Liz Unruh (Host): Hello listeners, and thanks for tuning in to the Well Within Reach podcast brought to you by Riverside HealthCare. I'm your host, Liz Unruh, and joining me today is Marla Barnard, who is our school liaison for the Riverside Behavioral Health Department. Thanks for joining us today, Marla.

Marla Barnard, LCPC, MA.Ed: I am so happy to be here. Thanks for inviting me.

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Host: And we're back. So, today we are talking about something that happens beyond the classroom in schools, and it's our Hospital School Liaison Program. Before we get into that program and what it all means for our communities, can you tell us a little bit about yourself, Marla?

Marla Barnard, LCPC, MA.Ed: Yes, I am a Licensed Clinical Professional Counselor. I do case management at Riverside. I also am a clinician. I, have worked on the behavioral health unit at Riverside, working with families, working with kids, working with adults, leading groups, facilitating groups. I've been at Riverside for about 12 years, and prior to that, my history is in school education.

I'm a licensed I'm a teacher, Type 09 certification, as well as having my administrative certification, Type 75. So I spent a lot of years in the schools, and I now spent a lot of years at Riverside, and I'm back in the schools, and they just kind of go hand in hand.

Host: Yeah, they do. I assume you have a lot of experience working with kids then with your, being a teacher and then coming and working at Riverside.

Marla Barnard, LCPC, MA.Ed: I would agree with that. Yeah. Kids, people, people in general of all ages.

Host: So now that we've learned about you, we know that you have a great background, to be one of our school liaisons. Can you tell us about the main responsibilities of your role as liaison between the schools and our mental health services?

Marla Barnard, LCPC, MA.Ed: Riverside partnered with local school districts to provide students with individual and group therapy services. And then these services are facilitated by licensed clinicians. And we actually go into the identified school and provide therapy on an individual or group basis.

Host: Okay, so that's a great service that's provided because I know that's often a gap that people see in schools is that there's not that opportunity to have those services.

Marla Barnard, LCPC, MA.Ed: Well, there's a great need. I've been in this position. This position was kind of created as there was a need in the community. As we know, Riverside is very cognizant of community and our community needs and within the past three years, it's been well identified that we need help, additional help in the schools.

Host: Yes, for sure.

Marla Barnard, LCPC, MA.Ed: And so, Riverside made that happen.

Host: Yeah, I think it's a great partnership with the schools to show we do care about the communities.

Marla Barnard, LCPC, MA.Ed: We do.

Host: Around us.

Marla Barnard, LCPC, MA.Ed: We do.

Host: So what does a typical day often look like for you?

Marla Barnard, LCPC, MA.Ed: Well, depending on the day, I am in schools five days a week. Now there are two and a half behavioral health school liaisons, and I say two and a half because I am in school five days a week, and then our other school liaison is in schools five days a week, and then we have a third person who goes to one school for a half day, just to kind of keep up with the demand.

And so a typical day is, depending on the week, I will go to my school, usually report eight o'clock, quarter to eight, and then, we just start meeting with kids. I start meeting with kids, and the kids that I see are by request of the school counselors, the school social workers, some of the families for some of the problems that they have, so I get my list from them and then the schedule stays the same because we're navigating many schools throughout the week, so we stick the same day, and then, pretty much the same kids as well, and then we reassess maybe after the semester or a quarter to see if this child still would benefit from our services, and sometimes they do, sometimes they go through the year, and then sometimes they can stop, and then we bring in new kids or stay with the kids that we have.

So the typical day is going and counseling kids. I would say that every day is the same, but every day is different. Like I do the same thing every day, but every day is different depending on the needs and, the kids.

Host: Yeah, those kids that you're seeing, and obviously you see like different kids on, different days.

Marla Barnard, LCPC, MA.Ed: I do.

Host: So that's definitely, your day looks similar, but not exactly the same every day.

Marla Barnard, LCPC, MA.Ed: That's right, Liz.

Host: Yes. Are there some common mental health challenges that you're seeing come up often in schools today and are there ways that you work with the schools to address those common topics?

Marla Barnard, LCPC, MA.Ed: A common thread is there is an increased level of school anxiety. COVID didn't help. And an increased level of depression. There's some anger issues. So these are kind of the common home life issues that we work with. A lot of anxiety and of course school anxiety turns into school refusal.

Host: Yes.

Marla Barnard, LCPC, MA.Ed: And as we know, the only cure for school anxiety is to go to school, but then, God bless the parents. They just want to help and they just want to feel like, they're doing the best by their child. So they engage in this rescuing behavior, like, okay, I'll let you stay home. And then that just manifests the anxiety that increases.

And then of course, the more we avoid things, the worse it gets in our own minds. So that's real common. And they're not alone, and we say to parents, you are not alone. Let us help you. Pass the baton. Let us help you with this. But in addition to that, there's some outliers, I've done some groups where all of the kids had an incarcerated parent.

