[inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] thank you all very much for being here, and were going to continue this discussion on the issue of enormous concern for the american people. Senator murphy was going to introduce ms. Russelltucker but, unfortunately, he is detained. Let me begin introducing her, that is ms. Russelltucker was appointed commissioner of the Connecticut Department of education in 2021. Previously she served as chief operating officer division chief of the Departments Office of student supports and organizational effectiveness. Ms. Russelltucker, thanks so much for being with us. Thank you. Good morning, chairman sanders, Ranking Member cassidy, and members of the Senate Committee on Health Education labor and pension. I am charlene russelltucker come commissioner of education and connecticut. I am honored to share critical information regarding the Youth Mental Health crisis and connecticuts response to supporton the needs of students. My big audacious goal is to ensure every Connecticut School has a court need a sustainable system of care to provide comprehensive behavioral Mental Health services to all students and school staff. The Surgeon General murthy mention an associate of connecticut Connecticut High School students confirms our students face unprecedented Mental Health challenges. Too many for students reported having felt sad hopeless, and that the Mental Health was not good, most or all of the time. Most concern is 14 said they are seriously considered suicide, and 6 actually attempted suicide. These data highlight the immense need to address Student Wellness and underscore the action at federal, state and local public or effective solution our team to stakeholders including policymakers, Community Leaders, parents and fans, educators and students. I like to see it cant be about them without them. The commissioners roundtable for family and Community Engagement and education is a diverse constituent group of stakeholders representing school staff, advocates, parents and guardians, Community Leaders and students to advise me on policy and programmatic priorities. Connecticut Student Voice for change Program AllowsHigh School Students to propose projects utilizing state funds. Notably, 80 of student proposals focus on Mental Health. Using divorce to advocate for Mental Health support for their peers. They spoke and we are listening. The pilot establishes a system of kournikova for schools and seven districts. One Pilot School District identified 250 students at risk of suicide and was able to provide critical and Immediate Responses. Our states mobile Crisis Intervention Services delivers a range of Crisis Response and Stabilization Services to youth and families. Simply calling 211, are now 988 now 988, immediate dispatch clinicians to schools or anywhere a childeu is in crisis. The Surgeon General report an epidemic of linnaeus reinforces the g importance of School Attendance and engagement. The program is a researchbased Home Visit Initiative that improves attendance, feelings of belonging, and Family School relationships. Additionally we invested 33 million in funding in a multieuro summer enrichment grant program, prioritizing communities, disproportional impacted by the pandemic. Programs face a strong focus on peer relationships, wellness and academicn acceleration during e summer. In the first year this program connected more than 108,000 students with enrichment opportunities. Department invested 2. 2 million extra funds for innovation grants to support new partners in the underserved communities in designing innovative, highquality afterSchool Programs to address student academic and Mental Health needs. Mental health is a bipartisan, state priority. Including addressing workforce shortages. The governor and are generously directed 100 million fromio all agency Mental Health initiatives, including 28 million for Mental Health professionals in schools. Multistate agencies are working together to expand the ranks of clinicians to meet increased Mental Health needs. Ea additionally when school to six have levied over 183 million of local extra funds for students and staff wellbeing. We are committed to funding and sustaining what works. We also invested funds to establish a groundbreaking collaborative that brings together University Researchers to conduct rigorous evaluations of them in your programs and initiatives thats underway and our state to ensure programs and investments are achieving results. Thank you for modeling bipartisan National Discourse that would lead to enhanced access to needed services and ultimately improved academic access, support and outcomes for young people. Thank you very much and im happy to take your questions. Thank you very much. Were going to jump over dr. Garcia for second and go to doctor joy osofsky who will be introduced by senator cassidy. Its a joy to introduce doctor joy osofsky competitive gothic Mental Health at a wish to medical governmental psychologist a National Leader in her Childhood Development or a learned a lot from dr. Osofsky, shias who taught me you can actually begin thinking of separation disorder fromat day zero and just amazing to me and she was very informative of what chris murphy and i did at least my part of the Mental Health reform bill of 2016. A lot to her. Chess expertise and trauma informed care, help manyan belizean families recover from Hurricane Katrina and applied that expertise during the culminating pandemic. She received numerous awards and recognition for worker dr. Osofsky, thank you for being here. Thank you very much, senator cassidy for the invitation and senator sanders. I very much