Sierra High School's School Based Health Center

 With us today are Dr. Maya Boustani and Yesenia Ceballos to engage in a conversation around the development and implementation of the school based health center at Sierra High School. The hope and intent is that listeners can glean from the conversation, meaningful and useful information and ideas as they embark in their development and implementation of school based health centers in their schools and communities. 

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School-based Health Center information: California School-Based Health Alliance Visit Inland Empire School Health Coalition to join the Coalition Check out past recorded webinars on School-Based Health Centers: 2023-2024 2022-2023.
For more information on Healthy SBCSS, visit www.healthysbcss.net or contact Ms. Farrah Northcott, RD, Director, Healthy SBCSS by calling 909.386.2775 To contact today’s podcast host, please email: hector.murrieta@sbcusd.k12.ca.us If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lif...

Transcript

Hector  00:08

Hello and welcome to the inaugural episode of the school health connection podcast. My name is Hector Murrieta and I'll be your host. I'm also the proud principal of Sierra High School in the San Bernardino City Unified School District of which you will learn about throughout this podcast. A deep and heartfelt thank you to the California school based health Alliance, and the San Bernardino County Superintendent of Schools for making this possible. With us today are Dr. Maya Boustani and Yesenia Ceballos to engage in a conversation around the development and implementation of the school based health center at Sierra High School. The hope and intent is that listeners can glean from the conversation, meaningful and useful information and ideas as they embark in their development and implementation of school based health centers in their schools and communities. Dr. Maya Boustani is Associate Professor in the School of behavioral health at Loma Linda University, and is a licensed psychologist. She has partnered with Sierra High School for the past six years. Welcome to the school health connection podcast Maya.

Maya  01:15

Thank you for having me.

Hector  01:17

Yesenia Ceballos is the wellness counselor at Sierra High School, and an associate Professional Clinical Counselor. She has been at Sierra High School for nine years. Welcome to the school health connection podcast you Cynthia.

Yesenia  01:30

Thank you. I'm happy to be here.

Hector  01:32

So thank you, and welcome, ladies. So for our listeners, can you just describe your background a little bit so they know more about you? And we'll start with you Maya. .

Maya  01:43

Yes so, as you mentioned, I'm associate professor at Loma Linda University. I'm also a licensed clinical psychologist, I specialize in children and adolescent mental health, mostly adolescents. And my research really revolves on developing and implementing mental health prevention and promotion programs, in community settings, and particularly in school settings. Which is why you know, I've been hanging out with you guys for the past six years.

Hector  02:06

That's awesome. Thank you. Yesenia tell us about you?

Yesenia  02:11

About me? Let's see, I've been in education for about over 25 years. Actually, I started as an instructional aide a long time ago. And then I went to teaching, I was an academic advisor, went into counseling. And then right now as a clinical counselor, the work that we've been doing and ultimately, where we are right now has been driven by my past experiences and shared background with our families and with our students. So that's what brings me here today.

Hector  02:39

That's wonderful. Well, thank you, ladies. A little bit about me. Gosh, I'm entering my 20th year as a school administrator. But I was a math teacher before that instructional assistant as well as a teacher at the adult school. And yeah, so it's been a, it's been a blessing and, and it's been fun to be here now. With with both of you. So now, you know as we go back to the beginning of our journey together, takes us back to about 2018, where I reached out to Dr. Juan Carlos Belliard at Loma Linda University, and pitched an idea to him. The idea was this, that Loma Linda University, your higher clinical psychologist, and Sierra high school pays for the position. The reason that I had to pitch the idea to him in that way was because I as principal, I can't just go around creating positions, especially if of that nature, the district would have to do would have what the district would have to do would be an onerous process. So I figured that would be a good way to, to work around that because as a principal, I can pay an institution like Loma Linda for a service. Anyways, his response was something like, Hey, I'll do something better than that. Hector. Let me connected with Dr. Boustani from our psychology department. And I've never asked you my you know what, what happened after that? All I know is that here we are in our six, seventh year of a wonderful and robust partnership that was that resulted in our school based health center. So I'll ask you now, what describe what happened after that after Dr. Belliard approached you.

Maya  04:26

So this was my first job as a professor, I left UCLA as a postdoctoral scholar working at LAUSD Los Angeles Unified School District. So I had some partnerships there through my mentor. When I moved to the Inland Empire, I needed to set up my own partnerships, and Dr. Belliard runs the Institute for Community Partnerships at Loma Linda University. So my chair department chair said you should talk to him and maybe there's already some people out there that want to work with you. And he said you need to meet these people at Sierra High School. They want to partner with a researcher they want to do this work and I I think we met. ,

Yesenia  05:01

Yeah, this is all interesting for me too. Because it's news to me. I'm like, Oh, cool. I didn't know. .

