Las Cruces students wanting mental health care face waitlists

Mayfield High School is one of several high schools in the Las Cruces Public Schools to host a school-based health center. But some counselors say the clinics aren’t staffed enough to meet surging surging mental health needs among students. The Mayfield High clinic is run by Ben Archer Health Center, a community health provider. (Photo by Diana Alba Soular/ SNMJC)

Editor’s note: This article is one in a series by the Southern New Mexico Journalism Collaborative examining possible solutions to an ongoing mental health crisis among youth. This project is supported by a grant from the nonprofit Solutions Journalism Network.

School-based health centers lack staffing amid youth mental health crisis

By Juan Corral & Diana Alba Soular

Southern New Mexico Journalism Collaborative

LAS CRUCES – In Las Cruces schools, a series of clinics are meant to offer students easy access to medical care and mental health services.

But several clinics, known as school-based health centers, aren’t staffed enough to meet students’ needs amid an ongoing mental health crisis among Gen Z youth – spurring criticism the facilities are falling short on their mission to overcome barriers to care across the 23,000-student district. 

A few factors are complicating the centers' effectiveness. One provider is facing funding constraints. Some parents and faculty may be hindering students’ use of the school-based health centers, according to counselors. Plus, the centers are run as a collaboration between multiple large organizations with distinct leadership, and one counselor said the clinics’ challenges seem to be on the backburner.

A counselor who works for the Las Cruces Public Schools, who’s not being identified by SNMJC over the person’s concerns about possible retaliation, said the centers aren’t open often enough or staffed with as many licensed counselors as would be needed to meet students’ mental health needs during a widely recognized crisis. 

“As the mental health crisis grew, especially after COVID, those services are just not there,” the counselor said. “So there's a good game that's talked about – what's going on on paper to look good, but in practice, it's not happening. And we're not doing what's best for kids.”

That means students are more likely to encounter a closed door or a waiting list if they seek mental health help at a school-based health center. When students can’t access care at a center, school staff refer them to other providers in the community, where waiting lists for counseling services can stretch out for months, the counselor said.

Some of the problems kids are experiencing include depression, suicidal thoughts and addiction.

The counselor expressed concern because, while the school-based health center model holds a lot of promise to connect kids to care, it’s not working seamlessly.

Las Cruces Public Schools contracts with two nonprofit providers, La Clinica de Familia and Ben Archer Health Center, to offer clinical care to students at the school-based health centers. And the schools provide space on campus for the providers to offer an array of services, ranging from vaccinations and yearly wellness exams to STD screenings and mental health counseling.

La Clinica runs the school-based health centers in Centennial High and Rio Grande Preparatory Institute, with recently celebrated expansions to two middle schools and an elementary. Ben Archer, meanwhile, operates school-based clinics in four other high schools: Mayfield, Organ Mountain, Las Cruces and Arrowhead Park Early College High. Both organizations operate extensive clinic networks outside the schools, too, serving kids and adults alike. They’ve also historically been key providers in low-income communities and rural areas lacking care.

Two providers have different funding

Amy Himelright, LCPS director of behavioral health & academic counseling, said the school-based health centers were “open pretty much full-time five days a week pre-pandemic.” Then COVID-19 struck in early 2020, forcing students to in-home learning. The two clinical providers pivoted, too, and began offering mental health care through telehealth.

When students returned to the classroom, La Clinica soon resumed offering its in-person care at the school-based clinics, according to Himelright. But Ben Archer was slower to transition.

“They stated that, one, they had to transition all of their clients who they now had through telehealth out before they would have the staffing available to be face-to-face,” she said. “And two, quite honestly, that telehealth was more profitable – that they had a hard time kind of making ends meet, so to speak, just based on the reimbursements from the schools.”

Himelright said while Ben Archer has increased its mental health services at the school-based health centers, “they have definitely not bounced back to full-time in all of the schools. And we do really miss that and need that.

“We really, in all of our high schools, would benefit tremendously from having them (school-based health centers) all open five days a week,” she said. “I believe there's enough need that they would stay busy, and they would be busy every day, all day.”

At least part of the challenge is rooted in the way school-based health clinics operate and are funded. The centers are able to bill Medicaid in many cases, Himelright said. But she said services to students whose families have private insurance aren’t billed because that could require the student to shell out a co-pay, hindering their ability to access care.

“If the kiddos don’t have Medicaid, then they (the providers) don’t get reimbursed for those services,” she said.

This is less of a problem for La Clinica because it’s part of the New Mexico Alliance for School-Based Health Care, which results in extra funding from the state to help support its work, according to Himelright. But Ben Archer is not a member of that organization and so is not eligible for that added funding. La Clinica has been able to expand its services to the middle schools and elementary school, she said.

