Episode 11: Blue Hawaii

Even in the land of sandy shores and swaying palm trees, anxiety and depression remain on the rise. Between Covid, school closures, new variants, and more, the past 24 months have created a roller coaster of big emotions for many Hawaiian students. At the same time, mental health providers are burning out. Dr. Dennis Itoga, clinical psychologist and Adjunct Professor at Chaminade University in Honolulu, discusses the increased need for mental health professionals to serve students and the challenges of attracting more people to this work. But as Dr. Itoga explains, there are also reasons to be hopeful.

Connect with Dr. Itoga on LinkedIn: Dr. Dennis Itoga Profile

Transcript

Announcer:

You're listening to the Voices In Education Podcast powered by Securly, where we hear from new voices and explore new ideas about how we can reimagine education to support whole student success. Education is at an inflection point. As we grapple with complex challenges like funding and enrollment, as well as diversity, equity, and safety, we also have an opportunity, an opportunity to reimagine education. Now more than ever, we know the importance that students’ overall wellbeing plays in their success. They need to feel supported and safe and connected to be able to engage in their learning and achieve their full potential. Join your host, Casey Agena, a former teacher turned instructional coach and technologist, as he interviews inspirational educators, school leaders, wellness professionals, and more to amplify their voices. You'll learn about the innovative work they're doing to support student safety, engagement, and overall wellness. And who knows, you may even spark a new idea of your own. Ready to reimagine education? Let's go.

Casey Intro: 

I'm your host Casey Agena and in today's episode we are uncovering the challenges of getting more counselors and psychologists in our schools and having them available for students and their families. Dr. Dennis Itoga is a professor at Chaminade University in Honolulu, Hawaii, and he's working on this pipeline. And we will also be talking about the challenges that he has had. Welcome, Dennis. I'm glad to have you.

Dennis:

Thank you for having me. Appreciate it.

Casey:

Yeah. Well, we had a chance to talk a little bit briefly pre-show, but how has the past 24 months impacted your work and the communities that you serve?

Dennis:

Well, when COVID came, it just impacted us instantly. It was almost something we had very little time to prepare for, and as we were quarantined and told by our state to stay home, we were blessed to be in the work that we do and considered as essential workers, because we all felt like we got to keep doing our work. The difficulty is we weren't prepared to do comprehensive psychological evaluations, which is what we do at Family Strengthening Center, where we're contracted to work with children and families affected by child maltreatment, and it was essential for us to go from onsite evaluations to find a way to do tele-assessments.

Casey:

And with all the work that you do in conjunction with either the state, court-appointed, whatever it may be, having that remote piece was I think really challenging, because it's not only just hearing from folks, but it's seeing them in their environment, making those evaluations that are really crucial I think for them, and information that's going to really put them on a trajectory towards an end goal.

Dennis:

Absolutely. Well, one of the things was we do lose a certain amount of abilities in assessing via tele. It's just because of the tactile or motor kind of pieces that we might need for younger children. At the same time, we also were mindful of the need to deliver the service, because permanency is the outcome. The desired outcome is to reunify children once we identify the risk, and provide treatment recommendations to strengthen families.

Casey:

Clinical psychologists, it's been challenging, I think not only for folks in Hawaii, but I think in all the rest of the 50 states or any regions that we're working on. One of the unique things that you also have as part of your professional work is not only as a clinical psychologist working with adolescent youth and families, but also as an adjunct professor and working with individuals who are wanting to be just like you and jumping into this field. Tell us a little bit about your work there and what you're seeing from these students who are wanting to get into this pipeline of clinical psychologists.

Dennis:

Well, first I would hope that they don't want to be like me and they want to be like them, but to be a competent and confident clinical psychologist, yes. And it is a new experience for me to be teaching at the college level, but what I see is, it has been just amazing to see the hunger and the desire and the prospect of having clinical psychologists being prepared to address a shortage that we see here in Hawaii. We are short of clinical psychologists, and the need, and largely in part to the pandemic, we see the mental health treatment needs, serious harm occurring, domestic violence and increased substance abuse.