Maya  05:05

Yes and, you know, he knew I wanted to work with adolescents. He knew I wanted to work in settings where there's a lot of need, and not a lot of services. And that's when he introduced me to you. And I came over and saw the school and met you both and the rest of the

Yesenia  05:18

organic Yeah, it was very, it wasn't, it didn't feel official or dry or rigid or anything like that. It was just a conversation. We had like mutual interests, it felt like we were open to it. I was just a static when Mr. Meredith said that, you know, hey, we have somebody willing to come and work with us, like what, you know, it felt like Christmas

Maya  05:39

such a blessing to have partners like you all, because I do know, sometimes it's hard for researchers to partner with committee and committee settings, because people are busy, you're busy doing, you know, instruction and classes and things like that. You don't necessarily want to work with a researcher and do all that stuff. So it really worked out nicely.

Yesenia  05:59

It absolutely did. But it's interesting that you say that, because the feeling, I guess like from our sides, or the people that I've spoken to, to also say it's so hard to find somebody that wants to come to the school and do the research and provide the services. I think it's also a good example, to show that how this relationship has grown and how we're open and pretty flexible to do everything actually could work. And it's beneficial, I think, to both sides.

Maya  06:24

I agree. And you know, I think there's also sometimes history of researchers kind of doing their research and leaving, you know, and I think here, it's a true partnership. And when I have students join my lab, I always tell them, you know, I'm married to San Bernardino Unified School District, it's a marriage, you know, sometimes things are well going, well, we have stuff happening, sometimes things are tough hiccups, but we stick together, you know,

Hector  06:49

Yeah, and we'll get into those and precisely, you know, I was reflecting, you know, when we're preparing for this, that it's just fascinating, it's going on seven years. And so, you know, for our listeners, we would just like to stress and you're hearing it, the importance of partnerships in establishing your school based health center, we've said all along, and we continue to say this, that, without this partnership, and others, we really wouldn't have a school based health center, definitely at Sierra High School. And, you know, being where we are today. So having said that, you know, the next step, you have to forming the partnership was starting to set up systems collaboratively. Yesenia, I'm gonna go to you to see if you know, for our listeners, if you could describe your experience in process in, in setting up the things that we don't really see, you know, running a school based health center, a lot of visible things, of course, but there's a lot in the background that that you don't see. So for example, you know, back six, seven years ago, I recall that you told me that Maya worked with the data that Dr. McCray had gathered had gathered. How both of you worked on the student survey? physical space needs your themes like that. The basics, yeah, describe that. How did that go?

Yesenia  08:10

How did it go? Or how did it originate? How is it actually originated? Because Dr. boustani actually was the one who said well, we need A, B and C if we're gonna do this. And I didn't know what to do either. We were visiting other schools were following other guidelines trying to get an idea. I really based a lot of the stuff on from CSHA, the handbook, the guy to see what do we need to have in place, I just didn't know what to do it. So really, the partnership was Loma Linda, guide a lot of the work because by Maya telling us, okay, this is what we need in place, we need a space, we need a pilot, so many students, we need, you know, what do you have, you'd ask questions why I was like, Okay, what do you have in place for this? And I'd be like, well, we don't have it created yet. But we do need to, you know, create some kind of a survey. A lot of the work helped with Dr. McCray previously being at our school and, and doing the focus groups and the study for the year and just guiding that work. But the work with Loma Linda actually, with my eyes, what launched everything. So I I honestly knew what kind of systems I needed based on the handbook. And by my recommendations. Well, you know, for example, we need a space, what space do you have? We didn't even think about that, right? That was a biggest thing. And I know I say it all the time. We needed to build it because they were already there. Right? They came we had to hurry up and figure it out. So we had to get creative. So more than anything, it was those structures. So we needed to have the universal screener. That's why we came up with that because we had to have a pool of students to feed what I call feeding your students, right? Because if they don't have clients, why are they going to come to our school and just wait for clients to come because they need to fulfill their hours. Of course we had students that needed services too, but we didn't want to be reactive. We wanted to be proactive and be ready just have that pool for yourself overall for Loma Linda for Pav for IEHP. And that's how that started because under Myers and Dr. McRae's suggestion with just the screener itself, right. And then the systems, it was just our partners telling us what they needed. And us creating a space and the systems that we needed to have for them to be able to be functional at our school. So it wasn't like, Okay, this is how I want you guys to function. And we said, this is Sierra High School Division, and I want you to fit into our puzzle this way. It's more like, every time I envision our program, I see it more like the grinds of if you take off a watch right or o'clock, and you see it all working together and simultaneously, but at the same at different times as well. We had a work together that way and move, because also with Loma Linda, they have different schedules, right, we had to make sure that we're gonna be flexible with the students, and we're gonna create that space. IEHP needed different things to so it's a long answer to that question, because, honestly, it was flexibility, making sure that we created the space and provided the the services and systems that our partners needed to be able to function at our schools. 