I've done some grief groups where kids at a very young age have lost a parent, some abandonment issues. So, it's life. It's the hard side of life so those are some common themes. And of course, school bullying. And the low self esteem and social media. Don't get me started on social media.

Host: Oh yeah.

Marla Barnard, LCPC, MA.Ed: Because that would be another podcast.

Host: Oh yeah.

Marla Barnard, LCPC, MA.Ed: The perils of social media and how they just use it as a weapon of mass destruction when it's not monitored and the kids base their worth on how many followers they had and who said what to them and they just don't see how destructive that it is. So there's just a number of issues and like I said, it just depends on the day.

Host: The social media, I could definitely see you. We could talk for a whole hour probably on that.

Marla Barnard, LCPC, MA.Ed: Yeah, that's another session, Liz.

Host: Yes. I think you bring up a lot of common things that a lot of kids deal with, and it does impact their ability to have that school anxiety. Oh, I can't leave for school because my parents is gone and, those things I'm sure build on each other.

Marla Barnard, LCPC, MA.Ed: And the feeling or the faulty narrative that no one else on this earth could possibly be going through what I'm going through and could possibly understand my level of pain or my level of shame. And so they just feel alone, and lonely people tend to isolate themselves more. And we're saying, come to us with open arms, and the schools are wonderful in facilitating the needs and it's just a wonderful partnership.

Host: Yes, for sure. So as you go into the schools and you're meeting with maybe some students you haven't met with before, how do you go about building the trust with the students and the parents and the school staff when addressing these mental health needs of the students?

Marla Barnard, LCPC, MA.Ed: Well, that's a great question because I think this is changing, but the stigma related to mental health. And a lot of people feel like, well, what happens in our house, we just keep it in our house. We can work this out.

So building trust is full disclosure. Here's who I am. Here's what I do. Because sometimes kids will say, I don't need to talk to you. And I respect that. And I say, this is absolutely optional. You do not have to talk to me, but are you willing to just give me a chance? And can we just talk and see how it goes?

And then oftentimes they say, okay, I'll come back. But it's just, here's what I do, and here's what I want to talk about, or what would be helpful to you to talk about. And the parents sign a consent before I ever even meet with their children. So parents are fully aware. So building the trust comes from the education, changing the stigma of here's what we do and here's what we can kind of help with.

And then in that process, they're very open and saying, okay, well I get mad a lot. And so then they start to talk and then it becomes easier. I think it's the connection. It's how do we build trust with anybody? We listen. I hear you. I'm not trying to tell you what to do. We know how I think. I wanna know how you think. Just that human connection and building relationships.

Host: Yeah.

Marla Barnard, LCPC, MA.Ed: We show an empathy, compassion, an understanding.

Host: Yeah, I think showing that you understand that you might not have had the same experience, but you're willing to listen is huge.

Marla Barnard, LCPC, MA.Ed: And, oftentimes, parents are a little reluctant because, well, what's my child going to say? And then I invite parents. I say, you are welcome. This is my time slot with your child. Tuesdays at 9:30 a. m. Please join us if you would like to.

Host: That was going to be something else that I was curious about. What role the parents or the families play in the process? And like how would you tell them or ask that they support their student or their child?

Marla Barnard, LCPC, MA.Ed: As the Behavioral Health School Liaison, I don't spend a lot of time talking to the parents, and that comes from the school, but having said that, I have talked to parents, I have called guardians, so they're there if they need to be.

 And so we just offer, here's how we can help you, but oftentimes that would go to the school, but I said just last week in one of my schools, I said to the boy, you know, I mentioned the mom, and he said I would love it if my mom would come and talk to us because we just don't get along.

And that's a, you know, well you're a teenager and Yes. Okay. That's not unusual.

Host: That's not unusual at all.

Marla Barnard, LCPC, MA.Ed: So that is certainly an option. And I am certainly there and I have given my phone number to parents. However, nothing is engraved in stone and everything is an option.

Host: Mm-Hmm.

Marla Barnard, LCPC, MA.Ed: Anything.

Host: I think that's good. So I know that we talked about sometimes kids don't necessarily want to talk to you at first. What are some of the biggest challenges that you face when trying to connect with the students, with yourself as a resource, but also other resources that might be available to them?

Marla Barnard, LCPC, MA.Ed: Every once in a while, we have a child, individually or in a group, that the school says, you have to do this. Or, we're really concerned about your safety, your well being, the safety of others, if you don't do this. So the child that feels forced, there's a little resistance. And so, we ultimately try and empower them.

I didn't see anybody carry you into this room. You walked in on your own and that took a tremendous amount of courage and bravery and honesty and I appreciate that. Let's just talk. So everybody's a little different. Some kids are just so easy. They'll just sit down and then just tell you everything and then other kids, you really have to ask the right questions, the reframing and helping them change their faulty narratives and just to set their fears at ease.

But most, I would say, very willing, because it's like, finally, relief. Finally, help is here. I don't just have to stay home.

