Mental health care services are available in more than 80% of Minnesota’s public school districts. That figure represents
progress over the past 20 years
, though persistent gaps remain.
While most student mental health support is provided by a combination of school staff and school-based mental health practitioners employed by outside agencies, other nonprofit programs also spend time in the state’s schools, offering unique types of care. These services include peer support for students living with addiction, or culturally specific support groups and activities designed to meet the unique needs of students from immigrant and refugee communities.
One of these nonprofit programs is Know the Truth, an independent offshoot of the Twin Cities-based Minnesota Adult and Teen Challenge. Know the Truth was created in 2006 as a prevention program designed to bring young people who had recently completed addiction treatment into schools to talk to teens about their own experiences.
Sadie Brown, Know the Truth director of prevention and community engagement, said that her organization started as a “grassroots effort going into schools,” providing guest speakers to add context to information that students were already learning in health class units on drug and alcohol use. Eventually, Know the Truth expanded to provide peer recovery services, developing partnerships with a number of Minnesota public school districts, including Anoka-Hennepin and District 916, which provides alternative programming to students in the northeast metro area.
Know the Truth provides expansive supports related to substance use, Brown said. “Not only are we meeting with students who are actively using now, we are also hearing from students who have use present in their home, say with mom, dad or siblings. And we are meeting with students who are in recovery and want to explore recovery — like how do they navigate that and find like-minded students who are also on a recovery path.”
Another nonprofit, St. Paul-based Restoration for All, focuses on supporting the mental health of the state’s African immigrant and refugee community. It also has also brought mental health-focused programs into public schools. Founder Tolulope Ola, a Nigerian immigrant and community activist, explained that she and her colleagues decided to expand their mental health supports to refugee and immigrant youth because they felt that not all teachers and staff understood their unique culture and experiences.
“We saw that students from our community were struggling,” Ola said. “We were concerned they were being misunderstood, and we knew we were best equipped to support them and explain to others where they were coming from.”
Working with youth is work with ‘purpose’
Every morning, Tiffany White wakes up knowing she’s doing a job she was born to do. As a youth peer support specialist for
, White spends her days talking to young people in schools about drug and alcohol use.
Peer support specialists rely on their personal histories of addiction and recovery. White, now four years sober, is more than willing to talk about her long and painful journey with alcohol abuse. “I talk about my life every single day,” she said. “I tell the young people everything I went through because I want to help them. My life is no secret.”
In her teens, White avoided substances, but by the time she turned 21, she started drinking alcohol. “It seemed OK to drink because it was legal. I fell into it,” she said, explaining that she wasn’t “an instant alcoholic.” Within a few years, White’s dependence on alcohol had accelerated, and what at first felt like fun lost its luster.
“I started to get some real-life consequences,” she said. “I spiraled into depression and suicidal ideation. I got to a place where I didn’t care if I lived or died.” She drank so much, she said, that, “I started to have
and
. I’ve been in the hospital, in jail, but hallucinating really scared me.” For White, that crossed a line. “I thought,” she recalled, “‘If I’m not going to drink myself to death, I’m going to go to treatment.’”
White checked herself into a 13-month-long residential program at
, a faith-based addiction treatment and recovery program with locations around the state. After completing the program, she took a job doing urinalysis tests for program participants. Then, someone told White about Know the Truth, a secular offshoot of Adult and Teen Challenge. She signed up to do a presentation for a local high school health class, where she and others shared personal stories of addiction and answered student questions.
The experience was significant.
After the presentation, a girl came up to White. “She was crying. She said, ‘I didn’t think anyone did the same things my mom did until I heard you speak.’ I saw I could use my own experience to help her. I thought, ‘This is what I’m supposed to do with my life.’”
During the academic year, White works out of three Twin Cities public schools (
St. Anthony Middle and High School
,
Quora Alternative Learning Center
in Little Canada and
), where she meets with individuals and groups. But her work isn’t limited to school hours: She also provides peer support services for students in the community and she regularly attends public events, like
, a training and education program for young people on probation in Ramsey County.
If a student is assessed by a school social worker or psychologist and approved for peer support services, White can meet with them outside of school. In those cases, she selects spaces where teens feel comfortable. “We go to events, for walks, to the movies,” she said. “Sometimes we just ride around for two hours and talk.”
White also gives the young people — many of whom are struggling with their own or their family members’ addictions — her phone number. “I tell them they can text or call me anytime.”
Always being on duty suits White just fine. “This is what it is like to work out your purpose,” she said. “I work a lot. I don’t take time off, because it’s my passion. It doesn’t feel like work to me.“
One size does not fit all
The way young people think and talk about their mental health is influenced largely by their cultural background.
founder Tolulope Ola understands this at her core.
