Vermont Legislature SmartTranscripts:

[Rep. Leslie Goldman (Member)]: Welcome, everyone. It is February 11,

[Rep. Daisy Berbeco (Ranking Member)]: 01:15 in the afternoon, and we're here to talk about suicide prevention. We're going to start with Kelsey Stassef, who's going to lead us into the conversation talking about suicide care supports and services.

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: For the record, my name is Kelsey Stabsef, and I'm the Executive Director of Northeast Kingdom Human Services, but I also serve as Co President of the Vermont Care Partners Board. So first of all, you for having us in to talk about suicide and the supports and services that are provided in FMA. I really appreciate that. So just as a reminder,

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: we go.

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: So just as a reminder, Vermont Care Partners is a network of designated and specialized service agencies that do mental health substance use and developmental services, and there's 16 agencies that serve all 14 counties in the state. And so one thing I just want to highlight about the designated agencies is that, you know, feel like that they're specialized, provide longer term supports. We do short term, we do crisis, but I think one of the most important things to highlight about the care that we provide is that it's a continuum and that there are many different doors to enter, but you have access to many different services as needed. We're really here as a safety net for the most vulnerable, really when we're speaking to serious mental illness or severe emotional disturbance for children. Again, those terms a little outdated, but it's what instead is in statute. And then really want to highlight that we have a continuity of care for complex needs. And that, you know, in our opinion that we provide expertise, not only in the one on one services that people might provide, but we're also go to in supporting our partners in the community. And I'll speak a little bit about that moving forward. So I know you've all seen this. I just want to highlight like a couple of facts saying like, you know, how do we address this? What are we doing to address it? And what does the issue look like on the ground? And again, we're drawing from sources, Vermont Department of Health, the annual suicide data report that came out in June '25, it's sort of the year 2024, which is the most up to date data that we do have. But just saying there's a lot of information out there that is helpful to get an understanding of what's happening across state. One thing to highlight here is saying 6,000 people headed to the emergency department, which is great. We love that there's care there, but saying that that's not always the best place to go when you are in crisis and saying what are the alternatives to ED that we can do. And oftentimes when people do show up to the ED, we're called, we send people in, support them and then try and find different placements, hopefully community based for most folks. Talk a little bit about that. Here's the data is parsed a little bit, but saying like males are four times more likely to die by suicide. BIPOC and LGBTQ youth are more likely to attempt suicide. Young adults are impacted. And this is a comparison across country. And then also important to some of the things that we're focused on, service members and veterans are two times more likely than general population to die by suicide.

[Rep. Leslie Goldman (Member)]: These statistics, are they national and are those trends mirrored in Vermont statistics?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: So these are compared to national statistics and this is coming from the annual suicide data report, the youth risk behavior survey, which is in 2023, and then the BRFSS report, which I can't quite remember that meant for. But these you can see at the bottom, I do cite the sources and saying they are a few years out of date. So some trending where we were trending up throughout COVID, there is a little trend on the way down, but compared to some areas we are higher. And if you really want to get into the data and analytics saying like as a rural low population state, more suicide attempts, more suicide deaths have a larger impact on the data, but saying that the trends are still significant and more monitoring and intervention. So I just wanted to highlight some of what is best practice that we know today, what are we citing? And so, this is coming from CDC and NIH information of saying like, what I really wanna do is just highlight saying, look, there's a lot of things that we should be doing to create protective factors to do preventative work, upstream work. And then what does it look like when we do need to intervene if someone does attempt suicide or is having suicidal thoughts or ideation? And so the number one here, talked about the loneliness epidemic, social connectedness and belonging, huge. So how are we creating opportunities to connect socially at school, through your family units, through friends, through your communities? What opportunities do you have? Because the more isolated you are, that's an indicator for potential suicide. Lethal means restriction. So firearms are one of the leading causes of suicide. So you can see here accounts for over fifty percent. So how do we restrict access to lethal means? That is one of the things we ask in screening questions. Do you have access to a firearm? For working with kids, always wanna talk to the parents saying, do you have firearms in the home? Are they locked? Do you need a lock? Those are handed out. We have a lot of what we call gatekeeper trainings. And so PPR, mental health first aid assist, those go in order of intensity. So PPR can be done in about ninety minutes. Until health first date a few hours and assist is done over two full days. We also have universal screening in health systems, which is relatively new, saying I'll show you a little data saying when you just have people self report rather than when you just universally screen, you'll see there's a large difference in people who identify having suicidal ideation. We need a good crisis continuum and ED diversion so that when people are acutely suicidal or have attempted and need support, there should be somebody there or some support there right away. I also want to highlight peer support, which has been really intentionally built into mental health and some students relatively new in some areas. Obviously Pathway has been doing that for a long time as spearheading some of the peer supports in The States, I want to name them, as doing good work in helping build in peer supports, but find that peer support folks can go a long way, especially when you're talking about intimate details. Sometimes talking to someone who has lived experience can help create a better environment for speaking about something as hard as suicide. We also provide postvention and loss supports. And then again, the last one, the social determinants saying like the environment in which you live that has so many facets to it does impact suicidal ideation. I'm not gonna go through all these, but what I do wanna highlight is there is a lot going on. There's a lot of expertise. There's a lot of specialty care and saying, you know, one of the things we're trying do is get the word out about how you access these, but when folks do come into the designated and specialized service agency, they do many of our clinicians are trained in CAMS care, DBT programs, and that we have access to a lot of information around surveys, assessments and screenings.

[Rep. Leslie Goldman (Member)]: Kelsey, real quick, are all of these services things that designated agencies are mandated to provide?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: Not mandated. I think it's best practice in saying, I would say you would probably find these across all DAs in various different places, depending on the needs in the community. And with turnover and stuff, usually come in and say, we're going to train our clinicians in camps care. If you have new clinicians, they might not have that, but we will train them in that. So I would say that these are pretty ubiquitous across the DAs, but depending on the moment in time, it may look slightly different.

[Rep. Leslie Goldman (Member)]: So you don't necessarily always have funding to provide all of these?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: No, I think funding for training is important. I think as we're going to CCBHC, but also trying to implement more evidence based practices, that can become more costly over time for sure. So this is usually just carved out of the budgets that we currently get. These just go a little bit further in-depth. One of the things I just want to highlight here is saying like assist with DPR and mental health first aid is really about trying to yes, train our staff, but also train people in the community. It's not meant to be a clinically heavy training. It's about how do you recognize, intervene and talk about something that can feel taboo and saying like talking about it can save a life. It's not taboo to ask. It doesn't increase someone's likelihood to commit suicide. Really important to be able to talk about it. So how do you have the skills to do that? And so we do provide this internally and externally to partners and community members who are interested. The Stanley Brown is a one pager. We really try to, as we're talking about partnerships with hospitals, with schools, with family members, how do we give people documentation that says based on the person, sometimes the child, what does best support look like? How can we hand information off to people, do warm handoff so that support after an encounter can be carried out and then how do we follow-up? Again, I did send us in the PDF, you'll have this. It was very recent, just finalizing this, but I just wanted to include, what are the things that have evidence based and has been helpful and what do we train our staff in? So just a couple of things from the health care states, so statewide training. I do just wanna highlight that there's been a lot of training that has gone on. Vermont Care Partners does get some funding from SAMHSA and distributes that out to the various DAs to provide trainings in our communities. So I just wanna talk a little bit about the crisis continuum. So intervention look like? I just want to be mindful. How many people are testifying, Daisy? Just want

[Rep. Francis "Topper" McFaun (Vice Chair)]: be mindful that I have

[Rep. Daisy Berbeco (Ranking Member)]: to- There are five after you.

