Bringing Telepsychiatry to the Classroom
Currently, 13-20% of children and adolescents in the United States suffer from a mental health condition, making it one of the five most common pediatric conditions. The majority of these cases (60%) are chronic, yet only 20% of kids receive the care they need .
Research shows that even those who are fortunate enough to begin care often end treatment prematurely due to a shortage of providers, lack of transportation and financial restraints. In rural states such as Missouri, where nearly 40% of the population resides outside urban areas, access to timely care is even more limited .
As a leading provider of mental health services to Jefferson County and 10 surrounding areas in Missouri, COMTREA, a certified community behavioral health organization, knew that they needed to be innovative in order to abate these health disparities and best meet the needs of their pediatric community.
A Genoa partner since 2017, COMTREA saw telepsychiatry as a meaningful and effective way to close the treatment gap, so they decided to approach the local school district about using this modality to make mental health care more accessible for students. Over their 45 years of service, COMTREA had formed a strong alliance with the schools, as well as with other community partners, who shared their vision of caring for the youth of Jefferson County.
Dedicated telepsychiatry room at Senn-Thomas, part of the Dunkin School District
“Since recruitment for child psychiatrists [was] a huge challenge, we had to step outside our comfort zone and expectations and explore telehealth to allow for access to care and create capacity,” explained Margo Pigg, MBA, MEd, LPC, former Chief Behavioral Health Officer at COMTREA.
“This was a risk as ‘face to face’ service delivery was expectation and anything outside of that was a concern/unknown. We had an excellent relationship with the districts and to meet their needs was a risk worth taking,” said Pigg, who spearheaded the initiative for her organization.
The timing also aligned with an update from CMS which allowed clinicians to bill Medicaid and MCOs for services within schools, outside of “school based health center” designations.
Building a successful school-based telepsychiatry program required close collaboration between COMTREA, the school district’s leadership and clinical staff, and the Genoa team. The first step was to crystallize the purpose of the program based on the community’s greatest behavioral health needs. This was the foundation for setting program timelines, establishing designated appointment spaces, training ancillary supports like medical assistants and IT, and allowing Genoa to find a psychiatrist that was the right cultural and clinical fit for the community.
“Collaboration/trust was the name of the game,” said Pigg. “Collaborating and creating efficiencies between us to leverage this type of service is what opened the doors.”
Since the school-based telepsychiatry program went live in August of 2019, COMTREA has provided psychiatric services to more than 100 new students across three sites: Fox School, Dunklin School, and the Arnold office. A mix of initial evaluations and medication management appointments, these telepsychiatry sessions mean that students are now able to access care from the comfort of their school.
“This partnership allows Dunklin R-5 students to get the support they need in a timely manner and at a reasonable rate,” Dr. Clint J. Freeman, Deputy Superintendent at Dunklin R-5 School District. “It is our belief that helping the child mentally and physically first can lead to greater student achievement for our students,“ continued Freeman.
While this was the district’s first telehealth collaboration, it was not their first school-based care endeavour. COMTREA established an onsite health center with live psychiatric services Northwest School in 2015, then they opened an oral health center at Fox School the following year.
Interested in learning more about school-based telepsychiatry and what a program might look like for your community? Contact Genoa Telepsychiatry to chat with a telepsychiatry expert in your state.