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Working Where It Counts: In the Schools

Larry Epp and Ayannah Brower-Jones, here at Dunbar High, and their fellow therapists have helped hundreds of East Baltimore students as part of the little-known but vitally important school-based mental health program.
A few years ago, one of Larry Epp’s students would stop by his office every single day—whether or not she had a scheduled appointment. “She needed to check in, to know that an adult was there to counsel her when she needed help,” says Epp, senior psychiatric therapist at Dunbar High School.

For students like these, and for plenty of others who are much needier, Epp provides day-to-day support and counseling—and more. He has gone out to the streets of East Baltimore in search of truant kids. He has showed up at the emergency room at the request of distraught parents. He’s provided grief counseling when a classmate is lost to an unexpected accident or street violence. Now he can add fund-raising to his achievements. Epp and Ayannah Brower-Jones, therapist at Lake Clifton High, recently organized a chamber recital by three members of the Baltimore Symphony to raise money for the school-based mental health program, part of the Division of Child and Adolescent Psychiatry’s Community-Based Services.

The program provides full-time master’s and doctoral-level clinicians like Epp and Brower-Jones to 16 Baltimore City public schools surrounding Hopkins Hospital. Six psychiatry residents each devote two mornings a week to working in the schools. In the wake of the Red Lake and other cases of multiple homicides committed by high school students, this little-known program, one that for 11 years has provided easy access to counseling services for hundreds of indigent children and adolescents in East Baltimore, has emerged as a significant force in deterring violence before it erupts.

Epp, Brower-Jones and the other counselors are visible, approachable and trained to recognize signs that a student might be considering suicide or a violent act. They work with teachers on dealing with issues that can affect mental health, like drug use, peer relationships, trauma at home and obesity. Each has a caseload of about 20 students with whom they meet on a weekly basis, but, says Jacquelyn Duval-Harvey, director of Community-Based Services, “they are really available for anyone who needs them.”

According to Epp, acts of homicide are thankfully rare in the high schools. “Because the stressors in the community are so great,” suicide, he says, is a bigger issue. A few years ago, Epp was in the pediatric emergency room almost once every month, and he was aware of at least 13 students considering suicide. One student made a suicide attempt while waiting to make an appointment with him. “Because of our affiliation with Hopkins Hospital, we can respond quickly.”

Epp and Brower-Jones also serve on a Community-Based Services committee that helps to reintroduce juvenile offenders into the school system. “This collaboration with Baltimore City Schools is an important way to see that kids who haven’t been successful in the past get some additional support,” says Duval-Harvey.

The school-based counseling program isn’t limited to students at risk. Epp and Brower-Jones organize the Future Leaders Academy, a summer program for college-bound students that includes SAT prep and college application guidance. About 25 high school students will attend the six-week summer program, meeting every weekday and including special field trips—to places like the U.S. Supreme Court—on Fridays. These students are also peer counselors for younger kids at the summer camp run by Community-Based Services.

The school-based mental health program was started in 1994 with a five-year grant from the Substance Abuse and Mental Health Services Administration. When the initial grant ran out, says Duval-Harvey, “we kept on going.” Now the program is supported by Hopkins Hospital and the School of Medicine along with federal and state funding—including grants from the Baltimore Mental Health Systems and Baltimore City public schools—and fee-for-service billing.

But, as anyone who has been involved in public-school programs knows, there’s always need for more money. The funds collected from the April 25 chamber concert are earmarked not only to support the future leaders camp and but to also call attention to school-based mental health. The general public may not know a lot about these school counselors, but for the girl who routinely stopped in at Epp’s office—and countless others—these professionals have made all the difference.

—Martha Thomas



Johns Hopkins Medicine

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