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: Okay. So I'll just be mindful. I just want to provide some data and saying, look, so I just did an overview of the designated agencies. I do want to be mindful that I am speaking on behalf of my care partners, but what we try to do is also give the committee data. And so we are working on that as a network to saying, how do we have like statewide data? We do have it in pockets. Sometimes it's hard to talk to each other. So to give some texture to the conversation, and this is more about like acute support, what does that look like? Because there's been recent investment in that, I'm gonna speak about NKHS data. So I just wanna make sure that switching a little bit, but I do want to provide data to the committee so you can ask questions, but also just get an understanding of what does this look like when it's applied on the ground. So here we go. So this is for NCHS. This looks similar across the DAs. We do have a mobile crisis dashboard, which is publicly available, DMH publishes that. But I just want to say, look, when people call, and so this is for crisis, this isn't necessarily suicide specific, I do have some suicide specific data, that most folks are returned to the community. So they might call 998 and it gets resolved there. If not, we can send people out to you through mobile crisis. Eighty five percent of those encounters resolve in the community. People can do a walk into our urgent care facility, mental health and co occurring, and people come there, usually stay there and then head back to the community. I always want to say discharge, but we don't admit people. It's voluntary and outpatient and community based. But ninety six percent of people return there. Then we also have, just highlight here, the Vermont State Police embedded positions that can co respond or respond alone if you do call the police. And so almost 90% of folks head back to the community. So I just wanna say like we were really focused on community based interventions when acute things happen. These slides are a little out of whack here, sorry about that. So anyway, so again, community based prevention. So we started with the QPR, we do youth programs for

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: in

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: schools, and then we do have care pathways to identify and recognize and then have people respond. So really wanna highlight DMH has been a great partner to work with us. We work with our hospitals and FQHC very closely. And again, mentioned pathways, but this is a total What we're going for is real partnership and collaboration because we know that people enter the healthcare field or look for help through many different avenues. And so I also want to highlight that we work with SAMHSA and Fort Pines has been a private philanthropic organization that has really invested in the continuum of care and the designated agencies. I just talked a little bit about assist, won't go too deep into this. And this here's an example of partnerships. So we work closely with NVRH, North Country Hospital, but Josh Burke, our Director of Emergency Services worked for several weeks every day over the course of a few months to really work with NVRH, BPQHC to say what does universal screening look like, How do we share data? And what does a good collaboration and warm handoff look like if someone does come into the emergency department and screen positive versus subtle ideation? And so this work was done through VMH, VPQHC and local primary cares and hospitals. I believe this is happening across the state, but for us, we were very intimately involved. And I think oftentimes it doesn't need agencies or look to further skills and expertise in this area to help talk about what does it look like? How do we intervene? And what does the handoff look like after heading to the hospitals? Again, you've all seen this, a big part of saying how do we keep people out of the emergency room? It's not the best care for mental health. It stresses out their staff, space. It's not a great inviting physical space and saying, how do we get people back to the community? First of all, how do we get them to start in the community and stay there if possible in the hospital or inpatient being the last spots. Just wanna put this up here. Again, as the acute part of the system, is, went over this a little bit, I'm gonna add some context of like, what do these programs actually look like? Again, someone to call, someone to come to you and a place to go is how we think about this in the continuum. It's really important in terms of addressing the acuity. And then one to highlight from the designated agencies, there are five different, what I would call urgent care centers. They look very different, but currently Howard Center in partnership with Pathways and UVMC have their mental health urgent care. UCS has had their psychological urgent care for kids for a while. CSEC has Interlude and Washington County Mental Health, the Access Hub is responsible. Then we have the front porch in Newport. And so as you can see, they all look slightly different. They focus on slightly different things. I think one intention of the state is to invest in the co occurring medical care system and would really like to have regional 20 fourseven across the lifespan. There are challenges associated with that, but it can be done. Currently run one of those in Newport where it is twenty fourseven, three sixty five and can support children through adults. A couple of things. So this is more focused on suicidal ideation. And so I just want to highlight the when only self reporting. So before we started universal screening, had about eleven percent that would identify suicidal ideation as an issue that they want to talk about. But after implementing the Columbia suicide rating screening, we had about fifty percent of people endorse that. So it's important to ask and that changes what the intervention is. And so that goes all the way back to QPR and all of the interventions we want to do is just like we should be asking. When we ask respond when we get someone who says they are having suicidal ideation. This is just visualizing what this looks like when people call 988, we also screen. The red line at the bottom is the self reported. Then over the top is what happens when we did the universal screenings. So you can see it's almost six times more likely to occur when we proactively screen. Again, I just wanted to talk about this and this is what it looks like in mobile crisis. Follow-up on SI severity rating. So follow-up services provided to folks, percentage of people, and continued follow-up over time. So people who identify with suicidal ideation do follow them. We provide a follow-up service in the first three days. We work with them saying what works, then we try to do a continued follow-up over time to check-in and make sure that things are going okay or provide more services if needed. And then the urgent care. So the point I really want to highlight here is that 26% is the disposition of the ED and saying, when I showed the data before the front porch, think was at 96 Percent of all people who showed up, but when suicidal ideation is the primary issue to be addressed that we have a higher number. And so that goes to twenty six percent as opposed to four percent. And so there's a number of things saying how active is the ideation, do they have a plan, and saying if they're a threat to themselves or others that inpatient can be warranted and saying we want to try to avoid that at all possible, but we do have more involuntary inpatient treatment, which for some folks is necessary. But we also want to say this can be a step down. So our urgent cares can be a step down because go straight from inpatient where you have a very controlled environment and then step to non structured around people who maybe haven't been trained or supported, it can be destabilizing. And so really these urgent cares are meant to be step downs as well in coordination with any inpatient stay. And then this is just utilization trends saying like a lot of what we're trying to do is keep people in the community and out of the hospitals for a number of reasons and saying, as a percentage of what we've been doing, you can see that these urgent cares are making a difference on utilization at the hospital level. Okay, that was really fast. I want to be mindful that there

[Rep. Daisy Berbeco (Ranking Member)]: are six people to testify. Do we have your slides?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: They're coming through. I tried to send it a few times and apparently it's out so you will have those. But any questions currently? Yes?

[Rep. Alyssa Black (Chair)]: I noticed that Brockport has beds and do the other urgent care places have some similar

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: I think the idea is to get there. I think they're trying to build to that. We had So the front porch, we've been working on that for probably four years now. And so we bought a building and made it fit that way and had some granting from DMH. I think that is the intention. I don't believe that the other urgent cares have beds, but there is other initiatives saying like there are crisis beds which do overnights. So that is also available for mental health. They're trying to integrate that with the substance use. So there are some beds that are available that do similar work. I think the idea is to combine the urgent care walk in model with two to ten day crisis stabilization. I don't think that is fully formed what that might look like, but I think that's a good question for DMH that we're also trying to work out what does that look like across the state. But I think the idea is to regionalize the urgent care models that look like the 20 fourseven with some available beds.

