NOTE: Hawaii DoE just signed a $3.83 million statewide K-12 mental health telehealth contract with San Francisco-based Hazel Health (scroll down to see news release). Hazel Health 'counselors' mostly work from home. What is Hazel Health's mental health telehealth all about? Let's see what Hazel Health's National Director of Behavioral Health has to say ....
Creating safe spaces for LGBTQ+ students through telehealth
by Michael Fu, MD, National Director of Behavioral Health, Hazel Health, August 24, 2021
Students who are at higher risk for mental health concerns--including LGBTQ+ students--should have equitable access to confidential healthcare
Equitable access to physical and mental healthcare should be a human right. This access is especially critical for LGBTQ+ students.
At least one LGBTQ youth between the ages of 13–24 attempts suicide every 45 seconds in the U.S., according to a recent estimate from The Trevor Project.
“Understanding the number of LGBTQ youth who seriously consider and attempt suicide, as well as how often suicide risk occurs, improves our ability to serve and advocate for LGBTQ youth.”–The Trevor Project, 2021
Mental health is a long-neglected issue in pediatric populations, with those who are most vulnerable often lacking access to support and/or care. The COVID-19 pandemic has only contributed to this gap, leading to an increase in mental health symptoms, diagnoses and crises across the country.
Creating safe, supportive spaces where every student can thrive is a critical goal for most educators. To achieve this, education leaders can provide school-based services–like confidential telehealth.
The pandemic’s impact on LGBTQ+ students
In addition to academics, schools are a place for students to socialize. When the pandemic hit, classes moved online to keep students and staff safe. Unfortunately, some protective factors, such as peer relationships and the presence of mentors, were lost in the process.
An article from Brookings estimates the impact, stating “Although it’s too soon to conclusively link national youth suicide data to the pandemic, school districts across the nation have been reporting alarming spikes in both suicides and attempts at self-harm.” The same article cites educators as key in protecting student mental health.
When students aren’t on the physical campus, it is more challenging for educators to monitor and support their wellbeing. Issues of identity and development, plus relationship stress, are common consequences of this challenge. This is especially for LGBTQ+ students.
Studies have shown that LGBTQ+ youth are at greater risk of developing maladaptive behaviors, such as self-harm and substance abuse, which, in turn, leads to feelings of guilt and lack of self-worth. These behaviors occur due to the lack of supports and insufficient examples of healthy coping mechanisms. We all can default to harmful strategies, such as smoking and cutting behavior, without good guidance because it resolves immediate pains.
The family dynamic for LGBTQ+ students can also be more difficult, as they may not be receiving enough (or any) support from a parent or guardian.
I know adults who are still coping with this sort of trauma, which is painful to see. It’s also a reminder of why it’s so important that we do whatever we can to support, advocate for and protect our most vulnerable youth.
By providing access to telehealth services, school districts can:
First and foremost, telehealth helps remove stigmas and judgement that LGBTQ+ youth so often face.
There’s a long history between mental health and LGBTQ+ populations. Until not too long ago, their identity was treated as a pathology – or seen as a bad thing. Healthcare hasn’t been the warmest place for those who identify in this way.
Providers who specialize in serving LGBTQ+ patients exist, but it’s still a growing field. This means it can be incredibly difficult to find and see a clinician with this expertise in-person.
Through a telehealth service, however, patients aren’t limited by their physical location. They can access a wider range of physicians and other resources, including those specific to LGBTQ+ populations.
While we’re seeing progress in supporting equal rights, legislation targeting the LGBTQ+ community is still a reality. According to the Human Rights Campaign Foundation’s annual State Equality Index, 185 anti-equality bills were introduced in 2020–four of which were signed into law.
In the face of discrimination, schools are often the go-to support for LGBTQ+ youth. This means that education leaders should be doing everything they can to create safe, welcoming spaces for every student.
It must be intentional. A safe space isn’t just a physical place. Rather, it’s an environment where students are free to be themselves, without fear. It’s so important to listen. Center LGBTQ+ youth voices, so students can decide for themselves what they want from their school-based mental healthcare.
In therapy, you want to have good rapport with your provider. The same holds true for a physical, or any other appointment; you want to be able to trust that provider and feel like they “see” you. This is vital for LGBTQ+ students.
Districts can support this by providing access to in-school and community services. An important start is fostering opportunities where young people can express themselves–in terms of a pronoun, for example. I know this can feel like a stretch for some schools; it’s necessary for creating spaces that feel truly safe for all students.
Address students’ mental and physical health needs
Remember: finding clinicians with the right expertise can be a challenge. Telehealth opens the door to a larger base of support with which students can connect.
There’s safety and trust, too. A virtual appointment doesn’t require a student to visit a doctor’s physical office. Instead, they’re in charge of creating their own safe space to receive care.
Telehealth can be used to address immediate health needs, like a fever and chronic conditions like asthma, as well as behavioral health through therapy and other services.
Working together to support all students
There’s much to be learned from the districts that are taking active steps to create inclusive, welcoming classrooms. And schools don’t have to go about this alone. Consciously partnering with telehealth providers, such as Hazel Health, on well-being initiatives is another way to nurture safe, non-judgmental and confidential spaces where young people can receive care.
Adolescence is about holding onto hope and envisioning a future. When that’s taken away, it has detrimental effects on mental and physical health. Let’s work together to eliminate barriers and extend proper care to every student, especially those most vulnerable.
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Hawai'i State Department of Education and Hazel Health partner to increase access to student mental health services
The Department is providing students with access to supplemental community-based mental health support through Hazel Health's telehealth platform at no cost to families. (TRANSLATION: Without telling families.)
