FOCUS on Clinical Service and Community Outreach: Yale Child Study Center Returns to School-based Mental Health

May 31, 2013

School-based mental health services are delivered in a variety of ways, including school-employed staff (social workers and school psychologists) and clinicians from school-based health centers (SBHC's).  The typical SBHC provides both pediatric primary care and mental health care; advanced nurse practitioners (APRN's) commonly deliver primary care services, while licensed clinical social workers deliver mental health care.

There are about 75 SBHC's in Connecticut, most of which are operated by community-based organizations, including hospitals, child guidance clinics, local health departments, and Federally Qualified Health Centers.  A few SBHC's are operated by the school districts themselves.

The Yale-New Haven Hospital (YNHH) Department of Community Health Services operates 3 SBHC's in New Haven and 3 SBHC's in Branford.

Due to increasing awareness of the need to deliver psychiatric services in school settings, the Child Study Center sought to collaborate with YNHH’s efforts in 2012. From the beginning, Yale Child Study Center’s work at the Branford SBHCs has been a tremendous success. There has been such a positive outcome from this work that the team from the Child Study Center has moved forward on providing mental health services in a Hamden SBHC.

For the work at Branford over this past year, Christine Dauser, PhD, the Director of the Child Study Center’s Outpatient Psychiatric Clinic for Children who facilitated this collaboration, highlights the role of Rhona Weiss, the SBHC Coordinator in Branford, in all aspects of the mental health integration.  Dr. Dauser reflects that “It has also been a pleasure to get to know Rhona. She championed our collaboration within the Branford SBHC.  She has a wealth of knowledge, which she has shared generously with regard to our pending SBHC in Hamden.  I'm looking forward to our continued partnership.”

In collaboration with the YNHH Department of Social Work and the Department of Pediatrics, Eric Arzubi, MD, a Yale Child Study Center child and adolescent psychiatry fellow, provided clinical support to the SBHC staff at the 3 Branford locations.

"This incredible clinical and educational opportunity was made possible by the leadership at Branford Public Schools," said Dr. Arzubi.  "They truly see the value in providing students ready access to mental health supports."

Dr. Arzubi spent 4 hours every Tuesday morning at a Branford SBHC beginning October 1, 2012.  Over the first six months of the initiative, he provided psychiatric evaluations to sixteen (16) K-12 students, none of whom had ever met with a child and adolescent psychiatrist. Yann Poncin and Dorothy Stubbe in addition to Christine Dauser have also worked towards the success of these mental health services within the Branford SBHCs.

Dr. Dauser says “We've been so pleased with the first year of this collaboration.  It's been a wonderful experience for Eric, as a fellow, to be fully incorporated and accepted into each of the school communities with ready access to the students to be allowed classroom observations.  He has had the opportunity to work closely with the classroom teachers, SBHC Social Workers and APRNs, school Social Workers and Administrators on a weekly basis.  Eric has set the bar quite high.  He's done an amazing job in this first year.”

"This rotation is so rewarding," said Dr. Arzubi.  "These are kids who may have otherwise gone months or years without seeing a psychiatrist."  He continues to see many of these youth regularly for ongoing evaluations or medication management.  Additionally, spending time weekly in the schools has created many new opportunities for collaborating with school staff, he said.

Submitted by Emily Hau on May 31, 2013