Hector  11:17

Yeah and I want to expand on some you you've said a lot in your answer was word space. I know. That's the part where for me, and if there are any school administrators out there listening, you'll you'll know where I'm coming from. But yeah, when when the issue of space came up, because for those of you that those of us that work at Sierra, or if any listeners have been to Sierra, we know that Sierra space at Sierra is a is a commodity. So I remember that was, that was a difficult task to figure out a space. And I don't know if you both of you recall, but we we settled on that that self standing building, commonly known at Sierra as F5. And if you recall, that's where we first launched this class, right? Like, right there. And then we quickly learned, right, like, like, within a semesters time, that it just wasn't, it wasn't going to work. Do you remember that Maya?

Maya  12:14

Yes, yes. And just to back up a little bit and informed our listeners, the partnership was really me having my doctoral students doing their training at Sierra High School in terms of gaining clinical experience and clinical hours. So the students needed space to my doctoral students needed space to see your high school students, you know, to therapy. And so we had this classroom, which first of all is too big for therapy room, it just didn't feel very cozy or private. And then you have multiple doctoral students there at the same time, and there's one classroom. So how do we, you know, navigate all the scheduling and the space when you only have one space, which is, by the way, large, and like a classroom setting does not feel very therapeutic? It feels like you're still in class. Right?

Hector  12:59

And we learned that pretty quickly. And I know, from my standpoint, you know, I had to have, you know, the conversation with the teachers. And again, for those of us that work in schools, we know that what, what, what of, there are a few things that upset teachers more, I think, than movie. And I remember, you know, I had to have those conversations, and it wasn't an Ask it was, okay, this is what we're gonna do. And but you know, going to task on finding another spot for them. And, you know, and and maybe this is a whole different episode, but we can get into how, you know, wellness was getting a lot of attention at that time. And not everyone was on board. So it was a unique time.

Yesenia  13:42

On campus on campus. There were some feelings. Oh, yeah.

Hector  13:45

Yeah, the hurt feelings. And but anyway, so we launched that. And then, so when you told us Maya that oh, yeah, you know, the space isn't ideal. So we knew, Okay, we gotta go to task on finding another space. And then, and I know that day was memorable for me. I don't know about you miss Ceballos but we were we were walking out in the quad in the back. Oh, yeah. And we were talking, I forget about what but then I looked over at the current building, where we have our current Wellness Center, and I said, I positive Hold on. What if, and I point it I said, when we

Yesenia  14:15

stopped my heart because I knew it. That meant we're gonna have three classrooms as opposed to one.

Hector  14:21

Yeah, for our listeners that obviously I've never been to the school. It's, it's, it's a building with three classrooms and they're connected inside. So it hit me in that moment. It's like, right there. We got to do it there. And I remember you just saying, well, but

Yesenia  14:43

now yeah, it was gonna be great. But are you gonna be you know, we're gonna get a lot of pushback.

Hector  14:47

And we laugh. Yeah, we did. So I went to task on informing you know, those teachers because it displaced six teachers, three classrooms, and we had to figure out where and then I had to go between you know, I felt like had my tail between my legs and go back to the teachers that I had just displaced and said, oops, I'm gonna change my mind. Now, also, yeah, I got a lot of the rolling of the eyes and but anyways, when we got through that we are we're, you know, we, that's where we're

Yesenia  15:17

creating the individual spaces to because to address the part of the huge classroom just for one, it wasn't feasible for at that point we were piloting the first year just to see how it would feel. And then after, you know, you and your students who said it was a good thing for you guys. And of course, we loved it, we couldn't service more than five students, maybe even a day or maybe, like, at a time or yes, at a day was one classroom. So to get the biggest bang for the buck, when you moved over there, then we had to create smaller spaces, that gave a little bit more privacy. And that was a tall order, too, because we had to figure out, you know, what's approved, what's not approved, what's private, what's not private, in order to have these confidential conversations, but it worked out because even the counselors, when we were, where we were, before, we had just separators in between, it's like three foot, you know,

