In the Long Beach Unified School District, more than 1,400 students are treated by school-based mental health agencies each year, said Tiffany Brown, the LBUSD's director of coordinated student services.
The number of students treated for mental health problems has grown from 350 a year in 2000, largely to a growth in the range of services available, she said, adding that local schools expect to see more students seeking treatment in light of the mass shooting in Connecticut.
The school district collaborates with nine local community and mental health agencies to offer a comprehensive scope of services, ranging from individual and family counseling, to intensive, long-term therapy.
Teachers are often the first to identify problems in the classroom and are trained to recognize abnormal behavior, Brown said.
Students displaying warning signs such as violent outbursts, aggression towards others and longer-than-average temper tantrums are referred to a school psychologist who can determine the proper form of treatment.
Those who show a more withdrawn behavior, which teachers call "acting in," or those who show a sudden drop in academic performance, are typically referred to a school counselor who can determine if the child needs a more extensive form of treatment.
In addition to observations from teachers, counselors and administrators, schools also receive referrals from concerned parents who may have noticed abnormal behavior at home.
"Some of the best referrals we get are from a student who is concerned about a friend," she said. "We work with our students to recognize the signs of mental illness and how to access help, whether it's for themselves or for a friend."
Brown said the district's mental health programs are largely funded through Medi-Cal since about 70 percent of students in the LBUSD qualify for the state's Medicaid welfare program.
She said the district can usually find a way to provide some form of counseling or therapy for students who have no health insurance.