An Innovative Approach to Care: Integrating Mental Health Services Through Telemedicine in Rural School-Based Health Centers

Pradhan, Taniya; Six-Workman, E Ashley; Law, Kari-Beth

doi:10.1176/appi.ps.201800252

Cited by 15 publications

(14 citation statements)

References 5 publications

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“…For decades, telehealth has been central in the digital strategies of major countries to support long-distance healthcare, education, public health, and administration [1][2][3][4]. In the rural context, telehealth has been extensively promoted to ensure safe, effective, and equitable service delivery to people impacted by distance and isolation [5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Challenging technology and commercial arrangements, risk adversity, limited resources and increased costs, issues with public trust and data security, lack of digital skills amongst workers at all levels and resistance to education, and lack of political and organisational leadership to drive change have all been documented [1][2][3]17]. Specific rural barriers included lack of digital connectivity, coordination and turnover of senior management, lower levels of health literacy, lack of resourcing at the client end, challenges in disciplines where touch is a requirement, concerns about security, inadequate staffing, lack of equipment and other resources, inflexible billing arrangements, complex referral patterns, and lack of local control [5][6][7][8][9][10][11][12][13][14][15][16]19]. In 2018, in the UK, harsh criticism was directed at an increasing gap between technological potential and usage [1].…”

Section: Introductionmentioning

confidence: 99%

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Mental health professionals and telehealth in a rural setting: a cross sectional survey

Nelson

Inghels

Kenny

et al. 2023

BMC Health Serv Res

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Background Telehealth usage has been promoted in all settings but has been identified as a panacea to issues of access and equity in the rural context. However, uptake and widespread integration of telehealth across all parts of the health system has been slow, with a myriad of barriers documented, including in rural settings. The crisis of the COVID-19 pandemic, saw barriers rapidly overturned with the unprecedented and exponential rise in telehealth usage. The uniqueness of the crisis forced telehealth adoption, but as the urgency stabilises, pandemic learnings must be captured, utilised, and built upon in a post-pandemic world. The aim of this study was to document staff experiences and perceptions of delivering rural psychological therapies via telehealth during the pandemic and to capture learnings for future rural telehealth delivery. Methods An online cross-sectional survey that explored mental health professional’s experiences, use, and perceptions of telehealth before and after pandemic-enforced changes to service delivery. Results Sixty-two respondents completed the questionnaire (response rate 68%). Both the delivery of telehealth via telephone and online video conferencing significantly increased during the pandemic (66% vs 98%, p < .001 for telephone and 10% vs 89%, p < 0.001 for online video). Respondents indicated that client’s access to services and attendance had improved with telehealth use but their attention and focus during sessions and non-verbal communication had been negatively affected. The challenges for older adults, people with learning and sensory disabilities, and residents in remote areas with poorer mobile/internet connectivity were identified. Despite these challenges, none of the respondents indicated a preference to return to fully face-to-face service delivery with most (86%) preferring to deliver psychological therapies fully or mostly via telehealth. Conclusions This study addresses three major gaps in knowledge: the experience of delivering local telehealth solutions to address rural mental health needs, the provision of strong rural-specific telehealth recommendations, and the dearth of rural research emanating from the United Kingdom. As the world settles into a living with COVID-19 era, the uniqueness of the rural telehealth context may be forgotten as urban myopia continues to dominate telehealth policy and uptake. It is critical that rural resourcing and digital connectivity are addressed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mental health professionals and telehealth in a rural setting: a cross sectional survey

Nelson

Inghels

Kenny

et al. 2023

BMC Health Serv Res

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“…In addition, barriers to delaying treatment are access to services and not knowing where and from whom to seek services or assistance. Other concerns are long waits for services to begin, cost of services, no insurance coverage, lack of resources, lack of skilled professionals, and lack of communication between professionals working with the child (e.g., pediatrician and counselor not communicating; Pradhan et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Where Is Counseling in School Psychology Literature? A Review of Six Prominent School Psychology Journals

Flood

Joseph

2023

Contemp School Psychol

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School psychology professionals rely on professional literature to access information on scientifically supported practices. Counseling is certainly one of those practices. The purpose of this review was to determine how many articles published in prominent peer-reviewed school psychology journals have addressed providing effective counseling services to children and youth. We wanted to determine the types of counseling approaches that were described in those articles and which approaches garnered the most attention. Findings revealed that there were relatively few articles about counseling in prominent school psychology journals. Interestingly, most studies employed quantitative rather than qualitative designs and analyses. Cognitive behavior therapy (CBT) was the approach that was implemented the most in empirical studies across the school psychology journals. Empirical studies mainly included elementary and middle school students from diverse racial and ethnic groups who were receiving counseling services in a small group (tier 2) format. Implications for the profession of school psychology are provided.

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“…Oftentimes, school personnel including special education teachers and school-based providers are the only professionals available to support children/students with behavior concerns and face challenges regarding access to training and resources ( Hemmeter et al, 2008 ; Kurth & Keegan, 2014 ). There is a growing evidence base supporting school-based telehealth approaches can successfully bridge the gap between behavioral health services and the training needs of rural communities with limited access to such care ( Love et al, 2019 ; Pradhan et al, 2019 ; Young & Ireson, 2003 ). For example, school-based telepsychiatry services have been used in rural West Virginia to improve access in under-resourced areas ( Pradhan et al, 2019 ).…”

mentioning

confidence: 99%

“…There is a growing evidence base supporting school-based telehealth approaches can successfully bridge the gap between behavioral health services and the training needs of rural communities with limited access to such care ( Love et al, 2019 ; Pradhan et al, 2019 ; Young & Ireson, 2003 ). For example, school-based telepsychiatry services have been used in rural West Virginia to improve access in under-resourced areas ( Pradhan et al, 2019 ). Similar school-based behavioral telehealth in Maryland found it was effective in improving access to mental health services and removed barriers (e.g., transportation, scheduling) that prevented families from accessing other mental health supports in their community ( Stephan et al, 2016 ).…”

mentioning

confidence: 99%

Connecting Behavioral Health Specialists With Schools: Adapting a Telementoring Series During COVID-19

Zhang

Bellinger

Swails

et al. 2023

Rural Special Education Quarterly

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To address the daunting behavioral and mental health needs of Kansas’ rural and underserved communities, Telehealth ROCKS (Rural Outreach for the Children of Kansas) Schools project partnered with school-based health centers, school districts, and special education cooperatives to provide a range of telebehavioral health intervention services and teletraining. This project used the Project Extension for Community Healthcare Outcomes (ECHO) telementoring framework to connect specialty providers with school/community providers for web-based continuing education and case consultation to support students with special education needs. Our team created Function Friday for Better Behavior ECHO series to address challenging behaviors in schools, based on the concept of functional behavior assessment and function-based treatment. Part of the ECHO series occurred after the onset of the COVID-19 pandemic. This article describes how our ECHO series provided an effective mechanism for supporting school and community providers during the pandemic, and participating educators utilized skills as they transitioned from onsite education to the virtual learning environment with students.

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An Innovative Approach to Care: Integrating Mental Health Services Through Telemedicine in Rural School-Based Health Centers

Cited by 15 publications

References 5 publications

Mental health professionals and telehealth in a rural setting: a cross sectional survey

Mental health professionals and telehealth in a rural setting: a cross sectional survey

Where Is Counseling in School Psychology Literature? A Review of Six Prominent School Psychology Journals

Connecting Behavioral Health Specialists With Schools: Adapting a Telementoring Series During COVID-19

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