As the COVID-19 pandemic continues to induce stress for many, a team of multidisciplinary mental health specialists with The University of Texas Health Science Center at Houston (UTHealth) is leveraging telemedicine to connect students experiencing emotional or behavioral crisis with sustainable care.
Through the Texas Child Health Access Through Telemedicine (TCHATT) program, UTHealth has partnered with seven school districts in the Greater Houston area to prevent unnecessary psychiatric hospitalizations in youth and connect them with community support for therapy, psychiatry, and positive development.
The program is part of the Texas Child Mental Health Care Consortium, which was created by the 86th Texas Legislature in 2019, and seeks to establish and improve access to care for children throughout the state.
According to a recent 4-H survey of 1,500 youth nationwide, 64% of teens believe that COVID-19 will have a lasting impact on their generation’s mental health, and 79% say they wish they had an inclusive environment or safe space for people in school to talk about mental health.
“Following COVID-19 and the extended quarantine, children who may never have struggled previously are now having difficulties with mental health concerns for the first time,” said Elizabeth Newlin, MD, vice chair for child and adolescent psychiatry with the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Health at McGovern Medical School at UTHealth. “Youth with preexisting vulnerabilities or known mental health concerns, however, are at the greatest risk during a pandemic or quarantine. The TCHATT program is a timely initiative to provide immediate and urgently needed stabilizing care as well as link children to ongoing services.”
Untreated mental health conditions in childhood are associated with reduced school attendance, poorer academic performance, and disruptive behaviors, Newlin said.
School personnel are seeing the stress play out in the classrooms.
“Many students need mental health support outside of school – this often becomes evident through their behavior or things they write and draw during class,” said Charlotte J. Davis, PhD, assistant superintendent of student support services with Aldine Independent School District (ISD), one of the school districts enrolled in the program. “By speaking first with a UTHealth physician, students aren’t afraid to express what they’re truly feeling. Sometimes there are hesitations to confide in the school counselor because the student knows the counselor is connected to their teacher, their friends, etc. This program is a blessing for students who might not have otherwise received the help they need.”
The program includes sessions with a UTHealth mental health specialist for up to eight weeks, because that is the average length of time a young person waits to be seen by a child psychiatrist in most communities. During that time, the physician evaluates if the student would benefit from further care to maintain mental health stability, and ensures that the handoff is smooth.
“UTHealth team members work with the student and their family to ensure that they’re prepared to engage in a health care plan, and they follow up to ensure that they made it to their initial appointment and determine their continued commitment to treatment. It is common for schools to have one school counselor that serves hundreds of students, so the program helps to expand access to sustainable mental health care and ensures a warm handoff between our mental health experts and the community provider,” Newlin said.
School districts enrolled in the program include Alief ISD, Aldine ISD, Fort Bend ISD, Huffman ISD, Humble ISD, Lamar Consolidated ISD, and YES Prep.
Senate Bill 11 was authored by Sen. Larry Taylor and sponsored by Rep. Greg Bonnen, MD. It includes the SB 10 consortium language by Sen. Jane Nelson and former Rep. John Zerwas, MD. House Bill 1, the general appropriations act, which was authored by Nelson and sponsored by Zerwas, funded the new Consortium programs.
UTHealth has received nearly $10 million from HB 1 for the Consortium mental health care programs, including the more than $2.1 million for the TCHATT program. This funding has already supported service agreements with seven local school districts and charter school systems and will provide the potential to reach more than 400,000 children.
“When TCHATT was envisioned, we knew there was a need to leverage telemedicine to fill the mental health care gap for children,” Sen. Nelson said. “Little did we know just how important these services would become as we navigate the many challenges of COVID-19. These services will go a long way to help young Texans access the expert care they need to lead healthy lives.”
“I was honored to join forces with Senator Nelson to pass legislation and funding to give ISDs the resources to tap into the state’s excellent medical schools,” said John Zerwas, MD, former state representative and now executive vice chancellor for health affairs for The University of Texas System. “Establishing telemedicine connections between our school children and mental health resources at medical schools, such as UTHealth’s McGovern Medical School, especially during this pandemic, will make a big difference in their mental health, safety, and performance in school.”
“With the Consortium, there is a transformation of child mental health services underway in Texas and the timing could not have been better,” Newlin said. “TCHATT is just one of several programs we are working on to improve mental health care in Texas. We’re looking forward to bridging the gap to sustainable mental health ecosystems for families across the state thanks to the efforts of the Texas Legislature, especially Sen. Nelson and Dr. Zerwas for envisioning the Consortium and making it a reality.”
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