Schools are where kids learn, but also a place where they grow up and spend most of the waking hours of their childhood. Given the changes and challenges of childhood, facilities that can treat their mental and physical health are all the more important.

Through a partnership with the Summit County School District, the Summit County Community Care Clinic has been able to provide behavioral health services to Summit’s schools for over 10 years. During that time, the clinic’s behavioral health staff have provided therapists and counseling to hundreds of children, helping them navigate the most confusing part of their lives.

For most children, the counselor or therapist they meet at a school-based health center — which are based in Summit High School, Summit Middle School, Dillon Valley Elementary and Silverthorne Elementary — is the first interaction they have with the mental health system. The care clinic’s behavioral health director, Dr. Cassie Coumeau, a licensed clinical psychologist who practices at Silverthorne and Dillon Valley elementary schools, said she and the rest of the behavioral health team are equipped to take on that responsibility.

“All of the behavioral health centers are staffed by licensed professionals, or counselors with a master’s degree or above,” Coumeau said. “They all have experience with social work, clinical counseling or community counseling.”

Coumeau said that the biggest challenge kids face in school is adjustment issues; whether it’s adjusting to a new teacher, a grade, a school, a social circle or just being new to Summit. For young people who have never experienced these changes, they can feel overwhelming.

“We see a lot of kids for adjustment-related issues,” Coumeau said. “It is by far the No. 1 stressor, as it comes with a natural amount of stress and anxiety.”

The second biggest issue kids face for their behavioral health is parent-child or family-related stress. For so many working families in Summit, the pain of parents might be felt deeply by their kids. It is even more challenging for immigrant families who must also adapt to a new culture.

“Our families are economically and culturally stressed, and kids are keenly aware, ” Coumeau said. “That stress ripples through a family, and for kids who could otherwise thrive without those stresses might act out in different ways.”

Coumeau said that something adults might not realize about kids is that while the problems are different between childhood and adulthood, the resultant stress and anxiety and the toll it takes might be greater with kids.

Helen Royal, the care clinic’s CEO and a licensed professional counselor, said that applies with substance abuse issues.

“We see substance abuse issues, or family substance abuse issues, that trickle down to the children,” Royal said.

Given the balance needed between treating minors and respecting the right of parents to raise their kids the way they want, the clinic has introduced two new programs to integrate family to help kids work through their issues.

The first is an early childhood program that seeks to involve parents in the therapy for pre-adolescent children.

“It is almost impossible to work with that kid at that age range and not involve family, because their whole sense of self is so imbedded with their family life,” Coumeau said. “We’re starting a new early childhood program where we’re going to work on getting more of a commitment from parents to come more regularly and be more involved in their child’s treatment, because we know there are barriers to their kids getting better if they don’t. Over the years, we’ve learned that we probably need to work harder to get engagement from parents for more parent-child interaction therapy, and so we try to do more parent coaching at that level. There is only so much you can do with little kids, and if the home environment remains the same, we’re not all working on the same team.”

The other program the clinic introduced this fall was a Dialectical Behavioral Therapy program, a much more intensive outpatient program for children and families.

“It is for more high-risk, more severely, emotionally disregulated adolescents,” Royal said. “Parents usually don’t know how to handle such serious issues, so we involve them with the child’s therapy as well as involve them with a multi-family group support that gives families a peer support network, which can be key to treatment for the child and their family.”

When asked how the clinic staff deal with the responsibility of caring for kids, who may be permanently affected by the care they provide, Coumeau said it was about looking at the forest for the trees.

“Being a therapist, when you can help one kid, that reward feels like enough to sustain you for your entire career,” Coumeau said. “But that is balanced with other realities, that there are so many kids that struggle. Sometimes you move a few inches in the right direction, sometimes a few steps in the wrong direction before you correct. It can be a gradual, constantly variable progression, as is any child’s development.”