American country asphalt road with school bus coming.

Kids and teens have lived through a traumatic and stressful two years, the effects of which we are only beginning to understand. As students in Michigan and around the country return to classrooms full time, expanding behavioral health services is one of the most important steps schools can take to respond to the impacts of living through COVID-19. For districts trying to figure out what the “new normal” should look like, Family Medical Center’s telehealth model can serve as a starting point.

This work predates the pandemic—advocates have long promoted school-based behavioral health services, and many districts had vastly expanded their support in the years before COVID-19 compounded challenges. Providing care and resources during the school day helps overcome common barriers like local provider shortages, lack of transportation, complex or narrow coverage, and stigma. These benefits are particularly important for students of color, rural students, and other underserved communities—often the same communities that now face disproportionate impacts from COVID-19.

An Emerging Mandate

Underscoring the importance of this moment, the State of Michigan released a recovery plan that provides a framework for expanded behavioral health services as students return to schools. The report, called MI Blueprint for Comprehensive Student Recovery, breaks down those services into three tiers of support, all of them crucial for a holistic behavioral health response:

  • Tier One: Providing general mental health literacy, stigma reduction, and wellness techniques for students and staff.
  • Tier Two: Providing direct services to students experiencing behavioral health struggles.
  • Tier Three: Providing support for those most at risk for immediate crisis or suicide.

Highly trained professionals are needed to meet the increased need of tier two interventions for schools, yet shortages in social workers, therapists, and school-based psychologists are at an all-time high. Embedding a behavioral health program in a school by hiring new staff can be a daunting endeavor, but approaches like FMC’s offer an alternative method to ensure professionals can meet the needs of students.

The FMC Model

FMC’s work started small and has grown rapidly. In the 2016-17 and 2017-18 school years, they provided behavioral health services to seven schools in Southeast Michigan through a Health Fund grant. Since then, their work has expanded to 30 locations and has met the needs of over 1,100 students—and there’s strong potential for even more scaling and replication, in Michigan and nationwide.

In order to respond to a wide range of student behavioral health needs, FMC takes a hybrid approach. In-person, FMC-led therapy ensures a day-to-day presence of behavioral health professionals that can provide information and counseling to families, staff, and students. Those therapy sessions cover over 85% of behavioral health visits at the schools. The other visits are with an off-site psychiatrist via telehealth technology, allowing students to have access to increased support and medication as necessary.

Students, staff, and teachers have embraced the relationship with FMC and now view time needed for therapy as an essential element of the school day, not a disruption. The project adapted to the needs of each school and created a staffing model and workflow to facilitate communication between school staff and FMC. This deliberate partnership has resulted in 11,288 therapy sessions for students who may not have otherwise received care.

Throughout the pandemic, FMC social workers have continued to connect with students through telehealth visits, and they will continue to play an integral role in providing direct services to students in the next school year. The key to this successful partnership is the buy-in and commitment of both the FQHC and schools. As John Krimmel, Superintendent of Airport Community Schools, advised to other schools, “As Nike says, ‘JUST DO IT!’ It is worth every minute that it takes to make this program a part of your school.”

To learn more about the partnership between Family Medical Center and area schools and to access sample tools and documents from the project, head over to the Bringing Care to the Classroom – School-Clinic Telepsychiatry Case Study and Tools.

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