At an October 2022 National Seminar sponsored by the Education Writers Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association, declared a national state of emergency in children’s mental health.

Mental health issues such as depression, anxiety, and even suicide amongst the nation’s youth were on the rise before COVID and intensified as a result of the pandemic.  Declines in assessment scores and increases in chronic absenteeism and bad behaviors have occurred simultaneously.

When discussing the rise in Hartford Schools bad behaviors, Superintendent Torres-Rodriguez said, “I don’t see that.”  However, she apparently felt the country’s mental health crisis among school students was being mirrored in Hartford Schools (minus the bad behavior symptom), so spending ESSER funds (COVID relief money) on hiring in-house social workers to deal with the crisis was off the table.

The Superintendent’s strategy was instead to bring in a company founded in 2009, Effective School Solutions (ESS) for a 3-year run at the cost of $1.7 million per year (in ESSER dollars).  ESS deploys a team of licensed mental  health clinicians to partner school districts (13 in Hartford) to provide a higher level of mental health services than could be provided by an in-house staff of social workers.

The HPS/ESS marriage was consummated in May of 2021.  ESS’ proposed “3-year plan” was accepted by HPS when ESS applied an 11% discount to the initial contract, with additional discounts given at each 1-year renewal of the contract.  ESS came before the Board during a Teaching & Learning Committee meeting in March of 2023, seeking the 3rd renewal of their discounted mental health services contract under the “3-year plan.”

To measure the effectiveness of Effective School Solutions’ services on Hartford students, we can look to their pronouncement that better mental health leads to better school attendance, better grades, and more disciplined students.  They shared their first-year data with the Board in June of 2022, a year which they described as being “a strong success.”

Keep in mind that “success” in this context is based on the percentages measured from a group of 80-85 students, meaning that extreme numbers off the mean either way can alter your “success” measurement.  This is the number of students that ESS has worked with each year of their contract, and at the March 2023 meeting they stated their capacity was 120 students a year. 

Also keep in mind that ESS CEO Duncan Young stated that students in their 2nd year of the program show better results.  Therefore, the 80 students in year 1, and the 85 students in year 2, are in many cases the same student.  It is not as if there were 165 different students serviced by ESS over the first 2 years of the contract with HPS.

Basically then, “strong success” claims are made on the slimmest of evidence, especially when you are removing the more cost effective professional social workers normally found in schools, for the fully licensed, more expensive mental health specialists found only at ESS (not once in discussing ESS contracts has comparative shopping been addressed).  For that level of expertise, dealing with a small group of 80-85 students a year, efficacious results would be found with positive assessment measures in the 80-100% range.  When assessment measures showing the needle not moving for a third or more of those being serviced, we must ask, could an in-house team of social workers have obtained similar results?

Let’s look at the results as shared by ESS.

In June of 2022, the ESS and HPS presentation states that the number of students receiving ESS mental health services was 83.  As a measure of student outcomes, the average discipline incidents per week  “Before ESS Intake” number was .77 incidents per week, versus the “After ESS Intake” number of .54, which is a 30% decrease in average discipline incidents per week.  Looks great in percentage terms, but it started out less than 1 and ended up less than 1. 

The ESS/HPS presentation states, “44 of 62 students (71%) reduced or maintained their weekly disciplinary incidents.”  We were already told that 83 students were under ESS care, why does this statement reflect a number for 62 students only? 

Also, we expect ESS to improve on the data, “maintained” is not a measure of “strong success.”  And what is the actual “reduced” number alone, and the “maintained” number alone?  Success shouldn’t have to be colored grey.

Realizing in 2022 how silly it looked comparing two numbers less than 1 and calling the change “strong success,” ESS and HPS sought to widen the scope, for better visualization I suppose.  Rather than comparing discipline incidents per week, they now would compare average discipline incidents per marking period.

In March of 2023, ESS was now in 9 Hartford Schools, serving 85 students.  The 9 schools averaged 12.23 total incidents per marking period “Before” ESS.  “After” ESS, the 9 schools averaged 8.04 total incidents per marking period, a difference of only 4 incidents per marking period for all 9 schools. 

However, ESS and HPS didn’t present the data as such, they presented it by showing that there was a 20% drop (1.5 to 1.2) in average incidents per marking period per school. To put it another way, for every 10 students, 2 showed improvement in behavior.  

Like 2022, ESS and HPS make the statement in 2023 that “on average 71% of students reduced or maintained weekly disciplinary incidents.”  The same 71% number given for 2022 and 2023.  At least they’re consistent.  However, also like 2022, there is no “reduced” number alone, or “maintained” number alone.  And of course, “maintained” as a measurement of success is ok if you’re in a leaking boat.

While ESS and HPS try to water the flowers and not the weeds, it is the weeds that are constantly popping up in their presentation.  In 2022, ESS and HPS conspire on a GPA bar chart for 2 different marking periods, marking period 2 and marking period 3.  What happened to marking periods 1 and 4?  For MP2 only 48 students of the 83 under ESS care are accounted for.  Twenty-one (44%) students showed an increase in GPA, while 27 (56%) either saw no change or saw a decrease in GPA.

For MP3, 63 students out of the 83 students under ESS care are accounted for.  Twenty-five (40%) students showed an increase in GPA, while 38 (60%) either showed no GPA change or saw a decrease in GPA.

