Boosting Pediatric Mental Healthcare Through School-Based Telehealth

April 03, 2023 - To address the growing youth mental health crisis, healthcare providers are enacting various strategies to extend access to behavioral healthcare. One such strategy is partnering with schools to set up telebehavioral healthcare programs.

The mental health crisis among American youth is not a recent phenomenon, with Centers for Disease Control and Prevention data showing a 40 percent increase between 2009 and 2019 in the number of high schoolers saying they had experienced persistent feelings of sadness or hopelessness.

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Then, the COVID-19 pandemic hit, exacerbating the problem. In 2021, about 42 percent of students said they felt persistently sad or hopeless, and 22 percent seriously considered attempting suicide.

"A lot of things…really impacted our youth in particular during the pandemic," said Christine Zazzaro, facility executive for Behavioral Health Charlotte at Atrium Health, during a Healthcare Strategies podcast.

"Instead of going out and in the community and meeting with your friends or going to a movie or doing sports, you're on a screen trying to connect with people," she continued. "And so, sleep decreased, exercise decreased, and that human-to-human contact decreased."

To address growing mental health issues among kids, North Carolina-based Atrium Health is providing school-based telehealth services. These services span 35 schools across five counties, enabling on-site staff members, such as school nurses, to use iPads to connect students with behavioral health specialists.

Bringing needed behavioral healthcare to kids where they spend most of the day – their school – has provided numerous benefits. For one, school-based telemental healthcare has shortened the time between a referral and an appointment.

"I'll just tell you one statistic that's just amazing for me," said Donnie Mitchem, director of facility clinical operations for Atrium Health's behavioral health services, during the podcast. "An in-person referral to intake takes around 20, 25 days…The first year we did [school-based telehealth], nine days was the average [time] from a referral to that student being able to receive services. And that's the important thing. A kid doesn't have to wait an additional 11 or 12 days to get the care that they need."

Not only that, but school-based telehealth services have helped mitigate hurdles related to the behavioral health workforce shortage. Through telehealth, one therapist can provide services at multiple schools as they don't have to drive from one location to another to be physically present, Zazzaro noted.

The benefit to parents is also clear, as they no longer have to take time off work to pick up their kids from school and drive them to a therapist's office. Conversely, kids with behavioral health issues, who may also be at higher risk of education problems, don't have to miss school unnecessarily.

And finally, school-based telehealth boosts equitable access to behavioral healthcare.

"What virtual care does is it takes away barriers," Zazzaro said. "It provides health equity to everyone because everyone has the same opportunity to seek services. Your ability to get therapy is not dependent on transportation. It's not dependent on having a parent or guardian that can take off in the middle of the day and take you to your therapy. That, I think, is such a benefit."