HB 60-PUBLIC SCHOOLS: MENTAL HEALTH EDUCATION  9:27:50 AM CO-CHAIR DRUMMOND announced that the final order of business would be HOUSE BILL NO. 60, "An Act relating to mental health education." 9:28:00 AM CO-CHAIR STORY moved to adopt the proposed committee substitute (CS) for HB 60, Version 32-LS0261\B, Klein, 3/25/21, as a work draft. 9:28:17 AM CO-CHAIR DRUMMOND objected for purposes of discussion. 9:28:29 AM REPRESENTATIVE MATT CLAMAN, Alaska State Legislature, as prime sponsor, introduced HB 60. He stated that the bill would amend the existing K-12 public school health education statute to include mental health education guidelines. He explained that, currently, the health curriculum guidelines developed by the State Board of Education & Early Development include learning about prevention and treatment of diseases, good health practices like diet and exercise and personal hygiene, and bad health habits such as substance abuse, alcoholism, and physical abuse. But the guidelines do not address mental health. REPRESENTATIVE CLAMAN related that this bill was brought to his attention in 2019 by a college student who successfully advocated for similar legislation when he was in high school in Virginia, and who then worked with a group of Alaska high school students advocating for increased mental health resources in Alaska schools. These students spoke of their own struggles with mental health as well as those of their peers. Some students even said their mental health struggles began as early as elementary school. These students continue to say that while they learned about treatments for physical health at school there wasn't nearly enough conversation about mental health with their friends and teachers. REPRESENTATIVE CLAMAN specified that Alaska's adolescent suicide rate is three times higher than the nationwide rate. Alaska's adolescent suicide rates are increasing, he noted. According to the 2019 Alaska High School Youth Risk Behavior Survey, which surveyed 1,875 students in grades 9-12 from 39 high schools across the state, the percentage of students who have attempted suicide has doubled since 2007. Given that 50 percent of all lifetime cases of a mental illness begin by age 14, and 75 percent by age 24, these conversations about mental health need to be started at an early age. REPRESENTATIVE CLAMAN said HB 60 requires the State Board of Education & Early Development to work with representatives from tribal and mental health organizations to update the health education standards to include guidelines in mental health education. Once the legislation passes it will be up to high schools and school districts across Alaska whether to use the guidelines to incorporate mental health into their education curriculum. As is the case with current health education curriculum, the Department of Education & Early Development (DEED) is available to assist schools with incorporating health standards into local curriculum. He stressed that HB 60 does not create or mandate that schools adopt a curriculum. REPRESENTATIVE CLAMAN said the state has a responsibility to treat the current mental health crisis in Alaska as a serious public health issue. This bill underscores the notion that mental health is just as important as physical health and should be treated as such. Conversations about mental health must be normalized starting at an early age, just as is done with physical health, in order to de-stigmatize mental illness and increase knowledge on the fundamental aspects of mental health, as well the causes, risk factors, and treatments for mental illness. 9:31:43 AM SOPHIE JONAS, Staff, Representative Matt Claman, Alaska State Legislature, on behalf of Representative Claman, prime sponsor of HB 60, provided a sectional analysis of the proposed committee substitute, Version B. She began by first relating that during a hearing of the Senate companion bill, SB 80, in the Senate Education Standing Committee (SEDC), the Advisory Board on Alcoholism and Drug Abuse and the Alaska Mental Health Board recommended changing the intent language to eliminate organizations that were specifically listed out so as to not exclude anyone. Additionally, there was confusion about the word "standard" as opposed to "guideline." So, she explained, the proposed work draft before this committee mirrors the changes that were adopted in the Senate Education Standing Committee. MS. JONAS reviewed the sectional analysis for the proposed work draft, Version B. She said Section 1 adds intent language stating it is the intent of the legislature that the Board of Education & Early Development develop guidelines for instruction in mental health in consultation with the Department of Health and Social Services, regional tribal health organizations, and representatives of national and state mental health organizations. MS. JONAS stated that Section 2 amends AS 14.30.360(a) by removing the word "physical" when referencing instruction for health education and adding "mental health" to the list of curriculum items that each district is encouraged to include in health education programs. MS. JONAS specified that Section 3 amends AS 14.30.360(b) by adding that, in addition to establishing guidelines for health and personal safety education programs, the State Board of Education & Early Development shall establish guidelines for developmentally appropriate instruction in mental health. MS. JONAS explained that Section 4 amends the uncodified law of the State of Alaska by providing that the State Board of Education & Early Development shall develop the aforementioned guidelines within two years of the effective date of this Act. 9:34:28 AM CO-CHAIR DRUMMOND opened invited testimony. 