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Telehealth for School-Based Mental Health

Telemedicine  for School-Based Mental Health was established to meet the mental health needs of Galveston County’s adolescents and youth through a collaborative framework—involving the University of Texas Medical Branch (UTMB), the Robert Wood Johnson Foundation (RWJ), the Galveston Independent School District and the city’s philanthropic community—for mental health care in area primary and secondary schools. This undertaking is driven by a simple but powerful goal: to close the gaps in access to mental health services for adolescents and youth in the Galveston County community. The initiative currently operates in the Galveston, Dickinson, La Marque and Santa Fe Independent School Districts (through a collaborative with the school systems and community-based partners) to deliver services to underserved youth and adolescents.

On August 31, 2005, the RWJ announced that UTMB had been selected as one of 49 organizations (out of 219 applicants) invited to bring forward a full proposal through the foundation’s Local Initiative Funding Partners (LIFP) Program. And, on July 6, 2006, UTMB was named as one of the 12 recipients of grants through the LIFP Program. Since that time the program has received an additional grant from the Robert Wood Johnson Foundation, in addition to funding from the Annie E Casey Foundation, seven local philanthropic organizations, and a number of community entities.  The program just completed its fourth and final year of the original RWJ grant and since has established a braided funding model (incorporating billing for service with multiple national, state and local funding sources, contracts and various grants) which will keep it functioning and sustainable in the community beyond the initial philanthropic gifts. 

The goals of the program are to:

  • Improve the access to mental health services for adolescents, youths, and their families
  • Improve education, consultation, and assistance to primary health providers involved in the care of these individuals and their families
  • Improve patient satisfaction with mental health services received at the THC
  • Improve provider satisfaction with mental health services at the THC

UTMB is the world’s largest and most respected provider of patient care through telehealth.  By using advanced videoconferencing technologies to link four school-based Teen Health Clinics with mental health providers on the UTMB campus and elsewhere, we have created an even more accessible tool for adolescent mental health in Galveston County.

The integration of mental health services into the public school setting itself is not novel. Mental health issues often surface during the tumultuous years while a child is enrolled in school and the school campus is considered a safer and more comfortable place to receive services (less stigma) and is an easier place to access services. The use of a telehealth link between behavioral professionals at UTMB and our community partners integrates a multidisciplinary, holistic approach to delivering community-based youth and adolescent health services that will effectively coordinate the multiple health and service providers involved in treatment and delivery of clinical and social services. Without this linkage, for the most part, these students would not get the help they need. And it is well documented that untreated mental health disorders lead to higher rates of juvenile incarcerations, school dropout, family dysfunction, drug abuse and unemployment (American Academy of Pediatrics 2004).

Mental health focus groups among Galveston Independent School District parents and teachers have revealed four key areas of concern: many students’ inability to cope without using violence; a dearth of problem-solving skills; inadequate parenting skills, and a prevalence of angry, violent and depressed adolescents and youth in the community.

In response to community concerns, UTMB convened a Mental Health Task Force in fall 2004. Now over 35 members strong, that group has performed a needs assessment, convened political action groups and developed specific strategies to address community needs. The school-based telepsychiatry program is an outgrowth of those discussions.

Over the last four years this program has provided over 11,780 patient contacts that might not have happened. Over the last year, we are also pleased to report that we have continued to demonstrate a democratized access to care: 40% White, non-Hispanic, 32% African-American, 27% Hispanic and 1% Asian. This statistic is of additional significance given that the Galveston population demographics post-Ike have shifted dramatically from what was approximately 1/3 Hispanic, 1/3 African-American, 1/3 White, non-Hispanic to approximately 45% Hispanic, 27% African-American, 27% White, non-Hispanic. Our results continue to indicate progress in improving paths of access to mental health services taken by minority racial/ethnic groups and massive efforts to affect parent attitudes, knowledge and opinions related to the use of mental health services. And our efforts to expand services to additional school districts on the mainland reflect this. Many of our clients who were previous residents of subsidized housing on Galveston Island were forced to relocate on the mainland after the hurricane as their housing complexes were destroyed beyond repair and ultimately razed.

Additional accomplishments during the last year include the following:

  • Results that indicate a statistically significant reduction in symptom levels between initial visit and 3rd month visit.
  • No statistical difference between African American and White, non-Hispanic parent’s  perception of care (“helped with child’s treatment goals”; “the staff treated me with dignity and respect”; “staff was respectful of my family’s religious beliefs”; “staff was sensitive to my cultural/ethnic background”; and others.
  • 72% of parents/guardians “strongly agreed or agreed” that “as a result of services my child is getting along better with family members”.
  • 68% of parents/guardians “strongly agreed or agreed” that “as a result of services my child is doing better in school”.
  • Nine school-based clinics (actually one is juvenile justice-based and two are in development and will be open this Spring) that are integrated through an electronic medical record system.

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Copyright © 2014 Office of Health Policy and Legislative Affairs, UTMB
Phone: 409.747.2789 • Fax: 409.747.2795 • HPLA.mail@utmb.edu
Office of Health Policy and Legislative Affairs, Galveston, TX 77555-0916