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  • Sue Gehling

Mental Health Crisis in Rural Iowa schools: How school-based telehealth impacted one district

The pain from untreated student mental health issues overwhelmed the Spencer Community School District.

Staff spent hours each day attending to students struggling with mental health concerns.

And to complicate the situation, the demand for children’s services far exceeded local resource capacity.

Enter Classroom Clinic, a school-based telehealth company that collaborates with rural school districts to provide timely and convenient access to children’s mental health care.

“Mental health treatment is complex,” said Sue Gehling, founder of Classroom Clinic. “And outcomes are largely influenced by a person’s social determinants of health. That is why including schools as members of the child’s care team is so critical to achieving better care.”

“The reality is that, to improve our system of mental health services, neither the mental health sector nor the education sector can afford to go at it alone,” continued Gehling. “We can no longer operate in separate silos.”

The Spencer school contracted with Classroom Clinic, and initiated services at the beginning of this school year. Using telehealth, mental health services were brought directly into the school, which is where students spend most of their day.

“The relief was immediate,” said Cammy Hinkeldey, district nurse for Spencer schools. “I was able to offer that resource and have a tool to give families that I knew would help. We could live up to our mission to serve students.”

“During the pandemic, we began seeing far more explosive behaviors — hitting, kicking, a lot of anxiety, kids basically balling up, and those things we had not seen before at this level,” said Pat Hamilton, Spencer schools’ student services director.

“Our local agencies couldn’t keep up,” Hamilton continued. “We were struggling to find quality, timely care for our students in need.”

The Spencer community has it better than many rural Iowa cities when it comes to children’s mental health providers. The city of about 12,000 has several agencies, including a community mental health center, which offer help to children.

Yet it was not uncommon for families to still wait up to eight months for an evaluation.

As a result, parents and families often drove their children two hours west to Sioux Falls, South Dakota, or three hours southeast to Des Moines to receive services.

“Students missed a whole day of school for a 30-minute appointment,” said Angie Ward, counselor at Spencer Middle School. “Parents would have to take off work. It just added to the stress.”

The addition of Classroom Clinic services within Spencer schools has eased the pain for both students in need and their day-to-day caretakers.

Hamilton said more than 80 students in Spencer schools need some form of mental health support from counseling to medication management.

“There is strong justification for the integration of mental health and education, as it can provide more children access to services,” noted Gehling. “And there is much less stigma for families when services are located within the school setting.”

The school provides a secure room where students and their parents meet with Classroom Clinic providers over a telehealth connection.

Services offered by Classroom Clinic include telepsychiatry, which is provided by Psychiatric Nurse Practitioners, and teletherapy, which is provided by licensed mental health counselors. Now that Spencer Schools is working with Classroom Clinic, students are getting their needs met much quicker.

“I’m not aware of any situation where we’ve referred someone to Classroom Clinic where they’ve had to wait more than a week,” Hamilton said. “It is making a difference for our students and families!”

Classroom Clinic services are partially funded by the school district, so families already struggling financially can get help for their child without adding to their bottom-line burdens.

Hamilton concluded, “Classroom Clinic was the right investment for all our students.”

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