Casey:

You know, it reminds me of someone that I talked to a couple weeks ago. We were talking to folks out in the Northeast, and they're a school psychologist, which I know that is different from a clinical, but a school psychologist working at the district there. And he identified through indicators coming up through the school social worker, through the interventionist and the classroom teachers, that there were two particular students, a 14-year-old and a 16-year-old that really needed more support, by calling for help, some substance abuse issues and whatnot, but he was stuck. He didn't have a place to refer these two children outside of the district because there were no clinical psychologists to help them out. Is that pretty similar in Hawaii?

Dennis:

In the beginning, just finding providers was very difficult. People were responding with their own family needs, and having their own children at home was difficult too. So the amount of providers went down. As far as the levels at this point now, it's very much similar, is we have wait lists and people are three to four months on a wait list trying to get these services. And that in itself, at best you're maintaining the problem or whatever an individual child, or an adult, or a couple will present to a clinic or an office or a practice. And so there is a huge delay.

Casey:

Thinking about the youth across America, and they're dealing with different levels of trauma in school, whether it's socially impacted in terms of how they relate peer to peer, if outcomes of that are around substance abuse or other indicators that they're needing help. And then on top of that, if there's a lack of providers to help support them as they get older and they go through the system and the right levels of support are not there. We're seeing teachers and interventionists leave schools, and now there's more lack of support for these students coming through.

What next? I mean, it feels like it's a challenge now, but for these 10, 11, 12, 13-year-olds coming through who really need our support and not having those support, I'm kind of looking ahead, what's laying out for them and what are we doing in our roles to kind of help mitigate that?

Dennis:

So, one of the things I would suggest to professionals in the field is to stay optimistic. One of the things that we had seen, at least anecdotally from my point of view, is when children were at home, it also removed a great amount of supports for them regarding, for example, mandated reporters. You had more parents who were unemployed, they were stressed out, they didn't have the technology to do distance learning. After March 2020, there was a real lag in any services, meaningful services. And so we speed that up to today, I see the optimism. Children are back at school. Yes, we do have this new Omicron variant, and people are responding to it in different ways, but what we see with the children is they're lighting up, being able to socialize, being able to engage with their teachers. And it comes at a time where we need to strengthen not only our social workers, our clinical supervisors, or anyone who works with educational assistants, principals, to stay optimistic in that sense.

Because right now, we're also seeing a high level of burnout, as you had mentioned. And I think that between the level of vicarious trauma that we see in the field, with people struggling with their own families as well as trying to still be service providers, and then seeing people leave the field altogether because it's taxing after two years plus. And so for me, the optimism that I see at the university, seeing this engaged and motivated and hungry and capable group of individuals at larger numbers than I had seen in the past, it's promising. And I think that particularly for Hawaii, I hope people stay here to practice.

Casey:

Well, no, hopefully they don't leave Hawaii, and I know that there are a lot of reasons for them to stay in the 50th state, weather being one of them.

Dennis:

It's interesting you say that, what we are seeing, we take interns and post-docs, but we see a lot more applicants from the mainland. And as far as welcoming that, we're looking to provide that training opportunity to have a skillset that is very, very narrow, and to hopefully practice and to share that with others and to train others basically in the spirit of just helping. And so that is one thing, is we're constantly trying to train people so that one day we can be replaced.

Casey:

Let's talk a little bit, I mean, we're here, we have this opportunity to talk about you and where you work in Hawaii. And thinking about it and myself living and born and raised there and understanding the cultural components of what makes Hawaii Hawaii, this melting pot, there's also this challenge too I think with the cultural component, with all these different ethnicities and folks that are there and how family units are organized and what that relationship is. How adolescent youth and their siblings, older, younger, fathers, mothers, grandparents, it's really, I think, unique in terms of what you have to deal with in terms of how that relation works. And it's different whether it's Korean families, or Samoan families, or Native Hawaiian families. Tell us a little bit about that work and having that knowledge on working with families and children coming from these different cultures and ethnicities.

