SCHOOL’S OUT: WHAT HAPPENED TO SCHOOL-BASED MENTAL HEALTH SERVICES (SBMHS) IN THE COVID-19 ERA?

Abstract

Prior to the COVID-19 pandemic, over 90% of students in the United States attended “brick and mortar” public schools (PS). The reach of PS has facilitated school-based mental health services (SBMHS). In March 2020, schools closed abruptly and students transitioned to virtual learning. Numerous studies indicate a surge in child mental illness (CMI) during COVID-19 with an increase in the need for SBMHS. This Clinical Perspectives examines the impact of COVID-19 on the functioning of SBMHS in 4 states and nationally. After the panel introduction, the impact of COVID-19 on children’s mental health (CMH) and mechanisms to identify at-risk children will be briefly reviewed by Shirley Alleyne, MB, BS, and David Pruitt, MD. Next, each presenter will describe the impact of COVID-19 on SBMHS in their state, focusing on adaptations in the services offered and delivery methods, changes in SBMHS referral and attendance rates, and treatment outcomes. The presentations include: Dr. Alleyne, Quantum Leap: The Metamorphosis of a School-Based Mental Health Clinic in the COVID-19 Era; Brandon Johnson, MD, Supporting Our Most Vulnerable: The Pandemic's Impact on School-Based Day Treatment and LGBTQ Teens; Erika Ryst, MD, Flexible Adaptation of School Psychiatry Consultation to Meet the Needs of Schools During COVID-19; and Kristie Ladegard, MD, Sustaining the Mental Health of Our Youth: The Rapid Adaptation of School-Based Health Clinics During COVID-19. They will share recommendations to optimize SBMHS during periods of crisis. Participants will share their experiences with COVID-19 SBMHS. Sharon Hoover, PhD, will synthesize the presentations, reflecting on national changes in the delivery of SBMHS during COVID-19 and implications for future policy. The panel will then hold a Q&A session. SBMHS is essential to identifying and treating CMI during the COVID-19 pandemic. The use of telehealth and other innovative measures facilitated continuity of SBMHS with a decline in access to external CMH services. SBMHS referral and attendance rates varied across states with some common trends. COVID-19 has reinforced the critical importance of SBMHS to CMH. Concurrently, when a school is closed, its unique strength (being school-based) becomes its Achilles' heel. Policy considerations are necessary to maintain SBMHS during national crises, when its need is greatest.