MEETING STUDENTS WHERE THEY ARE: BEHAVIORAL HEALTH SOLUTIONS IN SCHOOLS

Nov 13

There is an urgent need for Washington to improve our ability to connect children and youth with behavioral health care and services. Not only do we need to find a better, broader, and more accessible solution, but it needs to be implemented soon. This is why many, including Children’s Alliance, are exploring the expansion, improvement, and promotion of school-based behavioral health solutions. By doing so, we can meet students where they are and make accessing care as easy and convenient as possible.

There are currently 73 school-based health centers across the state, with more opening each year. And while there is still much to learn from providers, caregivers, and kids in our own state, we are also learning from programs in other states.

By the numbers:

Colorado’s I Matter Program: A universal screening and treatment model

Earlier this year, Children’s Alliance worked with the Children and Youth Behavioral Health Work Group to coordinate a presentation about a promising package of programs out of Colorado, namely the I Matter universal free therapy program and their 6th through 12th grade universal mental health screenings. Click here to watch a recording of that presentation, including Q&A with the prime sponsor of the bills and key state agency staff.

Here are some highlights of the program:

Created in 2021 as a temporary program in response to the COVID-19 pandemic and rising mental and behavioral health issues among children and youth;

Provides six free therapy sessions to anyone under 18 (under 21 if enrolled in special education program);

Relies primarily on telehealth, but in-person options are available;

Available in multiple languages and to anyone, regardless of immigration status; and

Made permanent in 2024, operating on a relatively small budget of around $6 million annually.

In addition to providing free therapy, Colorado also recently passed a bill creating a universal school-based mental health screening program, allowing school districts to opt in to providing the screening to their students. The program is set to begin screenings this fall. These screenings, conducted by state-approved personnel, identify students who may benefit from accessing behavioral health resources, and in some cases, may refer them to the I Matter program so they can receive clinical support for free. This type of screening model has also been tested in parts of Washington, with successful local versions being implemented in places like Spokane County.

The success of Colorado’s program shows that a state like Washington could provide affordable and accessible behavioral health care to young people. Even with a smaller state budget, Colorado was able to deliver behavioral health services to schools across the state and ensure that thousands of students who need services are aware of what supports are available to them and can access them freely.

What might we want to do differently?

There are also several ways we could improve upon this program if we were to replicate it in Washington. Notably, the I Matter program does not interface with school-based health centers, leaving some to question what the handoff procedure is for when students exhaust their six free sessions. Including school-based providers in the conversation about universal therapy programs could both simplify the care journey for kids as well as ensure that relationship building work that providers do with kids is not undone when they have to find a new provider.

What barriers are we facing?

Beyond the typical political barriers present when trying to create new policies and programs, there are likely some barriers unique to behavioral health care that we must address before we are able to create a truly universal solution. One of the most significant barriers is the workforce.

It is clear via multiple metrics that we have a shortage of providers to staff a potential statewide behavioral health program. A national analysis placed Washington within the top 10 states for the number of behavioral health care deserts, suggesting that over a quarter of the state’s population, about 2.2 million people, is underserved. Nearly half of the counties in Washington do not have a working psychiatrist. To provide accessible services to children and youth, we must have a workforce large enough to support a statewide program. There are many reasons why we are struggling to grow our workforce, such as reimbursement rates, financial barriers to becoming a provider, long timelines for education and licensure, and overworking/burnout.

The Washington State Legislature must take action to address these issues now, especially if we ever hope to create any form of universal statewide solution to the youth behavioral health crisis.

Get involved!

Children’s Alliance is working diligently alongside our partners and allies to develop solutions to these problems, and we invite you to join in our work.

If you are interested in learning more about behavioral health policy opportunities, please join us for Path Forward: a virtual event on November 20 where we will discuss behavioral health, economic opportunity, and the future for Washington’s kids.

Notes:

There are about 1.7 million Washingtonians under the age of 18: https://ofm.wa.gov/washington-data-research/statewide-data/washington-trends/population-changes/distribution-washington-population-age-and-gender
Over 1.1 million students are enrolled in nearly 2,400 public schools: https://ofm.wa.gov/washington-data-research/statewide-data/washington-trends/budget-drivers/kindergarten-through-grade-12-k-12-enrollment
58% of students in WA grades 8-12 are experiencing one or more symptoms of anxiety or depression: WA Healthy Youth Survey (2021)

9% of students in WA grades 8-12 have attempted suicide in the last year: WA Healthy Youth Survey (2021)

64% of youth with clinically diagnosable anxiety or depression are receiving no care: WA COVID-19 Student Survey, Department of Health Workforce Survey 2022, Rowan K, Et al. Access and cost barriers to mental health care and https://www.kff.org/other/state-indicator/children-0-18/

Charlotte Linton