[Rep. Alyssa Black (Chair)]: I don't know if you're a follow-up. Do you know what the need is statewide for that? How close is it to being?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: Need? I think it's a good question. I'm not sure how to answer the statewide need about beds. I think one thing we try to convey is saying, want to look at the data, some of our crisis beds we want to have 80% utilization for us, we're close to that. And that's also just with turnover and staffing, but one of the challenges is how do you get it right? Because 100% occupancy is great and efficient, but doesn't have any slack. So when you talk about pricing services, really want to think about it as a firehouse model, right? And saying like, is it available when people need it? You know, to a reasonable extent. So I am not sure what the statewide need is or how that's Everest Philip, that's a

[Rep. Francis "Topper" McFaun (Vice Chair)]: good question. I'll follow-up on that. Thank you.

[Rep. Alyssa Black (Chair)]: Thank you, Kelsey. Thank you so much.

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: Yeah, of course. Thanks for having me.

[Rep. Alyssa Black (Chair)]: So we have Sally next. I personally want to apologize to everybody. I'm sorry, I was going to get one thing that when you get to become a chair, you get to take chair's prerogative. And we're doing this today because this is my prerogative. And I'm sorry I wasn't here to begin. So I'm so happy that you're all here today. Thank you.

[Sally Hespe (Area Director, AFSP Vermont)]: I'm glad I found I'm following somebody with slides and all of the data because I'm not talking about the data. My name is Sally Hespe. Thank you so much for the opportunity to be here today. You're making me tear up. So sorry. So I'm the relatively new area director for the American Foundation for Suicide Prevention, the Vermont chapter. So I've been in this role for four months. So as you can see, I'm new. So I brought a lot of backup with me. And I have some prepared remarks, but I think I've had the opportunity to spend the day today with 10 individuals, young people, and

[Rep. Daisy Berbeco (Ranking Member)]: some

[Sally Hespe (Area Director, AFSP Vermont)]: of our board members who are going to speak from the heart, and I hope we get to hear their testimony. So I'm going to keep mine short. Just a little bit about our organization, we passed out some information. We have a small chapter here in Vermont, we're looking to grow that. But AFSP is a national organization, is one of the leaders in the fight against suicide. We save lives and bring hope to those affected by suicide. Last year, this tiny little chapter of volunteers were all volunteers except for me, over 35 programs in prevention and postvention to different communities in across the state of Vermont. So I think the data was very telling. And in Vermont, the story is particularly urgent, I think. And we could see that. Always dive into and the latest one said fourteen percent of those that took that survey, and these are high school students reported making a suicide plan 14. So this is something that I think some of these students are going to speak to today. So you'll also find in your packet that we as an organization and a chapter are asking for support on three bills. And those are in an issue brief in there. And I understand they're not before this committee, but we hope that you'll share them with your colleagues. One is House Bill eight seventeen, which is for mental health support and substance use disorder prevention in schools, and House Bill eight eighteen, which is a mental health screening in schools. And again, I think some of the people that are going to speak after me can tell you the importance and the need for those. The other thing that we are asking for your support for is for House Bill 20, which is a voluntary firearm storage program. And again, in that packet, you'll see in the datasheet, the prevalence of suicide deaths by firearms, especially in Vermont, and you can compare it to what it is in The United States. One of the messages that I want to give that before I turn it over to our other volunteers and these lovely students is that AFSP is a large national organization, and we can be a resource to you. We are the largest private researcher on suicide prevention in the state. And so as you look to pass bills or any information on these topics, please reach out to me, my number is in there. But anyway, we thank you very much for your leadership. Thank you. And, know, please call on us so that we can help and support and provide resources.

[Rep. Alyssa Black (Chair)]: Any questions for Sally? It's so hot in here by the way.

[Rep. Daisy Berbeco (Ranking Member)]: I just wanna say. Like It's so hot. Wow. I'm just like

[Rep. Alyssa Black (Chair)]: They removed a storm window from that window over there. And I think we can open that window now a little bit.

[Rep. Leslie Goldman (Member)]: It's hard.

[Rep. Brian Cina (Member)]: It'll in Isn't it open a little right here?

[Rep. Alyssa Black (Chair)]: Is it open? No.

[Rep. Francis "Topper" McFaun (Vice Chair)]: Oh, okay.

[Rep. Daisy Berbeco (Ranking Member)]: Open it more.

[Rep. Alyssa Black (Chair)]: But only if the people sitting over there

[Rep. Daisy Berbeco (Ranking Member)]: Of course. Will be frozen out. It's actually

[Rep. Alyssa Black (Chair)]: quite Do you want to push the window open a little bit to let

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: clear air in? And if you

[Rep. Daisy Berbeco (Ranking Member)]: do not, that is okay. If

[Rep. Brian Cina (Member)]: you want help, let us know. If you're afraid it's

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: going to fall on you.

[Sally Hespe (Area Director, AFSP Vermont)]: But again, thank you, and I'm so excited to let you introduce these other volunteers who speak from direct experience.

[Rep. Alyssa Black (Chair)]: I'm so excited that everybody's here today.

[Rep. Brian Cina (Member)]: Oh, it's not totally open yet. I bet that'll help anyway, though. Yeah.

[Rep. Alyssa Black (Chair)]: Reality show. Birth's still alive. Oh yes, we are.

[Rep. Francis "Topper" McFaun (Vice Chair)]: And you're

[Rep. Alyssa Black (Chair)]: in the house. I'm in the house. I've been here before.