Dennis:

So, I think there's many different ways to talk about it. I think in pre-COVID versus post-COVID, we've seen a dramatic change. Just again, being mindful of the elderly family members and not knowing early on about the outcomes of COVID, just seeing on the news, it was a tragedy that we weren't prepared for this disaster. And so people were staying separate, and that was different from a collectivistic point of view. So people weren't going out and socializing because of the state mandates, but also there was unknown factors. We didn't have the vaccine or the booster or any kind of information of what the outcome was.

There was angst, and how people dealt with that culturally, they took away some of the biggest protective factors from the melting pot mentality, is the sense of social support and family. And I think that we are returning to that, where people are comfortable with where they are with the vaccines and booster, and they're also hungry, I use that word again, to socialize and to offer that support and to receive that support in ways that we had before.

Casey:

And at the same time, that's almost a relearning, right? Because we've had this period of time being away, and speaking specifically about adolescent youth, when they come back into our school systems where there are other supports to help them, or even lack thereof, but they're coming into a system to do that, how they interact with both peers and adults at the schools are different than it was years ago.

Dennis:

Right.

Casey:

And there are indicators of trauma, anxiety that may not have been there before but are showing up now. Knowing what we know now, and I had this asked a while ago, but I'll bring it up to you since we're at this point, what have we learned particularly from K-12 professionals as these students are coming in back into our schools and our classrooms, and what are we looking for to know that students really do need help and are struggling at home or with their peers? It's a very different short history that they had being away, that they're now coming back in, and I think that's just the challenge I think for our K-12 professionals on what to look for.

Dennis:

So one of the words you used was it's almost a process of relearning, but I would also suggest that for the professionals in the schools to also continue to look at developmental trajectories as far as the ones who are children who are younger, this is their adaptability, this is their life. They have no real comparison, especially if they went through COVID before they developed even language, versus the adolescents who had a semblance of what normal was with sports, with cafeteria lunch, with sharing snacks, after school care with people going to be able to go to school with a runny nose.

It's where I see the adults who have an experience and the anxiety and fears, they just need to be mindful of that as well, because some who are returning to work, who have returned to work are worried. Especially in Hawaii, with 70% of our jobs related to tourism and hotel management. They're wondering, "When is the next variant going to affect my work? When are we going to open up for international visitors?"

Casey:

Right.

Dennis:

So as far as the school, I think we're looking at how children adapt to social-emotional problems, and one of the indicators that we look for is children either internalize or they externalize, if there's any differences of behavior, and that takes a relationship. It takes a relationship with providers to recognize when a child is not behaving in ways that are protected of themselves. It could be not eating, it could be not doing their homework, could be not listening. At the same time, it could be shutting down. And these are ways that many of the educators, that it's part of their training to understand and to know that they can and be able to intervene.

Casey:

And I think that's the "what have we learned?" question that is really highlighted here. We've learned that, yes, it's even more challenging than before, but at the same time we are much more, I'm wondering aware of it, because as professionals, K-12 professionals, we're amongst it. We know what those inputs are of stressors, we know what those inputs are of anxiety, whether it's our work or environment or families, and then how that makes us feel. And some of those same inputs are related to the students that are coming into their classroom, yet how they internalize or externalize that is different, but it's still internalized and externalized in ways. And I think having that knowledge is what we can look for in supporting students.

I want to highlight all the things that you're doing in Hawaii as a clinical psychologist, as well as working with the students as an Adjunct Professor at Hawaii School for Professional Psychology at Chaminade University, of getting more folks into that pipeline, and ultimately always thinking about our adolescent youth, their families, and the communities for which they reside in. Thank you for your time. Thank you for lending your voice to Voices in Education. 

Dennis:

Thank you so much.

Announcer:

Thanks for tuning in to the Voices In Education Podcast powered by Securly, where we hear from new voices and explore new ideas about how we can reimagine education to support whole student success. If you enjoyed today's episode, we hope you'll consider subscribing to the podcast and sharing it with others who would benefit from listening. Even a small act of support helps us reach more people and make a bigger impact. For the resources from today's episode and additional details about the podcast, please visit www.securly.com/podcast. Until next time, thanks for listening.