appreciate being here. One of thehe things i want to sy introducing my testimony is how important the opportunity has been for me. Actually together with my husband who is a psychiatrist, to be able to consult with senator cassidy on Mental Health issues, to identify and support community and state agencies that work individually and collaboratively in supporting the Mental Health needs of children and families, including prostate efforts. We started this in 2016. Wewe have been pleased to suppot his efforts to increase Mental Health support in schools and in communities, and we didnt talk earlier as much aboutan communities and to think we need to integrate that in the conversation have now. It would expand to meet basic behavioral Health Services and ask at the mental Care Services in schools and c communities boh rural and urban areas we know in rural areas its much harder to access Mental Health services in general. The act would provide funding for the National ChildTraumatic Stress network to improve trauma informed training, treatment and services for children, adolescentss and families who have experienced trauma. I have been fortunate to work with the National Traumatic network being funded since 2003 to develop Mental Health collaboration with schools and communities. Our latest effort, and to think one that isch really very much reflective of the direction of the National ChildTraumatic Stress network is going, has been to not just work in one community but develop regional coalitions so we spread the word that we do, the effort each of us make in working with the children who have been traumatized iniz different ways, and experienced trauma to be able to share that knowledge with other communities. So, for example, and it actually happened to be quite fortunate during the covid pandemic, we had a center within a National Trauma network that t just ende, the Disaster Coalition for child and family resilience. And through that coalition we build regional relationships across states. One in the gulf south where we already had relationships because of disasters Hurricane Katrina chemical oil spill, but then in the northeast region of the United States across five states the regional coalitions are composed of people from all different backgrounds, state agencies,e education agencies, stakeholders in the community, people are involved in policy. We had some politicians involved. So that we were able to share information across the different groups for much better preparedness as we share information, response, and in recovery when the disaster of any type occurs, not just a natural or technological disaster but also at terrorism attack or shooting that has occurred in a community or shooting that is occurred in schools, that we can share information haveon Immediate Response to the situations. I really feel that the work of the National ChildTraumatic Stress network speaks to some of the issues that isth already coe up in terms of integrating across Community Innovative ways to provide Mental Health services in ways that would be quite acceptable. The other thing that want to bring up thatt has not been discussed is the imports of houses for resilience of how to support resilience in children and how to support resilience in families. Certainly we have seen family being pressed immeasurably during the covid pandemic. What i call it is a definite and definite information, everything changed all the time, and definite uncertainty. We did know what was going to happen from one day to the next. How can a family come together and howsy can a School System or Community Come together when you dont know how things are going to change from day to day works and the issue came up of how to communicate and i think thats why theres been excellent exit interviews of social media as a way to connect. We were told we couldnt be around people, so i can children relate to their friends . And how can one have a sense of family if you cant see people and relate to them . I think its really very important for us to think about how to establish connections across families and connections across communities. Oneti of them, i see in just abt out of time, is going to give you a brief example how we brought together families and children after Hurricane Katrina on some of the crew ships that house people, did not have housing, and how we worked together, including Mental Health as a way of just being there. That Something Weird to think about also as supporting parents to be able to just be there and listen to the children and give support to parents to be able to do that. Thank you very much. Thank you. Our next witness is doctor joshua garcia. Dr. Garcia is the superintendent of the tacoma, washington, School District. He previously served as deputy superintendent assistant Superintendent High School principal, assistant principal, athletic director, teacher. Other than that, not much . [laughing] thank you very much for being with us, dr. Garcia. Chairman sanders come Ranking Member cassidy, members of the committee, i am proud superintendent of tacoma School District and honor to share the viewpoint of superintendents for ons important hearing focus Mental Health of our nations you and to speak with you about what we have observed, what weve been doing and what we might do together to curb the Youth Mental Health crisis in america. Tacoma is fullyco committed to each of our students being safe, engaged, supportive, healthy and challenged. We recognize Mental Health impacts us all. Mental health includes her emotional, psychological and social wellbeing. It h affects how we think and a. It helps us determine how we handle stress,ma relate to ots and make healthy choices. During aof highly critical phase of development for lack of support and comprehensive approaches are significantly impacting our sensibility to go socially, emotionally and academic development. Tacoma Public Schools more than 28,000 suits represent 170 represent 170 tribes and ethnicities, over 2000 qualifies homeless come over 51st present qualifies low income and over 15 qualify or special education students. In the 201112 score each of our high schools was labeled as a dropout factory. We were inpo the dire state ande needed a new approach. A new approach. We started the tacoma hold Child Initiative and intentional action plan the recognize student of 124 hours a day seven days a week. Fast work to 2022, 90. 