News Release from Hazel Health, Oct 18, 2022
HONOLULU, Oct. 18, 2022 -- The Hawai'i State Department of Education (HIDOE) and Hazel Health (Hazel), the national leader in school-based telehealth, announced today a new partnership to expand access to mental health services for K-12 public school students. The statewide partnership, which is the first of its kind and serves over 170,000 students across 295 schools, offers the opportunity for students to access community-based mental health services at no cost to families. (TRANSLATION: Without telling families.) The program officially launched in May 2022 (Did you know?) and HIDOE is investing roughly $3.83 million over three years to support the platform that provides services to students.
Through the partnership, Hawai'i public school students will be able to connect with diverse, multilingual, licensed Hazel therapists to receive an assessment and, where appropriate, short-term, evidence-based counseling via secure video visits. If long-term care is needed, Hazel's family resource managers work closely with parents, health plans, and community partners to help connect the student to local providers.
(TRANSLATION: Parents might be notified if long-term therapy is warranted.)
Students' therapy sessions can take place while in school (where available) or at home, shortening wait times to receive care and access to no-cost mental health support.
(IDEA: Pretend to be a student and record audio of what Hazel Health 'therapists' try to talk you in to.)
"Hazel was created to address the ongoing challenges that students, families, and school faculty face in their attempts to access timely, high-quality mental health care for their children," says Andrew Post, a lifelong educator and Chief Innovation Officer at Hazel. "Hazel will help to streamline the identification, treatment, and ongoing support for student's mental health concerns, paving a path to improved academic outcomes and social-emotional development."
(TRANSLATION: Without telling families.)
The partnership supports HIDOE's broader effort to help students gain timely access to mental and behavioral health services. Provider shortages, long wait times, and a lack of insurance coverage for mental health services are known gaps to care. According to the 2022 Mental Health America report, 71% of Hawai'i's youth with at least one major depressive episode are not receiving treatment. While not unique to Hawai'i, this high need for mental health care is straining the system as it exists today. The Hawai'i Department of Health views access to telehealth as a solution to address these gaps.
By collaborating with Hazel, community-based health care groups, agencies, and other organizations, the HIDOE aims to bridge gaps in care for students and streamline the approach for families with limited time or resources.
(TRANSLATION: Families are just too busy to be bothered. We'll handle this.)
"This partnership strengthens our commitment to care for the social-emotional, behavioral, and mental health needs of all students," said Heidi Armstrong, deputy superintendent for the Hawai'i State Department of Education. "The combination of school and community-based resources will increase access to affordable mental health services for all of our students and families, ensuring that every child has access to the services and care that they need."
To ensure mental health access is broadly supported and sustainable statewide, Hazel has received support from the State of Hawai'i Department of Human Services (DHS) Med-QUEST (MQD) division and forged strong relationships with leading health plan partners, including Ohana Health Plan, Hawai'i Medical Service Association (HMSA), Kaiser Foundation Health Plan Inc., United Healthcare, and AlohaCare.
"We are very excited about this opportunity to partner and help support vital access to tele-mental health for our keiki at this critical time. This initiative will further the commitment to our vision that our children and the people of Hawaii will thrive," Judy Mohr Peterson, Med-QUEST administrator and Hawai'i Medicaid director said. We look forward to continuing to work with HIDOE and Hazel Health on other innovations."
It is Hazel's mission to ensure that every child is seen, heard, and cared for, and to improve the quality of children's lives. In partnership with HIDOE's support, Hazel is offering specialized mental health in a way that helps to alleviate some of the systematic inequalities that prevent millions from receiving proper care.
About Hazel Health
(San Francisco based) Hazel Health (Hazel) is the leader in school-based telehealth, contracted to provide services to over two and a half million students in nearly one hundred school districts across the country, consistently delivering successful outcomes for access and quality of care. Hazel partners with school districts to provide mental and physical health care services to K-12 students where they are–at school or home. Hazel's diverse, culturally competent providers partner with parents and school staff to make the best care decisions for students. Hazel's mission is to transform children's access to health care because when students feel better, they learn better.
For additional information about services available to students in Hawai'i through Hazel Health, please visit my.Hazel.co/hawaiipublicschools. For additional information about Hazel Health, please visit www.Hazel.co or contact hello@Hazel.co.
About the Hawai'i State Department of Education
Hawai'i's public school system was founded on Oct. 15, 1840, by King Kamehameha III. It is the oldest public school system west of the Mississippi and one of the largest in the country – 295 unique schools on seven islands, with more than 22,000 full-time and 20,000 part-time/casual employees serving about 180,000 students, their families and the community. Our vision: Hawai'i's students are educated, healthy and joyful lifelong learners who contribute positively to our community and global society. Learn more at hawaiipublicschools.org.
About the State of Hawai'i Department of Human Services (DHS) and Med-QUEST (MQD)
The State of Hawai'i Department of Human Services' mission is to encourage self-sufficiency and support the well-being of individuals, families, and communities in Hawai'i. The department's Med-QUEST Division provides eligible low-income adults and children access to health and medical coverage through managed care plans. The QUEST program is designed to provide Quality care, Universal access, Efficient utilization, Stabilizing costs, and to Transform the way health care is provided to recipients. To learn more about DHS and MQD programs and services, go to www.humanservices.hawaii.gov.
 https://health.hawaii.gov/opppd/files/2013/04/Hawaii-Department-of-Health-Strategic-Plan-2015-2018-081616.pdf (page 15)
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