At the Senate Special Committee to Protect All Texans meeting on June 22, Dr. David Lakey and Dr. Laurel Williams of the Texas Child Mental Health Care Consortium discussed the mental health resources available as a result of Senate Bill 11, passed during the 86th legislative session in 2019. Dr. Williams, Chief of Psychiatry, Director of Residency Training and Associate Professor of Psychiatry & Behavioral Sciences at Texas Children’s Hospital and Baylor College of Medicine, reported on Texas Child Health Access Through Telemedicine, TCHATT, which embeds mental health care assistance within the schools. TCHATT, which was modeled after the Campus Alliance for Telehealth Resources (CATR) at Texas Tech University Health Sciences Center, uses telepsychiatry to connect students and families with counseling services. Currently, TCHATT serves 3,000 campuses with more than 2.2 million students, about 40% of Texas students. The Texas legislature increased the appropriation for the program in 2021 for statewide expansion this fall.
In a recent conversation, Dr. Jennifer Rojas-McWhinney, Texas Tech University Health Sciences Center Managing Director, shared how TCHATT has connected families with needed services in west Texas over the last three years since SB 11 was passed.
The Texas Tech University Health Sciences Center serves 85 counties in Regions 14, 16, 17, and parts of Regions 9, 15, and 18. Of the 231 districts in these areas, at least 148 have signed on to use TCHATT. The growth has been “nonstop” according to Dr. Rojas-McWhinney. Texas Tech University Health Sciences Center partners with Region Education Service Centers to provide training and support to school districts using the service. Training topics include how to recognize signs of stress or trauma, as well as how to gather data to form the basis of a referral.
Many rural districts in the area have limited access to mental health care: only eight of the 85 counties have practicing child and adolescent psychiatrists. Parents referred to a child psychiatrist can wait from 6 to 12 months for a first appointment—too long to delay for a child at risk. With TCHATT, the wait is reduced to 2-3 weeks. Dr. Rojas-McWhinney said that referrals are increasing astronomically: from 110 in 2019-2020, to 457 in 2020-21, and to 1139 in 2021-22. Parent permission is required for a student to be referred for services. Referrals are usually made by a school counselor, but may also be made by a diagnostician, LSSP, social worker, or even a primary care physician.
Suicide is the second leading cause of death for children between the ages of 10 and 21, so TCHATT originally was offered for grades 4—12. This year, Dr. Rojas-McWhinney said that the service is expanding down to Pre-Kindergarten level. Younger children are also showing signs of stress and depression as many families recover from the impacts of COVID.
Expanding the capacity to meet the demand for services is the biggest challenge, according to Dr. Rojas-McWhinney. However, they can recruit from many geographic regions since services are delivered remotely. With the many rural districts in West Texas and the Panhandle, this option is more accessible and convenient for many families.
TCHATT is intended to be a collaborative approach between health care providers, ESCs, local school districts, and parents. Dr. Rojas-McWhinney noted, “we seek to meet the needs of families and district staff through both clinical and educational services. Although each year may bring new challenges, we want to walk alongside districts and families on the journey to improved mental health.”
Contact your ESC or your regional mental health consortium to participate in TCHATT, or learn more at: Texas Child Health Access Through Telemedicine (TCHATT) – TCMHCC (utsystem.edu)