice Supervisor with Marathon County Social Services:

“Many kids were being criminalized at a young age based upon mental health issues. Placing them in secure detention didn’t address the cause of their actions.”


Imagine if the office next to the school nurse contained the school’s very own mental health therapist.

Imagine if that mental health therapist represented an agency that was already practicing in the community.

And imagine if that local agency was also willing to reach out to educate teachers and school staff in better ways to connect with kids who are in mental health crisis.

Well, you don’t have to simply imagine this…

Two years ago, a group of dedicated public and private citizens in Marathon County came together to evaluate the state of mental health crisis intervention in our area. They realized that the intake procedures and available resources at North Central Health Care were simply not meeting the rise in the need for mental health crisis services.

Many positive changes came from this group’s study, which also revealed that:

Young children in Marathon County — those experiencing trauma at an early age that resulted in dissociative disorders — had very little support in the way of mental health services.

The group agreed that providing mental health services to younger students would bring more success to those students, more attachment to the education process from the get-go, and more opportunities for the child or teen to then successfully complete high school.

Hence, the Marathon County School-Based Mental Health Consortium was formed.

Early members included:

  • Laura Scudiere, Bridge Clinic
  • Becky Schultz, North Central Health Care
  • Chad Radke, M.D., Aspirus Wausau Hospital
  • Jeannine Nosko, Aspirus Wausau Hospital
  • Heidi Keleske, Bridge Clinic
  • Susan Coleman, Marshfield Clinic
  • Lee Shipway, Peaceful Solutions
  • Chad Billeb, Marathon County Sheriff’s Office
  • Robin Rudie, Aspirus Wausau Hospital
  • John Schunke, Langlade County Sheriff’s Office
  • Matt Barnes, Wausau Police Department
  • Ashley Williams, North Central Health Care
  • Becky Bogen-Marek, Marathon County Social Services

In this same window of time, United Way of Marathon County’s Partnership for Youth Juvenile Justice Action Team learned from schools that poor student behavior in the classroom was increasing both in frequency and severity. In addition, Marathon County Social Services stated they were receiving calls for children who were younger and younger in age.

At the high school level, the number of Wausau West and D.C. Everest Senior High School students cited in Truancy Court increased by 51% since the 2012–2013 school year, and the Youth Risk Behavior Survey contained increasingly worrisome data from local youth regarding their mental health and substance abuse.

See the Partnership for Youth’s “Education Concerns in Marathon County” video here:

After consultation from Georgetown University, the Vera Institute of Justice, and a significant dedication of time offered by community partners, United Way’s Partnership for Youth developed a framework to better integrate systems of support available to students and their families — including services both in the school and from the community.

The Partnership for Youth’s Diversion Pilot includes “Tiers of Support” considering student-family needs like mental health, hunger, housing, mentoring, parent coaching, and more. The development of tiered interventions included review of initiatives in Madison, Minnesota, and the Fox Valley.

The Diversion Pilot is working with the Marathon County School-Based Mental Health Consortium to ensure a 3-pronged approach:

  1. Get mental health counselling directly to students in the schools.
  2. Educate students and parents to lower the stigma associated with seeking out a therapist.
  3. Provide continuing education for teachers and staff.

Starting the Fall 2017 semester, 3 sites within the Wausau and D.C. Everest School Districts have started implementing the Partnership for Youth’s Diversion Pilot “Tiers of Support”:

  • Thomas Jefferson Elementary
  • Wausau West High School
  • D.C. Everest Senior High School

A fourth site — Weston Elementary — will join the Diversion Pilot during the Spring 2018 semester.

The long-term goal of the consortium is to expand the “Tiers of Support” to EVERY school in Marathon County — including having mental health services on-site in schools and having better connections to broad community-centered supports, based on what is learned in the Diversion Pilot schools.

Cathy_ProzanskiCathy Prozanski, Principal of Thomas Jefferson Elementary said:

“Every year we’re seeing younger and younger children who are aggressive and violent. We now have a therapist treating 6 kids. We are so grateful.”

But what if the child is not acting out? What if he or she is suffering silently?

