Children with mental health needs get help via telemedicine. ‘A lifesaver,’ says mother

Jamie Sutta’s 5-year-old son is on the autism spectrum and he usually gets speech and occupational therapy at Palmetto Elementary School where he’s enrolled in pre-K. But since schools have been closed due to both spring break and the coronavirus outbreak, Sutta and her husband have taken on those roles.

“We’re now watching the kids, trying to be their teachers and therapists, getting them fed — and we’re still working,” said Sutta, 39, whose workday job is running The Children’s Voice Chorus, a non-profit organization focused on choral education that performed at this year’s Super Bowl. While it hasn’t been easy, Sutta and her husband have been able to take on their new jobs — while still getting paid by their real bosses.

For years, Florida has ranked near the bottom among states for per capita spending on mental health care. Data from 2012 — the most recent available — place Florida at number 48, spending just $37.28 per person, while the top state, Maine, spent $338.24 per person.

Spending improved after a student with well-documented psychiatric problems went on a shooting rampage in a Parkland high school in 2018, killing 17 students and staff. With its share of a $69 million pot of money created by The Marjory Stoneman Douglas High School Public Safety bill in 2018, $7.7 million, Miami-Dade schools created the MDCPS Department of Mental Health Services, which provides mental health and wellness-focused services to its students.

Sally Alayon, the assistant superintendent of the MDCPS mental health department, said that while each school has a mental health coordinator who holds a master’s degree in either psychology, school counseling or social work, students who require more care are referred out to one of 12 contracted mental health providers.

“When the break is over, we’ll continue with their mental health services,” Alayon said. While she couldn’t offer specifics on the transition back, she did say, “Like everything else, it’s going to be a little different.”

The school lockdown has introduced speed bumps, though not roadblocks, to care for students.

Many mental health experts are offering telemedicine to students already in treatment — as well as to children and adolescents who may require care for the first time as the COVID-19 virus upends family routines. Mental health professionals are anticipating an uptick in demand for mental health services as kids experience greater anxiety, fear and stress while stuck at home with frazzled parents.

Sutta and her son still see their child psychologist, Dr. Meaghan Parlade, at the University of Miami, who is continuing to offer her services via telemedicine. Parlade specializes in diagnosing and treating children with Autism Spectrum Disorder, or ASD, and she’s a therapist with a type of treatment called Patient-Child Interaction Therapy that helps parents manage their children’s behaviors.

The therapy has “been a lifesaver,” says another mother whose 5-year-old son is also a patient of Dr. Parlade. The mother asked to remain anonymous for privacy reasons.

She and her husband — a resident at Jackson Memorial Hospital — live in Coconut Grove with their two children. She worked full-time for an education technology start-up in New York, but lost her job last week as businesses closed in reaction to the virus’ spread. The woman and her son, who sees Parlade for the therapy, also have transitioned to telemedicine, which Parlade offered to her patients before the coronavirus outbreak.

Parlade says PCIT is well-suited for virtual consultations.

The Coconut Grove mother, 35, said there might actually be an advantage to her son receiving his therapy remotely: Parlade can see how the boy acts at home. He’s always on better behavior when they go to the clinic, so the telemedical appointment is like a virtual housecall.

On the other hand, she added, there’s no replacement for in-person treatment.

The PCIT clinic at The University of Miami is funded by The Children’s Trust and there are no minimum salary requirements for the free service. PCIT is designed for children aged 2-7, and involves one-to-one play time between the child and parent, while the therapist observes and coaches the parent from an adjacent room with a two-way mirror.

While some parents still prefer in-person therapy, telemental health has been in use, and studied, for more than 60 years — and considered a proven approach.

While originally conducted over the phone, the advent of the internet, personal computers, tablets and smartphones made remote mental health care, now done through video conferencing, more accessible, and effective.

A 2013 study on the effectiveness of telemental health published in the Telemedicine Journal and e-Health, found that, “Telemental health is effective for diagnosis and assessment across many populations (adult, child, geriatric, and ethnic) and for disorders in many settings (emergency, home health) and appears to be comparable to in-person care.”

The practice was already considered mainstream, though more patients are seeking remote treatment since the coronavirus outbreak forced families to stay home.

Chrysalis Health is one of the 12 mental health providers contracted by Miami Dade County Public Schools, and it historically has offered therapy both in-person and via telemedicine for children and adults. The provider is beginning to see an increase in patients, as more and more South Floridians suffer the stress and anxiety of being cooped up at home, said Doug Leanardo, the company’s senior vice president.

Leanardo said that last week, people were adjusting to the new normal, but this week new patients started seeking help. Before the pandemic, about 25% of Chrysalis Health’s patients chose the telemedicine option, but the company has now successfully transitioned its more than 270 clinicians and 13,000 active patients to the service.

“Children are so comfortable with technology, that for them it’s been seamless,” said Leanardo. “In fact, the crisis has helped get other people used to technology, too,” he said.

Chrysalis Health providers see children, adults, and families statewide, and work largely with Medicaid patients while also accepting private insurance.

For Miami-based telemental healthcare start-up BraveHealth, offering virtual mental health care is all they have done since being founded in 2017 by CEO and Co-founder Anna Lindow, a graduate of Columbia University who holds a graduate certificate in Addiction Recovery from the University of Florida.

BraveHealth offers both psychiatry and psychology services to adults and adolescents (13+) across the state.

“Really fortunate to be a virtual company that’s able to help right now,” Lindow said.

BraveHealth accepts Medicaid and private insurance.

This story was originally published March 28, 2020 at 2:29 PM.