Teletherapy and Telepsychiatry Visits Help Southeast Michigan Students Improve Mental Health

This article is part of Health, a series on how Michigan communities are mobilizing to address health challenges. It is made possible by funding from the Michigan Health Endowment Fund.

As a safe and reliable access point for Michigan children in need of behavioral health treatment, Michigan school districts have seen particularly promising telehealth solutions. As virtual tours become more common, community health care clinics and established schools can team up to use technology to help more students get the care they need.

An excellent example of a successful school-based behavioral telehealth program is the Michigan Family Medical Center‘s (CMF) with 20 schools in Lenawee, Monroe and Wayne counties. FMC, a Health center accredited by the federal government, partners with schools that do not have access to community health services. Since 2016, its school-based behavioral health program “Someone to Talk to” has offered teletherapy and telepsychiatry to students, as well as in-person therapy led by a social worker in school buildings. Monroe County Airport Community Schools have partnered with FMC under the program for three years.
Airport community school staff, including the superintendent. John Krimmel (far right) speaks with Family Medical Center staff, including School Services Supervisor Meredith Gilliam (far left) and Behavioral Health Therapist Alexis Cavins (in orange shirt).
“The positive impact has been significant,” says John Krimmel, Airport community schools Superintendent. “Telehealth services have provided an additional and higher level of support that we did not have access to before. “

For all schools served by CME, the ability to virtually connect students with therapists and psychiatrists has proven to be financially viable, scalable, and particularly relevant for rural communities or other areas with few practicing psychiatrists or therapists. .
Meredith Gilliam, Family Health Center School Services Supervisor at Wagar Middle School in Carleton.
“We definitely have a need in our schools that we’ve seen with our kids,” Krimmel says. “It’s just great that we can not only provide the services and seamless entry to more support services, but also have it right here in the schools.”

Fun, focused and familiar therapy

Because FMC provides face-to-face services in district buildings as well as telehealth services, Krimmel notes that students are more comfortable engaging in services and that parents have a level of trust and confidence. higher support for FMC. FMC also offers mental health screening services that help identify additional students who need support, and the services do not end with the school year. FMC continues to receive students over the summer.
Alexis Cavins, Behavioral Health Therapist at the Family Medical Center, and Meredith Gilliam, School Services Supervisor, at Wagar Middle School in Carleton.
“We are meeting children and families who are in dire need of more intensive mental health services,” Krimmel said. “It allowed us to give them access.”

In addition to video and audio calls, CME therapists engage students through virtual desks where children can click on a variety of activities, games, and mindfulness techniques to complement their therapy sessions.
The virtual office of a therapist at the family medical center.
“We have really sharp and talented therapists. They’ve created virtual offices – really fun and colorful interactive environments on the Internet where students can do home exercises outside of the visit,” says Jessica Parsil, director of the behavioral health of CME. “Teenagers love to be on their phones. They love technology. That’s what they do.”
Jessica Parsil.
Through telehealth, students also have access to a wider range of therapists and psychiatrists to meet their unique needs. A student with a specialized need can be matched with a provider that focuses on that specialty. Students who feel more comfortable with a male or female therapist can more easily be accommodated.

“This has been another benefit – students have access to all of our therapists. We can bring all of our psychiatrists and therapists together and be able to offer their services to any school,” Parsil said. “Therapists have different areas of specialization. So if someone has a diagnosis or a problem in one county and the specialist who could help that patient or student is in another county, we can always match them up.”

Help ready when the pandemic strikes

Since FMC’s virtual mental health program was already in place before the pandemic-related school closures, Airport Community Schools was well prepared to deal with the resulting spike in mental health issues.
Audrey Smith.
“Thanks to the implementation of our services, we were able to continue their therapy and had a very small decrease. Our students were simply able to continue to virtually access their services, ”said Audrey Smith, Executive Vice President of FMC. “We also continued to go to schools. For some school districts, the buildings were open and the students were very comfortable seeing us in their buildings. But for the most part, we were doing this work virtually.

Parsil has seen students deal with more stress, fear, sleep problems, depression, and anxiety. In addition, more and more high school students have started vaping, abusing substances like alcohol and marijuana, and engaging in risky sexual and illegal behaviors. While social isolation was difficult for all students, those who lived in dysfunctional home environments suffered even more.

“We are really able to look at different issues that we might not have known if we hadn’t seen the home environment through telehealth services,” Parsil said. “It was truly an unexpected result. We hadn’t thought of this when we started doing remote telehealth, that we would get a glimpse into student family life. This allowed us to alter treatment plans by addressing difficult and deeper issues that we may not have known. “

One of the disadvantages of telehealth is the potential lack of privacy for patients. Students who speak to their therapists within earshot of parents and siblings may feel uncomfortable or unable to share their thoughts and feelings.

“We have to be aware when they’re at home versus at the office, and that means others can maybe hear,” says Parsil. “Some of our students got creative, if needed. Some have a fan that blocks the sound. Some go in the car and have sessions there to make sure no one overhears. We have to respect the need for privacy.”

A vital role after the pandemic

When COVID-19 forced medical and mental health providers to switch to virtual services in the spring of 2020, Medicaid and private insurers also changed reimbursement protocols to cover these services. As a result, the Michiganders have benefited – and telehealth and telepsychiatry have proven to be extremely effective modalities for the delivery of health care. Some fear that payers will no longer cover virtual services to the same extent after the pandemic.

“The importance of reimbursement for telehealth services is really essential in order to be able to reach everyone,” says Parsil. “This platform … removes some of the barriers, [such as] transportation, students and parents must be absent from work and school. It also allows for greater reach. Thanks to our psychiatric services, we are now able to provide this in all three counties. It is very important that mental health services are able to reach more people. This is the good thing about telehealth. We have seen many positive results. “

A freelance writer and writer Estelle Slootmaker is happiest writing about social justice, wellness and the arts. She is the development news editor for Fast growing medium and L’Arbre Amigos chairs, Wyoming City Tree Commission. His greatest achievement is his five incredible adult children. You can contact Estelle at [email protected] or www.constellations.biz.

Photos of airport community schools by Christopher Slat. All other photos courtesy of the Subjects.

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