Ending the silence and stigma for youth with mental health needs

A conversation with Blue Cross of Idaho Foundation for Health Executive Director Kendra Witt-Doyle

In schools across the country, students are often suffering in silence. They have learned coping mechanisms to deal with anxiety, depression, trauma or any number of other conditions that negatively impact their emotional and mental health. Yet, this type of coping doesn’t address the underlying issues and can put them at greater risk.

In Idaho, 35 percent of high school students have reported depressive symptoms, compared to 31 percent nationally. In addition, the state has higher-than-average rates of bullying and suicidal thoughts among teens.  

The adolescent years offer a critical window in which to promote good mental health and begin treating behavioral health issues. Idaho, however, faces a shortage of professionals trained in early recognition and intervention. To help fill the gap, in 2017 the Blue Cross of Idaho Foundation for Health began collaborating with schools and behavioral health professionals on the Healthy Minds Partnership (Healthy Minds). The partnership places behavioral health specialists in schools allowing students to easily and conveniently access care. 

The program is growing quickly, with more and more schools across the state adopting the approach. We spoke with Blue Cross of Idaho Foundation for Health Executive Director Kendra Witt-Doyle to learn more about Healthy Minds and how it is helping Idaho’s youth.

1.  Why was Healthy Minds needed?

We are working to address the root causes of some of Idaho’s most pressing health issues, and we knew providing adequate access to youth behavioral health care was greatly needed in communities throughout the state. So often, individuals are referred to behavioral health specialists, but don’t access the recommended care for to a variety of reasons including: stigma, lack of transportation or the inability to take time away from school or work.

Healthy Minds is helping schools partner with specialists to improve access by offering onsite, school-located clinic space that gives convenient access to much-needed services.

2.  Health doesn’t just happen in a doctor’s office, and youth behavioral health is a growing concern across the country. Why is it a focus for the Blue Cross of Idaho Foundation?

It is one of our four key initiative areas: health care innovation, High Five­ – a statewide initiative to eliminate childhood obesity, rural health and youth behavioral health. It stems from multiyear work within communities throughout the state where youth behavioral health was identified as a primary concern.

3.  A key component of Healthy Minds is meeting students where they are by having specialists set up offices in schools. Why is this important?

Twenty percent of adolescents between the ages of 13 and 18 live with a mental health condition. If left untreated, it can have lasting consequences, including substance abuse, interactions with the criminal justice system, and poor academic performance, that impede health and well-being. By moving care into schools, we are able to remove some of the barriers to access and reduce the stigma. Students can receive care while limiting the amount of class time they miss, parents don’t need to take time off of work, and families without reliable transportation aren’t burdened with finding a way to the appointment.

The middle and high school years mark a critical time to reach kids who are struggling. Nationally, 37 percent of students over the age of 14 with a mental health condition drop out of school, so it’s important to address these issues while we still can and set students up with the skills and tools they need to successfully navigate these conditions now and throughout their lives.

4.  How are students referred? Is there a cost?

Students are typically referred by the school counselor. All specialists participating in Healthy Minds must accept private insurance and Medicaid, with students paying their customary co-pay if it is required. The specialists also provide a certain percentage of pro bono services.

The cost to schools is minimal – usually just office space and time to create and implement processes. We provide technical assistance to the schools in the form of contracting with subject matter experts to provide coaching, facilitation, project management and information sharing to build the necessary relationships. We worked with a variety of partners to jointly create a comprehensive roadmap which helps participating schools train other schools in their district to launch the program.

5.  How do you know if Healthy Minds is successful?
Thus far, we are seeing mostly anecdotal evidence, but there is a lot of excitement among educators. Schools are scaling up the program because they say it is so impactful. We began in one school district, now more than a dozen schools across four districts offer Healthy Minds, with eight additional schools throughout the state slated for technical assistance in 2020.

Nampa School District, one of the first to implement Healthy Minds, started with two schools and is now expanding to 14. The district cites significant improvements among participants including a 57 percent reduction in absences at West Middle School, and Nampa High School noted a five percent drop in absences as well as a 14 percent increase in participating students' GPAs.

Going forward, we are working to support quantitative data collection. We continue to receive interest from various interested parties including the State Department of Education, health care professionals and health insurers.

See what other Blue Cross and Blue Shield companies are doing to improve mental health.