Can nursing care really make a meaningful, long-lasting difference in the lives of our youth? If young lives could be positively influenced, might this impact create a ripple effect to actually strengthen our communities?

My eyes and heart were pried wide-open this fall when I stood witness to just that – the profound work done by the Nurse Practitioners at the school-based health clinics run by University of Rochester’s School of Nursing in Rochester, NY. While these dedicated Nurse Practitioners will reach a student population of over 3000 youth this year, they make a difference one student at a time. Their story is one of amazing, heart-felt successes, and comes down to the interactions and relationships built between the practitioners and the students. 

Mary Ellen Dennis, known as Ms. Dennis to the students, is a familiar face the students look forward to seeing in the high school’s corridors.

Mary Ellen Dennis, a University of Rochester School of Nursing graduate, is known to be one of the most competent and effective mental health nurse practitioners for adolescents in the city. She has worked at East High School, offering the students behavioral health services for 16 years, and has literally saved many of these students’ lives while positively impacting hundreds of others. Her Program Director, Kim Urbach, thinks she is phenomenal, stating, “Kids have stayed in school and graduated because they have received Mary Ellen’s services.”

These sentiments are echoed by Jamia, a 20 year-old graduate of East High. In fact, Jamia says there is no question that she would be in jail - more likely dead - had it had not been for the care she received from Mary Ellen during her high school years. She is not exaggerating. These years for her were ones of incredible pain, emotional turmoil, severe behavioral issues, broken relationships, an unstable home life, and isolation. She is afraid, that without Mary Ellen, she would have been just another statistic, individually robbed of her potential and humanness; while her community would have been left living in fear of yet another potentially dangerous young adult.

But that is not Jamia’s story. Hers is one of redemption, one that is full of incredible hope and promise, and is inextricably linked to her relationship with Mary Ellen during her high school years.

As Jamia’s school-based psychiatric nurse practitioner, Mary Ellen bonded with Jamia during their weekly sessions across five years. Mary Ellen offered her expert therapy along with practical advice for applying behavioral modification tactics to everyday life situations. Jamia utilizes these tips today as she navigates the world as a young adult.

All along the corridors, within the clinic, and on the school grounds of East High School, lies the critical turning point. This is the location where behavioral health care can – and does – make the difference between the child making it through her adolescent years and graduating from high school, or becoming another all-too-common, frightening statistic. It’s where Mary Ellen walks the halls and intervenes, providing the purest form of patient-centered care right where the kids are every day – in their school.

Given the intensity of the issues discussed, Mary Ellen often walks with her students during their sessions, escaping the enclosed feeling of her office’s four walls. Jamia thinks back to her weekly sessions during her high school years, remembering many times when she and Mary Ellen walked outside around the grounds of the school.

Taking the stigma away from “therapy”, Mary Ellen welcomes students into her office to have a cup of hot cocoa with her. In this relaxed atmosphere, students begin to open up and share. Jamia calls this Mary Ellen’s ability to “work her magic”.

During each and every school day, Mary Ellen is weaving a safety net of support for the students, ensuring that the teachers, student support staff, counselors and administrators know the issues the kids are facing, and the effective support required to keep them healthy and in school. It’s a milieu where there’s understanding, availability and care that allows for the students to voice their problems, get much needed support, counseling and medication if needed.

Mary Ellen confers often with school guidance counselors and members of the Student Support Center, tapping their perspectives and ensuring they are working together to help the students in a coordinated way. Jamia knew that everyone was looking out for her best interests.

Mary Ellen sought out teachers to inform them when significant events happened in Jamia’s life. When Jamia would have an emotional outburst in class, she felt the shift in her teachers as they approached her with understanding and the gentle question “What has happened?” versus disciplining her with the approach of “What’s wrong with you?”. She knew Mary Ellen was behind that change.

Despite her traumatic and emotional high school years, with Mary Ellen’s guidance and constant support, Jamia survived two suicide attempts, multiple cuttings, homelessness, a stint in jail, and graduated with honors from East High School in June 2012. This was a lifelong dream and still brings tears of pride to Jamia’s face today when she thinks about what she was able to accomplish despite all odds.

