Members of the Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century who serve on one of the Joint Subcommittee’s workgroups took up the issue of children’s access to mental health supports at a recent workgroup meeting. Traditionally the Joint Subcommittee has focused on the needs of adults, but members had expressed interest in incorporating more attention to the needs of children during its 2019 work period. Child psychiatrists are in short supply in Virginia, but efforts are underway to enhance primary care doctors’ ability to treat children’s mental health needs. School nurses, counselors, and psychologists play key roles in identifying and addressing students’ mental health needs as well.
Nina Marino, Director of the Office of Child and Family Services at the Department of Behavioral Health and Developmental Services (DBHDS) and Dr. Sandy Chung, Medical Director of the Virginia Mental Health Access Program (VMAP), made a presentation on this program, which was developed through a federal grant, supplemented with state General Fund dollars. The program addresses the serious shortage of child and adolescent psychiatrists in Virginia by bolstering pediatricians’ capacity to treat common mental health conditions. VMAP provides education for primary care providers, telephone or video consultations with mental health specialists, telepsychiatry appointments if needed, and referrals and linkages to mental health resources for families. VMAP launched as a pilot program in August 2019, and there are plans to expand the program to serve more providers statewide in the future.
Workgroup members also received presentations from representatives of school nurses, school counselors, and school psychologists about the important roles these professionals play in supporting student mental health. Debra Ruppert, a school nurse at Independence Nontraditional School in Prince William County, explained how the nursing staff at her school work collaboratively with school administration, school resource officers, counselors, and social workers to ensure a safe and supportive learning environment, and her efforts to connect students and families with community resources. Several representatives from the Virginia School Counselor Association spoke about the role they play in their respective schools, which typically includes individual or small group counseling sessions, as well as classroom instruction on social/emotional learning and career exploration. The presenters discussed the state’s work in the most recent legislative session to lower counselor-to-student ratios, and encouraged members to continue to work toward a ratio of one counselor per 250 students. The workgroup meeting concluded with a presentation by several school psychologists, who explained how they support student mental health through efforts such as educating parents and teachers about mental health; participating in crisis intervention and suicide prevention efforts; and developing re-entry plans for students transitioning back to school after a mental health crisis. The presenters noted that school psychologists typically support several schools within a school division, and that they would prefer to see lower staff-to-student ratios so that they could spend more time on prevention services.
Later in the day, the full Joint Subcommittee met to receive updates from DBHDS and the Department of Medical Assistance Services (DMAS) on major behavioral health projects underway at the two agencies. Acting DBHDS Commissioner Mira Signer began by briefing members on the status of implementation of STEP-VA. The first two “steps,” same-day access to assessment and primary care screening, are underway; crisis services and outpatient services are in progress, and planning for the remaining steps is ongoing. Work continues to address the serious concerns about overcrowding at the state hospitals, which continue to operate at dangerously high census levels; a workgroup is developing short- and long-term proposals to fix this problem, and in the meantime, DBHDS is opening temporary beds at Catawba Hospital to relieve some of the pressures on the hospital system. Members also received a briefing on a joint effort by DBHDS and the Department of Medical Assistance Services (DMAS) to redesign the state’s Medicaid-funded behavioral health system so that it supports initiatives underway in other human services agencies (such as changes to federal assistance with foster care incorporated in the Family First Prevention Services Act) and invests resources to support evidence-based and trauma-informed services across a continuum of care. A report is due to the General Assembly later this year on the proposed redesign.
VACo Contact: Katie Boyle