Behavioral health has seen an increase in services delivered through community-based care in schools. At New Hyde Park, N.Y.-based Northwell Health, the system has created a unique model by partnering with school districts with the aim of solving one of healthcare’s most stubborn access problems: how to get behavioral health support to kids before the crisis hits.
Across New York City’s suburbs, from Long Island to Westchester County, Northwell Health’s school mental health program has grown in the past six months from 55 to more than 70 school districts — reaching roughly 275,000 students — with the goal of making immediate psychiatry care as accessible as a school counselor’s referral.
“[I]t can take up to six months or longer to get an appointment with a specialist,” Vera Feuer, MD, child and adolescent psychiatrist and program director for Northwell’s School Mental Health partnerships, told Becker’s. “So that gap of same-day to six months is a really wide gap, especially in the life of a developing child.”
Northwell’s model focuses on three components: building resilience for teachers, parents and students through education, screening for early recognition and providing immediate access to services, and connecting students to continued mental health support.
It rests on a network of behavioral health centers strategically located near clusters of school districts. These sites serve as regional hubs, offering same- or next-day assessments, care navigation and crisis intervention.
“It’s been a very bottom-up process where we meet with school districts and listen to what their needs are,” John Q. Young, MD, PhD, chair and senior vice president of behavioral health at Northwell Health said. “Some school districts want that whole, full-thickness school mental-health program. Others only want a part of it … and so we modify and design our program in a way that really aligns with what they have and what they want.”
With clinical programs being run solely at Northwell sites, children and their families can access mental healthcare without waiting months, and without the stigma sometimes associated with in-school services.
“Some of the reasons why we structured the program the way we did is being mindful of the fact that many families want privacy,” Dr. Feuer said. “They can come on their own. … They don’t have to give us consent to talk to the school. This is their healthcare, protected as any other healthcare that they receive.”
And the system is seeing results.
“When you break it down to the specific districts … the numbers have significantly decreased — an average of 60% consistently … through the openings of the centers and the new districts joining,” Dr. Feuer said, referring to a decrease in emergency department visits for students with psychiatric-related concerns. “Despite the national significant increase, our ER volume from those districts stayed the same or decreased a little bit.”
The finding shows the model’s power to redirect nonemergent psychiatric care out of the emergency room, she said.
“Most kids don’t need the ER,” Dr. Feuer said. “They just need access.”
While clinical outcomes are clear, Northwell emphasizes the educational infrastructure as equally transformative.
The system has provided 30 to 50 hours of continuing education and certification training for school counselors, psychologists and teachers. One superintendent said that training has shaped how their staff approach student well-being.
“Our psychologists are saying it’s the best professional development they’ve ever had,” Jen Lamia, EdD, superintendent of the Byram Hills Central School District said. “To me, the risk is not partnering … because when you don’t partner … you are further [hurting] an already needy system. So for me, it is a no-brainer.”
Northwell’s long-term goal, Dr. Young said, is to build a complete health continuum.
“That includes embedding behavioral health in settings where people routinely play, engage, worship, work,” Dr. Young said.