2 of her students graduate in four years, 86. 7 of our high schools take collegelevel classes because youre alone over 12,000 participants in kindergarten through eighth grade of engage in afterschool activity in kindergarten through eighth we have engage in afterschool activity and Record Number of High School Students are participating in job experience. Tacoma has been able to make big strides to improve outcomes but we know the challenges our sins are facing are only growing. In the last year our students, tony, and you, real, i said, marco, dj, savior, larry and i havent shot in our community. Our students have to survive human trafficking, about homelessness, drug abuse, physical and mental abuse and social media harassment and bullying. Es although this may not be new challenges to assassination, the speed of thepe incidences and te Traumatic Stress are only increasing. Likee you and i are students ae being pumped combined wiw defense come daily expensess of, hate and stress that unlike us doing this without fully developed brains. Pi coping skills or access to preventive and a therapeutic services. In 2021, 13,239 of our 10thgraders in ourde state mada plan for suicide. As you heard Washington State is not unique. Our students are facing tremendous challenges and schools cant do this work alone. Weve moved away from episodic events to Sustainable Practices across our buildings and our community. They are focus on three elements, Prevention Strategies, response strategies, and therapeutic services. Our Prevention Strategies can each of our schools develop and intentional plan to support social and Emotional Learning. They contextually each plant at each school site. Our students are engaged in physical and Mental Wellness supports during the day and in the afterschool ecosystem. We do this with the beyond the club which use shared as a model, committee assets, and bld fighting over 70 partners. Our system of positive behavioral supports ensures student unrest in school expectation, fostering stability and reinforcing healthy Mental Health habits weor provide a sae space for students to build belonging during evening and nonschool hours. We support and train, facilitate practice with intentional hearing and understanding. We provide peer support. And intensive supports for student at risks. The department of Education Credits we were able to invest in therapeutic prevention and strategy, tps is not obviously to alone to meet the needs. To meet this challenge were implementing an ambitious plan for students for health providers. Here are things i encourage them to do together. I know budget decisions are tough, but with the message, students are telling us, we have to listen to. Pay for health Care Services with Health Care Dollars to ensure medicaid access, and incentivize schools prioritizing youth first. Building on Capital Funding opportunities. The labor grants, build hope require states to match your investment. Have we done everything we could . Not yet. We know that engagement and shared strategies, our students are more successful dealing with individual emotions and stresses, developing emotional awareness and working academically at all times. And americans and individual communities cant do this alone. We must work in partnership, we know there are egos, turf battles and we may not be united on everything, but our future with us now and we must be committed to serving youth first. Thank you. Thank you very much. Let me begin the questioning. Mrs. Russell tucker, you mentioned the importance of after school and summer programs and i think one of the things we all agree on is that were going to have to do a lot of treatment, but on the other hand, were going to have to give young people a lot of communitybased activity. Can you talk a little about the impact that increased funding for summer and after School Programs has had in connecticut . Thank you, senator. Its really important for and i appreciate that question because its such an important piece of the work that weve been doing. Under the funding, that we received 11 million for summer enrichment and we immediately put that to work and our space and added more funding for the kwen summers so were now up to 33 million of state investment around summer enrichment. Were able in that space, to really try to get the students back together, back with their peers, back in that environment and allowing them to work sometimes with Behavior Service in that space while theyre having a good time with each other so its enrichment, which is so important so weve been able now, weve also evaluated the impact of that reimbursement as i mentioned in my testimony over 108,000 students were served that first summer and now were into summer number three and were evaluating it to make sure we know whats happening and let me guess that you would Like Congress to continue that kind of project. Exactly. And ive found what