As preschool mental health issues skyrocket, St. Cloud offers unique, intensive program

ST. CLOUD – Five-year-old Emmett beamed as he held up a green paper leaf inscribed with his name and then stuck it on the branch of a tree painted on the wall at Clara’s House in St. Cloud.

That mid-April day was a day of firsts: The leaf was the first to don one of the tree’s spindly branches — because Emmett was the first to graduate from a new CentraCare program. And that program — a partial hospitalization program focusing on mental health concerns in children ages 3-5 — is the first of its kind in the Midwest.

“It’s been a night and day difference in his life,” said Emmett’s mother, Kristin Henning-Olsen, who said Emmett was referred to the program by a school counselor and was subsequently diagnosed with autism and attention-deficit/hyperactivity disorder. “I’m glad to see my kiddo happy again.”

Clara’s House, which is run by CentraCare, opened in 2004 to provide intensive mental health services for youth ages 5-18 with emotional, behavioral or psychiatric difficulties. It now serves about 330 patients each year.

But between 2016 and 2020, CentraCare saw a 390% increase in mental health referrals for children younger than 5. So the CentraCare Foundation spearheaded a campaign to raise more than $3 million for an expansion at Clara’s House for preschool-aged children. Leaders expect the new program, which opened in February, to serve upwards of 80 children each year.

The program provides an opportunity to intervene early and provide diagnostic assessments and interventions at an age when the brain is still developing, said Barbara Skodje-Mack, director at Clara’s House.

That need is something Skodje-Mack saw firsthand many times during her 20-plus years as a mental health provider.

“I would see kids when they were 8, 9, 10 years old and you would hear the story and the problems started way back when they were 2, 3 years old,” she said. “And so for several years, the family tried to figure it out or weren’t able to access services.

“I would think in my head, where were the helpers for you early on?”

The longest waitlist for Clara’s House programming is for elementary-aged children, most likely because that’s the age kids enter a school setting.

“If there are some learning difficulties or neurodevelopmental concerns, those are going to probably show up with struggles in school,” Skodje-Mack said. “And social/emotional skills might be more pronounced if they’re in more social settings.”

But an increasing number of children younger than 5 are also being referred for mental health services. Skodje-Mack attributes some of the steep increase to the implementation of CentraCare’s integrated behavioral health team: For the last decade, mental health providers have been placed at primary care settings to provide more immediate help to pediatricians.

There’s also been a growing emphasis on early intervention in the mental health field.

“It’s like if we catch a child who is struggling to learn how to read,” Skodje-Mack said. “When we do special interventions early, they can kind of catch up and perform pretty well down the road. And it seems to be true about emotional regulation, as well.”

For Henning-Olsen, who lives in Sartell, Clara’s House has been a gamechanger for Emmett, who she said has big brown eyes and “endless” eyelashes, and who is the most huggable “silly goose little boy you will ever meet.”

When Emmett was about 2½, he started doing repetitious behavior such as lining things up, and he seemed more interested in that behavior than actually playing with the toy, Henning-Olsen said. He also developed a food sensory disorder. He was hyper-focused and easily frustrated, and going to a few occupational and behavioral therapists helped — but he still struggled at preschool and at home.

“School did an amazing job with helping Emmett when he had his emotional meltdowns, which were daily,” Henning-Olsen said. “They understood that he needed more support than what they could give.”

Earlier this year, Emmett went to Clara’s House from 8 a.m.-1 p.m. every day for a few weeks, where he would see doctors to address any medication needs and participate in music therapy, art therapy, recreation therapy and social/emotional skill groups. Henning-Olsen also joined for sessions two days a week.

“We also work really hard to engage the caregivers to develop responsive relationships and effective parenting skills because any time you’re working with kids, you have to also work with their family system,” Skodje-Mack said.

Since completing his program — and proudly putting the first leaf on the graduation tree at Clara’s House — Emmett is calmer in both body and mind.

“He’s pretty quick at getting through his struggles,” Henning-Olsen said.

Emmett will continue to see a therapist and will have an individualized education program when he starts kindergarten in the fall, but Henning-Olsen said she already feels Emmett getting the help he needed at an early age will help him regulate better as he grows.

“It’s definitely an evolving science, but we’ve made a lot of progress and there’s still room to continue,” Skodje-Mack said. “We’re supposed to have big emotions. Helping kids manage those big emotions [sets] kids up for good skills in the future.”