[Rep. Daisy Berbeco (Ranking Member)]: Hi, Terry. Thanks.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Welcome. Thank you, representative Black. Thank you for having me today. My name is Terry Lavely. I use she, her pronouns, and I am a resident of St. Johnsbury, Vermont. A little bit about me. I'm gonna wear multiple hats as I'm speaking to you today. The first most important hat to me is I am a mom of two beautiful children, and I am also a loss survivor. I lost my 18 year old nephew on January 28, ten years ago. So I'm a decade away from my loss. And I'm also an attempt survivor, a suicide attempt survivor. I attempted to take my own life when I was 15 years old. And I'm so happy that I'm here to share this story with all of you today. I'm also a volunteer for the American Foundation for Suicide Prevention Vermont Chapter. I'm the current board chair, but I'm turning out, still be on the board, still be volunteering. I do a lot of work in advocacy, fundraising, and training and education. And probably something that I'm most proud of is I have spent twenty two years working for Northeast Kingdom Human Services, working in the community doing mental health supports. I'm currently the training and community engagement director. So I get the distinct privilege of working in schools with these youth, these wonderful youth, our communities, our agency as well. But I have the privilege of working with youth. And the two bills that we're talking about that are supporting youth mental health are near and dear to my heart because of my own attempt and the loss of my nephew, as well as the work I have the privilege of doing in these schools. Oftentimes, we get called to go into schools to provide trainings to educators after there's a loss, after they've lost somebody in their community. I'm working with one of our local high schools. I have lost two youth this year to suicide. I'm now going in and doing that prevention and postvention training. We want to get to a place where we're doing prevention training so we never need the postvention support, so we never lose another individual to suicide. And that's why Bill H817 is vital to our youth and their mental health and the supports they get. They spend thirty five to forty hours a week with teachers and educators who don't have the tools to take care of their mental health. They're wonderful educators. They went to school to teach our students. But when our students are coming in with higher risk factors such as food insecurity, housing insecurity, substance misuse, domestic violence, they're not prepared to learn. And not all students show all warning signs in all areas. It usually comes out at school where these safe adults are around them. So we need to equip our teachers and our educators on the warning signs and how to support our youth. It is scientifically proven that if a youth has one safe adult in their world, that is a huge protective factor. That is the biggest protective factor we can give to youth. And if you know that their teachers and their educators are comfortable talking about mental health, substance misuse struggles, it creates a community of awareness that supports our youth and what they need and the place they need. I think a couple of youth in this room have pretty much grown up in my house since kindergarten. And they can say I'm a safe adult to them because they know that I'm comfortable talking about their mental health and they know I'm going to hold that safely for them. So I'm proud to say that we at Northeast Kingdom Human Services have been doing a significant amount of work in schools to train our teachers and educators to give them the tools to work with our youth, recognize those warning signs, the risk factors and the protective factors. I'm not going to go into it again, because Kelsey outlined all the wonderful trainings that we offer, QPR, Mental Health First Aid Assist, and so many more, but also working with the youth. I go in from pre K right through college, and I work with them, and I teach them about their mental health, what warning signs look like. We're myth busters, like we break down the stigma around the myths. And what 18 what age eight, 17 does is it supports our educators in having the tools to support our youth. I wish I had one safe adult when I was 15 years old. And I wish ten years ago, my nephew would have had that because my story would look very different today. Also, 18 is mental health screenings in the school. Again, we want to be able to provide supports to our youth at their points of access. Not all youth go to the doctors all the time or engage in mental health or physical health services. And these evidence based and evidence informed screening tools, anybody can take. You as a community member can go online and take a CSSRS, which is the Columbia Suicide Severity Rating Skill training, and learn how to do that. So if you see someone struggling, you will know what to do. Anybody can go on and take psychological first aid. These are trainings that we provide to our community because suicide prevention is a community responsibility. It is all of our responsibility. And then the last bill that we're asking for support on is H20, which is a firearms bill. We know firearms is a very hot topic across The United States, not just in Vermont. But this bill does not restrict access to firearms. What this bill does is create safe spaces for people to store their firearms in a time of crisis. We know that suicide is the long term answer to short term problems. And if we put time and space between the crisis and the access to means, we are saving lives, allowing people to drop their firearms off if someone in their home is struggling or they're struggling themselves, and then to pick them up when the crisis has passed. This is a lifesaving measure, and we know that sixty three percent of deaths by suicide in Vermont are by firearms. We don't want to restrict people's access. We want to provide resources for them to safely store their firearms. So I'm not going to also take up too much more time. And those are the three bills that we're asking for your support on. And we appreciate you taking time with us today. And I appreciate you listening to me again. This is not my first time in front of this committee. And I welcome any questions you might have.

[Rep. Daisy Berbeco (Ranking Member)]: Any questions for Carrie? You

[Rep. Alyssa Black (Chair)]: said that you're working with a school right now who has had two in just this past year? Yes, ma'am. Could you speak a little bit, just kind of the impact on sort of what happens in a school, the immediate impact and also more the longer term, particularly where there's a repeat?

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: So immediately following a death, reaction. The students are in crisis. The teachers and educators are in crisis. The families supporting the students are in crisis. The principal of the school is a rock star. I just want to say that because she's holding all of that for her staff, for her students and for the families and her communities. So we provide that immediate crisis response. And then as we get a few weeks out of that, we just rolled out a new program through the American Foundation for Suicide Prevention called Caring Communities, where we go in and we talk about how to have a conversation and welcome people back to the community after a death. So we usually try to wait a few weeks after a death, but we really like to provide it before death happens so they're prepared. We're oftentimes reactive after a death, we want to be more proactive and this bill allows us to be proactive. So from there, sixty to ninety days afterwards, we go into that prevention training. We start offering trainings like QPR, Talk Saves Lives, and we feel that time and space to allow the grieving process to happen and for people to work through that is extremely important for mental health. For our educators, I just did caring communities a few weeks ago in the school. They are struggling to hold it together themselves and support the youth in their classrooms. They have not had a chance to process this death. They also have a loss. It's not just the peers that lost one, it's the teachers and educators too. So it's really being present and talking about safe ways to have the conversation, how we open and share space together. And then we jump back into the preventative stuff where we offer QPR. So I'm offering that next month at the school. And then in May, I'm going to start working with the students with It's Mental Health. We've already got it scheduled. And then next school year, it's going to be built into their curriculum. A lot of these students have had me in their school as freshmen. Do it's real Real team mental health at the academy. So it really goes from crisis to postvention, background to prevention. And once we have those relationships with the school, they're grateful for it. And again, do, I have the best job of working at and volunteering through AFSP to be trained and being able to deliver this because I can fold space for them. But it is not something that is easy to witness as a human being, as a lost and an attempt survivor, and as a mom. It's not easy to watch these teachers struggling as they're trying to figure out how to support youth. Thank you.

[Rep. Francis "Topper" McFaun (Vice Chair)]: Not

[Rep. Brian Cina (Member)]: only what could be provided when people seek help, but what the legislature in general can do to prevent the conditions that drive suicidality. What are the current drivers most commonly seen for young people? What makes people not want to be here anymore? I think that's something that the general assembly should look at, like, what are the social factors?

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Yeah. So the social needs of health are the drivers, and oftentimes people don't realize housing, food insecurity, substance misuse, domestic violence, all of those social needs. Also, the kingdom where the rule is part of the city, it's lack of social connection, lack of transportation. And for the youth, if it's okay, I would like to open it up for them to answer that question because I am not young anymore, and they have the answers better than I do.

[Rep. Alyssa Black (Chair)]: I think that's a fantastic

[Rep. Brian Cina (Member)]: That's kind of what I was hoping. Yeah. So

[Rep. Alyssa Black (Chair)]: the question is, what

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: are some things that make you struggle with your mental health, and how can we help with that? Or your peers, you don't have to speak about yourself, you can speak in a general way.

[Rep. Brian Cina (Member)]: Youth in general, like what are the things that are stressing out the youth today? What are the things causing youth to struggle so much that they would consider not wanting to be alive?

[Rep. Alyssa Black (Chair)]: I think social norms and the rise of social media above the youth, especially in younger ages, especially with how mental health is actually rising among younger children because of the rise of social media and the social norms that are pressing upon them with the rise of social media. I see you too. Go ahead. I fully agree with my thoughts on it. I think social media is a huge factor in it.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: There could also be certain signs of

[Rep. Alyssa Black (Chair)]: bullying could be a huge thing, and because of

[Rep. Daisy Berbeco (Ranking Member)]: the rise of community, cyber bullying could be huge.

[Rep. Alyssa Black (Chair)]: Yeah, I know some people do struggle with bullying and stuff and I know how that affects them, so I think can,

[Rep. Daisy Berbeco (Ranking Member)]: fully interest can be a big factor.

[Rep. Alyssa Black (Chair)]: You want to go ahead?

[Unidentified student speaker]: Yeah, I think helplessness and not feeling listened to is a big part of it because we hear about this school that's lost two of its children and only now we are taking procedures to teach these teachers. But how are we going to sacrifice that until like we have to make that sacrifice to actually give the teachers now and next year, they're going to have an equivalent.

[Rep. Alyssa Black (Chair)]: But before those students, they didn't.

