Silent struggles: Grieving Houston-area students’ well-being at stake as COVID-19 funds fade – MMHPI – Meadows Mental Health Policy Institute
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Silent struggles: Grieving Houston-area students’ well-being at stake as COVID-19 funds fade

This article was published by Houston Landing on January 4, 2024.

Each day after his shift as a machine operator, Eliberto Ortega used to walk through the front door of his east Houston home, take off his steel-toed work boots and call out, “¿Quién es la princesa de Papá?” meaning, “Who’s Papa’s princess?”

His daughter would holler back her own name, bolting into his arms. Ortega would scoop up his little girl and, after the hug, she would ask to carry his lunchbox into the kitchen.

It’s been over two years since Ortega’s daughter, now 8 and a third-grader at Houston ISD’s J.R. Harris Elementary School, has felt her father’s embrace.

Ortega died of cardiac arrest while sick with the coronavirus in July 2021. Since then, there’s been a father-sized hole in the lives of Ortega’s daughter and her younger brother, who is 7. His daughter still struggles at times to sleep at night, as swirling memories of her dad occupy her thoughts. His son has become more reserved, listening to music about loss and longing.

HERE TO HELP IN GREATER HOUSTON
While many local school districts are struggling to keep up with students’ mental health needs, many districts and outside organizations offer free services, including:

  • Counseling and therapy
  • Hotlines staffed by trained professionals
  • In-person and virtual classes
  • Suicide prevention support

To learn more about what’s available, click here.

“We still have an invisible string to him all the way up to heaven,” said Ortega’s daughter, whose name is being withheld by the Houston Landing due to the sensitive nature of discussing her mental health. “He’s with you. It’s connected with you but you cannot see the string.”

In Harris County, thousands of students continue to grapple with the long shadow of grief cast by the deaths of parents and caregivers from COVID-19. Yet today, with federal stimulus funding for schools drawing to an end and state lawmakers dedicating virtually no additional money for public schools during the 2023 legislative session, education leaders are starting to make tough choices about whether to maintain mental health support for children like the Ortegas.

Their decisions will have lifelong effects for students quietly struggling with their anguish. Researchers have found the sudden loss of a parent trumps all other traumas when it comes to impact on academic performance.

“​​Those kids who don’t want to think about or talk about what happened tend to struggle longer,” said Julie Kaplow, executive director of the Trauma and Grief Center at the Texas-based Hackett Center for Mental Health. Professionals trained in trauma-informed care — including those placed at schools — can help children process their grief in a healthy way, she said.

No government agency has tallied the number of pandemic-bereaved children in the Houston area, but the number might reach about 5,000. An estimated 41,000 Texas children lost a caregiver to the virus, according to a tracker maintained by the Imperial College of London, and about 12 percent of the state’s coronavirus deaths occurred in Harris County, Texas Health and Human Services data show.

A 5,000-person estimate could understate the magnitude of the losses because parent deaths due to reasons other than infection, such as drug overdoses and other health issues, also increased nationwide during the pandemic.

A family man

In the Ortega family, before the virus that changed everything, Sundays meant time with Dad.

It was the one free day in Eliberto’s six-day work week, said Laura Ortega, his widow. After going to Mass in the morning, the afternoon would become an adventure of his design. Many weeks, the family would enjoy a bite to eat, then head to a flea market. The four would peruse the multicolored stalls and his daughter would ask to go on rides that her younger brother was still scared of. Eliberto, relishing the chance to spoil his daughter a little, would always say yes, Laura said.

The husband and wife met at a Houston nightclub when Laura was 19, him coaxing her onto the dance floor. After that, the couple dated for several years, at first only meeting up at parks to swing on the swing sets, then later watching Eliberto’s favorite Spanish telenovelas and dancing together to música norteña. Eventually, they married.

Both dreamed of becoming parents, but Laura struggled to get pregnant. Several years later, when her belly started to swell, it felt like a miracle. A second child followed a year afterward. It felt like everything was falling into place.

But one evening in 2021 shattered the future Laura had pictured. Eliberto, who had tested positive for the coronavirus earlier that day, took a rapid turn for the worse. As his children slept in the same room, his breathing became raspy, his lungs closing in on themselves. His eyes rolled back into his head as he slumped in his chair. A trickle of blood slid down from his nose.

