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BY KATHLEEN NELSON

System's social worker teaches Catholic grade schoolers emotional resilience

"Fortunately, it was a lovely day, and Milo liked going to Granny's house because she always had cake.

"Unfortunately, a dark cloud appeared and it soon began to rain.

"Fortunately, he had Granny's umbrella.

"Unfortunately, he didn't look where he was going …"

Kim Harrelson, a licensed clinical social worker for Mercy, and Kelsee Phillips listen to Syrvon Marsh-Calhoun describe good things that happen to him each day as part of a presentation to fourth graders at St. Louis the King School, one of three schools in the Archdiocese of St. Louis that have partnered with Mercy in a pilot program called Mercy Kids in Schools.

The fourth graders in Michelle Mueller's class at St. Louis the King School hung on the words of Kim Harrelson, laughing at each unfortunate thing and cheering the next fortunate thing to happen to Milo the monkey in "Fortunately, Unfortunately" by Michael Foreman.

The story ended, Harrelson divided the class in groups of two and gave each a negative situation they had to turn into a positive and present as a short play. One wasn't invited to a party. Another failed a test. Each play lasted 30 to 60 seconds and ended on a positive note that earned giggles and clapping.

"Life has its ups and downs, and it's not always easy," said Tarissa Hamilton, one of the students.

"So, next time something unfortunate happens in your life, you can think of fortunate things, too," Harrelson said, ending what's known as a Tier 1 presentation of Mercy Kids in Schools. The pilot program between Mercy Kids and the Archdiocese of St. Louis uses a social worker and  telemedicine technology from Chesterfield, Mo.-based Mercy to connect students at three archdiocesan schools with a high percentage of low-income families to health system resources that otherwise would be out of reach. Mercy Kids is Mercy's four-state network of pediatric care and services that includes 700 physicians, 125 pediatric specialists and two hospitals — one in St. Louis, the other in Springfield, Mo.

Adaptive response
"I really appreciate that Mercy didn't find a grant and then go tell the schools what we'll provide," Harrelson said. "Mercy wanted to do what the school needed."

Kim Harrelson, the licensed clinical social worker for Mercy Kids in Schools, conducts a telemedicine session with a student at Most Holy Trinity School. The equipment allows Harrelson to talk to students at any of the three schools in the program when she is on one of the other campuses.

Christine Crain, chief operating officer for Mercy Kids, said the program started with a request in 2013 from St. Louis Archbishop Robert J. Carlson to see how Mercy could contribute to the Catholic grade schools in economically marginalized neighborhoods. Initial ideas centered on improving the physical health of students. But after officials with Mercy and the archdiocese toured the three schools that became part of the program and talked to principals, "We started shifting away from direct medical services and toward social work, where we could work on behavioral health and connect families to health services that they qualified for but weren't taking advantage of," said Maureen DePriest, the archdiocese associate superintendent for elementary school administration.

Thus, Mercy and the archdiocese transformed the proposal to include a single licensed clinical social worker assigned to three schools, an individual whose accessibility and professional range would be maximized using telemedicine equipment and consults with Mercy specialists. The three-year pilot program with a budget of $176,000 is funded from private donations to the Mercy Health Foundation St. Louis. The program began in January in the three schools, with a combined enrollment of about 400 students.

"My reaction was 'Oh, thank goodness. This is exactly what we need,'" said Jessica Kilmade, principal at Most Holy Trinity Academy, another of the schools in the pilot program. "If we can't help students feel safe and secure socially, emotionally, physically and spiritually, the academics aren't going to happen."

Resilience training
Mercy hired Harrelson, a licensed clinical social worker with experience in the charter and public school systems of Kansas City, Mo., and University City, an ethnically diverse suburb of St. Louis. Harrelson spends about 12 hours a week at each of the schools, and provides three levels of face-to-face programming.

Tier 1 prevention programming consists largely of classroom presentations to students in kindergarten through fifth grade that provide resilience training, "using language to solve problems and accepting change as a normal part of life," Harrelson said. Tier 1 programming is targeted to reach about 85 percent of the students.

Tier 2 includes small-group sessions that deal with such topics as anger management or grief and loss with other students going through similar issues. Harrelson said these interventions are designed to reach about 10 percent of the students.

Tier 3 consists of one-on-one counseling and/or individual referrals to other Mercy programs.

All day, every day
Mercy also supplied each of the three schools with telemedicine equipment so that students can link virtually with Harrelson when she is at one of the other schools and Harrelson can link with Mercy's behavioral health specialists for consultation. Use of the video equipment accounts for a relatively small part of Harrelson's time when compared to face-to-face meetings, but it has proven invaluable. Harrelson notes that the virtual sessions cut down on her travel, allowing her more time to work directly with the students and quick access to experts at Mercy.

"The telemed system is amazingly helpful," Kilmade said. "Our counselor might only be available two days a week in person, but the need doesn't just check itself at the door when she's not there. So the fact that we can follow up regularly or if the child needs to talk and Kim isn't there is valuable. It's like having the physical presence on campus all day, every day."

Parental support
When the program started, Harrelson, Kilmade and the other principals weren't sure that families would use the services.

"But the families said, 'We trust this school and we trust the resources you bring in.' Since then, it's been success breeding success, " Kilmade said.

The pilot program has filled physical, intellectual and emotional gaps. Some examples:

• Harrelson arranged a series of four dental visits, including transportation, for a student when the child's parents could neither afford the treatment nor arrange time off work to take him.
• She connected eight students in grades five and six with Aim High, an intensive summer school and weekend program that helps students prepare for admission to Catholic or other private high schools.
• She worked with two students at St. Louis the King in applying for and earning $500 scholarships to defray the cost of tuition at St. Louis the King.
• She collaborated with 14 families to get low-cost computers through Web Innovation & Technology Services, which refurbishes hardware and software.
• She assisted a mother with two children at one of the schools in finding permanent housing.

Close connections
"Kim has done what our principals and teachers do. She has entered relationships with families," DePriest said. "They know her. They trust her. Once you have that relationship, you can get the job done."

DePriest would like to see the program spread to other schools in the archdiocese; Crain hopes to expand it throughout Mercy's network in Arkansas, Kansas, Missouri and Oklahoma. Expansion depends on the success of the pilot and finding funding.

"The root problem, the number one issue on the minds of pediatricians and communities, is behavioral health services for children," Crain said. "We need to figure out how to respond to that need. It's a different way to think about health care, but, boy, it's a really important need."

Copyright © 2015 by the Catholic Health Association of the United States
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