/ April 11, 2021

Mental Health Services for High-Needs Schools: A therapist shares the story of one student’s transformation

With the support of the Mayor’s Office of ThriveNYC and the Office of School Health, Henry Street Settlement operates a mental health clinic in eight schools on Manhattan’s Lower East Side. Here, a therapist at the Clinic shares the story of one student’s transformation:

“Miguel sat across from me in my office, hoodie up and arms tightly crossed, making little to no eye contact. He didn’t talk much, but it was clear he was in deep pain.

It was his freshman year of high school, and Miguel had been referred to our clinic by his school social worker. At the time, Miguel was experiencing anxiety, depression and self-harm. He was suffering from the recent loss of his grandfather, and symptoms of trauma stemming from years of physical and emotional abuse.

It took weekly sessions and extra support from his school community to demonstrate my care for him – and for him to begin sharing more in therapy. His teachers and school social worker met with me on a consistent basis to discuss ways to provide support during class, especially in those tough moments when he refused to engage in classwork. We collaborated to become more aware of his warning signs, and to offer helpful coping strategies during the school year. Collaboration is the basis of our clinic – we work to strengthen mental health supports for students throughout the school community.

To offer additional support, I referred Miguel to Henry Street Settlement’s outpatient psychiatric clinic for an evaluation. Our psychiatrist prescribed psychotropic medication to support with symptom management, and worked closely with me to ensure that Miguel was getting the best possible treatment.

I continued working with Miguel over the next four years – his entire high school experience. Throughout this time, his grades and attendance improved significantly. He began to sit comfortably with me: hoodie off, with open body language and consistent eye contact.

Being on-site helped make this progress possible. It allowed me to support him immediately in times of crisis – whether I found him somewhere in the school, or he came looking for me in my office. We made sure to reserve therapeutic space every week – and sometimes met outside of our scheduled meetings. Miguel became comfortable enough to text me on my work cellphone, asking to come and see me when he was having panic attacks. He began to acknowledge to his peers and teachers that I was his therapist when I went to pick him up from class.

By working with Miguel for four years, I can see clearly the relationship that developed, and the transformation he made. His self-harm ended, and he began building stronger relationships with friends and family. By the end of his senior year, he accepted an offer to attend college – to study psychology! And he agreed to continue his treatment with a new therapist.”

AT A GLANCE: Mental Health Services for High-Needs Schools

• Mental health services are on-site at 248 high-needs schools across the five boroughs
• Students have access to individual and group supportive counseling and psychiatric treatment
• Community partners also focus on building each school’s capacity to address mental health needs


• Students have participated in over 181,000 individual or group supportive counseling sessions since the program began in 2017
• Over 14,000 trainings have been provided to teachers, staff and families through this program