In Ohio health care deserts, schools step up
The pandemic exacerbated rural mental health care gaps. A state program is trying to help.
Michaela Warner, a school psychologist for a small school district about a hundred miles east of Columbus, is used to interacting with her students face-to-face.
She solves puzzles with kindergartners to assess their development and counsels high schoolers through anxiety.
But recently, she’s started doing this work in a new way – using advanced telehealth technology.
It’s part of a pilot telehealth program with the Muskingum Valley Educational Service Center and BroadbandOhio.
From her side of a telehealth computer cart, Warner displays a series of four illustrations: a pink ruler, a pair of scissors, water color paints and a fountain pen.
The images, which would typically display in front of a student, appear on another screen miles away.
“Look at picture number one,” Warner directs. “Look at picture number two. Look at picture number three. Look at picture number four. Which one shows a ruler?”
On the other side of the screen, a giant camera can be used to track the student’s movements.
“Traveling to things can be difficult, whether it be traveling for an assessment or for counseling or anything of those needs,” Warner says. “It’s a lot easier that we can bring [these services] to the students where they are versus asking them to travel to another location, whether it be Gainesville an hour away or another surrounding city.”
How BroadbandOhio is expanding telehealth
In parts of rural Ohio where the closest doctor is hours away, telehealth can be a godsend for accessibility.
But there’s a problem.
“We are in these dead zones in terms of broadband,” says Dr. Mike Fuller, the director of school psychological services for the Muskingum Valley Educational Service Center. “People go to McDonald's to get on WiFi.”
While high speed internet is commonplace in Ohio’s major cities, nearly a million Ohioans in rural parts of the state are still without broadband access.
“Particularly in the Appalachian counties, the topography is very hard for wireless technologies to connect,” says Lt. Gov. Jon Husted.
Because of this, private internet providers have little incentive to invest in rural communities.
That’s where the state comes in. It’s partnering with telehealth administrator OCHIN to bring health care access to kids right where they’re at – local schools.
Together, BroadbandOhio and OCHIN are identifying school districts in Ohio where health care providers are not nearby, helping those districts connect to broadband, and providing them with up-to-date telehealth technology so they can connect to mental health counselors and school psychologists like Warner.
The pandemic has made the need for her sort of services even greater.
“Anxiety has been higher with a lot of our students with just the unpredictability and the changes which (the pandemic) has brought,” she says.
Warner is the only psychologist in her district. She serves 800 kids, a relatively light load compared to the upwards of 2,000 students that Dr. Fuller says other school psychologists serve.
“Right now, 77 of the 88 counties (in Ohio) are mental health shortage areas,” he says. “What that means is that they don't have enough psychologists, psychiatrists, counselors and social workers. So we have to stretch resources.”
On top of that, counselors and psychologists in spread-out, rural districts like Warner’s sometimes have to drive for hours to see kids at different schools.
Telehealth technology eliminates those long drives, so health care workers can use their time instead to treat more students through online screenings.
“It definitely does allow us to reach a lot more students and get them connected because we are in such a rural area with not as many resources really, really close,” she says.
The state’s next step is expanding telehealth programs to 10 more school districts.
It’s working with OCHIN to make a game plan for how to do that.
When it does, rural schools won’t just be connected to faster internet. Their students will have access to better health care too.
“Technology is changing the nature of how we do everything,” Lt. Gov. Husted says. “There's no reason it shouldn't change the way that we access health care.”