Laura Ortega closes her eyes and readies to take care of her two children before exiting a room covered with frame photos of her husband, Eliberto Ortega who died in July 2021 due to complications from COVID-19, on Sept. 27, 2023, in east Houston. (Marie D. De Jesús / Houston Landing)

Desperately, Laura tried speaking to him. She got no response.

“I literally felt at that moment like he took his last breath in my face,” Laura said. “Because after that, I didn’t feel his heartbeat. I didn’t feel nothing.”

Emergency medical staff arrived at the home to perform CPR and transport Eliberto to the hospital. But hours later, doctors pronounced Eliberto dead.

The next day, the kids arose to an alternate universe. As the news sunk in, the brother and sister spent the following days alternating between bewildered silences and hysterics.

It was late July, just a few weeks before the first day of school. The return to classes would inevitably mean classmates and teachers asking her kids how their summers had gone. Laura decided she had to get them help from a counselor.

Mental health needs mount

Across Texas, schools saw a surge of demand for the sort of services Laura was seeking.

The Texas Education Agency’s School Mental Health Task Force found a “staggering increase” in the rates of students experiencing depression, anxiety and other mental health concerns since the pandemic, according to its 2023 report. About half of roughly 750 school districts surveyed by the task force reported rising rates of “distress related to trauma and grief.”

Sean Ricks, senior manager of HISD’s crisis intervention team, said he saw a surge in student psychological challenges during and after lockdown. The district launched a 24/7 crisis hotline that fielded about 600 calls, according to HISD.

“If I can just use the Richter scale … we were used to tremors of 2.5 or 3,” Ricks said. “At the return of the students to school, I would say it was probably a 5.5 or 6.”

A shortage of psychological support for students has long plagued Texas public schools. For nearly a decade, zero districts in the state had all the recommended ratios of counselors, nurses, psychologists and social workers, a 2022 Houston Chronicle investigation found.

But facing never-before-seen levels of psychological distress among students amid the pandemic, and simultaneously flush with cash thanks to the passage of a federal stimulus package that sent billions to Texas campuses, districts began investing in mental health.

As of 2022, Texas schools had spent $64 million in pandemic relief grants on student mental health needs, according to data the TEA provided to the Landing. All told, districts planned to devote over $300 million to the issue, according to a 2021 federal report, the most recent available. The vast majority of the spending went to bringing on new staff, the TEA data show.

The investments spurred tangible, though modest, increases in the number of adults that students struggling with their mental health could turn to.

Statewide, schools added about 820 school counselors and 230 social workers from 2019-20 to 2022-23, according to the Landing’s analysis of TEA data. The change nudged the number of students per counselor or social worker statewide from 389 down to 363. Although school counselors in Texas are required to have training in mental health support, their jobs typically also involve helping with scheduling and making plans for after graduation.

In HISD, which lags behind statewide averages in mental health resources per child, the shifts were more extreme. Over the same period, the student-to-counselor-and-social-worker ratio decreased from 793-to-1 to 547-to-1. HISD also brought on more staffers known as “wraparound specialists” meant to address students’ non-academic needs and added seven Sunrise Centers this year that offer free psychological services.

Families like the Ortegas would finally have better access to the services they were looking for, it seemed.

‘They never call back’

That’s not exactly how the situation played out for Laura.

Before the 2021-22 year began, just weeks after the death of her husband, she spoke with leaders at her children’s elementary school. She explained what her kids had experienced and asked what counseling services might be available. To her astonishment, she learned the school did not have a counselor.

 

J.R. Harris Elementary, facing a tight budget, had no guidance counselor to start the 2021-22 school year, Principal Jessica Rivero confirmed during an early September community event attended by the Landing.

In the meantime, without options at her children’s campus, Laura looked for psychology practices after she enrolled in Medicaid following Eliberto’s death. Medicaid had suggested several providers, so she went down the list calling every number. It yielded nothing.

“They will just say, ‘Well, you can call this place, and you can call this place, and you can call this place,’” Laura said. “And you call them, but they never call back.”

The lag time without access to counseling meant Laura’s children spent roughly six months going to school every day, attempting to maintain a semblance of normal life, with no outlet to process their loss other than with family members who were also grieving.

That unmet need can be dangerous to children, said Bradley Smith, director of the University of Houston’s school psychology doctorate program. Young people often need therapy catered to dealing with traumatic experiences in order to process them in a healthy way, he said.