You will note that for the GPA assessment in 2022, ESS and HPS did not combine an “increase” in GPA with the “no change” in GPA, resulting in a less than flattering sub 50% measure of actual success for both marking periods.  They would not make this mistake in 2023.

In 2023, combining the “increased” number with the “no change” number, which they are now calling “maintained,” shows that 69% either showed an increase in GPA or maintained their GPA, while 31% saw a decrease in GPA.  And of course, we are not given a stand-alone “maintained” number to actually gauge how many students were positively impacted by ESS when it comes to grading.  Despite the grey lipstick, just under a third of the students in the care of ESS professional services in 2023 did not show a positive move in GPA score. 

When they moved on to the chronic absenteeism outcome in 2022, suddenly ESS was servicing 112 students, compared to the 83 number which they stated at the beginning of the presentation.  ESS and HPS claim that of 112 students, 84 (75%) either improved or “maintained” their attendance record, while 25% showed a “worsening” attendance record.  In this instance we are given stand-alone numbers for each category.  From this stand-alone data, it is claimed that 66% of students improved on their attendance while under ESS care.  In 2023, it is shown that students in the ESS program had a 63% chronic absenteeism rate prior to joining ESS, and a 47% chronic absenteeism rate after joining ESS. 

Their “student outcomes” data and their “impact of services” data is underwhelming and their presentation of that data an obvious attempt at obfuscating their failures.  Keep in mind, this is data described by ESS and HPS as showing “strong success” and revealing “great outcomes.” 

ESS tell us in 2023 that they surveyed the students in the program to gauge their opinion of the program.  Only 33 of the 85 students in the program took the survey, however, of those who did take the survey, 84%, or 27 students, called the program “helpful.”  This group is only a third of the kids in the program.

ESS said they also asked the parents for their opinion on the program, only 25 parents responded to this question.  However, 84% of parents who responded said they were “satisfied” with the results, which means that 21 parents were satisfied, while 64 stated they were unsatisfied or showed they were unsatisfied by ignoring the survey.

Which probably isn’t far from the truth.  Another important element in “improving” a student’s mental health according to ESS, is to “strengthen the bridge between home, school, and community.”  However, in 2022, with 4,220 sessions held by ESS clinicians, only 12% of these involved family.  In 2023, family was further blocked from the ESS “bridge” as only 11% of 6,758 sessions were with family. 

Who best to build a “bridge” to the school than a teacher, right?  In 2022, ESS clinical sessions with a teacher occurred 2% of the time, in 2023, only 1% of clinical sessions involved a teacher.  This, according to ESS, is an example of a “very strong partnership.”  That’s a bridge only Indiana Jones would cross.

The strength of the partnership between HPS and ESS varies depending on which member of the Superintendent’s team is giving the appraisal.  At the March 2023 meeting, Board Member Browdy asked if there was a plan in place for HPS to be able provide these services in-house, rather than spend nearly $2 million a year on dubious outcomes. 

The Superintendent’s Assistant Superintendent of Special Education, Jennifer Hoffman, replied that “mainly” they are looking to “sustain” the partnership with ESS.  ESS is being paid with ESSER funds, which run out in September of 2024.  Ms. Hoffman said that they would need grant money in order to “sustain” the partnership.

Board Member Walker asked the same question at an April 2023 meeting concerning the contract continuation with ESS.  Questioning the cost effectiveness and cost benefit of the ESS partnership, Mr. Walker wondered if there were community partners available to provide similar services. 

The Superintendent’s Acting Deputy Superintendent of Academics and School Leadership, Madeline Negron, stated that this year is the last year of the original 3-year plan with ESS, so the plan is to create an in-house team to provide similar services, “we can do it on our own,” she stated, if staffing is available.

However, as reasonable as the reasons for creating an in-house mental health team appear to be after 2 years of ESS data, the Association of American Medical Colleges (AAMC) states that there was a mental health staffing shortage prior to COVID, and that shortage, like all others, has been exacerbated since COVID with the increased need for mental health services by everybody.  The AAMC state in 2022 that more than 150 million people live in federally designated mental health professional shortage areas, and within a “few years,” the country will be short between 14,000 and 31,000 mental health workers.

And if you can find them, it is hard to hold onto them.  Something HPS has trouble doing with teachers, imagine what their retention rate of mental health workers would look like.  A 2019 report published by the National Institute of Health (NIH) states that between 30 and 60% of therapists leave their “organization” each year.  Like the leaking teacher pipeline, the high turnover rate of mental health workers has created, according to the NIH report, an environment of poor staff morale, reduced productivity, weaker work teams, and increased costs of training new employees.  So, yeah, it looks like ESS has HPS over a barrel.

Board Member Walker related to Dr. Negron at the April 2023 meeting, that he had spoken with a licensed social worker at a Hartford elementary school who stated that her skills and training were not being utilized by HPS.  Instead of hands-on work with students, she is doing administrative work.  Dr. Negron said that would be “worrisome,” however, she stated, “it’s one story across the district.”  Is it?

There are many complaints from teachers whose skills and training are not being recognized or leveraged by Superintendent Torres-Rodriguez’s administration, and now we hear similar complaints from mental health professionals employed by the district. 

Superintendent Torres-Rodriguez is blind to student behavior when it suits her, and with under utilized teachers and mental health staff she is blind to the possibility that this may be the root of much of HPS’ educational and mental health failings.

After following this district’s administration and school board, I’m going to need a psychiatrist.