Guest post by Ben Anderson, Director of Health Policy at Children’s Defense Fund – New York.

On February 5, 2018, Children’s Defense Fund – New York (CDFNY) released a new report related to the health needs of and services available to displaced students—namely homeless children and unaccompanied immigration children. The report included survey results from school administrators in high need school districts in New York City. Alarmingly, the report found that many schools continue to call 911 to send students to the emergency room to address disruptive behaviors related to underlying mental health issues. Eighty-four percent of school administrators responding to CDFNY’s survey indicated that they had to refer at least a few students to the emergency room because of mental health or behavioral issues. Students at the schools surveyed are disproportionately students of color.

The survey responses were obtained nearly two years after the New York City Department of Education issued Chancellor’s Regulation A-411, which requires schools to intervene and de-escalate disruptive student behavior prior to calling 911 to send students to the emergency room to address the behavior. Issued in 2015, the regulation requires schools to employ a variety of de-escalation strategies, such as obtaining support from on-campus mental health professionals or mobile crisis teams. The required de-escalation strategies were intended to curtail the practice of calling 911 to address mental health issues.

CDFNY’s concern is that the high percentage of schools sending students to the emergency room suggests that New York City may still be spending millions of dollars on emergency response services and emergency room care, rather than investing more in preventative mental health services that better serve the students and their families. If schools had sufficient resources to address the mental health and behavioral needs of their students, we would expect a lower volume of 911 calls. Without additional investments in mental health services and other behavioral interventions and supports, schools will continue to struggle to achieve the desired results of the regulation.

Other issues addressed in the report are the significant health needs of displaced children, including lack of consistent meals and medical care. In total, the report recommends:

 Expanding school-based health centers (SBHCs) and services—particularly mental health services—in medically underserved areas;
 Allowing SBHCs to serve as health homes in the Medicaid and Child Health Plus programs;
 Increasing support for teachers to implement PBIS in the highest need school districts; and
 Expanding access to after-school and weekend meal services in the highest need school districts.

For more information on this report, contact Ben Anderson at banderson@childrensdefense.org or (212) 697-0942.