“The saying, ‘Time heals all wounds,’ that doesn’t really apply to trauma,” Smith said. “Just the passage of time doesn’t automatically take care of things. And so I think we have a lot of kids walking around that are still experiencing negative effects of the pandemic that haven’t been worked out.”

J.R. Harris Elementary ultimately added a school counselor midway through the 2021-22 school year. While the counselor was not a child psychologist, she agreed to meet regularly with Laura’s children throughout the spring semester. The school later added a second counselor.

Talking about the loss of their dad in one-on-one meetings over the course of months helped Laura’s children begin to heal, she said. Then, in mid-2023, Laura finally found a therapy practice that would accept her insurance. Her kids now attend sessions regularly.

Still, it can be hard for Laura to gauge how her children are processing their grief.

This past summer, she received a troubling report from a staffer at her son’s YMCA camp who said she saw him cutting himself with scissors on two occasions. The second time, the staffer said she asked Laura’s son what he was doing, and he said he wanted to be with his father.

The episode triggered her own memories of childhood trauma for Laura, who cut herself when she was young while struggling to find an outlet to process difficult experiences.

“I want to make sure he doesn’t go through the same thing I went through, that it was hard to get somebody to help, or to listen, to hear me out,” Laura said.

A fiscal cliff

Some of the mental health resources that Texas schools invested into supporting students’ mental health may now be in jeopardy.

The federal stimulus money that helped fund many positions will end in the fall of 2024, meaning districts will soon have to make tough choices about whether to keep or cut any recently added roles.

And state lawmakers, despite a nearly $33 billion surplus, ended their legislative sessions in 2023 without dedicating any new mental health funds to Texas public schools. One bill promised $100,000 or more per district for students’ psychological needs, but it died early in the legislative process. Barring an unexpected call for a special session, schools will not see significantly more funding until 2025 at the earliest.

That means school leaders likely will have to decide whether to pull money from other sources, such as teacher salaries, to pay for keeping recently added mental health services.  Those decisions will play into student learning, said Brian Woods, deputy executive director of advocacy for the Texas Association of School Administrators.

“A student with mental health needs, just like a student who’s hungry or can’t see well, is going to really struggle academically,” Woods said.

In HISD, district leaders hired seven “intensive mental health specialists” for positions that will not extend beyond the deadline to spend federal funds this year, spokesperson Joseph Sam said.

Nearby Fort Bend and Conroe independent school districts added six and 10 new mental health-related roles, respectively, thanks to stimulus funds. The positions will remain indefinitely, district officials said.

And Katy Independent School District said it has yet to decide the fate of 20 roles funded by the stimulus package, which totaled $4 million and included counselors and social workers.

Districts that decide against retaining pandemic-era mental health support fit into a troubling trend, said Kaplow, the Hackett Center grief specialist. People are eager to forget about COVID-19 and its lasting effects, she said.

“I do think it is in the rear-view mirror of most individuals,” Kaplow said. “I think that the silence around it is making it even more difficult for the children and families who are grieving.”

Laura Ortega closes her eyes as she looks at a framed photo of her husband Eliberto Ortega on Nov. 2, 2023, in Houston. Eliberto died of cardiac arrest while sick with the coronavirus in July 2021. (Marie D. De Jesús / Houston Landing)

‘He’s watching them’

Laura does her best to erase the silence and show her children that it’s OK to talk about their father. She frequently sports the cowboy boots her husband bought for her last birthday before he died. She keeps a locket around her neck that, when the light hits it right, reveals an image of the couple stealing a kiss.

She and her kids still sleep in the same room where her husband died because there’s no extra space in the house they share with their cousins. On the wall, she hung a framed picture of her children’s father wearing a white cowboy hat and tan blazer, hands stuffed into pockets, eyes shadowed by the brim, but gaze strong and directly into the camera. A teddy bear named Eric, Eliberto’s nickname, sits on the bed.

Laura’s son said he often brings his father’s voice to mind. If he needs help staying calm, like if someone is annoying him at school, he remembers Eliberto.

“In my head, I don’t forget him,” Laura’s son said. “I know, if I forget him, I’m never going to know him anymore.”

Now, in lieu of the old rituals the family had, they have created new ones. Every Sunday after church, Laura and her children visit Eliberto’s gravesite. Most of the time, the kids race through the headstones in a game of tag or soccer.

Meanwhile, Laura sits by the stone marker, enjoying the fact her children can, once again, play in the presence of their father.

View the full article from Houston Landing