District nurse reports 46% increase in depression cases

T-R PHOTO BY LANA BRADSTREAM — Marshalltown Community School District Board of Education President Sean Heitmann asks a question during the regular Monday meeting as Superintendent Theron Schutte looks on. The board learned that there was an increase in the number of depression cases in students and approved the purchase of equipment for the Career and Technical Education wing and the date of a July 15 public hearing.

During the regular Monday meeting, the Marshalltown Community School District (MCSD) Board of Education learned that there was a 46 percent increase in student depression, for a total of 197 cases.

MCSD Nurse Stacey Tool-Crawford presented the information to the board during her annual district health report for the 2023-24 school year.

“Nothing has changed much on here, other than the depression and you guys may have seen this as well. [Marshalltown High School] MHS and [Marshalltown Learning Academy] MLA have the highest numbers,” Tool-Crawford said. “Of course depression is increasing throughout the United States in our teen population, and it has certainly gone up since the pandemic.”

She speculated that part of the reason for the increase could be the fact that parents were not previously reporting their child’s depression.

“I think there’s been more of an awareness, and I think people maybe feel more comfortable to report,” Tool-Crawford said. “We will continue to monitor that closely. As mental health is on the rise, it’s something we will continue to track.”

Board Member Karina Hernandez said the increase was quite a bit and asked if the cases were self-diagnoses or professional.

Tool-Crawford said it was a combination, that a professional diagnosis was not required. She said they ask for the student’s provider and added some of the students are on medication, which is administered at school.

Hernandez then asked if the students who are self-reporting are referred to outside providers.

“Not always, unless there is a concern,” Tool-Crawford said.

She provided the number of depression cases in a list of health conditions tracked by the MCSD, which are also tracked by the National Association of School Nurses. In addition to depression, she said there were 402 students with asthma, 307 with anxiety, 65 with seizures, 14 with Type 1 diabetes and two with Type 2 diabetes.

Board President Sean Heitmann asked how the percentages of chronic health conditions in MCSD compares with other Iowa school districts. Tool-Crawford told him they are fairly comparable. She tracks MCSD numbers and rates and compares them with those of districts similar in demographics and size, such as Ottumwa.

Tool-Crawford said three of the elementary schools had to report to the state and Marshall County Public Health for 10 percent absence rates due to illness last year.

“Anytime we reported this year, there was nothing specific,” Tool-Crawford said. “It was a scattering of various illnesses.”

As of May, there were 5,308 students enrolled in the MCSD, and 45 percent, or 2,385, had chronic health conditions.

“Some of those students have multiple [conditions],” she said. “That is almost 50 percent of our students. That is not very much. The highest I have seen it since I have been in this role was 48 percent. Last year it was 47 percent, so it is down a little bit. We are at the mercy of parents reporting those diagnoses.”

There were 67,310 office visits last year. Of those, 2,352 students were sent home, and emergency medical technicians were called six times. Tool-Crawford said that meant 96 percent of students were kept at school following a health office visit.

There are nine registered nurses covering the buildings. One of the nurses covers both Anson Elementary and Marshalltown Learning Academy. On average, the district has 167 scheduled daily office visits.

“Most of those are for medication administration, some treatments — tube feedings, various things like that, diabetic checks,” Tool-Crawford said.

The nursing staff does maintain emergency medication, such as for anaphylactic emergencies or opioid overdoses.

Tool-Crawford said some changes were noted from last year. One was a health aide added at MHS. Based on the number of health office visits, Tool-Crawford said it was determined one more aide was necessary at the high school.

Two staff members — Nancy Pins and Mikki Englund — became certified as cardiopulmonary resuscitation (CPR) instructors. By having two certified CPR instructor staff, Tool-Crawford said it will save the district money and time. The instructors taught seven CPR classes last year.

In other business, board members:

• Approved the purchase of $811,924 of equipment for the MHS Career and Technical Education (CTE) wing. Principal Jacque Wyant said the equipment includes such items as cabinets, tables, chairs, sewing machines, storage, a floor stand mixer, commercial dishwasher, convection oven, a six-burner stove, range hood and interactive touch screen panels. The district will use the SAVE fund to buy the equipment. Hernandez asked if there would be an open house after CTE is done, and Wyant said there would. Board Member Zach Wahl asked if the project was on track. Superintendent Theron Schutte said it was on schedule. He added that the tornado safe room is ahead of schedule, even though there may be a delay due to materials. It will not change the completion date, Schutte said, but rather the order in which work is done.

• Approved awarding the B.A. Niblock Orpheum kitchen bid to Hay Construction for $229,715. The district will use the SAVE fund to pay for the project.

Scheduled a July 15 public hearing for a property exchange between MCSD and the City of Marshalltown. Schutte said the district is proposing an exchange of district property at Bicentennial Park and the lease to Arnold’s Park land for eight city-owned acres adjacent to seven acres the district owns between Sixth and Twelfth streets near the end of Southridge Road. He said the reason for the exchange is the potential for residential development, and the standard number of acres to build a new elementary school is 15. That eight acres owned by the city would make it possible for the district to build another school in the future if necessary.

• Determined mental health, supplemental state aid, student achievement and teacher recruitment and licensure as the district’s legislative priorities.


Contact Lana Bradstream

at 641-753-6611 ext. 210 or



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