Back-to-School Behavioral Health Check-Ins

This piece was written by Holli Stayton, nurse practitioner for Inpathy, InSight’s direct-to-consumer division. Originally published on American Journal of Managed Care

As summer draws to a close, parents naturally begin to consider back-to-school preparations such as well-checks with primary care providers and immunizations. As part of a holistic back-to-school wellness plan, it’s also important for parents to proactively monitor a child’s behavioral health and consider a mental health checkup in addition to a physical checkup.

The reality is that emotional wellness can take a downward turn as the start of school approaches. Reminders of school-related pressures are visible as early as midsummer as parents and children are exposed to an array of back-to-school advertising and school-related communication. These activities can cultivate anxieties and tensions well before the start of the new academic year, and it is not uncommon for demand of behavioral health services to soar near the end of the summer as parents identify concerning behaviors and begin back-to-school preparations.

Amid severe provider shortages, this increased need can create notable supply and demand challenges. Direct-to-consumer (D2C) telepsychiatry has emerged as an advantageous alternative that parents and children appreciate and value. A study in the Telemedicine Journal and e-Health even determined that telepsychiatry may be better than in-person care for younger age groups “because of the novelty of the interaction, direction of the technology, the psychological and physical distance, and the authenticity of the family interaction.”

The Behavioral Health Access Challenge for Children
Consider this all-too-common back-to-school scenario:

A child suffering from undiagnosed depression becomes agitated about the start of school in mid-July. As the weeks progress, parents begin noticing the child has become more withdrawn and is sleeping more. In August, the child becomes combative, lashing out at family members and responding to conflict in irrational ways.
The parents determine it is time to seek a psychiatric consult. Yet, when the attempt to schedule an appointment is made, they find out the child will have to wait 2 months for an appointment. During this time, symptoms continue to exacerbate, and the parents are left with few options.

Unprecedented demand exists for child and adolescent psychiatric services. The CDC has found nearly 1 in 7 children between the ages of 2 and 8 has a mental, behavioral, or developmental disorder. The statistics for preteens and teens aged 9 to 17 is higher—as many as 1 in 5.

Unfortunately, severe provider shortages, especially for child and adolescent specialty areas, are working against this heightened need. Currently, all states lack an adequate supply of child psychiatrists, and severe shortages exist in 43 states, according to the CDC. Some rural areas lack a single psychiatrist, and many behavioral health issues in children go undiagnosed or underserved.

For children who have a behavioral health diagnosis, it is important to schedule routine check-ins as part of a proactive approach to managing the disorder. Unfortunately, provider shortages make routine check-ins more difficult, and frustrated parents often let scheduling fall behind or give up. This often results in further disruptions in a child’s life and can require more costly interventions.

Fortunately, there is a better way.

The Telepsychiatry Advantage 
D2C telepsychiatry is quickly becoming a fundamental part of the solution to improve behavioral health access for children and adolescents, both at home and in schools. Powered by videoconferencing technology, these models are readily embraced by younger patients because they have grown up communicating via video and mobile devices.

Telepsychiatry not only helps normalize mental and behavioral health care with the use of technology, but it also helps breakdown barriers to establishing rapport with children because it gives them a greater sense of control. Interactions with behavioral health professionals can occur from the comfort of home or in a familiar, private setting where they feel safe.

In addition, the privacy afforded by these models helps alleviate concerns of running into peers in a waiting room or outside a facility and allows children and adolescents to learn to cope with whatever challenges are at hand in a comfortable setting.

Most notably, telepsychiatry opens doors to greater access while also providing a convenient means of scheduling appointments. In an academic setting, for example, staff can connect students with timely and proactive care directly on campus during times that align with their schedules. One alternative school in Pennsylvania, The Lincoln Center, has experienced success with its on-campus telepsychiatry program, which provides mental and behavioral health services to students who need such care on a regular, ongoing basis.

Because telepsychiatry providers are available for sessions outside of traditional office hours, parents can avoid missing work, and children do not have to miss school or sit in a waiting room—key advantages to ensuring added stressors are not placed on this age group while they are receiving help. Instead of waiting several months to see a behavioral health professional, children can typically schedule an appointment in less than 2 weeks—and at a convenient time.

In 1 instance, a student was at risk of getting expelled from school due to intensifying behavior issues in the classroom. The child’s mother faced significant struggles finding behavioral health support and medication management services. The telepsychiatry option was introduced and quickly embraced by both the parent and child, and now he is stabilized and thriving in the both his home and school environments.

Today, children and adolescents face unprecedented challenges and pressures. It’s important that parents proactively track not only a child’s physical well-being, but also his or her mental and emotional well-being. Back-to-school planning is an optimal time to consider a behavioral health check-in, and families and schools are increasingly turning to telepsychiatry as a viable and advantageous approach to better care.