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Schools Turn to Telemedicine to Tackle Student Depression, Violence

A telemedicine program launched in 2012 after the Sandy Hook Elementary School massacre has helped schools in Lubbock, Texas, identify and treat hundreds of students in need of psychiatric services.

Source: ThinkStock

By Eric Wicklund

- Texas school officials are touting a telemedicine service that not only brings behavioral healthcare into the school, but also may be averting serious issues like potential violence.

Texas Tech University Health Science Center’s Telemedicine Wellness, Intervention, Triage and Referral (TWITR) program, in place in 11 school districts in and around Lubbock, has been used by some 34,000 middle and high school students since its launch in 2012, TTUHSC President Tedd Mitchell recently told Politico. Mitchell said 10 percent of those students have received counseling as a result of those visits, and roughly 300 have been referred for psychiatric care.

But with memories of the Feb. 14 massacre at Marjorie Stoneman Douglas High School in Parkland, Fla., still on everyone’s mind, Mitchell – speaking at a Politico event in Washington D.C. – pointed out that 25 students were taken out of school through the program because they showed a heightened risk of suicidal or homicidal actions.

“The good news with a program like this is, you can find those kids who are just about to blow,” Mitchell said, adding that a virtual visit platform enables behavioral health experts to connect with students who might not otherwise have access to needed psychiatric services.

While the potential for averting a school shooting is a hot-button topic, the idea of using telemedicine to push healthcare resources into schools has been gaining traction for years, as school districts and administrators look to improve access on a limited budget.

While many schools have sought to enhance the nurse’s office with a telemedicine link for non-acute health concerns, a growing number are looking to expand the platform to help students with chronic conditions and bring in specialist services.

Behavioral healthcare is at the top of that list.

Experts say there are roughly 15 million school-aged children in the US who need psychiatric care, yet only 8,300 practicing child psychiatrists, many clustered in large metropolitan areas.

“The shortage means some of the most vulnerable children in our country will go without help,” Jack Turban, MD, a resident child and adolescent psychiatrist at Harvard Medical School, wrote in a June 2017 piece in Psychology Today. “According to the Centers for Disease Control and Preventionsuicide is the second most common cause of death among U.S. teenagers. Despite this, only one-third to one-half of children who need mental healthcare have access. The situation is only projected to get worse.”

In Utah and Georgia, lawmakers are considering legislative action to fund telemedicine programs and other efforts to improve access to telemental health services in schools.

“Kids who have an unmet mental health need, if it continues to get worse, miss significantly more days of school than kids who don’t have those needs,” Erica Fener Sitkoff, executive director of Voices for Georgia’s Children and a commission member, recently told the Gainesville Times. “We know if we don’t intervene, it starts to have a compounding negative impact on them - they get behind and it feeds into stress, anxiety, depression.”

And, potentially, violence.

The TWITR program was launched in response to the Sandy Hook Elementary School massacre and Aurora, Colo., theater shooting in 2012, as well as escalating national incidents of school violence. Those incidents prompted then-Gov. Rick Perry to call for a “model project … to identify those most at risk for committing violence in schools and intervene with those students before acts of violence occur.”

Through the program, students are identified and screened for risk-based behaviors in schools, then provided two telemedicine psychiatry sessions if they meet the requirements; those needing further treatment are incorporated into the TTUHSC Psychiatry Clinic.

Program officials say the telemedicine platform has reduced the number of referrals by 37 percent.

“Whatever your approach is to cutting school violence, this can be a part of it,” Mitchell told Politico. “We couldn’t have screened thousands of kids without telemedicine. And you could do the same thing in urban areas, where there are healthcare deserts.”

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