Host: Someone is here to listen to me. Yeah, I think that's really big. We're going to take a quick break for a moment here to learn about primary care.

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And we're back. Can you share any examples of any success stories or collaboration between the school, social workers or case managers, and like yourself or our team here at Riverside has made a positive impact on a student life?

Marla Barnard, LCPC, MA.Ed: Yes. Last year, I was called to a particular school and they were really struggling with a second grader who had such school anxiety that the parents pulled him out of school to homeschool him. Now, my personal feeling is homeschooling is not a great solution when your child is afraid to come to school.

 So the school called me and then I actually met with the parent, the parent and a couple of family members came and met with this boy, just sweet as can be, but just so afraid of school, afraid of the weather, afraid that something's going to happen to my mom and dad if I'm not at home.

Something's going to happen to my sister, so I just have to be at home. So he was not enrolled in school. So then we started working with the parents and the child. And then we got him coming to school. And it was a struggle. Sometimes they had to really try and escort him in, but the long story short was, as we got him coming to school, there were some other real anxiety issues to deal with, and then he stopped coming to school, so then we had referred him to our outpatient program, Pathways, and that's a wonderful program.

The outpatient program and so he came to that for a little while and then he was a little more confident to go to school. So now, fast forward a year, and he is thriving in school. Yeah. So that was a real success story, but I feel like we have a lot of those. When we listen to people and we work together, that was the school, that was the school liaison program, that was Pathways. So that's probably one of many.

Host: Yeah, I think that's a really great example, knowing that, that child went from being like, I'm not going to school at all, there's all these things that are just going on in my mind to being able to go, okay, I'm okay going, and I'm sure there's still barriers that they face, but.

Marla Barnard, LCPC, MA.Ed: But now they're given the tools to handle those problems, whereas before they didn't have the skills or the tools necessary. It's like being a mountain climber. I mean, we all know in this thing called life, there are mountains before us, but people who are successful at climbing mountains, they use the right tools and the right safety harnesses, equipment.

And so that's a great analogy for life. It's, I just need the tools, because we can do the hard things, but sometimes we need help believing, and we need to be shown. And kids that we meet with in this program are very receptive to that. Because like I said, I didn't see anybody carry you into this room. And one kid says to me, he said, I just really like Thursdays, at 8:30. I was like, well, I like them too.

Host: Yeah. I think that's important. Then they learn if they have the school anxiety, they know, okay, well, Thursday at 8:30, I know that I'm going to have that time to talk about it, you know.

Marla Barnard, LCPC, MA.Ed: And some of it is talk therapy. Some of it is play therapy. Sometimes we get out the clay and work on shaping because you'd have a lot of natural conversations when you're doing other things.

Host: Yes. Oh, for sure. Well, my last question for you here today is what would you like schools and our community to understand better about the importance of accessing these mental health services such as a school liaison program and having those early interventions for students?

Marla Barnard, LCPC, MA.Ed: We are one phone call away. We are here, we are readily available, and here's another incredible thing that Riverside did. When we first started this program, I was the only hospital school liaison. So then as the demand increased, Riverside hired another Behavioral Health School liaison because more schools were saying, we want to do that too.

Then we hired that other part time person. And so schools, all they have to do is just call and realize they're not alone and there's help. And, the one piece of advice that I give people is if, something's not working, let's just try something else and we're something else. I was going to say, well, you're something else, but, but what I mean is we can change the trajectory just by doing something different.

Host: Yeah. They always say like the one butterfly wing can make all the difference in a student's life and that's just that one little change can mean all the difference.

Marla Barnard, LCPC, MA.Ed: Don't be afraid to ask for help. And sometimes people don't know what to ask for. And so all we would say is just make a phone call and we'll help get the rest sorted out.

Host: Yeah, for sure. Well, thank you so much Marla for joining us today.

Marla Barnard, LCPC, MA.Ed: Well, it was my absolute pleasure to be here. I'm always happy to talk about the good things that people are doing and helping and trying to shed light and just helping people to feel better.

Host: Yes, and highlighting those community ties that we have is always good. We love giving back to the community, especially to our students, and the schools.

Marla Barnard, LCPC, MA.Ed: Can I give a phone number?

Host: Yes, for sure.

Marla Barnard, LCPC, MA.Ed: Okay, just call. This is our outpatient program.

This is how to call and ask about the school liaison, 815-936-7373.

Host: Yeah, that's great. And they can call that and get through and ask all their questions.

Marla Barnard, LCPC, MA.Ed: Sure can. And they can also call the school, but they can call us directly as well.

Host: Yes. Well, thank you, Marla, again, and thank you for tuning in to the Well Within Reach podcast with Marla Barnard with Riverside Behavioral Health and your host Liz Unruh. To learn more about the services provided by Riverside's Behavioral Health Department, visit our website at riversidehealthcare.org or call our Central Intake Department at 844-442-2551.