[Unidentified student speaker]: We can't just lose more children because they don't feel listened to. And we can look at data, but the real thing that we need to listen to as humans, to our peers and to our students, or children.

[Unidentified student speaker]: Thank you. Go ahead. I think another big part of it, especially for me personally, is lack of understanding. I think something that really gets me upset on a personal level is when adults, more specifically like my mother, my therapist, my friends, or just people around me in general, or adults even don't have knowledge or a proper, I guess, grasp on struggles of mental health or depression or suicidal ideation. And I also think older adults that are, again, not very understanding of mental health and people who are maybe from older generations that didn't really grow up with the same understanding of mental health or teaching of mental health as people do today may see younger generations or younger people that are struggling with it as sensitive or weak or whatever it be, I also think that contributes to feeling unnormal or abnormal, or just kind of making you feel like something's wrong with you or that you're not normal or you're not, you're weird or you're strange or you're just not okay or you're weird or whatever because you struggle with something that's very real. I think older generations or just adults in general that aren't as educators, they probably should be treating mental health as like this facade that does actually exist. What it does is also a big issue as well.

[Rep. Alyssa Black (Chair)]: Thank you. Thanks for everyone sharing.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Carrie, thanks. I just heard how proud I am of.

[Rep. Alyssa Black (Chair)]: Yeah. I don't think you've ever been in the witness chair, have you?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: In any capacity. I'm proud

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: of that record.

[Rep. Alyssa Black (Chair)]: That record ends today. Thanks. This is a friendly She's actually a friendly witness. Thank

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: you for having me. I appreciate the time that you're you're taking to listen to me. My name is Tim Jenden. I'm from Essex Junction. I am a lost survivor, and I'm a board member with the Vermont chapter for AFSP. I'm a a committee member for advocacy and public policy, and I am trained in healing conversations. I grew up in Barrie in a large family. There were 10 kids, eight girls, and two boys. Yeah. A lot of sisters. And I'm here to tell you about the siblings we have lost to suicide. So in 1972, I lost my sister, Maureen. She was 20 years old. I was 19, and she was my best friend. And my parents would not allow us to talk about it at all, and that negatively impacted my entire adult life. So I thought it could never happen again, you know, because of the the pain and the trauma that it it caused for the family. However, fifteen years after Maureen died, my only brother Patrick took his life. And, again, my parents would not allow us to talk about it. There was a time when I don't know. It was one anniversary or the other. Doesn't matter. I was feeling particularly low when I called my father, and and I told him, you know, what I was feeling and what he shut me right down. He says, Tim, we're not gonna talk about this. So that was a learned behavior. So, as if that wasn't enough in December, just two months ago, I lost a younger sister to suicide again. Her name was Joni, and she lived right here in Montpelier, not too far from where we are right now. She took her life in her apartment. So, that old familiar pain has returned. All three suffered from some form of depression and mental illness. You know, back in 1972, you hardly ever heard the word suicide, let alone mental health. So I didn't know anything was going on with her. And, you know, I was 19 years old, you know, just full of myself, you know, just being 19 and, you know, I didn't have a cure in the world and just I didn't know anything. But my older sister, Kathleen, knew that there was something going on with with Maureen and that she was she was having problems, and she tried to get her help, but Maureen wasn't gonna have it. So then with my brother Patrick, I mean, always had mood swings. And again, I didn't recognize it. You know, and what else was there available in 1987 for mental health services? I don't know. And that was a complete surprise to us. Joni, on the other hand, suffered for years with mental health. And this we knew, and we tried to help her as best we could. Mostly, she was good. And when she was good, she was great. And we had a celebration of life just a couple of weeks ago. And we just heard so many stories of how she would just whenever she greeted you, you were the most important person. And she was funny and witty and, gosh, she made people laugh. I mean, sometimes we'd laugh so hard at her, But she had her demons. And when the demons took over, she would spiral downward, and it was not pretty. And we tried we tried to help. She was going to therapy. She had a psychologist who would prescribe medications and, you know, her medications would get tweaked and sometimes they worked and sometimes they didn't. And then she was she was good for a long while and and everything was great. But her psychologist moved out of town or she left and so she no longer had that psychologist. So now she's on a waiting list for psychologist because of her issues on Medicaid, Medicare. So, anyway, we're trying to navigate through that that she gave up. Fighting. So it took me decades to finally go and get some therapy. And back in 2015, I finally found a therapist or sought a therapist, and we immediately clicked. So I went to see her for about two and a half years. And at the end of it, I mean, we both knew that we were winding down and everything, and I was, you know, finally able to talk about, you know, my experience and and the like. So it was in 2018. I'm just I'm reading my book or whatever, and it was like a brick on the side of the head. Why aren't you doing anything for suicide prevention? So I picked up the phone, called the Center for Health and Learning, talked with somebody, and and I was on board. And I started receiving materials for doing some training to be able to give presentations about current stats, how to recognize risk factors, warning signs, all of that, and and pointing pointing whoever might be in crisis to some services. So finally being able to comfortably share my story has been liberating. Fortunately, our family is tough, and we support each other. I wouldn't be where I am without my sisters who are strong and fierce women. They're my support system. So I believe that any legislation that addresses increased funding and training for mental health, I'm all in. I'm in favor of it. And I realize that the bills before you address mental health and suicide prevention for schools, and that's a good thing. And that's not necessarily my story, but I think it's a good thing since 10 24 year olds are among the demographic that are at post risk for suicide. We know this. So I believe that helping school aged kids build resilience translates into them becoming more resilient adults. Thanks, Alyssa. Thank you, sir.

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: Appreciate it.

[Rep. Alyssa Black (Chair)]: Hey, Tim.

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: Any question?

[Rep. Alyssa Black (Chair)]: I'm so sorry for the I I knew of your your other siblings. I didn't realize you had just lost

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: That's been a gut punch. Thank you.

[Rep. Alyssa Black (Chair)]: Go ahead. Question for you, actually for me. Well, this has been very painful, difficult, and I'm wondering about people watching who didn't really know necessarily what they might be watching. And should we put a connection on our site to get 988 or whatever it is we think we should do to be sure people have someone to reach out to. Thank you. I hadn't thought about that, Leslie. Thank you. Yeah, I don't know how we'll do that. Yeah,

[Rep. Brian Cina (Member)]: think maybe you can You could say right now for anyone watching that if you need help, you can call 980 You can also call the Pathways Warm Line and speak to peers. That's, I can't remember it off the top of my head. Does anyone know the Pathways Warm Line? It's like 877 Talks or something.

[Rep. Alyssa Black (Chair)]: I can find it.

[Rep. Brian Cina (Member)]: Yeah, so we'll say it in a minute. So that's a resource. If you don't want to talk to crisis workers, you just want to talk to another person who has lived experience, you can call the Pathways Warm Line, but 988 is open 20 you'll reach crisis clinicians who can then talk with you on the phone and meet with you if you need to meet with someone or refer you to mental health urgent care or just check-in with you and be there to listen. So those are a few options for anyone listening.

[Rep. Alyssa Black (Chair)]: Yeah, and the number is (802) 565-5465.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: You can also chat online and text 988 if you do not want to make a phone call. Free, confidential, 207,

[Unidentified student speaker]: calls answered right here by the watches.

[Rep. Brian Cina (Member)]: And everyone should know that if it ever comes down to it, don't be afraid to call 911, and don't be afraid to go to the hospital and get help, and you can also text 911.