The level of reimbursement for services matters because that money pays for the staffing – including licensed counselors – who provide care to students.

Asked if she knows why Ben Archer isn’t a member of the state association, Himelright deferred to that organization to answer the question. Ben Archer’s administration didn’t return calls seeking an interview. The alliance for school-based health care also couldn’t be reached for comment.

A Ben Archer Health Center clinic on Del Rey Boulevard in Las Cruces is seen in late December 2024. Ben Archer runs a network of clinics – including in schools – in Doña Ana, Luna and Sierra Counties. (Photo by Diana Alba Soular/ SNMJC)

Hiring a private firm to boost access

Because the school-based health centers aren’t offering mental health care five days a week, LCPS has contracted with a third provider – Sol Counseling & Wellness, a private counseling agency in Las Cruces – to offer care at each of the district’s high schools one day each week. That’s in recognition of the high need for student support.

“Even the school-based health centers that are open more (often) tend to get full and have a bit of a waitlist, although they try not to keep kids on a waitlist for long,” Himelright said. “We don't like kids to have to wait at all. So we kind of added that additional layer of support.”

Sol Counseling is the same agency hired by the Deming Public Schools to boost mental health support for its students.

Ideally, Himelright said, each of the school-based health centers in the high schools would be staffed with at least one medical professional and one licensed counselor five days a week because being able to offer care to a student soon after a need arises is key. At Arrowhead Park Early College High, for instance, the center is open only on Wednesdays, she said.

“So if a kiddo has a crisis on a Thursday, the likelihood that by the following Wednesday they're going to still be motivated to go to the school-based health center is actually quite low,” she said. 

Youth facing a mental health crisis

Factors driving the youth mental health crisis are wide-ranging but include students’ fears over school violence, impacts of social media and cyberbullying, and pandemic-related disruptions to social and psychological development. Across Southern New Mexico, families find themselves without affordable or readily accessible care when facing mental health problems. Nearly all of the region is classed as a mental health provider shortage area by the federal government. 

The region struggles with high poverty, which goes hand in hand with mental health risks for youth and lower academic performance, according to a 2019 article in the Global Pediatric Health journal.

Laura Walter is a social worker at Organ Mountain High School who provides mental health support to students. She is not employed through the school-based health center, but she works closely with the facility. Some of the students she works with have problems with their home life. Others have been bullied online.

“The social media right now, the popular culture amongst our teens is crazy because social media just takes over everything and the social bullying is crazy,” she said. “You have kids coming and bawling. You have (school) admin trying to best handle it, but they can’t shut down Instagram or shut down TikTok.”

While public schools have long employed licensed counselors and social workers on their staff and those personnel do offer student support, they typically don’t provide the more intensive, ongoing mental health screenings and therapy that licensed counselors at a school-based health center can offer. School counselors are juggling a wider range of duties.

Himelright agreed there is an ongoing mental health crisis among youth.

“I think it was simmering before the pandemic, and then it really boiled over during and since the pandemic,” she said. “We haven't recovered from that.”

Organ Mountain High School is seen in late December 2024 on the East Mesa of Las Cruces. The high school is home to a school-based health center run by Ben Archer. (Photo by Diana Alba Soular/ SNMJC)

Growth of school-based health centers

Over the past 50 years, the number of school-based health centers across the U.S. has grown as a way to connect mainly teens – and sometimes younger children – to health care, particularly in communities where many barriers exist. The model seeks to provide an easily accessible door to health care at a key time when serious health conditions are first emerging and when positive experiences at an early age can pave the way for their involvement with care throughout their entire lives. But the centers’ financial sustainability, given their approach to treating any student seeking care, has been a persistent challenge.

Asked if the provider shortage is a factor in the staffing challenges of school-based health centers in Las Cruces, Himelright said she doesn’t think so because there are good connections to a New Mexico State University program and its graduates. But a bigger challenge is funding to pay counselors.

“I think it's more monetary,” she said. “I always advocate to our state legislators to help supplement school-based health centers operationally so that they're not just relying on insurance reimbursements. They have to at least break even to make it sustainable.”

Across New Mexico, there are nearly 80 school-based health centers, according to the New Mexico Alliance for School-based Healthcare. The types of care offered – whether medical, mental health or dental – can vary from facility to facility. Clinics can be found in schools across Southern New Mexico, including Silver City, Lordsburg, Truth or Consequences, Roswell and Carlsbad. 

