A growing number of public schools across the country are following the same path – turning to remote health care when the demand for help has increased and the supply of practitioners has not increased. To pay for it, some school districts are using federal covid relief money, as studies show an increase in depression, anxiety and suspected suicide attempts among teens.
Some of the contracts go to private companies. Other districts work with local health care providers, nonprofits, or state programs. In Texas, state officials recruited help from medical school providers, a collaboration that served more than 13,300 Texas students last year. “He provided many children with the support they needed,” said David Lakey, trustee and president of the Texas Child Mental Health Care Consortium.
Telehealth services have more generally skyrocketed during the pandemic as people seek to minimize in-person contact and embrace convenience. Over the nearly three years of pandemic life, families and providers have grown accustomed to remote medical visits.
Federal data shows that 17% of public schools reported having telehealth services in the spring, with a greater concentration in rural areas and middle and high schools. Seventy percent of schools said the percentage of students seeking mental health services had increased during the pandemic.
“I don’t know a single child who hasn’t been affected by this,” said Michelle Weinraub, health officer for 55,000 Cherry Creek District students, recalling that students have lost loved ones or homes during the pandemic, and many were isolated at home and learning remotely.
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At many schools, students can see a telehealth therapist using an iPad or other device in a quiet office away from their classmates. In Cherry Creek, they will do it from home, before or after school. Some school systems offer both options.
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For schools hosting digital therapy sessions, it’s not enough to simply outfit a room for appointments and send students there, said Sharon Hoover, professor of child and mental health psychiatry. teenager at the University of Maryland Medical School and co-director of the National Center for School Mental Health. “Most schools will need to provide staff to address security and privacy issues,” she said. Services are free to families in many cases, covered by school systems, government grants, or insurance reimbursements.
Hoover said the virtual mental health care trend is due in part to more providers offering remote sessions and a relaxation of strict regulations that prohibit interstate delivery and billing.
At Aurora Public Schools in Colorado, which began focusing on mental health efforts after the 2018 school shooting in Parkland, Fla., Superintendent Rico Munn said several hundred of his students benefited from a contract for telehealth services, including a number of children in crisis. . More than 1,800 therapy sessions were held remotely last spring, thanks to federal covid relief funds. “The need was there, obviously, and it was important to be there to meet that need,” Munn said.
Virginia Garcia’s daughter was among those struggling in Aurora. The 17-year-old was initially devastated by family issues, but while she was undergoing treatment a close friend was killed, her mother said. “The therapy helped a lot at that time because the situation was terrible,” Garcia said. Her daughter began to learn strategies to help her deal with her sadness and anger and to be more open to her feelings, her mother said. “I saw the change”
Garcia said her daughter continues to work with a private therapist. Still, she was grateful when school returned to see if her daughter needed more help.
According to a study published by the American Psychological Association, no-show rates for therapy visits for underserved families and children were significantly lower with telehealth programs than with in-person care before the pandemic. But the paper also noted some challenges unique to this format, including patients who don’t have the right technology to connect or enough privacy. at residence. Other research has also widely pointed to the benefits of telehealth for children.
While some schools used virtual mental health services before covid-19, particularly in rural areas, researchers from the nonprofit Child Trends said the pandemic had shown “proof of concept” to many more people.
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Colorado school districts in Aurora and Cherry Creek have hired Hazel Health, a San Francisco-based company that started with virtual health services in schools in 2015 and expanded to mental health in May 2021.
It now has telehealth in 80 school districts, including Florida, California, Georgia, Maryland and Hawaii; 20 other districts have signed contracts. The company said students are seen at relatively short notice and sessions are held in familiar school or home settings. Parental permission is required and referrals are made by school staff or families.
Hazel Health CEO Josh Golomb said children often receive six to 10 sessions, meeting the clinical needs of most students. For longer-term cases, Hazel connects patients with community clinicians. Some advocates have raised concerns that telehealth could mean a different practitioner from session to session. Hazel said the kids mostly stick with the same therapist.
The Hazel therapists, who together speak 10 languages, are working from home, Golomb said. All are clinical mental health professionals who are licensed to practice in the state where their patients receive therapy.
The company plans to work with school districts to determine if Hazel’s mental health services also help reduce absenteeism, Golomb said.
Reducing absenteeism was one of the main incentives for Maryland’s second-largest school system, in Prince George’s County. If the appointments are at school, many students will be able to return to class and miss less instruction, said school board supervisor Doreen Hogans.
Schools are already using Hazel for physical health services and will launch mental health services for high schools, colleges and K-8 schools ahead of the winter break. Elementary schools will come during or after January. Students in grades K-12 can apply for home telehealth.
Students will be able to go to the nurse’s office, where the nurse will find a quiet place to set up the student on an iPad with a practitioner, Hogans said. “The benefit is that the student doesn’t go home and we can hold him at school,” she said. The school system, like others across the country, has a number of vacancies in mental health-related positions, she said.
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It is funded by a $4 million federal grant, according to a spokesperson for the Prince George’s County Health Department.
The big question for many districts is what to do when their federal relief money runs out In the coming years — if they will find more dollars for telehealth.
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