works and thats why were thinking about sustainability. Same is true for after School Program and weve received funding to support. Weve significantly expanded those programs in the American Rescue plan. Absolutely. So its important that we are funding what works and thats why im so proud that were evaluating the impact of those investments. And i want you to pick up on that, again, we want to treat the millions of young people who are struggling, but we also want to challenge them we want to bring them together. We want to have proactive activities. It sounds to me like in tacoma, you are challenging young people and trying to provide job students among other things. Talk about the importance of treating young people with respect and allowing them to use their energies in productive ways. Thank you, senator. I think its important that each community has the opportunity to define what respect, responsible and see what it looks like and thats what our social and Emotional Learning plans do. They bring voice to that conversation, staff voice to that conversation and family voice. Each of our plans is published. Young people are involved in development of those plans . Absolutely, absolutely. Defining it in the locations, respect looks different in a classroom than a lunch room. And you have to build community through common language. Thats important. We bring respect and what does that look like in the after school world. How do we hear their voice and the activities that they want to participate in. Its very much an intentional effort to Bring Community together to define that, but those common words are against all towns. Im gathering that the empowerment of young people, giving them a voice in the community, has a positive impact on Mental Health among other things . We bring voice in several ways and we also hear from students. Students have asked me, they said, josh, stop asking us our opinions and bringing others to ask our opinions if the adults arent going to do anything. And thats a really important message. Voice through empathy interviews and data around positive interactions and we have a Student Voice at our board meetings. We students will vote with their feet, if you will. The increased activities and extracurricular activities, not what they want to offer, but what do they want to participate in. They dont want to be engaged in the business model, they want to know the activity of that and survey their interest regularly. Let me talk to a question. You use the term indefinite uncertainty. What impact, you know, as you walk through the streets of washington this morning, and you breathed the air, which is a result of the terrible fires in canada. Young people worry about climate change. We heard discussions as senator cain mentioned, his own School Gun Violence in the school and kids worry about gun violence and families are struggling economically. Louisiana, vermont. What impact does all of that and more have in indefinite uncertainty about worrying what the future is going to look for the young people, whether that will be a decent future from an environmental point of view, from a violence point of view, what impact does violence have on young people . Its interesting that youre asking that question. I struggle with this and a lot of us struggle with this in the Mental Health world. What children need in all ages, they need to have schedules, they need to have routines, they need to know whats expected. For example, having a schedule knowing they get up in the morning and go to school and who is going to pick them up at school and what their activity might be. What happened, unfortunately, with the covid pandemic, that changed continually, one of the things we recommended is, september a set a new schedule, and have something predictable for them, but it went on for a long time in that way and we also tried to support the parents, too, because the parents didnt have a schedule either, instead of getting up and if they went to work, go to work and doing whatever they were doing, having to balance that with educating their children virtually if they were fortunate to have internet and the equipment needed to do that and every day that changed, as well, for them. The other thing thats very important for the jung young people at their peers. Getting to know them and play with them and the older children know its more complicated with adolescence and that kind of thing and extensive use of social media. So its very, very important now that schools are open again for there to be that kind of schedule, and things that parents can count on on children can count on to be able to move forward. I also wanted to make a comment on the involvement of youth. We found out to be extremely helpful, after there was so much destruction with Hurricane Katrina, that there were a lot of teenagers who were on the streets because there was nothing there for them to do with themselves. They couldnt, there were no activities, so involved them with the recovery and teachers that have classrooms in school and they are involved with recovery so the teenagers instead of being in trouble, were able to contribute in positive ways. Thank you. My time expired. Senator cassidy. And senator susski, some schools there are parents and teachers, effectively cutting them out of their life. What does your research say about the role that parents and students are going through traumatic experiences . Its such an important issue that you bring up, senator cassidy, because we know the Important Role that parents play for children to be there for them, to listen, to advise them and to be very much a part of their lives. One of the studies that was