If a student is having behavioral problems, it makes sense that parents would turn to the school nurse for advice and assistance.
But those consultations often end in frustration, according to a Children’s Behavioral Health Needs Assessment for the Kansas City metropolitan area and surrounding counties. A group of about 160 local health providers gathered recently at the Kauffman Foundation Conference Center to hear the results of the assessment.
Even though mental health services are beyond the services typically expected of a school nurse, Tracy Kulik told those who had gathered that it was important to address the finding from the assessment that parents and guardians consider schools among the least helpful entry points (along with hospital emergency rooms) to the area’s behavioral health system.
Kulik is president of Collaborative Research, the San Antonio, Texas-based consulting firm that completed the assessment.
She said the key question for the mental health community was, “What can we give them (nurses) as support to help guide them through that (process)” of referring children who need help.
More than 600 people responded to a survey that was part of the assessment and about 25 percent of them said school nurses had been unhelpful. In contrast, nearly 40 percent of respondents said community mental health centers had been helpful and that they were still receiving care there.
The assessment also indicated that families on Medicaid and other government programs receive more affordable mental health coverage for their children than do families with private insurance.
Of the respondents, 10.4 percent said they could not afford the behavioral health costs not covered by their plan. All of those respondents had private insurance. Of the remaining respondents, including those on Medicaid and other government plans, nearly 75 percent said they could “usually” or “always” afford the out-of-pocket costs.
Privately insured families are “at the edge,” Kulik said. “They are really struggling with co-pays or lack of mental health coverage.”
Asked by an audience member if the assessment revealed any service disparities in the bistate region, Kulik said Kansas stood out negatively in clamping down on services available in psychiatric residential treatment facilities. She praised Missouri for treatment of autism.
“You see areas that are points of light,” she said of the two states, “and there is some dusk setting in, and in Kansas, it’s a little more dark.”
In a later interview, Kulik said one of the most surprising findings was the frequency with which parents or guardians stopped accessing services after one or two treatments though they knew a problem persisted.
She said that likely revealed a gap in the availability of services at times that do not force parents to choose between work and helping the child.
About a fifth of the respondents said they had not completed the treatment regimen recommended for their children.
Attendees spent the afternoon refining the draft recommendations included in the assessment. Organizers expect to post a final report online on the Web sites of the Mid-America Regional Council, the Health Care Foundation of Greater Kansas City, and the REACH Healthcare Foundation.
An action plan based on the assessment is expected to be in place by February or March, said Jody Denson, a health planner at MARC.
Groups involved with the assessment included the Children’s System Change Committee, which includes representatives from several area organizations, including the Kansas City Missouri School District. Marsha Morgan, chief operating officer for behavioral health at Truman Medical Centers, is the committee chair.
In opening remarks, Morgan said the assessment would “chart our course for the next year, 18 months, three years, whatever it takes for this.”