When it comes to kids, physical health may be what sends them to the doctor. Scrapes and fevers may get students sent to the school nurse.
But studies from the National Institute of Mental Health show that half of all mental disorders start by age 14, and almost half of teens have a mental disorder.
According to Dr. Keisha Ross, licensed psychologist and secretary of the Missouri Psychological Association, part of the problem is that parents may not even be aware their child’s issues could be psychological.
“There still is a great deal of stigma that goes along with seeking mental health care,” Ross said. “Honestly sometimes people just don’t know and understand what they need to look for.”
Even if they know, it can still be difficult to get treatment due to issues of transportation, insurance or long wait times – which is why Ross said school intervention can be so impactful. And that is why school intervention is now being implemented in Columbia.
Dr. Laine Young-Walker is the director of the University of Missouri’s new Bridge Program, which has been at work since March to put child psychiatrists into the school setting.
“It’s any psychiatric issues that children and adolescents are facing that are impairing their functioning day-to-day, impairing their ability to do well in school,” Young-Walker said.
Currently, the program has three psychiatrists and two case managers working with 11 schools in Columbia and Boone County. It’s referral based – a parent or counselor or teacher can refer the child if they have concerns. Then the child will have an initial evaluation with the psychiatrist, with two or three follow up visits and either a prescription or a referral to outpatient therapy. The program also reaches out to children who are homeschooled or who aren’t in a district where the program is in place.
Dr. Ravi Shankar is another of the adolescent psychiatrists for the Bridge Program. He said that children are usually responsive.
“Kids, they’ve been very open,” Shankar said. “When I usually see most of the kids I see them for their first visit with families and individually and then with the entire team in the room. A lot of them have pretty good insight into, ‘Yes, I think I need help.’”
Young-Walker said that she has been working on getting the program running since around 2012, but the funding wasn’t available to make it work. They ran a trial program in 2014 both diagnosing kids and evaluating the effectiveness of the program. In 2015, they received funding through the Boone County Children’s Services Fund. And now that the money is there, Young-Walker plans on expanding the program this summer to include more psychiatrists and more hours in schools.
Carole Schutz is a case manager for the program and the point of contact for many families involved. She said that, for many families, the experience can be overwhelming at first. But that quickly changes.
“When they realize that we’re taking a team approach and they are part of our team, I see that they become more motivated,” Schutz said. “They take our calls more readily, they are more receptive to following up and following through on treatment for their children.”
And the program tries to keep the price of that treatment as low as possible. Psychiatrists choose medicines from a list of four-dollar prescriptions and the case managers will work to get families Medicaid or insurance if they don’t have it.
According to Ross, getting children diagnosed early is important for the long term, too.
“When they are able to get help early on, it can change the trajectory of their life,” Ross said. “For some kids it means being able to stay in school versus dropping out, because their symptoms might impair their functioning to the point that academically they can’t continue to function in school.”
The Bridge Program has funding for one year through the Boone County Children’s Services Fund, with the potential to renew for two more years. If the program continues to receive funding, Young-Walker said they aim to help 300 children in the first year, 450 in the second and 600 in the third.
After that, Young-Walker said they will search for funding to keep getting Missouri children easy access to mental health care.