[Rep. Alyssa Black (Chair)]: And I want to put a plug in that there are multiple different support groups for suicide loss survivors. There is a component where if you have lost a close family member, you are at much higher risk yourself of dying by suicide. And I think a lot of people sometimes make the connection that somehow there's some hereditary component, which there may be, but also you are sitting before us and having lost your first sibling in 1972 and the cumulative grief and loss over that and not being able to deal with that or calling your father and we don't talk about that sort of thing, that it takes an emotional toll as well.

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: Yeah, think that's not a lot on me. And thank you for saying that. One thing that I've learned with doing this work is every one of these events is therapy for me. And and like I said, you know, I'm tight with my sisters. I mean, we we are very supportive of each other, and that means everything. I check-in with them, and they check-in with me.

[Rep. Alyssa Black (Chair)]: Thank you so much, Tim, and thanks

[Rep. Francis "Topper" McFaun (Vice Chair)]: for sharing. Thank you.

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: Thank you.

[Rep. Daisy Berbeco (Ranking Member)]: Alright. They

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: go.

[Rep. Alyssa Black (Chair)]: You wanna come on up?

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: My

[Rep. Alyssa Black (Chair)]: first home game. Welcome.

[Rep. Daisy Berbeco (Ranking Member)]: Thank you. Are you guys okay?

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Okay. I wrote

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: mine down because I will sit here and not say anything. Afternoon. My name is Raven Pfaff. I am the treasurer for Vermont's chapter of the American Foundation for Suicide Prevention. Today though, I am here wearing my educator hat, a paraeducator at a very middle school, and we are under Orleans Central Supervisory Union or OCHSU, as I'll refer to. Recently, we've developed the OCHSU Suicide Prevention Coalition. I think there was like nine of us, charged with the task of creating policies and procedures that will align with the model school protocol while acknowledging the unique challenges some of our schools face. Some of those challenges include a lack of tools, trainings, support, and any clear curriculum that we could follow. This year, as you guys have already heard, we have lost two of our high school students to suicide. Each has completely rocked our community. Our schools are working so hard to respond, to intervene and to tend to our wounds. And that is why our coalition has been created. And in our work so far, we have found that there is an overwhelm, there is a lack of resources, and that is why it's critical to support H817 and H818. For context, I was a child who had attempted to end my own life in the youth grade, And I have seen both sides of this problem now. That was in 2009. There has not been a whole lot of change since then in our systems. So I can promise you that we need this kind of change to make a positive impact and to save lives. I care a lot about our children, and it really starts there. For our rural communities, our schools are kind of a hub. So where I am, it's very small, tiny, isolated. I have 78 students in my school total. There's not a lot of support services. There's not a lot of things that we can draw from where we are because we're also on the fringe of our designated agencies. Are, like, thirty minutes away from Newport thirty minutes away from Morrisville. We're on the outskirts. Some people don't even know our town exists. So our students get everything they need under our roof. Transversely, of their needs meet under our roof. They come in hungry. They come in cold. They come in tired. So it is critical, I think, for us to support those bills. And I know my testimony is short, but I really thank you all for allowing me to be heard and for allowing our children to be seen.

[Rep. Alyssa Black (Chair)]: Brief but impactful. You, Raven. Yeah, Brian?

[Rep. Brian Cina (Member)]: Did you say that a school of 80 youth lost two students?

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: Our high school is bigger than that. Our middle

[Rep. Brian Cina (Member)]: school is

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: than our high school is not big at all. At all. It is a pretty tiny high school. I think we have like golf and basketball and soccer and maybe lacrosse. I don't even think so. So we are tiny.

[Rep. Brian Cina (Member)]: I just want to say too, though, that it doesn't matter how many different a school losing one student's enough for our community, but if it was two out of 80, I'm just thinking percentage wise, that's like high. It's a number thing, though, and it doesn't matter. Loss is enough, but two is worse. Hopefully, the awareness that is being brought to the issue will prevent any further youth from taking their lives.

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: I hope so. We have a school based clinician. We have a guidance counselor. We have an SEL specialist. And they're all so overwhelmed. And that's also just in my middle school. We have kids in crisis all the time. And, you know, as far as funding, there has been a year where principals have had to select where funding comes from for school based clinicians. And one year it had to be not from school funds. It was just a certain demographic of children getting services, and that was it.

[Rep. Francis "Topper" McFaun (Vice Chair)]: Have two

[Rep. Brian Cina (Member)]: more questions if that's stimulated, if that's okay. One is for you and then one is like, or they both could be for any of you, but the one was in the school, so this is for anyone impacted. In the school, after the students died by suicide, what was the postvention response like? Because just for everyone to know, I'm a crisis clinician part time in Chittenden County and we sometimes get called in after a suicide to meet with a community, and I'm sure that that's also offered in your area. So I'm wondering, what was the community response like? What was the postvention? What kind of support was offered to students that was extra and was it only short term or is it still ongoing? Is extra help being deployed to the school? That's the first question, then I have a second one.

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: Okay, it sounds like it's ongoing. Terry is the one that responded. That's the one that she spoke on.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Northeast Kingdom Human Services does go in immediately. We support everyone and then we continue to follow the school and take their lead on their instruction.

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: Though I don't work in the high school, we have seen the impact in our middle school as well. We've had children's, older students know these kids. We have staff members whose children know these kids, they knew them personally. They've had them in their house. And, you know, it has rocked the entire community. And those numbers are just what you see on the surface for every one suicide. There's 25 attempts behind it.

[Rep. Brian Cina (Member)]: I saw someone's hand behind me. Don't know if

[Rep. Alyssa Black (Chair)]: My head. Yeah, Jamie. Or did you want to wait until you're I think you're next, but you can go ahead.

[Rep. Leslie Goldman (Member)]: Yeah, can just respond to your question. I'm a fellow social worker, Brian. And I work at Euphrates II middle and high school. And in terms of like post crisis situation, it really depends, it's case by case because situations are also very delicate. And so we, in my experience, we're checking in with folks who are impacted and family, friends, a sort of circle of people who are impacted and seeing what people want. And it runs the gamut. Sometimes families don't want information shared. Sometimes family don't want, are getting support from other places. So in terms of like what role the school site is, but we do our best to keep checking in.

[Rep. Alyssa Black (Chair)]: Yes, question about, apparently you all have to go back to school. Quick question, and then again, I was around

[Rep. Francis "Topper" McFaun (Vice Chair)]: the box. Being from a small school, and you met a couple of people, it's sort like, being in a small school, was there signs?

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: Just

[Rep. Francis "Topper" McFaun (Vice Chair)]: right now, they're blue, or they'd be bullying, home life, drugs. What's the signs in a small school? Seems like you should be small enough to see signs.

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: Again, I guess I can't really speak on that because I'm not in the high school. But I guess thinking about the high risk cases that I have in my own, sometimes there are signs, sometimes not. Typically, currently, there wasn't really until we had started screening. Yeah, there really wasn't. But again, the town that I moved into was ranked the second poorest town in the state of Vermont when I moved there. And again, maybe those are the signs since they come in hungry, they come in. I've had kids had to leave school so they can go work in a salt mill to make money. It is a middle school.

[Rep. Alyssa Black (Chair)]: So poverty.

