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Advocating for better mental health care in schools

It’s not every day that I get to talk with state lawmakers in the beautiful setting of our state capitol. Recently, I had the opportunity to testify in Madison to the Wisconsin Assembly Committee on Medicaid Oversight & Reform on a topic that is very important to me: kids’ mental and behavioral health.

I spoke in favor of Assembly Bill 192, which would allow school-based therapists to be reimbursed for providing clinical consultation with parents, teachers and others who support students. The bill would allow practitioners to be reimbursed for time spent coordinating care and better supporting kids and teens covered by Medicaid who are struggling with mental and behavioral health challenges. This program has been on a two-year trial as a pilot, and has been extremely valuable for kids served by school-based mental health providers like Children’s Hospital of Wisconsin.

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The bill was introduced by State Representative Mike Rohrkaste from Neenah, who has been very engaged around issues of kids’ mental and behavioral health. We are grateful that Wisconsin lawmakers are making the well-being of children and families a priority.

Helping kids covered by Medicaid

On average, more than 75 percent of students we care for in school settings are covered by Medicaid. Continuing reimbursement for this important clinical consultation, including communications with parents on their child’s care, will better support school-based mental health providers in covering more of their costs to provide this valuable and much-needed care to some of our most vulnerable students. These smart investments strengthen early interventions for children and help improve kids’ health and well-being.

Breaking down barriers to mental health services

Children’s Hospital of Wisconsin mental health therapists have partnered with more than 30 schools around the state to serve children within the school setting, reducing common barriers to accessing care and increasing partnerships between therapists, teachers and parents. School-based mental health increases access to early intervention mental health services by treating the child or adolescent quickly after a concern has been identified in a comfortable, familiar setting. School-based care and treatment reduces the barriers of transportation, missed academic time, and stigma associated with obtaining mental health services.

School based mental health also helps teachers, classmates, parents and others engage more effectively with students — and that changes perceptions in a positive way, too. Many schools recognize the value of having on-site mental health professionals, and in the last several years they have become very open to inviting external mental health providers into their schools.

Success stories from our partners

School leadership in the Chippewa Valley has expressed how much they appreciate Children’s Hospital of Wisconsin providers for the high level of communication they have with educators and support staff in schools. This collaboration helps school staff understand a child’s behaviors, triggers and interventions to best support the child.

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A Chippewa Valley manager shared the story of a fourth grade boy who is seen in both clinic and school settings. His history of experienced trauma and abuse caused the boy to react to certain triggers by imitating aggressive behaviors. His therapist worked with him to cope with his feelings and better self-manage his behaviors. She also worked with the school staff to help them to better understand the underlying root causes of his behaviors and helped create a supportive environment around the student. He was no longer displaying aggressive behaviors and was successful in school. This collaborative and supportive environment fostered by his Children’s Hospital of Wisconsin therapist played a crucial role in the student’s ability to be safe and successful in school.

A therapist from our school-based clinics in Madison shared the story of a student whose negative interactions and dangerous behaviors in school were drastically impacting their well-being and ability to learn. The student was unable to stay in the classroom, often displaying aggressive physical behavior and running out of the classroom –– leaving their needs unmet and taking the teacher away from the other classmates. Our Children’s Hospital of Wisconsin therapist was able to explore the motivation behind the student’s behaviors and then worked with the school staff on a collaborative approach to better care for the student. The therapist’s consultation with other school staff team members ultimately helped reduce the child’s outbursts and allowed the child to grow and thrive.

A therapist at our Kenosha Clinic shared that one of her clients, an 11-year-old boy, had an early childhood history of trauma including abuse, neglect and loss; he had been to multiple schools in different states and had been diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). When the child experienced feelings of shame or fear with adults or with his peers, he engaged in disruptive and aggressive behaviors. He was suspended frequently and missed several days of school –– losing critical academic and social development time.

The child’s therapist spent time meeting with the child’s teacher to better understand symptoms at school and helped explain the rationale for the child’s behavior. The mental health provider, educators and the parent were able to work collaboratively to create trauma-informed plans and interventions that built upon his strengths and helped stabilize his school environment. The child has not been suspended since this collaboration began last fall, he hasn’t had any physical altercations with his peers and he has shown academic gains across the board — including gaining nearly three grade levels in reading.

The need for collaboration

While Children’s Hospital of Wisconsin staff have always performed the collaboration and consultation needed to optimize care for our clients, historically, funding and time constraints have prohibited supporting collaboration with their kids’ parents and educators to the full extent needed. With the support of Assembly Bill 192, mental health providers will continue to be better supported to dedicate time and resources to working collaboratively with schools to create consistent, systemic interventions that help kids learn and thrive.