At the elementary school level, the “K–3 Non-Crisis Tiers of Support” include 5 levels, with Tier 1 being the entry level of student referral and Tier 5 being the last resort of formal referral into the Marathon County Social Services system.

Every student is screened twice during the school year. If he or she is referred for counseling, the student is elevated to Tier 2. If Tier 2 activities do not result in a change in behavior, the child is elevated to Tier 3 and receives school-based therapy.

Although the therapy is based in the school, treatment is billed through the student’s health insurance; BadgerCare; or for those who are un-insured, grant funding.

At every tier, family and parenting supports are in place.

sad student

At the high school level, the “High School Truancy Tiers of Support” use truancy (excessive absences from school) as an indication that a student needs more support. Previously, students were sent to Truancy Court as the gateway to services. Instead, the goal of the “High School Truancy Tiers of Support” are to get students needed services and support without criminalizing them for a status offense like truancy. These tiers of support also include 5 levels, with Tier 1 being entry into the tiers due to absences and Tier 5 being the last resort of formal referral to Truancy Court.

At both age levels, students start at Tier 1 and only continue moving up the tiers if there is no improvement in behavior.

A key aspect of the tiers of support at each age level includes the school social worker or counselor administering a family screening tool to assess what family needs there may be: hunger, housing, or other aspects of family wellbeing. At every level of the tiers, there are connections to community-based services for the family, including youth programming, in-home parent education, and assistance with basic needs (e.g., food, housing, clothing). This may also involve family supports addressing any issues of domestic violence, sexual assault, other forms of abuse, or parents’ needs of mental health and AOD (alcohol and other drugs) counseling or treatment.

On-site, school-based mental health services for youth — with parental permission — are a vital component of Tiers 2–3 at both age groups. While similar, any screenings and services offered to each student age group do vary to ensure the services are based on the needs of that population. For example, at the high school level, at least 1 therapist in each school is dual-certified in mental health and substance abuse counseling. Tier 4 goes on to include intensive case management services for the family. The hope is that by offering the supportive services in Tiers 1–4, we will limit the number of children and families that ever make it to Tier 5.

High school students who aren’t actively truant can also take advantage of the on-site school-based mental health therapist with a referral from the School Resource Officer, from a teacher based on that student’s behavior, from a parent, or via self-referral.

. . .

United Way of Marathon County is serving as fiscal agent for Partnership for Youth’s Diversion Pilot work, both writing for grants and managing fund procurement and dispersal.

  • Approximately 80% of budgeted dollars will specifically support on-site mental health services in Diversion Pilot schools ensuring that every student has access to services, regardless of the family’s insurance status or ability to pay.
  • The other 20% of the pilot budget is to cover other services, including intensive case management, truancy abatement programming, and professional development for school staff.

Funding is still needed to support this important work.

Sustainability and expansion will require buy-in from those who will see their resources less stressed in a community of succeeding students and stable families.

Lee_ShipwayLee Shipway, founding member and Co-Executive Director at Peaceful Solutions Counseling in Wausau believes:

“We need to lower the stigma about seeking mental health counseling. I’d like there to be a day when two moms are talking and one asks the other, ‘Who’s your family therapist?’ the same way they’d ask, ‘Who’s your pediatrician?’”

For information about getting involved with or donating to this new mental health consortium for Marathon County youth, please contact either:

Karyn Powers - Marathon County Recreation Superintendent

Karyn Powers

Recreation Superintendent  |  Wausau / Marathon County Parks, Recreation, & Forestry Department 

Karyn Powers joined the Parks, Recreation, and Forestry Department in 1991. Prior to settling in Marathon County, she spent 5 years working for the Department of Defense in Morale, Welfare, and Recreation Services for the U.S. Navy in Iceland and the U.S. Army in South Korea. She holds a bachelor’s degree in Park and Recreation Administration and a master’s degree in Education. In addition to being the city/county Recreation Superintendent, she is a published poet and author. Karyn fell in love with Marathon County as a college senior when she interned here in 1979, then traveled halfway around the world to get back here as soon as was possible.  Email Karyn Powers.

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