done during covid by the workshop, sent out information to families, different backgrounds, racial groups and asked them to have their children talk about whats important to them during covid and whats going to help them, number one were the parents and the hero and parents were going to keep them safe and that was so important to them and also, from the Mental Health point of view, if parents are available, can be emotionally available and not just being there and listen to the children and be involved with activities, thats going to be very important and they will know when things are happening. Sometimes before the school will know, but obviously, that collaboration was very important, but parents play a key role in Mental Health and in supporting Mental Health of their children. And in the bipartisan Safer Communities act, the initiatives put forward for teleMental Health. And is there a role for that to be used in School Settings . We found teleMental Health to be helpful and works well generally for adolescents. They like that and theyre more used to being on the screen than others. And it is a way to stay in contact. Were very pleased that they allow a lot of Mental Health work to be done using telehealth during the pandemic because it was a way that we were able to stay in touch and help people. For younger children, it can be a little bit challenging when they want to press a button or Something Like that. But we found it to be very successful in working with teenagers, related to telehealth and hope that will continue as a way to reach them. I keep asking questions i dont know the answer to, but hearing you spoke today it suddenly occurred to me that the people that decided to lock down our economy, who have the noble goal of limiting debt or increasing isolation. Did they have psychiatrists, psychologists involved to do a costbenefit ratio, if you will, a risk benefit ratio, if we lock down well have x amount happen because of isolation, as much as foreseeable . Do you know that process . Thats why im asking. I dont know about that process, certainly, we were communicating, a number of us and talking about it and as i recall, almost every time i did an interview, i specifically recall interview with an npr reporter and took 15 minutes how can i support my children based on this. They see the holiday was coming and it was an important part of their lives. So their telecommunication was really helpful, but im not sure, senator cassidy, whether they did consult about well, hearing from you, it actually wasnt imponderable, it was predictable that when the children were isolated that there would have some of the problems that we now see, is that a fair statement . I think it is, i think in families its very clear in families where they have more resources. For example, where they could work remostly, where they could get help, where they could set up separate learning areas for a few kids, where the consistent kids wouldnt have to be afraid of covid. I know many families with resources were able to do that, but with families with fewer resources, it was going to set up an ongoing problem, including learning over time and catching up when many of these children have problems to begin with. And when i facetimed with my 8yearold grandkids, and hes got three minutes for me and hes gone. And you said that teleMental Health actually works, but a younger child they want to hit a button. At what point does it begin to work because well be asked to support the problems in schools at various ages. At what point does it begin to work or is it a little boy who has add. Squirrel, squirrel, squirrel. 8 years old and earlier, and they were were able to Pay Attention as boys and girls difference or the same . We didnt see differences between boys and girls. Earlier that age and older seemed to be going pretty well, but on the other hand we provided Mental Health services, the younger children, that was in person. I think its the really little ones because as you know, we work with very Young Children under the age of five and they have more difficulty with that, again, its the parents with them and working with them, its really a combination, its not just the Mental Health person working with 3 or 4yearold and then the parent learns how to support the child. And were finding now in Mental Health in general, even in person, but certainly virtual that involving parents, even with teenagers, with older children, is very important as a way to support them. Thank you. Thank you, senator markey. Thank you, mr. Chairman. Before i begin my questions, i want to address, make a comment about the health of trans youth. Reiterating some of what senator baldwin mentioned earlier. In the past six months, state legislators have passed 75 bills discriminating against lgbtqs americans, and gender affirming care. And drag shows, and gender affirming car and bomb threats and theyre installing security systems. A National State of emergency for lgbtq americans and the discriminatory actions and statements by elected officials at every level of government are fueling the fire and making the Youth Mental Health crisis worse. Passing bills into law is a tough process, what is easy getting the People Freedom to be themselves. What is easy is not using hatefueled rhetoric on trans kids to score cheap political points, and we need to do this, especially during pride week, to identify this as a huge problem in our country. So, i want to turn, you know, to issues that obviously the Surgeon General was addressing, but you are on the front lines. One in three teenage girls contemplated suicide, and attempted suicide last year. And one in five lgbtq youth