Despite serious emotional and behavioral issues, including a couple of admissions to psychiatric inpatient care for attempted suicide, Jamia graduated in the top 10% of her class. 

Today, Jamia is employed as a youth mentor at the Hillside Children’s Center. She works with teenagers 13 – 20 years old, serving as a role model and advocating for youth who have mental and behavioral problems. She shares her experiences with the teens along with the positive aspects of her current life, and is candid with them about her story. She openly acknowledges that she had, and still has, emotional problems, but that through her work with Mary Ellen she has learned to manage and control her emotions. She encourages the teens she works with to learn alternative, acceptable behaviors that work for them, and reinforces that they don’t need to go down the negative road. She proudly describes her role, “I am here to guide them and give them a nudge in the right direction, but to also let them know it is their choice. Mary Ellen did that for me.”

Jamia is excited about her new job as a youth mentor for Hillside Children’s Center.

Jamia also volunteers her time to support the city’s youth in the various recreational and community centers. Whether helping children after school with their homework or engaging with them in games and crafts, Jamia is an available young adult whose gentle, but direct style influences the children. As they erupt in frustration over a math problem and feel like giving up, she tells them that she, too, struggled with math, yet graduated top of her class. Hanging on her every word, they look at her with amazement and respect.  Each interaction is an optimistic playback of her life in easy-to-digest lessons of what she has learned throughout her teen years.

Jamia reviews the homework lesson with a student after school in one of the city’s community centers. The children are anxious for Jamia’s help. She is a patient and understanding teacher.

As Jamia teaches this 8-year old boy a craft, he begins to tell her of trouble with some kids at school.  She listens attentively with understanding, then imparts some wise advice based on her experience. 

While Jamia is thriving in both her job and volunteer activities in the community, her life also has renewed richness due to meaningful relationships she has built.  Having been estranged from her mother for years, Jamia is grateful to Mary Ellen for encouraging her to pursue building that relationship anew, and giving her guidance on how to begin to take that step. “Ms. Dennis knew I always wanted a relationship with my mom, and she told me to go for it, don’t give up. If Ms. Dennis didn’t encourage me to pursue that, and without her pushing me, I wouldn’t have tried.” In the past year, Jamia has reestablished contact with her mom. Seeing each other regularly, they are working on building the mother-daughter bond that had never previously been formed.

Jamia visits her mom each week, often spending the evening cooking, dancing and laughing together. She says that they are both working hard on their relationship, taking it a step at a time.

Once a high school teen without friends due to her anger issues, Jamia’s life is now full of rich and meaningful friendships.

Having learned the hard lessons of destructive interactions, Jamia now cherishes her loving, respectful, healthy relationship with her boyfriend of three years.

Jamia reflects on her thoughts the first time she met Mary Ellen: “At first it was weird when I met Ms. Dennis because she is an older Caucasian woman, so I thought, ‘What does she know about African-American kids and our issues?’ But the more I began to talk to her, I realized how much she understood what I said and how much she understood what I was going through. And Ms. Dennis doesn’t just give you tactics to help you that day, she gives you tactics that you can use forever in your everyday life. She just knows how to work her magic. I don’t know how she learned to do what she does, but she is just an awesome person”.

 Jamia knows that a new season brings hope, joy and fresh beginnings. She celebrates daily her success and the promise that her  life now offers.

Mary Ellen has her own thoughts about Jamia’s journey and their work together: “It makes my day to see Jamia now. It’s because of the Jamias that I do the work that I do, and it makes me really proud. I believe by us working together that Jamia now has the tools to move on and conquer the world. And you know what? She is going to do it!”

Having been privileged to witness Mary Ellen's work and therapeutic interactions with the students throughout our time together, I marvel at the impact she, the School-Based Health Centers, and the University of Rochester School of Nursing are having on these young lives - and the community in which they live. The University of Rochester School of Nursing's Psychiatric Mental Health Nurse Practitioner Program prepares future "Mary Ellen's" to work in the community and create a like impact. If you are inspired by this story and would like to support their efforts to ensure the longevity of these graduate programs, learn more about how.

~ Karen