Telepsychiatry Reaches Rural Students

WMCHealth is bringing mental-health services to local kids in need.

By Debra Bresnan

Living in New York’s beautiful Delaware County offers many advantages, but locally accessible mental-health services for students has not been one of them — until now.

Margaretville Hospital, a member of the Westchester Medical Center Health Network (WMCHealth), is using a new, innovative behavioral-health telemedicine program to bring mental-health treatment directly to at-risk students attending four school districts in the sprawling rural county.

To enhance access to care, WMCHealth has made ePsychiatry an integral component of psychiatric services in several programs since 2015. Students in the four participating school districts — Andes, Downsville, Margaretville and Roxbury — take part in in-person therapy sessions conducted by the program’s two licensed social workers. They also now have access to psychiatric evaluations and medication management services provided remotely via teleconference. Before telepsychiatry became available to them in 2016, families often had to drive two hours or more round-trip to access these services. With no-shows and cancellations being common, and wait lists for appointments lasting two or three months, students weren’t getting the help they needed.

According to Kenneth Oclatis, PhD, Program Administrator, Telepsychiatry and Special Projects for HealthAlliance of the Hudson Valley, another member of WMCHealth, two licensed social workers are based at the schools to help coordinate the program and provide in-person therapy. The program’s psychiatrists are available via teleconferencing as needed. Students and their families receive these treatment sessions at the school or off-site, if they prefer, at the hospital.

“We started with one board-certified child and adolescent psychiatrist, available during school hours and after school on certain days,” says Dr. Oclatis. “As the need has grown, we’ve made use of two others, and we will continue to recruit. We were surprised by the number of students who came over the summer: 14. Our expectation for the first school year was 30 students, but by December 2017 we had seen 51 students.” Out of a total of 346 visits, 37 sessions were conducted via telepsychiatry.

Treatment sessions revealed that many students struggle with anxiety and attention-deficit problems. But the gamut of issues also includes grief, loss, social and emotional concerns, drug abuse, depression, self-injurious behavior and broken homes. Dr. Oclatis says, “Some things are easier to spot. Teachers notice students who have trouble with attention, fidgeting and so on. Students with anxiety often keep it to themselves in a school setting or may refuse to go to school or habitually end up in the nurse’s office.”

The program has been nominated for a Healthcare Association of New York State (HANYS) Community Health Improvement Award and the New York State Public Health Association (NYSPHA) 2018 Public Health Achievement Award. It is funded by two grants: the Vital Access Provider Grant (VAP) through the New York State Department of Health and the U.S. Federal Government Center for Medicare and Medicaid Services, and a federal Appalachian Regional Commission grant.

Mark Pohar, RN, MSN, Executive Director at Margaretville Hospital, says, “Telepsychiatry has filled a void in our communities, and introducing this program to offer primary behavioral health services takes the stress off missing school or work for appointments. It has changed lives.”

Families and some adults have also received services, and future plans include addressing adult needs and offering a wider range of services, alongside preventative programs.

“Delaware County is the most rural part of the WMCHealth network, but we share the same problems as any urban or suburban area. We want to offer the same services and quality of care people would receive anyplace else. This connection to Westchester Medical Center makes it possible,” says Dr. Oclatis. 

School Superintendents Weigh In 

Roxbury Central School District

Thomas O’Brien has advocated for mental-health services for students throughout his 10-year tenure as superintendent of the Roxbury Central School District. He serves on the NYS Governor’s Heroin and Opioid Task Force and the Board of Directors of Margaretville Hospital and is an EMT in his community. “This program has had a positive effect on teacher morale and on our support staff in the guidance office because they know they can get a child the services they need. Our kids are facing a myriad of issues — environmental, medical and metabolic [like bipolar disorder]. Having access to therapy on site changes your school’s culture.”

Andes and Margaretville Central

School Districts

Dr. Robert Chakar, superintendent for the Andes and Margaretville Central School Districts, says, “Having Dr. Oclatis arrange for a psychiatrist to evaluate students is tremendous. The office is located at Margaretville Central School, just down the hall, so there’s ease of access for parents and kids, and there’s a comfort level because it’s confidential and centrally located. If a child is in real crisis, he or she can meet with a licensed social worker and reach a psychiatrist by teleconference if they need to. Dozens of people with unique needs are taking advantage of what’s offered. Our guidance-office personnel are relieved to know that additional help is close by when a youngster needs it.”

Downsville Central School District

John Evans is the superintendent of the Downsville Central School District and grew up in nearby Roscoe, where he also serves as superintendent. “As high-speed Internet access improves, we offer distance learning in our schools and give our rural students access to the same classes that kids on Long Island or in Westchester attend. Finding ways to use new technologies in small rural schools — whether on the education side or health-services side — is a win-win for everybody. This high-tech piece of equipment sitting in the room next to me is meeting a need for our students.”

For further information, please visit

wmchealthbh.org/epsychiatry

Behavioral Health at WMCHealth

Behavioral Health Center (Valhalla) 914.493.7088

MidHudson Regional Hospital 845.431.8287

Good Samaritan Hospital 845.368.5242

HealthAlliance Hospitals 845.338.2500

 

Photo By John Rizzo