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N.Y. Hospital, Schools Aim To Improve Kids' Access To Mental Health Provider


Even before the pandemic, schools across the country had noticed rising rates of anxiety, depression and suicide among students, and yet only 20% of kids with mental health issues get treatment. It can take weeks or even months to get an appointment, except for students in Long Island's Nassau County, where five school districts are providing quick, easy access to a mental health provider thanks to a collaboration with the local children's hospital.

NPR's Rhitu Chatterjee and Christine Herman of WILL have the story.

RHITU CHATTERJEE, BYLINE: In 2019, the Rockville Centre School District in Long Island was shaken by tragedy.

NOREEN LEAHY: It started with a very recent graduate and a current student dying by suicide.

CHATTERJEE: Noreen Leahy is an assistant superintendent for the school district.

LEAHY: And when you get these losses one after the other, you almost can't get traction on normalcy. You can't get traction on kids just functioning in a day-to-day basis in a school setting.

CHRISTINE HERMAN, BYLINE: The incidents pushed Leahy to try to find a way to connect students to mental health care. She raised the issue with her colleagues and some parents.

LEAHY: And I was talking out loud, gee, I wish we could figure out a way to get access to a psychiatrist, mental health professionals to make sure that we help our school team get kids handed off to care - to psychiatric care or psychological care.

HERMAN: One of those parents was Gina-Marie Bounds.

GINA-MARIE BOUNDS: I can actually remember the exact moment, exactly where I was sitting. And she said to me, I just wish there was a place to send their kids. I wish we could just hang up, like, a shingle on a storefront and send these kids there.

CHATTERJEE: Now, Bounds happened to work at the nearby Cohen Children's Medical Center.

BOUNDS: And I thought back to myself, and I said, I think I can do that. And she was shocked. I'm like, just give me a few weeks. I think I can do that.

CHATTERJEE: She took the idea to the head of emergency child psychiatry at the hospital, and they got to work. And in January 2020, they opened a behavioral health center within miles of the five school districts it now serves.

HERMAN: It has a child psychiatrist, medical office assistant and a mental health counselor.

ARIANA METALIA: My name is Ariana Metalia. I am a licensed mental health counselor.

HERMAN: School staff refer students to her, or parents reach out directly. And Metalia works with the center's child psychiatrist to evaluate the kids and draw up a treatment plan.

METALIA: We are able to prescribe medication and maintain a child in our clinic for as long as they need while they're waiting for an outpatient level of care.

CHATTERJEE: She says it's also her job to connect kids to providers in the community, and that's easier to do, she says, when a child has already been evaluated by a child psychiatrist.

METALIA: So that's kind of our golden ticket.

HERMAN: Metalia says the behavioral health center working closely with school staff has been able to weave together a safety net for children and families that didn't exist before.

CHATTERJEE: And parents like Jennifer Gibaldi are grateful. Her daughter Alyssa is 17 and attends Oceanside High School on the south shore of Long Island.

JENNIFER GIBALDI: She is extremely social. Like, she's like the mayor of the school. Everybody knows her (laughter). No matter where we go in town, there's somebody who knows her.

HERMAN: Alyssa has Down syndrome, and the pandemic upped her anxiety. Last fall, she became catatonic and was hospitalized several times.

GIBALDI: She went into, like, a zombie-like state. She couldn't talk. She couldn't move. She would go into tremors. She couldn't feed herself.

HERMAN: After her neurologist ruled out other conditions, they suggested Alyssa see a psychiatrist. But her mother, Jennifer, says she was turned down repeatedly by providers saying they didn't take her insurance or that they didn't work with kids with disabilities.

CHATTERJEE: That's when Alyssa's school nurse referred her to the new behavioral health center. The psychiatrist reviewed Alyssa's medical records and prescribed medications for depression and anxiety. Jennifer says they got the meds on a Saturday morning.

GIBALDI: And by Saturday night, she was out of the catatonic state. And ever since then, she's been coming back to us. Like, her personality came back.

HERMAN: Alyssa continued to go to the behavioral health center for several months until they were able to transition to a psychiatrist who works with kids with disabilities.

GIBALDI: They were such a lifesaver for us. We can never thank them enough.

CHATTERJEE: Most kids like Alyssa around the country might never even see a psychiatrist, says Ujjwal Ramtekkar. He's a child psychiatrist at Nationwide Children's Hospital in Columbus, Ohio.

UJJWAL RAMTEKKAR: Due to lack of care, they end up worsening, and they access the emergency rooms.

CHATTERJEE: To avoid a crisis or as the only way to get a mental health evaluation.

RAMTEKKAR: Even if that happens with emergency room care, there's no place for them to go and connect.

CHATTERJEE: Because there's a shortage of providers. All of this has played out around the country as the pandemic worsened kids' mental health. Last year, the hospital emergency departments saw a surge in the proportion of kids in mental health crises.

HERMAN: But in Long Island, Cohen Children's behavioral health center was able to reduce the number of kids from those five school districts ending up in the ER by at least 60%. Ramtekkar says this model is a great way to meet more kids in need, and it makes sense for children's hospitals to partner with schools.

RAMTEKKAR: It's the place where kids mostly are. And as the famous tale goes about the famous bank robber, why do you rob banks? And he said, well, that's because that's where money is. And that's exactly the thought in the field now.

CHATTERJEE: School staff often know their students better than anyone else and can spot early signs. It's why schools in many parts of the country are trying to partner with mental health care providers.

HERMAN: For Assistant Superintendent Noreen Leahy, the price her district pays for the new behavioral health services is less than the cost of one full-time staff member, and the state chips in to cover part of that. Leahy says the help couldn't have come at a better time.

LEAHY: It's just a real relief on many levels. And most importantly, it's helping kids.

CHATTERJEE: This summer, Cohen Children's will expand to a total of 14 school districts.

HERMAN: At that point, more than 60,000 students in Long Island will have access to immediate mental health support should they need it.

For NPR News, I'm Christine Herman.

CHATTERJEE: And I'm Rhitu Chatterjee.


MARTIN: This story is part of a reporting partnership that includes NPR, Illinois Public Media and Kaiser Health News. Also, Nationwide Children's Hospital, mentioned earlier in this story, is a financial supporter of NPR.

(SOUNDBITE OF NEW CENTURY CLASSICS' "POST-CARDS") Transcript provided by NPR, Copyright NPR.