To Combat Teen Suicide in Montana, This Coalition Unites Philanthropists, Schools and Healthcare

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To Combat Teen Suicide in Montana, This Coalition Unites Philanthropists, Schools and Healthcare

Sponsored: Grant funding plus a partnership with the local hospital allowed the administration to embed a psychologist inside one high school.

In recent years, Livingston, Montana — the county seat of Park County nestled along the Yellowstone River in the southwestern part of the state — has grappled with the heart-wrenching problem of teen suicide.

In 2016, two Park High School students in the town of just under 7,700 people died by suicide. 2018 saw another teen take his life. As of 2020, Montana had the third highest suicide rate in the nation. Figures from 2018 show that, over the prior 10 years, suicide rates increased by 26% statewide, and by 36% in Park County.

Community stakeholders came together to address the crisis themselves after the pair of 2016 suicides. In 2017, LiveWell49 Coalition was established, which is a diverse group of stakeholders working to enhance and improve the culture of health and wellness in Park County through creative community solutions and effective outreach. The group is a collection of community stakeholders working alongside healthcare leaders, public and school officials, and even students themselves to tackle problems such as teen suicide.

The group established the LiveWell49 Resilience Project later that year and began working alongside community partners, chiefly the city’s full-service hospital, Livingston HealthCare, to boost mental health support in county schools — particularly Park High School. “We knew we needed to try to identify kids with mental health needs that were not on our radar,” explains Jessie Wilcox, Livingston HealthCare’s community health coordinator and LiveWell49’s facilitator since its inception. Another partner, Rural Behavioral Health Institute, provides digital screening for anxiety, depression and suicidality; they operate within Park High School and are scaling to other schools as well.

In a small community with limited resources, it’s important that dollars go as far as possible to address the problem. That meant mapping out the work of each stakeholder from the beginning to ensure there’s no duplication of effort or funding. “We can be stronger together and we don’t have to recreate the wheel,” Wilcox says. “This way we’re being efficient with our community funding so that no two partners are doing the same thing.”

The group identified the need for an additional conveniently accessible dedicated mental health practitioner in the high school. Livingston HealthCare had already partnered with the school to start the Ranger Clinic, a part-time health clinic staffed with a physician’s assistant inside the school. But to address teen suicide effectively, a stronger focus on mental health would be necessary.

Thanks to a grant from the Arthur M. Blank Family Foundation, LiveWell49, the school, and the hospital worked together to bring Dr. Chris Spromberg, a licensed clinical psychologist, on board in 2020.

“I’m co-located,” Spromberg says of splitting his time between the hospital and the school, where he works from the Ranger Clinic two days a week. “It’s taking a healthcare provider and putting them in the school and increasing the proximity and physical access [to the student body].” Spromberg bills private insurance for his time in the same way that he would if a patient came into the hospital. But that doesn’t mean that uninsured kids are out of luck. “I just find unique, fun ways to check in with them,” Spromberg says of his informal efforts to connect with kids regardless of their insurance status.

Attending to mental health is still stigmatized, especially among teens, but thanks to the presence of the conference-room-turned-Ranger Clinic and Spromberg’s office within it, from the outside it looks as if kids are just popping in to see the school nurse. “I’m here to help [the kids] get back on their feet, engage in school, engage in their health care, or just get them what they need to get through the season. It’s about being resilient. My goal, especially for kids these days, is resiliency — that we can do hard things,” he says.

But Spromberg doesn’t just wait for kids to come to him to make a difference. “The hospital has given me a lot of leeway. I don’t need to have eight patients scheduled for the day. Sometimes I think I’m best served by helping the special education teacher out and giving them some strategies or a better understanding of a student I’ve met with a handful of times,” he says.

Part of the program’s success can be attributed to securing parental buy-in from the start. A consent form comes with the welcome packet that parents get at the beginning of the school year. This way, when an issue comes up with a kid, Spromberg can quickly check if he’s allowed to see them and then do so on the spot, without delaying treatment during a time of crisis to secure permission.

Another element of Spromberg’s success was the slow and help-focused approach he took with everyone he came into contact with from the start. “Initially there was a little bit of ‘who is this new guy?’ There was a little bit of apprehension,” he says, around someone who had come from Portland, Oregon to help out.

For the first six months, Spromberg dedicated himself to being helpful however he could. He says the approach was, “You let me know where I can fit in, instead of, here is how you can fit into my scheme.” Over time, “I earned my right to be heard, which was important.” He continues, “Now they turn to me for all sorts of things, so I can be beneficial on a lot of different levels.”

“We want to meet kids where they are,” says Lori Dust, principal of Park High School. “But we’re educators, we’re trained to educate. We have all of this other stuff on our plate — and I think we do a great job with it — but it’s a lot. So, when we get help from Dr. Chris,” as Spromberg is called at school, “it’s such a relief, because he’s in the therapeutic realm.”

“We lean on him,” Dust continues. “He receives our hardest cases. Not only does he help our kids …he can guide us on different ways to help the kids and it’s just great.”

The team of support staff embedded in the school includes the school resource officer, traditional guidance counselors, mental health practitioners supporting students with a diagnosed emotional disturbance, internal administrators and even youth probation officers. For Dust, adding Spromberg into the mix means that “we really have all of the players in the same room, and we can take a comprehensive approach to what’s best for our kids. Dr. Chris gives us that, and our kids really do benefit from it.”

Cinnamon Janzer is a freelance journalist based in Minneapolis. Her work has appeared in National Geographic, U.S. News & World Report, Rewire.news, and more. She holds an MA in Social Design, with a specialization in intervention design, from the Maryland Institute College of Art and a BA in Cultural Anthropology and Fine Art from the University of Minnesota, Twin Cities.

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