[Raven Pfaff (AFSP Vermont Treasurer; Paraeducator, Orleans Central SU)]: Okay. Want to be respectful of these students and their time.

[Kelsey Stassef (Executive Director, Northeast Kingdom Human Services; Co‑President, Vermont Care Partners Board)]: I'm going to defer on my second Thank you. We

[Rep. Alyssa Black (Chair)]: have three me's still, but if the students, you

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: can stay with me forever, but Mrs. Cote's making fun

[Rep. Daisy Berbeco (Ranking Member)]: of that.

[Rep. Alyssa Black (Chair)]: And thanks for your advocacy. Thank you. You.

[Rep. Brian Cina (Member)]: I hope you get credit for this. Thank you for giving some extra credit for this. This

[Rep. Alyssa Black (Chair)]: This is healthcare, we're allowed to cry.

[Rep. Daisy Berbeco (Ranking Member)]: We cry all the time in humans. Jamie,

[Rep. Alyssa Black (Chair)]: you want to have a seat?

[Rep. Daisy Berbeco (Ranking Member)]: Hello,

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: everyone. My name is Jamie Spector. I'm a clinical social worker, and I'm the school social worker at U32 Middle and High School just down the road in Montpelier. I was mostly coming here with my professional hat on, but I feel moved to also share that I'm also a loss survivor. Ten years ago, losing a student that I worked with very closely in the previous school I worked in. And also three years ago, I lost a community member who was a very close friend of my eldest child's. And that's been a huge impact on my child's life. And I use sheher pronouns. So first, I just wanted to start also with some data. Is it Kelsey? Yeah, Kelsey shared some of this, but just starting with the YRBS data. So the YRBS data, as you all probably know, we get it pretty slow. The data Some people may not know that acronym. Oh, the Youth Risk Behavior Survey. And we get the reports pretty delayed. So the report that we have for our school, the latest one we have is for 2023. The students take it every two years. So they took it last spring in 2025, but we won't get that report for a while. So the report that we have that has the data for our school, and then we can compare that to the state, international data is the 2023 report. So that's the most current data that we have. Roughly a quarter of our high school students reported having poor mental health and feeling nervous or on edge most of the time. Almost twenty percent of our students reported feeling sad or hopeless during the previous year. And seven percent of our students at U32 reported that they had made a plan about how they would attempt suicide the previous year, which is lower, I think, than the state average. But still, that's too high. It's too many. There are many factors. And as a social worker, I'm looking at the big picture also. Many factors leading to these disturbing statistics, of which I think you all are quite aware. Last year, the legislature passed some legislation that will keep cell phones out of schools, which I personally was happy about. And I think that this will be a start to help. And as you heard from the students previously, their concern around social media, I think that that legislation will hopefully help over time to calm the brains and the nervous systems of our students and hopefully start to address some of the anxiety and depression that I certainly see on a daily basis with a lot of the students. But I have to say, with all of the uncertainty around school funding, school reconfiguration, I do really fear about the increased stress coming on school systems. Schools are systems, and I am worried about that. A stress system is a stress system, and a stress system is going to lead to stressed individuals in that system, And that worries me. Families continue to become more and more stressed, as Raven was saying, as costs continue to rise for basic needs food, heating, health care, child care, transportation, all of these costs. Certainly, are impacted by just the disturbing news that they read every day, headlines. And so all of this just leads to more stress in the system. As funding cuts impact schools, there's going to be more stress on the individuals who are left in the buildings. And how is that going to impact students? And so these are just concerns that I have. Every day, we work in schools to check-in with students in formal and informal ways. So I'm a school social worker, but there's also school counselors. And we also have an SAP, a student assistance professional, in our building, which not every school has, but some schools do. We have with the substance use prevention grant, and this is also a mental health clinician. And some schools have school based clinicians, as Raven mentioned. So all of these folks, we're checking in with students formally and informally. We triage their care and connect to them with someone they trust to refer them to more care if needed. But one thing I know to be true is that for real suicide prevention to work, we need to have honest, real relationships with our students. I'm sure you see this in your work. If not, they won't trust us to be honest about how they feel. When you say, I'm worried about you. How are you doing? They'll say, fine. I'm fine. And real relationships take time, and they take patience. And this is harder to do in a stressed environment. So I really felt like I had to be real about that. So when we think about just our school environments, how can we create environments where the adults can really form real relationships? I support the proposed bill H817, the Mental Health Support and Substance Use Prevention Disorder Substance Use Disorder Prevention that AFSP is proposing, because I think it's very much in line with what we've done at U32 and could be replicated at other schools. Kelsey talked about this with Mental Health First Aid. That's something that we've really done a lot of at U32, particularly with Teen Mental Health First Aid. So mental health first aid, there's different versions of. There's youth mental health first aid, which is training adults who work with young people. So we've tried to train as many of our staff as possible in how to work with young people and work with our students. But we became the first as far as I understand, this is what I've been told by folks at our designated agency that we partner with that we've become the first high school in Vermont to embed teen mental health first aid universally for our students. And so teen mental health first aid trains young people in how to support their peers. Because we know who do young people go to most when they're struggling. It's their friends. They're not talking to me. I mean, sometimes they talk to me, but I'm not going to kid myself. I got too many gray hairs. They talk to their friends, right? And so what we've been able to do is myself and the health teacher got trained as instructors. And then every tenth grader is required to take health. And so we've embedded teen mental health first aid in health class. So all of our students get teen mental health first aid as part of health. And teen mental health first aid teaches them what is mental health, destigmatizes talking about mental health, teaches them signs of mental health challenges, signs of a developing crisis. And we talk about suicide openly about it. Everyone practices asking, are you thinking about suicide? Are you thinking about killing yourself? Everyone practices saying those words to just get it out of your mouth. And we're really seeing that it's changing the culture at school. It's building that culture of wellness and that culture of mutual support. And to get it up and running, it's about $5,000 It's not a huge outlay of money. So I think with a bill like this, really instructing schools to really institute something like that, we could see that replicated at schools across the state. Also, in your brief I saw about teaching suicide prevention to staff, it's not part of either of the bills. But like I saw in your presentation about the You Matter, I would love to see something like, I was trained as a trainer, but I've had a hard time getting time to train my staff. I would love to see something legislated that mandates that for school staff, like something working with the Agency of Education that this is mandatory training for all school staff. If we could somehow get that in there, I would love to see that. Because we have that training, but oftentimes, I can't get time with the staff because they have too many other things. And then I know that there's another bill also that's coming up, age six eighteen, the eightytwenty bill with the school counselors, I think would go a long way That's directing school counselors to use 80% of their time on direct and indirect work with students. That would also support the mental health of our students. So all of these things, like how can we just really support the mental health of our students and not have our school counselors substituting in classes, but actually focusing on mental health.

[Rep. Alyssa Black (Chair)]: I appreciate, by the way, everybody bringing up eight seventeen and eight eighteen introduced by our own representative, Berbeco. Unfortunately, they're in house education. But I will talk with the chair of house education to see sort of what they're planning on doing. And if they're planning on taking if they'd like to take that up. So I had, Topper, did you have a question? I have,

[Rep. Francis "Topper" McFaun (Vice Chair)]: no. Okay, and then I'll drop you, Brian. The training that you're talking about, is there training for young people? Yes, the teen. The students themselves and?

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: The teen mental health first aid is for students. They get trained themselves?

