A growing number of public schools across the country have started offering remote mental health services to students. On-site counselors invite troubled students into their offices to consult with mental health professionals via telemedicine solutions. Is this something schools should be doing?
As far as diagnostic accuracy is concerned, there are few worries about that. A recently released study from the Mayo Clinic shows that telemedicine diagnostic accuracy for mental health is about 96%. Furthermore, growing numbers of mental health professionals are very comfortable consulting with patients via telemedicine.
So if diagnostic accuracy and provider willingness are not concerns, why bring up the question of whether schools should be offering remote mental health services? It is a matter of determining the school’s role.
Schools Are Replacing Parents
It was 1996 when then-First Lady Hillary Clinton latched onto an old proverb that says it takes a village to raise a child. Her activism resulted in a new thinking among public school teachers and administrators, a thinking that said schools should become all things to the child.
In the decade-and-a-half since, we have seen a gradual movement toward public schools replacing parents. Schools now offer three square meals per day. They provide before- and after-school programs that keep children on campus for most of their waking hours.
Throwing in healthcare services, be they mental health or primary care, replaces yet another function parents traditionally handled themselves. This may not be such a good idea. Parents are being removed from their children’s lives little by little, which is bad enough. But putting healthcare decisions in the hands of school officials rather than parents sets a dangerous precedent.
Who Makes Decisions Matters
Again, the issue here is not one of technology or diagnostic accuracy. CSI Health is a San Antonio company that makes state-of-the-art telemedicine kiosks with a full range of on-board diagnostics. Their kiosks make it possible for clinicians to remotely consult with their patients as effectively as they would in the office.
At issue is the decision-making process – specifically, who it is that makes decisions on behalf of minor children. Historically, those decisions have belonged to parents. But we have seen a shift away from that toward handing decision-making powers to school administrators, teachers, and guidance counselors.
Student Mental Health in Texas
Texas is among those states that have begun embracing school-based mental health counseling for students. Back in 2019, state lawmakers created a consortium which, in turn, created a telemedicine system and network available to all schools in the state.
To date, the system has been implemented in 29 Texas school districts and includes some 3000 schools. In their defense, proponents of the system say that there are not enough providers in Texas to give students and their parents access to in-office visits. They say school-based telemedicine is the best way around that problem.
Still, that doesn’t change the fact that school administrators and counselors have assumed for themselves the role of determining whether a student needs mental health counseling or treatment.
According to a report from Austin NPR affiliate KUT 90.5, counselors and administrators at Oak Elementary School wait for children to arrive every morning. They greet them at the door and start looking for signs that any of them might be troubled. Invitations go out to students they believe should visit the counselor’s office for a mental health telemedicine session.
This sort of thing is highly unsettling to many parents. They wonder whether public schools should be inserting themselves into their children’s mental health. It is a valid concern on many levels.