About six years ago, Northwell Health launched a school mental health pilot on Long Island with the goal of meeting children where they are, according to Scott Falkowitz, DO, a child and adolescent psychiatrist and medical director of the Northwell School Mental Health Program.
Today, the New Hyde Park, N.Y.-based system partners with school districts across Long Island and Westchester County. Its behavioral health center in Mount Kisco, N.Y., saw more than 1,100 new pediatric patients in its first year. Only nine were referred to an emergency department.
The need behind that work is broad: Dr. Falkowitz noted that about 1 in 5 young people have a mental health condition that significantly impairs their functioning.
“For far too long, the emergency department has been the primary entry point in so many communities where accessing child and adolescent mental health services is in some places — and many places — literally impossible,” Dr. Falkowitz said. “For people who are in a behavioral health crisis, stepping into a loud, chaotic emergency department where there are traumas going on around you, where people are asking you the same question multiple times — you’re ultimately walking away with some guidance, but that important piece of making the connection to outpatient services is often missing.”
Under the partnership, a school counselor or psychologist with a student in crisis no longer has to default to an ambulance ride to the ED. Instead, the student can go to one of Northwell’s behavioral health centers.
“We’re now able to completely pivot to what we’re trying to create, which is a warm and inviting atmosphere, very similar to any other outpatient office that you might step into,” Dr. Falkowitz said. “You’re able to walk in, sit down, have a calm conversation in an environment that is not overly stimulating. For so many youth and their families, just having that experience in contrast to the emergency department really allows them to feel settled, to feel taken care of, to feel heard.”
Referrals aren’t limited to schools. Parents, pediatricians, faith leaders and others concerned about a child can also make a referral. Evaluations typically run 90 minutes to two hours, and a care coordinator follows up afterward to connect the family with ongoing services.
“For us, connection to care is just as important as having access when you’re in a crisis,” Dr. Falkowitz said. “They’re walking in the door perhaps with little or sometimes no clear sense of what to do, and they’re walking out not only with a roadmap but with a wayfinder, a guide, a person who’s going to really help them navigate that.”
The program aims to see students within a week of referral and offers same-day crisis availability every day. Many families arrive after a long search.
“There are many people who are coming to us who tell us, ‘I’ve been looking for a year, a year and a half,'” he said. “If we think about how much time that is and how much can change, it’s major to be able to intervene early, and that’s what we’re really trying to do every day.”
The Mount Kisco center, which serves the surrounding Westchester County communities, recently marked its first anniversary. From September 2025 through August 2026, according to data Northwell shared with Becker’s:
- The center saw more than 1,100 new pediatric patients and logged more than 4,500 total visits.
- Nine students were referred to the ED, fewer than 1% of new patients.
- Nearly 98% of referrals came directly from families and schools.
- 94% of students returned for continued care, and 93% attended their long-term appointments once connected.
The biggest win of the first year, Dr. Falkowitz said, has been knitting school mental health staff into a network of their own.
“They now also have a community of people who are doing this work and who can share with each other what’s working, what is not working,” he said. “They’re able in that way to keep each other at the real knife’s edge of what is working. That’s been maybe the biggest positive.”
The hardest lesson sits outside the program’s walls.
“The biggest challenge is confronting the systems of mental health care that already exist, and seeing the still ever-present gaps in many areas, including the higher levels of care, like a partial hospital program or an intensive outpatient program,” Dr. Falkowitz said. “Not only do we want to be able to provide access and be that open door for urgent and crisis needs, but we have to also be a part of the solution on the outpatient and the ambulatory side, where we have wonderful community partners, and we certainly need more.”
Prevention starts in person. Northwell clinicians show up at school events, parent university nights and mental health awareness events, and the program’s community education series for parents goes well beyond diagnoses.
“You might think we’re going to come in and talk about ADHD, depression and anxiety, which we certainly do. And we find there is a lot of value in thinking outside of the box a little bit,” Dr. Falkowitz said. “So we’re having conversations with families about how to have more effective dinner conversations at home, how to build family resilience, how to nurture individual resilience in your child, even to things such as micromobility, and the problem with e-bikes and scooters.”
Parents can scan a QR code to join lunchtime support groups led by experts in school avoidance and in parenting anxious children. Teachers, counselors, school psychologists and paraprofessionals get professional development and a forum to work through complex cases, with the goal of helping educators spot warning signs early and easily make referrals.
For leaders building similar programs, Dr. Falkowitz’s advice starts with patience.
“When we started this work, this kind of partnership didn’t even really exist. So we started small and really wanted to see, are we making enough of a difference,” he said. “We’re sometimes building the plane as we’re flying. These are programs that are evolving.”
He also stressed consistent communication, including regular check-ins with districts on how much of the program they are using. One sign the model is taking hold, he said, is who makes the referrals.
“In the beginning when we start working with a school district, the majority of the referrals come in from the school, and as we go, you start to see more and more coming in from the community on their own,” Dr. Falkowitz said. “To us, that’s a reflection of — we’re aiming things in the right direction. We’re connecting and partnering with the right people.”
That shift, he said, is the point.
“The more people that we can have positive mental health discussions with, and really lift the veil and show that, again, it’s people helping people, I think we’re going to be able to do a lot of good out there,” he said. “Youth mental health is essential and really needs to be a priority in all of our communities.”
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