California Mulls Guidelines for School Telemental Health Programs

September 05, 2018 - California lawmakers are pushing a bill to develop a statewide policy for telehealth and telemedicine that will give students remote access to mental health services.

AB 2315, which is now headed to Gov. Jerry Brown’s desk, calls on the California Department of Education and Department of Health Care Services to develop connected care guidelines within two years for the state’s public schools, including charter schools.

The bill passed unanimously in both the Senate and State Assembly.

"For over a decade, schools across America have been looking to technology to solve patient access to care issues for their student body,” Debbie Look, a senior legislative advisor to the California Department of Education, wrote in a Senate analysis of the bill. “A desktop PC or laptop with a video link can connect small and rural schools with a nurse at the district's head office, or even to a doctor at a nearby hospital. A telehealth platform can also be used for behavioral health counseling.”

“Schools are increasingly challenged by the rising number of children with behavioral health and mental health issues,” she said. “Unfortunately, there are limited resources available to address a student in crisis during the school day. Due to this lack of resources, schools often turn to School Resource Officers to intervene when a student is experiencing a behavior problem. These officers are not trained mental health providers and their involvement with a student during this time can escalate an already stressful situation. "

The bill stresses that telehealth guidelines would only be posted if sufficient funds are available. A Senate Appropriations Committee estimate placed the cost of developing guidelines at between $277,000 and $416,000, mainly to finance two new positions.

According to the National Alliance on Mental Illness (NAMI), more than 20 percent of children ages 13 to 18 face mental health challenges, along with approximately 13 percent of children ages eight to 13. This places an extra burden on school districts.

“Across the country, school systems are increasingly joining forces with community health, mental health, and social service agencies to promote student well-being and to prevent and treat mental health disorders,” Look wrote. “Because children spend more time in school than in community mental health centers, schools are well positioned to link students with mental health services. Schools are also places where prevention and early intervention activities can occur in a non-stigmatizing environment.”

In states like Minnesota and Maryland, state agencies are launching pilot programs to bring telehealth into schools. In Texas, meanwhile, Gov. Greg Abbott is continuing to lobby for an ambitious 40-point plan that includes expansion of the Telemedicine Wellness Intervention Triage and Referral (TWITR) Project, a program developed at Texas Tech University for the state’s schools.

“Since the TWITR Project’s launch, more than 400 students have been referred to the program, of which 200 students were screened for anxiety, depression, loneliness, isolation — and screened for whether they were prone to violence or violent thoughts,” Abbott notes in his report. “Those screenings led to psychiatric appointments and, sometimes, immediate hospitalizations and arrests for planning violent incidents like shootings. In four years, the program has resulted in 25 students being removed from school, 44 placed in alternative schools, and 38 admitted to a hospital.”