Hector  16:13

like three foot, three foot high cubic, zero privacy. Yeah, it was definitely a very disruptive to a lot of people and their work lives. And, and we were joyful, because we were actualizing our vision, but it was a tough time as well. But you know, as all of us know, those sacrifices reap a lot of benefits. And one of them is we're living it right now with with the services that students are, are receiving. And that kind of puts us in our current phase, which includes now the, the monitoring and the and the maintenance, if you will, of the entire operation. So ladies, I'm gonna ask you to describe you each of you describe, you know, currently, you know, what's your current experience, day to day in the operation of the school based health center at Sierra and Maya, I'll start with you. So in other words, you know, you're not at Sierra every day, but somehow it must affect your work day and please describe that.

Maya  17:15

Sure. So I am not on the ground, my students are on the ground, seeing your students. But the way it impacts my work life, if you will, is I'm the licensed psychologist, the students are in training. So they work under my license, I supervise their cases, I know about all of your students and what's happening and their needs. You know, oftentimes we're working with managing risky situations, you know, suicidal ideation, you know, domestic violence, all of these things. So it's really helping my students learn how to manage those risky situation, meeting them as a group, meeting them one on one, and then coming over to Sierra every couple of weeks to, you know, sign paperwork and meet with you all. So it's one of my favorite parts of my job is managing all those cases with my team

Hector  18:03

One thing, I'm going to add that because for you, it's probably you know, part of your, your work now is, you know, you're part of our COST team. Just to remind me that the acronym COST. It's our wellness team, but

Yesenia  18:18

coordinations coordination of services team, right?

Hector  18:22

So Maya participates in our bi weekly COST team meeting. So yeah, I mean, you're you're, you're actively involved in that as well. Yeah. And I know your students are giving you feedback, because sometimes I'll get feedback from you just saying, hey, you know, Maya asked for this or Maya needs this. So, so yeah, it's like

Maya  18:44

White noise machines for privacy

Yesenia  18:46

to make sure. Yeah, cabinets.

Maya  18:49

And all that stuff.

Hector  18:50

Yeah, that's right. So just saying, Yeah, how about you? How does obviously, I mean, you are there every day. So that's how it is the running of our school based health center. Impact, describe how it impacts your work, workday.

Yesenia  19:06

I'm trying to, I'm trying to figure out how to package that. Fortunately, you're wise enough to create that as a position, an official position a job, which is that's all I do. So, so basically describing like my job description, like what I do, what does it look like in our

Hector  19:23

listeners, you know, as they embark in this, what it's going to mean, let's say there's an administrator out there that says, Okay, I'm going to create a wellness counselor position. Yeah, like you did Hector. What what is that going to look like for that person? 

Yesenia  19:36

It's the coordination of all the services and managing all the relationships with the partners as well as building that rapport with the students and doing case management like to begin with as well. Sometimes you're doing depending on what the licensing is of the person who they assigned for them to provide services. Because when you do the intakes, you're also dealing with delicate situations and you have to know how to Do the referrals as well. So they have to have that background, at least for us. That's what it looks like with us and to be able to complete the referral services work with the interns to help because it's not a one man job either I, I have felt overwhelmed at the beginning, but it was a wonderful position to be in just because the need is there. So overseeing and training the interns. Thank God that you hired to AMFTs as well to help with case management, it's a lot of case management and coordination of services overseeing making sure that the data you have to learn about data to Maya has helped a lot about us learning how to record and track our students and see what the outcomes have been with them. I'm trying to think what else even just facilities I mean, I've gone down from building to mopping, sweeping dusting hosting, I mean, you're you're you shouldn't say you're a jack of all trades a little bit, but you do because people are coming to your home. And so you want them to feel welcome. You want to make sure that you're managing all the services as well as you can, it's since it's not a defined official defined position, I guess you would call it like a wellness coordinator type of position. That's basically what I've done, just make sure that from the little things all the way up to the relationships, especially the relationships with the partners to make sure that everything is flowing from there and that the students are receiving the care that they should be Yeah,

Hector  21:31

we knew we knew right away that it would be a full time job. You know, I knew from a principle standpoint that it couldn't be an adjunk duty of yours, you know, okay, do some scheduling and now do some wellness. No, no, it's a full time job. And I know from a principle standpoint, yeah, I know that. It's something like I even if I'm not doing it every day, I know, it's on my mind every day that, you know, not only in my running a school, but I have to remind myself Wow, I'm in a sense running a school based health center. And everything that comes with that. The the questions, the the visits, the inquiries, heartbreaks, the bad news I get from the district sometimes and maneuvering real tough situations. Because it's not typical in a school, you know, we you know, you become an administrator to run classrooms and things like that. But we're operating.

