by Amelia Ferrell Knisely

Some West Virginia schools are among a growing number of school districts nationwide using telehealth – or virtual therapy – to help students in the midst of a national child mental health emergency. 

Federal data shows that 17 percent of public schools reported having telehealth services in the spring of 2022. 

Relaxed federal regulations around telemedicine during the pandemic have pushed the expansion of virtual therapy options, and a network of groups in the state have made telehealth a part of their plan to increase mental health care for children. But, there are challenges to helping kids virtually, particularly in an impoverished state with internet gaps.

West Virginia Behavioral Health Care Providers Association CEO Mark Drennan said that the pre-pandemic, his network of healthcare providers was already expanding telehealth services because the state faced a shortage of mental health providers, particularly in rural counties. 

He said the relaxed federal guidelines allowed mental health providers to serve patients via telephone calls – not just video conferences, which may have excluded some in need who didn’t have access to video call functions. 

“That was very helpful,” Drennan said. “You could get right to that person in their home.”

Some schools in West Virginia are using telehealth to reach students, according to the West Virginia Department of Education. 

The West Virginia Department of Health and Human Resources, which is part of a multi-group initiative expanding mental health access in schools, didn’t provide specific details about what schools are using telehealth for students. Christina Mullins, DHHR deputy secretary of mental health and substance use disorders, said that the expansion of these mental health services costs $30,000 per school.

“Any student can access mental health services if they have an identified mental health diagnosis and the school has access to a therapist and/or telehealth services,” Mullins said in an email. 

The number of children ages 3 to 17 struggling with anxiety or depression rose by 1.5 million between 2016 and 2020, according to a report from the Annie F. Casey Foundation. 

In West Virginia, around 30 percent of kids were diagnosed with at least one emotional, behavioral or developmental condition in 2019, according to the nonprofit’s data. Nationwide, pediatric emergency room visits for mental health care have spiked, but West Virginia hospitals haven’t released comprehensive data to show if that occurred in the state. 

West Virginia’s high poverty rate was a factor in kids’ mental health struggles. Additionally, the state has the highest percentage of kids entering the foster system, and children in the child welfare system are far more likely to experience mental health issues.

Despite the need for mental health care, telehealth hasn’t yet successfully filled the gap in care for kids.

“Grantees reported during the pandemic that overall most students were not comfortable utilizing telehealth and preferred meeting with their therapist in person,” Mullin said. “However, overall, more people are using telehealth than they were prior to the pandemic, so comfort appears to be growing with this service.”

Research published by the American Psychological Association said telehealth significantly lowered no-show rates for therapy visits for underserved families and children.

There are other challenges to helping kids virtually, and Drennan highlighted privacy concerns because kids were likely to attend a virtual therapy session when someone else is in the home. 

“Say it’s a child (and) say there’s abuse or neglect going on, you could have someone listening. That’s not always ideal,” he said.

The state’s internet woes are also a hindrance to telehealth’s success in West Virginia. The intersection of high-speed internet gaps and children came into sharp focus during the pandemic, when kids couldn’t get online to do their school work while school buildings were closed. Gov. Jim Justice promised more than $50 million dollars in federal Covid relief funds for connecting homes and setting up 1,000 hot spots for kids. The state launched a bus service to provide hotspots for kids who couldn’t get online at home. But, there were still gaps, as Mountain State Spotlight reported here about what students were facing in Roane County.

Dr. Jenna Sizemore, a Morgantown-based physician, said she knew of patients in rural areas who had driven to find cell-phone service in order to make a telehealth appointment.

“Already, it can be a financial challenge to seek health care, and now they’re using cell minutes,” she said.

Sizemore teaches medical professionals, including behavioral health providers, best practices for using telemedicine. She said its expansion has been the “silver lining” of the pandemic and pointed to the American Medical Association’s work to urge legislatures, both state and federal, to increase access to telehealth to overcome geographic barriers to virtual care. 

Emergency room data collection project continues 

This story is part of a series on kids’ mental health in West Virginia. The project’s overall goal is to collect pediatric emergency room data with the goal of understanding how many kids are seeking acute mental health care and what that experience looks like (for example: How long did a kid wait in the emergency room before being transferred to a hospital bed?). This data, stripped of any personal information, could be analyzed for greater understanding of the state’s pediatric mental health needs as well as guide state leaders and lawmakers in decisions about financial resources for kids’ mental health. Other states, like Virginia, make this data publicly available.

Since the project launched in fall 2022, we have made traction with West Virginia University Health Systems in releasing data and continue to work with them to collect an amount of data that can be analyzed.

If you need help

From parenting support to immediate crisis response, contact 1-844-HELP4WV to talk to a trained helpline specialist who can help you understand options and link you directly to treatment providers. The resource is available 24/7.

You can also get immediate help 24/7 from the National Suicide Prevention Lifeline at 1-800-273-8255.

The West Virginia Department of Health and Human Resources recently launched weekly online sessions for parents and caregivers looking for help navigating child mental health care.

Amelia Ferrell Knisely is an award-winning journalist in West Virginia. Originally from Rand, West Virginia, she has written for Mountain State Spotlight and the Charleston Gazette-Mail about child welfare, hunger and poverty. Ferrell Knisely also previously worked for The Tennessean in Nashville. Follow her onTwitter


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