9:34:43 AM JASON LESSARD, Executive Director, National Alliance of Mental Illness (NAMI), Anchorage Chapter, provided invited testimony in support of HB 60. He first noted that he is the parent of a current Anchorage School District (ASD) student and a graduate of the ASD. He said it is important to recognize that mental health is health; there is not one without the other. While that is a simple and obvious statement, it is still a struggle to incorporate that concept into school curricula. This is why NAMI chapters in Alaska and the Lower 48 are advocating for the types of updates and guidance in bills like HB 60. MR. LESSARD related that while there is much national and Alaska centric data relevant to this conversation, he will focus on just two in the interest of time. He said the first data point is that one in five U.S. adults experiences a mental illness. Given this prevalence, he urged members to think about how many people they may know or how many high school students might go home to a family member with a mental illness. This is not just talking to students about their own mental health, this is about having evidence-based curricula that discusses and de-mystifies a set of illnesses that affects 20 percent of the population. And, he added, that's just adults and just diagnosable mental illnesses. He urged members to think about the benefits that these conversations concerning wellness and self-care could have on helping students to process grief or a depressive episode that don't have anything to do with mental health necessarily. MR. LESSARD said the next data point is that 50 percent of all lifetime mental illnesses begin by age 14, and 75 percent begin by age 24. He pointed out that age 14 is a ninth grader. These illnesses are showing their onset largely in the teenage brain, he continued, and it's really important to talk about it with them in a healthy, supportive, and effective manner. This is why this type of legislation and, hopefully, changes to curricula throughout Alaska's districts is critical. Giving students a better understanding of mental illness and mental wellness, the language to talk about it safely, the understanding of how and where to find resources for themselves, their family, and their peers is vital. He urged committee members to support HB 60 and pointed out that it will help to address these topics in an evidence-based, proactive, and caring way. 9:37:39 AM CLAIR RHYNEER, Representative, Mental Health Advocacy Through Storytelling (MHATS), provided invited testimony in support of HB 60. She noted she is testifying on behalf of MHATS as well as herself. She related that a few years ago she experienced a difficult and dark period of depression. But more than being difficult and dark, she said, her experience was governed by confusion. She was self-harming and all she felt was uncertainty. Did she need help? How should she know? She turned to Google and took dozens of "Are you depressed quizzes?" However, she continued, Google is not a doctor and is in no position to diagnose a seventh grade girl, let alone anyone, and it left her more confused. Each night she wondered not only what was wrong, but if something was wrong at all. In hindsight it is terrifying to know that she was physically harming herself and still unsure if she needed support. MS. RHYNEER pointed out that she isn't the only one. She said she could personally count on more than one hand the number of close friends who experienced suicidal ideation, and all of them filled the gap of mental health education with scrappy online resources. In 2019, she continued, 20 percent of ASD students reported attempting suicide one or more times. That means roughly four people in each of her classes attempted suicide that year. This bill would teach someone like her younger self about how to recognize symptoms of mental illness, and what to do moving forward. She doesn't wish her experience on anyone else and the best way of achieving that goal is to inform Alaska's youth. She continued: "We cannot be satisfied with Google University. We cannot be satisfied with allowing my friends and classmates and your constituents and neighbors to remain uneducated. We cannot knowingly let our students experience the confusion and harm that I felt." She said HB 60 must be passed. 9:39:55 AM KEEGAN BLAIN, Representative, Mental Health Advocacy Through Storytelling (MHATS), provided invited testimony in support of HB 60. She said she is testifying on behalf of MHATS as well as herself, a graduate of Dimond High School. She related that while growing up her parents had all the standard conversations with her, and answered questions like the standard health questions about sex and where the places are that only a doctor should touch. At 10 years old, her elementary school health teacher had her and her peers practicing saying no to alcohol and drugs. At age 13 her middle school health teacher taught about STDs and the major signs of domestic abuse. Ms. Blain stated that 10 years old is the age when her symptoms of depression first started, and at 13, she was institutionalized for the first time. She felt alone in her fight against her own mind. She had never been taught what mental illness was. She didn't know if she could go back to school, whether she should tell her friends and teachers. It was completely uncharted territory. MS. BLAIN said the Alaska Department of Health and Social Services reports that from 2005-2006, 8.6 percent of adolescents aged 12-17 reported having a major depressive episode. That percentage nearly doubled to 15.2 percent from 2015-2016. There is a clear upward trend in cases of mental illness in Alaskan teens, she continued, but no response at the educational level. She stated she is a success story of the Anchorage School District. She graduated summa cum laude from Dimond and has gone on to study bioengineering at a top research university, but the odds were against her. Sixty percent of students with a diagnosed mental illness don't ever graduate high school, she specified. Research has shown that early intervention is key to preventing the development of severe mental illness in later years, and HB 60 has the potential to bring that intervention into Alaska's schools. She asked committee members to please take this first step towards bringing mental health education to Alaska's students who so desperately need it. 9:42:30 AM CO-CHAIR DRUMMOND held over HB 60 for further consideration and public testimony. [The motion to adopt the proposed committee substitute (CS) for HB 60, Version 32-LS0261\B, Klein, 3/25/21, as a work draft was left pending with an objection.]