Tag: Behavioral Health

The City of Laredo: A Model for Border Town Behavioral Health

As the third-most populated city along the Mexico-United States border, Laredo, Texas is a unique microcosm of behavioral health challenges.  Laredo’s nearly 96 percent Hispanic population, which is predominately uninsured (31 percent) or underinsured (41 percent; through Medicaid, Medicare, or CHIP), has routinely struggled with affordable access to behavioral health care. With only eight or so licensed psychiatrists treating approximately 300,000 people, mental health treatment has traditionally been a reactive solution, rather than a proactive one.

The Times Are Changing

The City of Laredo Health Department (CLHD), the only Local Health Department in Webb and its surrounding counties of Jim Hogg, Maverick, and Zapata, has proved an invaluable resource for these rural Americans.  Thanks to their recent partnership with Televero Health, Laredo is finally able to offer comprehensive behavioral health care to its underserved and struggling citizens: women; adolescents; those living with HIV/AIDS; those struggling with addiction.  To quote CLHD’s Director, Dr. Hector Gonzalez: “once we found out more than 60 percent of our patients had an abnormal behavioral health screen, where did we send them?  We are a Health Professional Shortage Area and the most needed are psychiatrists.”  Many of these patients now get their evaluations and treatment exclusively through Televero providers.

Our approach is to deliver a turn-key behavioral health program, complete with a collaborative care team of licensed therapists and counselors (vetted, dedicated, and bilingual); provide integrated behavioral health programs (primary care, HIV child/adolescent, SUD/addiction, and more); enable telehealth visits through a HIPAA-compliant platform (care coordination, automated patient communications, scheduling, billing, and records integration); and guide the operation until it is self-sustaining.  With several hundred consults provided and a no-show rate of less than 15 percent, our joint efforts speak for themselves.

Our partnership with CLHD is a continuous process of growth and support. As their Chief of Health Preventive Services, Dr. Luis Cerda, puts it, “Televero has provided CLHD with an excellent service that I now feel is an in-house service.” 

We are proud of our shared accomplishments, and together, look forward to a future where behavioral health resources are at everyone’s disposal. 

Spotlight: The Adolescent Suicide Crisis in Our Schools

Suicide Is a Pervasive Problem

Suicide is the second leading cause of death among 10 to 24 year-olds in the United States, behind a broader category of unintentional fatalities (e.g. auto collisions, drug overdoses, accidental gunshots). The story is similar for Texas youth; the CDC recently reported that nearly 1 in 8 Texas high school students attempted suicide in 2017, highlighting just how common these mental health challenges are.

Suicide Impacts Our Schools

Although many are quick to blame external or interpersonal factors as the catalyst for suicide among students (bullying, academic stress, disciplinary issues), suicide is more often rooted in personal, emotional crisis.  Extreme emotional or psychological pain; the belief that one’s situation will not improve; desires of escapism – these have all been routinely cited as the overarching reasons by those who attempted suicide.

With nearly 80 percent of the approximately 5 million students suffering from suicidal symptoms unable to receive counseling or medication, it’s no surprise that rates of attempts continue to rise.  It’s not a simple issue to tackle, either.  Most teachers, school counselors, school nurses, and administrators all lack the appropriate training and tools to spot the signs and trends.  And even with training, isolating one high-risk student out of hundreds or thousands is a difficult ask.  Without state and federal provisions to address the systematic causes of suicidal behavior –funding, evidenced-based programs, mandates to prioritize mental health support – improvement is unlikely.

A student’s welfare reflects on their school as much as it does on their parents or guardians.  Students in crisis often perform worse and participate less.  It’s worth noting that suicides and attempts affect the student body at large: every time someone harms themselves seriously, a district performs damage control, over-extending resources into forums, speakers, presentations, and so on.  Intervention not only mitigates risk, it protects time, money, and resources.

