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In rural Georgia, telemedicine provides new option for children’s mental health
Telemedicine is being proposed as one of the state’s methods to improve mental health care for children. - photo by Nick Bowman

In more than half of Georgia counties, parents can’t find nearby mental health services for their children.

A deep lack of mental health professionals is one of a litany of problems identified by advocacy groups and state agencies for years, and that shortage is laying a hard road before parents in outlying communities in Georgia, some of whom have to drive hours to the nearest metro area for care.

Those same groups, like Voices for Georgia’s Children, point out that the shortage is having dire consequences: Based on the most recent information available, suicide is the third most common cause of death for people ages 10-24 in the Peach State.

“We know that there are significant number of counties that don’t have a licensed mental health professional, and when you’re a family that has a child who’s having a challenging experience, you’re already struggling and you need to have access,” said Erica Fener Sitkoff, executive director of Voices for Georgia’s Children.

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In December, the Commission on Children’s Mental Health, which was created by Gov. Nathan Deal in June, released a report with recommendations on how to improve mental health services for children in Georgia. Read more about that work and what the issues look like in our community.   

There could be as many as 76 of Georgia’s 159 counties that have not a single licensed child psychologist, according to the Georgia Department of Behavioral Health. The department found in 2014 that about half of the state’s counties lack mental health professionals, but more recent information isn’t available.

The teen suicide rate and other mental health issues faced by Georgia’s youth came to the forefront at the end of 2017 in a report from the Commission on Children’s Mental Health. Gov. Nathan Deal created the commission in June.

In December, the commission returned with five recommendations to address the state’s lack of services for children suffering mental health problems.

Among those recommendations is a recognition that, given the education required to become a child psychiatrist or psychologist in Georgia and the economic facts of less-populated areas, the demand for child mental health care in rural Georgia won’t be met on the ground any time soon.

So, instead, the state is proposing to bring children in need and health care professionals together another way: telemedicine.

Telemedicine, also called telehealth, is becoming a growing part of rural Americans’ health care consumption. Faced with few providers or high-deductible insurance (or no insurance at all), patients are turning to less expensive webcam consultations with a specialist.

Child health advocates like Sitkoff, who was one of the eight members of the mental health commission, argue that the state needs to do more to provide access to care for rural Georgians who don’t have access to mental health care, which often requires a series of visits with a service provider over weeks, months or even years.

“Kids who have an unmet mental health need, if it continues to get worse, miss significantly more days of school than kids who don’t have those needs,” Sitkoff said. “We know if we don’t intervene, it starts to have a compounding negative impact on them — they get behind and it feeds into stress, anxiety, depression.”

It’s no surprise then that so much of the new children’s mental health funding in Gov. Deal’s fiscal year 2019 budget request focuses on schools.

Much of the almost $23 million for children’s mental health programs requested by the governor’s office and the commission is intended to “connect kids to services where they are everyday, and that’s schools,” Sitkoff said. “Where we’ve seen great success in tele-mental health is where these school-based health centers leverage telehealth equipment to get kids access to behavioral health providers.”

Tucked into the budget recommendations are two line items totaling $482,500 for telemedicine services and infrastructure — money that will help fund the cameras, computers and training needed to coordinate and carry out telehealth programs through public schools, the state and public-private health care providers.

Combined with additions to the Georgia Apex Program, the funding would help connect kids who need help to counselors, specialists and physicians to whom they don’t normally have regular access.

Sitkoff held up the Tanner Health System in the West Georgia town of Carrollton as an example for its tele-mental health services, which include providing telehealth services in local schools. The system also does regular “mental health first aid” classes that teach people how to identify someone struggling with mental illness and how to approach them about it.

Sitkoff argues that increasing awareness of mental health needs of children and identifying state resources to respond to it can help health care providers, educators and — most importantly — parents in rural areas not just provide long-term care to children, but identify a child on the edge and help him or her recover.

“We’re seeing higher stakes now,” she said. “We need to be identifying these needs earlier and earlier, creating awareness, reducing the stigma around getting help.”

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