BISMARCK, N.D. — Simle Middle School in Bismarck has transformed a $150,000 state grant into an ongoing behavioral health program, establishing a partnership with Sanford Health to bring clinical psychological services directly to its campus. This initiative aims to address student needs by providing professional care within the school environment.
Under the program, Sanford Health psychologist Nicole Cross-Hillman works at Simle Middle School two days each week. Students typically meet with Dr. Cross-Hillman for approximately 45 minutes during the school day before returning to their classes. To ensure the program's long-term viability, visits are billed through students' insurance.
Simle Principal Russ Riehl stated that while the school recognized the need to support its students, it lacked the internal capacity to provide clinical care on its own. The partnership with Sanford Health was intentionally designed to be sustainable beyond the initial grant funding. Riehl emphasized the school's desire to build a lasting service, noting that they "didn’t want to say, ‘Sorry, but now we can’t do this anymore’" once the grant funds were depleted.
Dr. Cross-Hillman highlighted several benefits of providing care directly within the school. She explained that seeing students on campus reduces the amount of time they miss from class instruction. Additionally, it eases the burden on parents, who might otherwise need to take time off work and travel for off-campus appointments. Dr. Cross-Hillman also pointed out that clinic wait times in the wider community can often be lengthy, making the on-site school program a more accessible option.
The partnership also fosters a close connection between clinical care and the students' daily school experience. Simle staff and Dr. Cross-Hillman meet twice monthly to discuss support strategies for students, always with family consent. Principal Riehl noted that this consistent collaboration helps school staff and the clinician work toward shared goals for student well-being.
Students may be referred to the program by teachers or other school teams who observe changes in behavior, attendance, or academic grades. Parents also have the option to raise concerns about their children. The school works closely with families to ensure their involvement and obtain consent before a student begins receiving clinical services.
The program has shown significant positive impacts on student conduct. According to Principal Riehl, Simle Middle School experienced a substantial reduction in major discipline behavior numbers after implementing this more structured support system. These incidents dropped by approximately 70% to 75%, falling from around 800 students per year to roughly 250. Riehl confirmed that these lower discipline numbers have been consistently maintained for the past eight years. Simle estimates that about 1% to 2% of its student population utilizes the clinical services annually.
The success of Simle's model has extended beyond its campus. Sanford Health now partners with seven schools in the area to provide similar behavioral health services. Furthermore, Simle Middle School has developed its own three-phase behavioral health toolkit and offers technical support to other North Dakota schools and districts interested in establishing comparable on-campus partnerships.