The Tides Are Changing

States and cities all across the U.S. are now taking notice, in no small part due to the continued epidemic of mass gun violence:

∙ In January, Virginia passed HB1729, requiring that every school counselor spend a minimum of 80 percent of their staff time directly counseling students in individual or group settings

∙ In April, Florida implemented the controversial SB 7030, which finances armed safety officers in its schools

∙ In June, Texas put forth Senate Bill 11, which implements multi-hazard emergency operation protocols and screenings for potential student threats, and Rep. Four Price’s HB 18, 19, 1070, which provides educators with mental health training for times of crisis

In our home city of Austin, Texas, our district leadership is making great strides to combat this issue.  Under the guidance of Tracy Spinner, Director of Comprehensive Health and Mental Health, Austin ISD has made considerable progress in expanding behavioral health resources across its campuses.  Thanks to a $2.1M grant, Austin ISD has set-up on-site clinics in 24 of its elementary schools, many of which are zoned in socioeconomically-limited and culturally-diverse areas.

As the call for behavioral health care sounds nationwide, many districts are now looking for help on how best to take advantage of the increased funding.

What Televero Is Doing to Combat This Problem

At Televero, we offer custom behavioral health programs for student health and welfare. With our turnkey tele-behavioral health solutions, we equip schools with the tools they need for suicide prevention, intervention, and follow-up care.  As part of our crisis support triage model, we provide school nurses, counselors, and administrators on-demand on-campus access to behavioral health screenings and psychiatric evaluations to avoid the expensive ED visit and the traumatic experience of the student riding at the back a police car to the ED. Post-crisis, students receive access to ongoing care programs through scheduled weekly or monthly follow-up visits with the same licensed therapists and counselors.

We’re passionate about making a difference in student health and welfare, and through a partnership with your school, we can strengthen your resources in this fight. In this Suicide Prevention Week, we ask that you share your story with us and join us in a call to action and compassion in tackling this issue head-on.

What Are On-Site Telepsychiatry Services?

Telepsychiatry Defined

Telepsychiatry is the use of telemedicine, or “remote medicine”, technology, to provide psychiatric assessment and treatment to patients.  When implemented properly, telepsychiatry services are indistinguishable from in-person care.   While there are some limitations to telepsychiatry depending on the U.S. state of operation – the ability to prescribe certain classes of medicine; reimbursement rates for CPT codes – the quality of care is always equivalent.

Recent Developments and Their Impacts

With over 5,000 mental health care Health Provider Shortage Areas (HPSAs) in the United States, more clinics and hospitals have turned to telepsychiatry for solutions.  States like Texas are acknowledging the efficiency and reach of this technology by enacting parity laws – laws which guarantee equivalent reimbursement by private payers for services rendered through telehealth technology.  These laws are encouraging for physicians at the forefront of healthcare advancement, as they facilitate the low-risk methods that will be needed to address the growing demand for behavioral health services.

Improving Access to Care

For many clinics, telepsychiatry might be the only practical solution to treat patients needing behavioral health care.  As psychiatrists and other mental health professionals primarily practice within or close to major city limits, rural areas often rely on a single practitioner to treat hundreds, if not thousands, of potential patients.  Most general practitioners are not adequately equipped or specialized to serve those with mental ailments, and too often must refer their patients to emergency care.  Adding remote screenings, evaluations, and treatment to your current practice model would be useful in bridging this gap in care.

The Advantages for Your Clinic

As a fixture of your clinic, telepsychiatry is non-intrusive and cost-effective.  Depending on how you choose to finance your behavioral health services – whether by accepting commercial insurance; offering a sliding fee schedule; seeking external funding – you might be able to greatly increase your practice’s revenue.  Expanding your reach of care through behavioral health is also a good way to introduce new patients to your practice, and satisfy existing ones.

Getting Up and Running

Adding behavioral health services in your clinic comes with its own challenges: hiring the best-fit psychiatrist or counselor; understanding the billing and reimbursement structure; implementing a web portal and video client under HIPAA-compliance; and so on.  Thankfully, there are companies that will work with your clinic to operationalize the process (do the heavy-lifting).  Whether you are a physician, nurse, or practice manager, your priority is caring for your patients.  An external solution can help you focus on what you do best.