A fifth-grade student opens their pencil box, slips a piece of paper into a pocket and goes to the bathroom. After feeling the urge to self-harm, the student unfolds the paper to reveal an illustrated flower with positive affirmation petals that read “I’m a good dancer” and “I’m a good artist.” The urge fades.
After four therapy sessions and support from a teacher, the student stopped self-harming and learned healthy coping mechanisms. This is the type of outcome Corpus Christi, Texas-based Driscoll Children’s Hospital hopes to achieve by embedding licensed mental health specialists into schools amid the youth mental health crisis, Mary Peterson, MD, executive vice president and COO, and Michelle Goodman, MSN, senior director of care coordination, told Becker’s.
“Most children are spending a majority of their day in school, and we know that we have a large shortage of mental health providers,” Dr. Peterson said. “Even if families wanted to get help in a timely manner there are a lot of barriers — availability, financial.”
As part of Driscoll’s 2024-25 school-based mental health pilot, the system provided 8,302 mental health sessions to students across two school districts. These included 7,630 individual sessions, 649 group sessions, 369 parent sessions and 63 crisis interventions.
The program yielded a 54% improvement in emotional and behavioral screening scores among elementary students and an 86% improvement in depression severity among middle and high school students.
The idea began when donors from a community foundation approached the hospital, asking how to best address the mental health crisis. Dr. Peterson and her team proposed placing mental health professionals directly in schools.
First, the system had to align the donors and school district goals. Its initial partner, the area’s largest school district, requested that specialists be placed in elementary schools, noting a state program already provided telemedicine services for students. Financial benefactors pushed for placement in high schools where suicide commonly occurs in children ages 14-17.
Driscoll placed five specialists in elementary schools the district considered high risk and one high school. Before the high school specialist was placed, two telemedicine referrals were made in the previous year. Within the first month of placement, the specialist received 82.
“In our clinics, where we offer telemedicine, over 90% of our children and families choose to come for a face to face visit,” Dr. Peterson said. “A lot of legislators think telemedicine is the end all be all. It has a role, but … when you’re talking about a relationship with a therapist, there’s nothing that beats being in a safe space that feels comforting.”
The system hired licensed professional counselors and licensed social workers — a role it typically works with, Ms. Goodman said. Despite expectations that applications would lag due to the novelty of the role, all six positions were filled within a month.
Specialist training focused on short, solutions-based interventions for anxiety and depression, including positive parenting programs to support families.
“It’s about really learning those coping skills and learning how to self-regulate at that elementary school age,” Ms. Goodman said. “Our mental health specialists give them the tools and tips and hope to see them execute or utilize those skills in the classroom.”
Ms. Goodman emphasized the importance of building relationships with both parents and teachers is key to making school-based services work.
“For the clinicians, we really wanted to protect the time that they needed to serve the students, so that they were available to have appointments,” she said. “We looked at their caseload, making sure that they still had time to work with the teachers, provide education and training, and also just be available in the school line, the lunch lines and the pickup lines … so they build that trust.”
