Bringing Psychiatrists Into Schools Can Help Vulnerable Kids When They Need It Most
As the outreach counselor for Battle High School in Columbia, Missouri. Dana Harris’s job is connecting students with services when they have mental and emotional troubles such as ADHD, anxiety or depression.
This used to mean hours of calling community organizations and service providers, looking for available appointments, calling in favors, trying to to get students the help they needed.
“You could spend a whole day trying to get those services met,” Harris says.
Today, she just has to make one call: to a case manager. That’s thanks to an innovative program, MU Bridge Program, that essentially brings comprehensive psychiatric care into the school. It got its start at Battle High in 2014 and now is available to all school-age children in Boone county..
The MU Bridge Program provides case managers who come to the school, meet with the child and their family, and a psychiatrist to perform evaluations. The case manager will also help connect the child to long-term services.
There’s a growing interest in programs that bring mental health care into schools, as schools around the country struggle to tackle the unmet mental health needs of students, says Darcy Gruttadaro, the director of advocacy at the National Association for Mental Illness. She says when kids can “walk down the hall and see a mental health professional” that removes many of the barriers to care.
Often, children’s mental or behavioral health issues are first identified in school, by teachers and counselors. But few schools have the resources to help the kids get professional care.
“These conditions start quite young. We typically far under-identify the number of children that have a mental health condition and need help and need care provided,” Gruttadaro says. “So this presents an opportunity to really address that.”
The MU Bridge Program was created at the University of Missouri School of Medicine by Dr. Laine Young-Walker, chief of child and adolescent psychiatry, and nurse case manager Carol Schutz.
Schutz is one of the case managers for the program. She goes to schools throughout Boone County, and meets with students and their families. She sets up the psychiatric evaluation, helps families get medication and schedule therapies, and then follows up with the families over the course of several visits.
After the child is stabilized, Schutz makes sure a child is connected to adequate emotional and behavioral help outside of the Bridge program.
“I think that we’re catching children before their emotional, behavioral issues become so entrenched that they’re not able to make any progress,” Schutz says. “Not only in schools, but in their personal lives as well.”
Young-Walker, the head of the program and a psychiatrist, says bringing the initial evaluation and case management into a school can provide better care by eliminating the middle-man and letting school staff communicate directly with care providers about issues they observe in the kids..
Without the Bridge program, it was like a game of telephone.
“So it closes the loop that we often have in an outpatient clinic. Where a school has a concern, so they tell the parent to go see a doctor, [but] the doctor has no idea why the school referred,” Young-Walker says.
She says it’s also can be less disruptive to a student. It reduces the amount of class time a student misses, removes transportation costs for families, and increases communication between the families, doctors and school.
Gruttadaro says the interest in school-based mental health services continues to grow because, anecdotally at least, it has been shown that early identification of mental health issues leads to better long-term outcomes and less costly long-term care.
“There’s been a lot of interest in school-based care,” she says. “It makes so much sense because that is where children are - children and families are in schools, and it really is a wonderful way to ensure early identification, ensure early intervention and produce far better outcomes.”
Minnesota and Ohio have programs similar to Bridge throughout parts of the states - that bring mental health support and services directly into schools.
"These conditions start quite young. We typically far under-identify the number of children that need help. So this presents an opportunity to really address that."
Gruttadaro says that it seems likely school-based programs will continue to grow and become more common as “statewide, local, [and] county-based leaders step up to say ‘This is right for our community.’"
In Boone County the funding for the MU Bridge Program comes from theChildren’s Services Fund which was created in 2012 when county voters decided to tax themselves to support the needs of children in the community. The tax is a quarter of a cent sales tax. Bridge is one of dozens of programs funded by the tax. And many of the services Bridge connects students to are also funded by it.
Similar taxes have been passed in eight other Missouri counties since the passage in 2000 of a law permitting such taxes to be levied.
Young-Walker says in the nearly two years that the MU Bridge Program has been operating, it has worked with more than 400 kids in Boone County. She says in the future she wants to reach more kids and make sure that no child in Boone County is falling through the cracks.