Maya  22:36

Yeah, go ahead. And I just wanted to say two things. One is the partnerships and the Wellness Center for the listeners, it's not just Loma Linda. Oh, yeah, there are many partners involved. So when you say coordinating the partnerships, you know, just wanted to kind of stress that

Yesenia  22:50

just when it's our IEHP Navigators, the Hazel Health, also our Partners Against Violence, our PATH partners, other partners that come on as well, when we host health fairs that we started as well. So it's the coordination of health fairs for the school is you got to maintain those relationships. Absolutely. 

Maya  23:07

So so it's a lot. And then I also wanted to say, you know, what you said is so true. It's not You're not just a principal for academics, you do have this bigger role. And that's what makes you such an amazing partner, because you have that vision of the whole student. And that wellness is part of education. And you've said this before, you can't learn if your mental health is not stable. 

Hector  23:28

Exactly. Well, thank you, Maya. Yeah, no, it has it's been a blessing and, and it's been a huge learning experience. Yeah, because we're not we're not in a typical school. We're really not.

Yesenia  23:39

And to that point to what Maya saying, it's really hard to find leadership that isn't afraid, because a lot of it is the fear of what's the liabilities and what happens and what if so, I feel like sometimes, at least to the people who I've spoken to, they're they want to do it, but they don't go all in the way you have because of that apprehension of this isn't my space. I don't know what to do with this. What if the what ifs you do the what ifs in a good way but there's some what ifs and then my what ifs 

Hector  24:08

Yeah, my what ifs makes you guys a little bit nervous. Well gosh ladies, I'm sure we can talk about this forever because there's there's a lot to say but you for now I definitely want to thank you for your time and I personally this is just now me personally, selfishly I want to thank you for the distinct blessing it's been to work with both of you this whole time and it's just I know for me it's invigorating. You know what's coming I mean, look, we're doing a podcast now. So it just it's just like the unknown what's happening I know for me that's that's personally selfishly very invigorating. So, so thank you. So before we close out though, I just wanted to see if either of you had any final thoughts to share, Maya, we'll start with you anything?

Maya  24:57

I just want to you know, just encourage the Other schools to embrace wellness and and see where it takes them and how it can improve academic outcomes for, for their students.

Hector  25:09

Thank you, Yesenia?

Yesenia  25:10

Absolutely same as what Maya says. I mean, we've seen actually, when you talk about just academic outcomes and connection to the school, we have seen a change with the students, and the seven years of them feeling like a more sense of belongingness to the school, and it becoming the first space where they receive support and help and even the families, it's been extended to them, too. So I do encourage all of those who are thinking they have kind of their foot in the water, but they're not sure if they're going to jump in jump in, because they really do get a benefit to our families and our students from the services. ,

Hector  25:44

Yes I would agree, and the anecdotal and hard data, definitely the the, the play out in the benefits to the students. And, and to that point, I know, that's our next big challenge project, if you will, is really tying the data to academic outcomes. Because, yeah, and from a principle standpoint, I do hear, you know, I hear it Oh, that's great. Hector, but then there's that, but how is it resulting in in, you know, academic growth? Okay, I'm gonna for the challenge and what we're doing, right, and we're gonna work on that data, and we're gonna, we're going to show the world that it sure does, but well, so to our listeners, I also want to extend an immense thank you for joining us and sharing and hope you share this with others. As principal is at Sierra High School, I want to extend an invitation to everyone listening to visit our school based health center at any time, but especially spoiler alert in 2025. When our new when we move our current center to our new building, as we speak, building new buildings are coming up, and one of those will house our brand new Wellness Center. So we hope to see you out there, and we'll definitely see you next time on the next episode of the School Health Connection. Thank you very much.

Maya  27:11

Thank you.

Yesenia  27:13

Thank you. 

Hector  27:14

In our conversation today, we mentioned suicide ideation. If you or somebody you know is in emotional distress, or in a suicidal crisis, please remember that you can call 988 The suicide prevention and mental health crisis lifeline.