Midwest School Health Initiative Mental Health Services Kirk Wheeler, Ph.D. HSPP

Schools and Behavioral Health Local school corporations differ in their acceptance/ understanding of behavioral health services. Behavioral Health providers often have no direct experience in the school setting. There are existing school personnel who deliver behavioral health services, e.g. counselors and school psychologists.

Mental Health Service compared with School Counseling Mental health and substance abuse services do not replace school counseling. School personnel are primary referral source for mental health/ substance abuse services. MH/SA services cannot be primarily “educational” and usually do not appear on IEPs.

School based MH and SA Services Prevention – substance abuse prevention, psycho - education on suicide prevention Acute, secondary prevention services – assessment, therapy, psychiatric evaluation, family treatment Longer term, tertiary services – Case management, home based services, wrap around, partial hospital programs

Mental Health Services in the School Traditional Outpatient therapy Assessment/ Neuropsych Testing Family based Services Psychiatric Services Classroom based – partial hospital and intensive outpatient program Often school based services are coordinated with intensive wrap around or home based programs.

Providers and Funding Independent providers: Fee for service Community Mental Health Centers: Medicaid and MRO School/ Provider partners: Blended Any Indiana child who qualifies for the school lunch program should be eligible for Medicaid.

Recent Funding Changes CMS Rules (now in moratorium) affect Medicaid funding for: School based Administrative Claiming Case Management Medicaid Rehabilitation Intergovernmental Transfers

Indiana Providers 18 of the 30 Indiana CMHCs have some sort of school based services. Services include – individual and group therapy, family therapy, psychiatric evaluation and medication management, case management, assistance with activities of daily living, etc.

Basis of relationship Informal, school by school Informal, at the school corporation level Formal, contractual for school presence Formal, Specific contracted services within a school health clinic

Mental Health in the School Over 374 Indiana schools have mental health services in the school. All 92 counties have access to school referred services through their CMHC.

Challenges and Opportunities Co-location with primary health, especially FQHCs. Integration around “medical” care, e.g. tele-psychiatry and medication monitoring. Re-establishment of school personnel providing Medicaid services.

Contact Information Kirk E. Wheeler, PhD – HSPP Director of Clinical Operations InteCare, Inc