A Nigerian immigrant and community activist, she saw that members of her community — especially young people who straddled between their family’s traditional culture and that of their U.S.-raised peers — struggled with their mental health. The adults in their schools often misinterpreted what they were trying to say, or failed to see that they were hurting.
These misunderstandings arose from a lack of cultural knowledge, Ola said: “Most of the organizations working in the schools don’t have what it takes to work with immigrant and refugee families.”
These gaps include a lack of personal understanding of the immigrant and refugee experience. “Many of these kids spent a foundational part of their lives in refugee camps,” Ola explained, where they learned survival skills often at odds with American behavioral expectations. When they surface in everyday interactions, these survival skills can be misinterpreted by school staff, and students can end up with diagnoses that aren’t accurate.
To address this issue, Ola said that she and her Restoration for All team have visited schools to hold workshops with school staff. They share information with educators about the traumas that many young people and their parents endured on their journeys to the United States, and they offer concrete examples of how best to interact with students when speaking about their mental health.
“Instead of asking kids, ‘What is wrong with you?’” Ola said, “we want educators and other adults to instead ask the question, ‘What happened to you?’ These children have lived through so much. The body holds the score.”
Ruth Ezeagwula, Restoration for All mental health and suicide prevention coordinator, said many young people from African immigrant and refugee communities feel like they have to switch behaviors and ways of speaking between school and home, especially when it comes to discussions about mental health. While immigrant and refugee kids are taught about the importance of speaking up about mental health concerns at school, many of their families avoid or even discourage talking about these issues at home, Ezeagwula said.
“Mental health wasn’t a thing that was talked about among the older immigrant and refugee population. It was mostly just, ‘Suck it up,’” she said. “Trying to bridge that gap is hard.”
In 2023, Restoration for All was awarded a four-year, $400,000
Comprehensive Suicide Prevention grant
from the
Minnesota Department of Health
(MDH), allowing them to expand the services to young people. This feels particularly important, Ola said, because there has been an
among young people in the state’s African immigrant and refugee community.
“We are providing services for children, like mental health screening groups and individual therapy as well as suicidal monitoring,” Ola said. “We also do African mind-body practices to get them grounded. Sometimes they respond more to therapy when it is grounded in their cultural practices.”
Another MHD grant has funded Restoration for All’s work in schools in the Twin Cities, St. Cloud and Rochester “in connection with another organization called
Progressive Individual Resources
, as well as working in communities on [substance use disorder] and building peer support,” Ola said. “Though these issues cut across generations, our focus is on youth.”
On a late spring afternoon at St. Anthony Middle School, White is having a slow day. On the days she’s assigned to the school, she holds open hours in her basement office and schedules one-on-one appointments with students looking for addiction and mental health services. She also hosts support group meetings in the school library.
“It ebbs and flows,” White said of student visits. “Sometimes I’ll have a full load of kids. Sometimes it’s quiet.” Sometimes, concerned teachers send students to her. Other times, kids stop by for a quick check-in on their own.
While she wants young people to avoid using substances, White understands that many teens already drink or use illegal drugs or tobacco. She also believes that schools underreport substance use among students. “They might say only 2% use, but from what I hear it’s actually more like 70% of students use,” she said. “Schools turn a blind eye.”
Because of widespread use, White chooses to take a gentle-handed approach to her work. She believes accepting reality is the best way to actually help young people quit. “My goal is harm reduction,” she said. “I want these students to make educated decisions. That wasn’t available when I was young. I’ll just say, ‘Don’t do it for a day.’ They’ll come back and say, ‘I didn’t do it for a whole week.’ It’s a kind of reverse psychology.”
White’s work in schools is paid for by contracts and grants awarded to Know the Truth, not by individual insurance. Partway through the school year, she learned that her contract at Hastings High School was eliminated due to federal funding cuts. Not having a peer support counselor at the school has been a blow to some of the kids she saw there, White said. “They are really struggling. They’ll text me and say, ‘I wish you were here.’”
While cutbacks like this are discouraging, White tries to focus on the inroads she’s made with students at Quora, an alternative learning center for students with behavioral health needs in Little Canada.
For her first year in the building, White said that students didn’t trust her and it was nearly impossible to make inroads. “It was too chaotic,” she said, adding that the chaos made it impossible to hold support groups. But with time and patience, things changed: “It took me a year to get the students to trust me. But they trust me now. They are like night and day. They are asking me questions, talking to me. It feels pretty successful.”
White credits much of her success to what she calls her “genuine approach.”
“The kids call me Auntie,” White said. “They know I am an authority, but they want to hear what I’ve got to say because I have a friendly demeanor. I tell them, ‘I’m not here to judge you. I don’t care what you do. I just want to help.’ Saying that kind of stuff to them, that breaks the ice, and together we can make a change.”
This article was published with support from the Solutions Journalism Network’s HEAL Fellowship.
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