193 - School Based Telehealth Access and Resources for Mental Health Care for Students

Publication Number: 4190.193

Shireen M. Atabaki, Children's National Health System, Washington, DC, United States; Adelaide S. Robb, Children's National Health System, Washington, DC, United States; David Call, Children's National Health System, Washington, DC, United States; Shivaprasad Bhuvanendran, Children's National Research Institute, Washington, DC, United States; Anita Krishnan, Children's National Health System, Washington, DC, United States; Ranjodh Badh, Children's National Medical Center, Elkridge, MD, United States; Min Yu, Children's National Health System, Arlington, VA, United States; Sydney Meszaros, Children's National Health System, Washington, DC, United States; Ricardo Munoz, Children’s national Hospital, Washington, DC, United States

Background: In the District of Columbia (DC), over 20% of children aged 3-17 years reported experiencing a mental, developmental, or behavioral problem. Income inequality in DC is higher than any other state in the country. Care for mental illness is often difficult to access due to workforce shortages and cost and can take up to 6 months for a scheduled appointment. In 2023 our health system piloted a telepsychiatry program, the School-based Telehealth Access and Resources (STARS) program, to provide mental health care for students in DC and Maryland (MD) public schools. Patients were referred to STARS following an emergency department (ED) visit for psychiatric emergencies. Telepsychiatry visits were conducted by a pediatric psychiatrist and psychiatric nurse practitioner.

Objective: The objectives of this program were to increase access to mental health care, reduce time to outpatient psychiatric visits, and reduce ED bounce backs.

Design/Methods: Eligible patients were students of DC and MD public schools referred to the STARS program for an outpatient telepsychiatry visit following an ED visit for a psychiatric chief complaint. In this study we use descriptive statistics to provide demographics, telepsychiatry visit numbers, time to visit, types of diagnoses, ED bounce back and hospitalization rates.

Results: 118 unique patients referred to the STARS program between April 2024 and August 2025, were included in this analysis. The median age was 14 years, 65.2% were female, 71.2 % African American, and 19.5% Hispanic. ED bounce back rate was 4.2%, and hospitalization rate was 1.7%, within 30 days. The Child Opportunity Index for our population reflected 42.4% that were disadvantaged (very low, low) versus 53.4% that were advantaged (very high, high). The majority of telepsychiatry visits occurred within 30 days of referral. Patients received e-prescriptions, patient education, and follow-up telepsychiatry or in-person mental health visits as indicated. Feedback from caregivers have noted the relatively quick turnaround time for being able to be seen for a more thorough diagnostic evaluation and start of a treatment plan that collaborates with their pediatrician and school, as well as the convenience of use of telehealth to minimize disruptions from work and school.

Conclusion(s): This program has confirmed the effectiveness of telepsychiatry for an underserved population. This program is a model that can improve access to mental health care and reduce time to a scheduled outpatient telepsychiatry visit.