[Rep. Leslie Goldman (Member)]: Yes, yes. Okay. Yep.

[Rep. Alyssa Black (Chair)]: Brian and then Allen.

[Rep. Brian Cina (Member)]: Yeah, three questions. You talked about the impact of school transformation, quote unquote, on student mental health, and I don't think we've heard a lot about that. So I wanted to ask three specific questions and I'm hoping that these are the beginning of these questions because I actually think that the education committee needs to hear from you on this. One is, how do you expect increases in class size to impact the mental health of students? Two is what would increase in travel time to schools due to mental health of students? And three, what would restricting access to food by eliminating free school meals statewide due to students? Because those are three proposals that are on the table.

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: So I'll go backwards. I absolutely think that eliminating preschool meals would negatively impact mental health of students. I've been working really hard with various people in our school to do whatever we can to increase food access for our students and our families. We definitely have students and you talked about this too, Raven, if you have things to say. Food insecurity is real.

[Rep. Daisy Berbeco (Ranking Member)]: And

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: it's something that is hidden. It's quite hidden. And so there's a lot of people that hide it, I feel like. And there's a lot of shame around it, both on the part of parents and students. And so we have to ask many different ways, many times, to really get to who actually hasn't eaten, who actually needs the food. And then we're getting the food to them. And so restricting food, taking away food is just a bad idea.

[Rep. Brian Cina (Member)]: Could you speak up a little just because I don't know if everyone can

[Rep. Alyssa Black (Chair)]: hear. Sorry.

[Rep. Daisy Berbeco (Ranking Member)]: I had a student who would be in crisis quite often and basically our first line of prescribed treatment was to offer food and that was what would help the student but they would spiral without it. And there was very limited access at home and our food shelf also has very limited access, which I think you could only go to

[Rep. Alyssa Black (Chair)]: two times a month in total for

[Rep. Daisy Berbeco (Ranking Member)]: a whole thing. But our teachers bought the food that we've giving them outside of lunch with their own money.

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: Yeah. I mean, the travel time and the class size, this is I guess I'm speaking this is my personal feeling. I don't think it's black and white. I mean, I think it depends. It depends on how far they're traveling, and it depends on how big the class sizes are. Personally, I'm not a supporter of huge schools. But I do see, having worked in different sized schools and before Vermont, I lived in San Francisco Bay Area. So I've worked in quite large schools as a school social worker. And then I've been in quite small schools here. There is something to be said of what you can accomplish at a certain scale in terms of opportunities that students can have. So I think there's a happy medium that we can go for. And I guess I think schools just need to become more flexible is maybe my feeling as it relates to mental health, your question. And this, I think, is my feeling in general, just about schools in the twenty first century. Schools shouldn't be like factories anymore. Our schools were designed like factories one hundred years ago. And we're in a different world now. And so we need to become more flexible. And I think that's going to support the mental health of students instead of having to sit in rooms, in rows. It comes to your question of huge class sizes. Right? It becomes more of an issue if it's a huge class size of 30 people having to sit in a room crammed in sitting still. It becomes less of an issue if they're allowed flexible places to sit and they can get up and move their body. And if it's a class of 30 people, but oh, I can actually go and sit in this other space and do my work and sit in a different seating. What I'm

[Rep. Brian Cina (Member)]: hearing, if this is fair, that further study is needed about if school transformation is going to talk about class size, it needs to look deeper than that, that there's many factors involved and that we need to be aware of how these many factors impact mental health.

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: Yeah, personally, I want a redesign of just how schools are designed, period. It's not just about class size, but it's about, let's think about how they're designed.

[Tim Jenden (Board Member, AFSP Vermont; Loss Survivor)]: It's like

[Rep. Brian Cina (Member)]: size doesn't matter. It's what's in it that counts. Exactly. That's what my mom used to say. Yeah.

[Rep. Alyssa Black (Chair)]: She used

[Rep. Brian Cina (Member)]: to say that size doesn't matter. When kids would bully me, being smaller, she'd say size doesn't matter. It's what's inside that counts. And I think that's what you're saying. Like size matters, but it's not what it's all about. It's how schools function and many factors you're talking about.

[Rep. Alyssa Black (Chair)]: There's many factors,

[Rep. Brian Cina (Member)]: yeah. So we need to be, and ultimately your point was that it's a system and that when we mess with the system, it messes with the individuals. So we need to be aware of what we're doing to the system.

[Rep. Alyssa Black (Chair)]: Yeah. But as you said, the students go back to that environment and become hungry the next day. Yeah. And that's terrible. Thank you.

[Rep. Allen "Penny" Demar (Member)]: Well, the confusing little question. You were talking about curriculum in the schools, teaching children, students, talk about mental health. Where are they going to get their counselling prepared to do that? I know most schools have a counselor. So

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: I was talking about a class called Teen Mental Health First Aid, which is taught just in the high school. It's just a high school curriculum. Is it your school? My school. And we teach it only in the high school. And we teach it in tenth grade health class.

[Rep. Allen "Penny" Demar (Member)]: And how many students participate? Whole class?

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: The requirement of teen mental health first aid is that it has to be taught universally. You can't pick and choose. So it's offered to all tenth grade students.

[Rep. Allen "Penny" Demar (Member)]: Is that something you'd like to see throughout the state?

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: That would be great. It would be great. Yep.

[Rep. Allen "Penny" Demar (Member)]: Talking about it, everybody here said talking about it might be the first start.

[Rep. Leslie Goldman (Member)]: Yeah.

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: I mean, I think it's a, you know, there's different, you were saying the one that you teach, wasn't familiar with.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Yeah, there's different levels of So mental health first aid, you have to have 5% of the school that trained with youth mental health first aid before you can deliver it to the school. And then you have to come up with a plan to deliver it to the entire school over the course of four years.

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: Well, it has to be universal. So we got around the universal by saying we do the entire tenth grade. And they accepted that.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: The shorter trainings that we do, there's one called It's Real Team

[Jamie Spector (School Social Worker, U‑32 Middle & High School)]: Mental Health. That's the one,

[Rep. Alyssa Black (Chair)]: It's Real.

[Terry Lavely (Board Chair, AFSP Vermont; Training & Community Engagement Director, NKHS)]: Forty five to sixty minute offering similar to your training. So there's different levels of trainings and it's what the school is ready for. Oftentimes we find we go in and we start with like QBR, it's real team mental health, and then they're like, we want more. And then we get to build it in the mental health person into their curriculum for the next school year. It's building those relationships and also having the funding to be able to do it, because it is expensive to get these trainings up and going, and having the relationships with the school is the biggest key. I'm very trusted, I feel like I'm very trusted by our views in our school communities as a mental health professional. It's the system development, it's not

[Rep. Daisy Berbeco (Ranking Member)]: going happen over Thank the

[Rep. Alyssa Black (Chair)]: you. Thank you all, Jamie. Thank you for your work. So we're going to take a break until 03:00, but I wanted to, I just wanted to thank everybody for coming in. I wanted to thank you for being here today, for all the work you do, the advocacy. Sometimes I feel like I should do more and that I just We're doing more right here. Sometimes

[Rep. Daisy Berbeco (Ranking Member)]: I feel like, oh my

[Rep. Alyssa Black (Chair)]: gosh, I'm so concerned about healthcare that I never forget why I am sitting in this seat right now. Anyways, thank you.