Because they’re co-located in a place where kids spend much of their time – school – the centers are supposed to offer convenient access to care for students, while reducing the need for parents to take time off of work to take their children to appointments elsewhere in the community. Some clinics serve adults, as well as students.

A 2015 report that examined school-based health centers across New Mexico and Colorado listed the qualities of an "ideal" center, including that they have on-campus access, no-cost or low-cost care for students, and are "open regularly, with 24/7 options when closed." In addition, they should have strong relationships with the schools, community and youth they're serving.

Research on the effectiveness of school-based health centers to address kids’ mental health has shown generally positive results. One study found students in Oregon with more access to mental health care through school health centers had fewer depressive episodes and less suicidal behavior than their peers who did not.

Himelright said LCPS doesn’t have data on mental health outcomes of the students who are accessing care through the school-based health centers. That’s maintained by La Clinica and Ben Archer.

La Clinica also didn’t return calls seeking interviews.

Some parents interfere with care, counselors say

Under New Mexico law, students at the age of 14 are able to get some types of care – including for mental health – without their parents’ knowledge or involvement, which sometimes stirs contention.

Walter, the social worker at Organ Mountain High, said she’s met a lot of parents who are upset when their child seeks help without their approval.

“I have parents get upset with me all the time because they say: ‘I don’t want you talking to my kid about suicide prevention,’ and I say: ‘Well, why?’” Walter said. “‘Well, because you’re putting these ideas in my child’s head,’ is what they tell me.”

Walter tells parents that she understands if they wish for her not to speak about the topic but that it’s probably already been discussed among their peers. 

“We can excuse them from it, but more than likely your child has thought about it or has a friend talking about it or has been around someone talking about it,” she said.

Because of the significant need among students, Organ Mountain High took the step of hiring Walter to specialize in mental health support, whereas other school counseling staff have a wider range of duties, like offering academic guidance.

Kristin Rankin is a counselor who has worked at Organ Mountain High School’s school-based health center and three others in the district for 14 years. The centers are run by Ben Archer.

Rankin also said, when the model is working as designed, students are allowed to visit during class hours if they need to speak to a counselor or are concerned for health-related problems. Students can also get physicals, flu and COVID shots and regular check-ups without having to pay a copay or commit to a payment plan.

But Rankin said some parents interfere with their student getting help from a school-based health center over concerns about the child accessing care without the parents’ involvement. And some faculty interfere, as well, because they don’t want students to miss class time. She said more needs to be done to build trust with and educate parents about how access to care can help a student who’s struggling with their mental health.

Rankin contended the school environment itself is to blame for many students' mental health troubles.

“The kids will be like: ‘I can’t pass this or I’m not doing well in this class,’” she said. “So, I was noticing that the kids were always taking on the blame as if it’s just them, which is interesting. So, I started doing classroom observations. That’s when I noticed a different kind of factor, and the factor I noticed that I hadn’t appreciated was this tension between the kids and teachers.”

Rankin said it is a “weird classroom environment,” in which the classroom is either very loud and no one is learning or very quiet and no one is being taught. She said all in all, it’s very disruptive to the education system and the mental health of a child.

Rankin said she’s a “huge advocate” of the centers because they do help the students who get care. But she added that although centers are staffed, it may not be enough. 

Rankin said while there are many problems she witnesses, she is happy she can be a part of the solution. 

The administrative offices of La Clinica de Familia community health provider are seen in late December at 385 Calle de Alegra in Las Cruces. The health provider is one of two organizations running school-based health centers in Las Cruces. (Photo by Diana Alba Soular/ SNMJC)

A call for more attention

The LCPS counselor who is not being identified by SNMJC said the district has undergone leadership changes in recent years. And, amid the shuffle, school-based health centers seem to be on the backburner. The district is trying to boost academic performance of its students, but if it’s not also addressing the surging mental health needs of students, a key piece of the puzzle is missing, the counselor said. Counselors who work for LCPS are left with limited options to help students and their families.

“What are we supposed to do?” the counselor said. “Parents are calling us, and there's a waiting list and these kids need help.”

The counselor said while individual personnel are well-meaning and want to help students, clearing the hurdles surrounding school-based health centers will take administrative leadership from all the organizations involved – schools and community clinics – because needs among students have risen sharply.

“Resources, staffing, collaboration – a solid plan,” the counselor said. “I think it could be a great thing, but you need all those people to come together and work together and put the ideas together instead of everybody assuming ... from the top down that it's working like it's supposed to.”

Juan Corral is a freelance journalist working with the Southern New Mexico Journalism Collaborative, a partnership of local news organizations in the southern half of the state. SNMJC Editor Diana Alba Soular contributed to this report.