WHY Tele … Anything ?

1. WHY Tele …Anything ? Christi Beals Kim Chouinard Nick Little

2. The Journey • YBGR Receives $500k Equipment-Only Tele-med Grant • Goals: • Install Equipment • Improve Access to Mental Health Care in Schools a. Over 85% of children are Medicaid eligible b. Over 20% of children and adolescents have mental health problems (Taras & Young 2004) Now What …

3. School Based Services Benefits of YBGR– School Based Services • Therapy • Behavior Interventions • Increased Attendance • Services Year Round/Continuity of Care • Decreased discipline referrals to school administrators • Increased Communication Limitations of YBGR– School Based Services • Access to services in rural areas • Long waiting lists for additional services • Funding/insurance barriers

4. HealthLinkNow • 2 Board Certified Children/Adolescent Psychiatrists • Electronic Medical Record • Web-based IT Platform • Bill for Services • Care Navigator/Case Manager • Quarterly Chart Reviews • HIPAA Compliant

5. Community Partnerships MBI Belief Statement All students should be taught all the skills necessary for success: academic, social, emotional, and behavioral.*Schools are places where students can learn and practice positive interpersonal, cross-cultural, and citizenship skills. A caring school climate and positive relationships between students and staff are critical to student success and provide an environment where academics flourish. Schools are places where youth have access to many significant adults to help them feel collectively and individually valued. Schools and communities must work together to meet the diverse needs of students and honor the traditions and contributions of both family and community members. All students are entitled to be treated with dignity and respect. Successful schools gather and use a variety of information to improve teaching and learning. Effective use of a team approach involving all school staff working together provides a consistency which enhances student success.  Positive, proactive and preventative efforts of schools and communities can create a school climate free of stereotyping, harassment, hatred and violence—filled with a concern for justice and fairness. Dillon Primary School Website

6. Why is Mental Health Important to Education? • Mental health is directly related to children’s learning and development. • It encompasses or intersects with interpersonal relationships, social-emotional skills, behavior, learning, academic motivation, certain disabilities, mental illness, crisis prevention and response, school safety and substance abuse. • Each of these issues affects not only the success and well being of the individual student but also the school climate and outcomes for all students. Information Source: National Association of School Psychologists

7. Why School Based Services? • Mental health services provided within the child’s natural settings (Atkins & Lakind 2013) • School based mental health services help many children/families overcome barriers such as lack of transportation, financial constraints and stigma surrounding mental healthcare (Taras & Young 2004) • Fully integrated team providing unparalleled support for each child receiving care • Increased accessibility to child mental health providers (Barnett & Allison 2012)

8. Future Partnerships

9. Why is this so hard?? Lessons Learned • Scope of Project • Scheduling • Office Space • Communication • Training Obstacles • Roles & Responsibilities

10. YBGR: Success Story I was a resident at YBGR from December 2007 until August 2008, and with their support, my life was changed forever. I went from a depressed, suicidal, angry young man to a happy, appreciative, optimistic teen. Because of their support, I just graduated from a public high school, and won the two most prestigious awards given out by the Board of Education. Thank you YBGR...you saved my life. I am forever grateful YBGR Facebook Post June 2014

11. HealthLinkNow: Success Story During a follow up site visit with a primary care physician at a partnering critical access hospital, we were given insight into a success story about a patient using our PCMH model of care. This adolescent patient was diagnosed with severe depression and had been on several psychotropic medications. Because she was prescribed these medications, she was in need of timely accessibility to a psychiatrist to manage those medications. Due to the lack of accessibility to a psychiatrist (in which they had to drive over an hour to meet), the patient often had to wait weeks before being able to have follow-up consultations regarding medication. Without timely accessibility and medication management, she was not always able to get the medications she required and suffered setbacks affecting her and her family. Now that her local PCP offers access through our psychiatrist via our PCMH she has timely access to a psychiatrist, she has stabilized and is doing much better at home and in school.

12. Contact Us Christi Beals, RN, BSN, MBA Chief Development Officer Yellowstone Boys & Girls Ranch 406.655.2105 cbeals@ybgr.org Kim Chouinard, M.Ed. Director School Based Services Yellowstone Boys & Girls Ranch 406.245.2751 kimc@ybgr.org Nick Little, M.A.T. Clinical Coordinator/Business Development-Northwest Region HealthLinkNow 307.752-1794 nlittle@HealthLinkNow.com

13. References • Atkins, M., & Lakind, D. (2013) Usual Care for Clinicians, Unusual Care for Their Clients: Rearranging Priorities for Children’s Mental Health Services. National. Adm Policy Mental Health, 40(1): 48-51 • Barnett, S. & Allison, M. (2012). School-Based Health Centers and Pediatric Practice. Journal of The American Academy of Pediatrics, 129, 387-393 • Taras, H., Frankowski, B., McGrath, J., Mears, C., Murray, R., Young, T. (2004). School Based Mental Health Services. Journal of the American Academy of Pediatrics, 113, 1839-1845. • National Association of School Psychologists. An Overview of School-Based Mental Health Services. Retrieved from http://www.nasponline.org/advocacy/overview_sbmh.pdf