The idea for the program that has helped hundreds of Boone County students in need of psychiatric treatment was hatched in a hallway at the Missouri Psychiatric Center. Walking out of the inpatient youth unit, Carole Schutz, RN, mentioned to Laine Young-Walker, MD, that they needed to eliminate the barriers to child psychiatry.
“Carole said, ‘You know, we really need to have psychiatrists in the schools,’” Young-Walker recalled. “I said, ‘What do you mean?’ She said, ‘In the past, I participated in this program in St. Louis, and we went to schools and saw kids. I think that’s where we should be.’”
That conversation turned in to the MU Bridge Program: School-Based Psychiatry. After a successful three-month pilot study at four local schools in 2014, Bridge received full financing from the Boone County Children’s Services Fund and began operation in 2015. It is now available for any Boone County student in public, private or home school. The program helped more than 350 children in 2017.
“Access to child psychiatry was a problem,” Young-Walker said. “The length of time to get in to see a child psychiatrist could be up to six months. The lack of insurance, underinsurance for mental health services, and problems navigating the mental health system by families created challenges for children with problems. Bridge answered all of those issues and resolved them.”
Making sure children and their families get lasting assistance through therapy, a psychosocial rehab program or the Family Access Center of Excellence is a priority.
“One of the paramount concerns the Bridge team has is that children’s treatment will discontinue at some point after they’re discharged,” said Schutz, who is one of the Bridge Program managers, along with Chris Petner, RN, and Anna Compton, RN. “For this reason, much emphasis is placed on wraparound support.”
The program has been mutually beneficial to schools and students. A nationwide shortage of child psychiatrists has led to lengthy waits for appointments — if the parents can figure out how to navigate the mental health system at all — so Bridge offers some immediate answers and a link to long-term solutions.
“Before Bridge existed, counselors referred families to hospitals and/or community providers in the hopes that they could and would take advantage of the resources offered,” said Lou Ann Tanner-Jones, PhD, the director of Boone County Schools Mental Health Coalition. “Often the wait times were prohibitive to getting good mental health care. Bridge has changed all of these barriers by bringing excellent medical care to students at Boone County schools.”
Rachel Kirchner is a counselor at Parkade Elementary School in Columbia. She said before the Bridge Program was in place, she referred students to a local behavioral health center or to their family doctors, but often the students never got help because of their parents’ work schedules or transportation issues. The Bridge Program removed those barriers by seeing the students at school.
Kirchner said Parkade made 30 Bridge referrals in the 2017-18 year, and 25 of the students received follow-up care — either medication or therapy, depending on the diagnosis and the parents’ wishes — after their initial evaluation.
“I can’t say enough wonderful things about the Bridge Program,” Kirchner said. “They have made things so much easier for us as far as accessing mental health services for our kids.”
Young-Walker got a sense of how important the program could be when she was contacted by one of the students from the pilot study.
“She said the Bridge Program saved her life,” Young-Walker said. “Without it, she wouldn’t have known what to do or where to go.”
