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Hospital District tells Mental Health Association to help students

Dr. Bob Brugnoli on 2/22/2018.

As Dr. Bob Brugnoli gave a presentation to the Hospital District on the county’s Mental Health Association, details were still surfacing in the Parkland school shooting 100 miles away. Just the day before, on Valentine’s Day, a mental health crisis caused by a burst of semiautomatic rifle fire had ricocheted through a high school’s hallways.

Now, it had seized the focus of tens of thousands of students in surrounding counties, including Indian River.

The spreading pain reached the county commission chambers even as Brugnoli’s steady assessments of his organization’s programs seemed to offer comfort to District officials. Wrapping up his presentation, Brugnoli looked to the District Board for questions. But instead of the usual drilling down on total visits and outcomes, Trustee Ann Marie McCrystal spoke up with what clearly was on everyone’s mind: What can we do for our schoolchildren?

“We’ve all been shocked by what happened at Parkland,” said McCrystal. “I do assume any child that shows a problem would be referred to a psychiatrist. But are you doing anything in the schools for education of the school children about recognizing aberrant behavior and how that can be reported? What do we do to protect our children?”

Brugnoli, who holds dual Ph.D.’s in clinical and school psychology, as well as a master’s in school and community psychology, grew wide-eyed at their directive: Go out and explore this and come back with what we need to do.

“I was just like, Wow, this is great,” Brugnoli recalls. “I wasn’t expecting it. I was there to give a report.  The mission of the MHA is to fill service gaps in the community. And this is a need.”

Last week, Brugnoli was scheduled to begin moving forward with his new directive from the District, sitting down with Dr. Lillian Torres-Martinez, director of student services in Indian River Schools; she oversees guidance and psychology services. They were slated to review programs already in place and look for gaps the MHA could fill – the specific mission of the agency.

For children with anxiety and depression, two common mental health issues in adolescence, a nearby school’s tragedy can seem “almost like living through it themselves,” said Brugnoli. “If they were prone to fear and anxiety regarding their safety, that could start with them wondering, gosh, is school safe? And that could generalize into, is leaving the house safe?”

He said the effects are similar in other disasters. After the 2004 hurricanes, he says, some kids’ fears were triggered by ordinary rainstorms.

Brugnoli cited statistics at the District Board meeting that 20 percent of school children have significant mental health needs, and only half are getting any help.

“That’s a lot of kids. We’ve got to figure out how do we identify kids who need mental health care who also happen to have anger management problems and a history of violence. Those are truly the kids who we need to be intervening with,” he told the board.

Today, he is ruminating over how to mitigate the ripple effects of the Stoneman Douglas High shooting.

“What happened in Parkland had to do with the 14 children (and three adults) who lost their lives. But potentially every student in that school was traumatized. Many of these folks are going to end up in post-traumatic stress. It just got me thinking about what the response was in the community of the other mental health agencies. How were they going to pitch in and help? And what was the protocol for guidance counselors?”

A native of Staten Island, Brugnoli moved to the Vero in 1987. Over the next two decades, he served as a consultant to St. Lucie County schools, providing psychological services mostly for Fort Pierce’s Westwood High School and C.A. Moore Elementary.

That included in 1999, when the first large-scale school shooting – Columbine – took place.

“It was horrifying that something like that could happen . . . all these events – disastrous, tragic events – affect kids.”

By the time Brugnoli’s focus turned to the community as a whole in 2013, when he took on the CEO post at Mental Health Association, school shootings had become part of the American landscape. “As we began to see more and more of these events, with Sandy Hook, et cetera, it had effects. It had effects in our schools.”

While Indian River schools use a number of other mental health agencies – MHA’s mission is to “fill in the gaps” of care – Brugnoli has worked before with Torres-Martinez, looking at ways to partner, and one program came of it: an MHA therapist took on a counseling project for a year at Vero Beach Elementary.

This new effort could involve much broader involvement aimed at keeping schools safer by identifying kids with emerging issues of violence and putting counseling services in place when traumatic events occur.

“If you think about it, we have Level One trauma centers with physical injuries. But I don’t know what we have that would serve as a Level One mental health trauma center in the community,” said Brugnoli. “That’s worth looking into.”

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