BELLEVUE — Every Tuesday morning inside an office at Sammamish High School, Monae, 17, and her counselor, Piper Sangston, open a slice of Monae’s life and examine it together.

Monae talks confidently about conflicts, using terms like “generational trauma” and “an overstimulated relationship,” and “projecting her fear onto me.” 

Thanks to a Bellevue School District program, the Mental Health Assistance Team, she’s applied what she’s learned in therapy for the past year and a half to her own analysis of what happens in her life. (The Seattle Times is not using her full name to protect her privacy.)

The program launched in fall 2018 and screens all seventh through 11th graders in the district for signs of suicide risk and other mental health issues. If a student’s responses are concerning, counselors reach out and offer therapy on school campuses.

Other school districts in the Seattle area often refer students to licensed professionals because they don’t have the staff on campus, which can create obstacles to care. Although there is a growing trend for outside agencies to bring their staff to schools, only a handful of other districts — including Issaquah, Snoqualmie and Highline — screen all students and offer direct on-campus services, as Bellevue is doing.

The city of Seattle is providing Seattle Public Schools $4.5 million in funding for new mental health resources at five schools. School leaders will have control over how the money is spent to cater to each of their communities.


Youth mental health issues across the nation reached a crisis level during the pandemic. A recent Centers for Disease Control report found almost 60% of teen girls reported feelings of persistent sadness or hopelessness, and 30% of girls said they seriously considered attempting suicide.

“A lot of times you don’t see kids until they are in significant distress,” said Jared Taylor, the founder of MHAT and the district’s coordinator of mental health services. “We wanted to actively find kids.”

When the district was approached by King County in September 2018 to implement the Screening, Brief Intervention, and Referral to Treatment program, the district initially had one school participate, but quickly decided not to continue with the program.

A Seattle Times investigation found the program jeopardized students’ privacy.

Taylor said the district chose not to continue with SBIRT because “we felt it was a little too invasive,” and also because it connected students with outside agencies. Taylor wanted counselors to be in the school to provide a more comprehensive experience for students.

Valerie Allan, the director of the Highline School District’s social services, said Highline has been using the screening and referral program for five years. The way data is collected has changed to protect privacy; King County and Seattle Children’s hospital don’t have access to specific fields of the data so they can’t link student identifying information to the responses, said Allan.


The program at Sammamish High School operates under the U.S. Family Educational Rights and Privacy Act, which means information in a student’s file is protected, but the district needs parent permission before giving students services. The screening records reside in the student’s educational file, so parents can obtain screening results and therapy records.

If a student doesn’t want parents to know they are receiving services or to review their results, the district has some partnerships with outside providers as an option.

Within the first month of the school year, students take the MHAT survey in their science classes after a lesson about how to recognize the signs that a person may be contemplating suicide. Two weeks before the screening is offered, parents are notified, and have the option to decline the screening.

Even if a student isn’t screened, they can still obtain services if they ask for them, or if a friend, family member or staff refers them. About 86% of students take the survey. 

“If a student says ‘yes’ to services, services can start the very next day,” said Kerince Bowen, director of counseling at the district. “We don’t have to worry about intake, which is a huge barrier with going to outside agencies.”

MHAT counselors like Sangston have one job: to screen and provide direct services, unlike in other districts where counselors often have myriad tasks.


The program has screened almost 7,000 students, done secondary screening for over 1,2000 students and provided services for over 550 students this year. This school year, the district is working to expand screening and services to elementary students.

On a Tuesday morning in early May, Sangston’s long curly hair bounces slightly as she nods along, affirming what Monae is saying. Her eyes are wide behind large, tortoiseshell glasses. Bird sounds inconspicuously play from a computer behind her. 

A therapy session gives students a sense of focus. “All of a sudden their world becomes just this big,” Sangston said motioning to the size of her office. “They somehow can settle into that they’re safe. It is just us and them and that they matter. And somebody’s finally here to listen.”

Many of the students are the breadwinners of their family, caretakers of their younger siblings, victims of sexual assault or rape. 

Sangston often starts therapy sessions with: “It must be exhausting to be you.” She says students often start crying after that.

“These kids, they’ll tell you. They just will. It’s very rare that they’ll say ‘I made a mistake,’” Sangston said about reviewing the survey results with the students. “I can’t figure it out, why they are so honest when they come to us.” 


Sangston takes great pride in the work she and other MHAT counselors are doing. She feels the program catches the kids who are quiet and could be thinking of doing harm to themselves.

Students who die by suicide “are the ones that don’t ever say anything to anybody and they just do it,” Sangston said. 

Twenty percent of students report during the screening that they have thoughts of self-harm, and that been true both before and after the pandemic, Sangston said.

She says it’s key that she is on campus speaking with the school nurses, teachers and administrators about what her students are going through. 

“I’ve been a social worker a long time and this, this is it … This is the most meaningful,” Sangston said who has been working as a school social worker for 34 years. “And it’s also the worst and the hardest and the most awful every day.” 

About 80% of students have shown a decrease in symptoms after receiving services from MHAT counselors to some extent, according to a survey the district asks students to fill out.


“You know when you want to say something but your body is like no, just shut up, just don’t say anything,” Monae said. “[Therapy] has helped me build confidence. Now I feel it is OK to say something because if you don’t say anything, then nothing happens for you.”

Monae first went to therapy because she’d seen it in the movies and thought it would be cool to try. She never could’ve imagined how her understanding of her home life would fundamentally change.

“Even in families they make it seem like it’s OK … they don’t know better,” Monae said. “But talking to someone outside of your family that thinks differently, that was raised differently, went to school for it. You get to look at new ways. If in the future I have children, there’s a whole bunch of things I’d do differently.”

At the end of the 45-minute session, the pair stand and share a long hug. Sangston tells her she loves her and Monae echoes the sentiment. Then Monae closes the office door and within a few steps is back in oceanography class.