As Schools Go Remote, Pivot to Prevention Adds Telehealth Tools

Posted September 2, 2020
By the Annie E. Casey Foundation
Without children in classrooms, access to important behavioral health services remains important, especially during the pandemic.

Rhode Island-based CYC (Chil­dren Youth Com­mu­ni­ty) has served near­ly 1,000 chil­dren in Prov­i­dence through its Piv­ot to Pre­ven­tion Pro­gram and Tool­box — a frame­work and tool kit for school sys­tems that seek to improve the men­tal and behav­ioral health of stu­dents. In response to the shift to remote learn­ing dur­ing the coro­n­avirus pan­dem­ic, the orga­ni­za­tion has expand­ed its offer­ings to include tele­health tools. The new addi­tion comes in the form of a guide for imple­men­ta­tion of men­tal and behav­ioral tele­health ser­vices, and is based — as is the orig­i­nal tool kit — on suc­cess­ful meth­ods applied by CYC to schools in Providence.

The first iter­a­tion of the Piv­ot to Pre­ven­tion Tool­box, which is sup­port­ed by the Annie E. Casey Foun­da­tion, equips school sys­tems with strate­gies for bring­ing licensed ther­a­pists, social work­ers and oth­er Med­ic­aid-reim­bursed clin­i­cians to schools dur­ing the school day — pro­vid­ing stu­dents of col­or and those from low-income fam­i­lies with ser­vices they oth­er­wise might not be able to access.

CYC pro­vides coach­ing and tech­ni­cal assis­tance to school sys­tems imple­ment­ing the Piv­ot to Pre­ven­tion approach. The tool kit offers mate­ri­als and resources for every stage of the process — from financ­ing clin­i­cal ser­vices through Med­ic­aid to build­ing part­ner­ships with clin­i­cal providers, inte­grat­ing ser­vices into the school set­ting, inform­ing and engag­ing fam­i­lies and track­ing stu­dents’ evolv­ing sup­port needs.

With lim­it­ed access to in-school sup­port and ser­vices in many places dur­ing the pan­dem­ic, stu­dents — par­tic­u­lar­ly chil­dren of col­or — are expe­ri­enc­ing ele­vat­ed rates of inse­cu­ri­ty, anx­i­ety, depres­sion, grief and loss. To meet this press­ing need, some schools and com­mu­ni­ties are trans­fer­ring their on-cam­pus clin­i­cal ser­vices to behav­ioral tele­health. Schools are a place where many chil­dren and fam­i­lies access vital ser­vices,” says Ilene Berman, a senior asso­ciate with the Casey Foundation’s Evi­dence-Based Prac­tice Group. When school doors close, it’s real­ly impor­tant that young peo­ple can still access need­ed sup­port in a safe way.”

The guide and its rec­om­men­da­tions are ground­ed in lessons CYC learned dur­ing its own tran­si­tions with clin­i­cal part­ners in March 2020. With­in weeks of schools clos­ing to pre­vent the spread of the virus, CYC used Piv­ot to Pre­ven­tion to suc­cess­ful­ly tran­si­tion more than 300 stu­dents to behav­ioral tele­health. Over the next few months, an increas­ing num­ber of stu­dents and their adult fam­i­ly mem­bers joined the tele­health plat­form and gained access to clin­i­cal sup­port and ser­vices. In addi­tion to case-by-case improve­ments, many fam­i­lies report­ed that the tele­health ser­vices helped them feel more con­nect­ed to their schools.

CYC’s addi­tion to the Piv­ot to Pre­ven­tion Tool­box fea­tures a com­pre­hen­sive frame­work for each of the fol­low­ing stages:

  • Devel­op­ing a plan. Steps and resources for imple­ment­ing, sus­tain­ing and scal­ing behav­ioral tele­health services.
  • Sup­port­ing stu­dents. Ques­tions to ask stu­dents to ensure they have the space, time, trust and sup­port they need to inter­act effec­tive­ly with behav­ioral tele­health services.
  • Engag­ing with fam­i­lies. Guid­ance for com­mu­ni­cat­ing with care­givers to deter­mine whether they have the resources, tech­nol­o­gy, devices and com­fort lev­el to sup­port their child in receiv­ing tele­health ser­vices, and whether they need or want ser­vices for addi­tion­al fam­i­ly members.
  • Eval­u­at­ing clin­i­cal part­ners. Ques­tions to ask clin­i­cal part­ners about their pro­ce­dures, pro­to­cols, avail­abil­i­ty and pre­pared­ness to pro­vide tele­health ser­vices dur­ing the time of esca­lat­ed need.

As the 20202021 school year unfolds, CYC plans to con­tin­ue to eval­u­ate its tele­health efforts and add new pro­grams as needed.

Read more about CYC’s Piv­ot to Pre­ven­tion work dur­ing the pandemic

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