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While many individuals have come to rely on telehealth services as a way to receive mental health care during the COVID-19 pandemic, children in low-income families have experienced barriers to mental health care access that existed prior to the pandemic and in many ways were exacerbated by the pandemic.

In the San Fernando and Santa Clarita valleys of California, well before 2020, many parents of children in need of mental healthcare services found the traditional intake process for their children could be challenging and confusing.

A PCORI-funded study designed to address these parents’ concerns demonstrated the usefulness of mental health coordinators equipped with telehealth platforms back in 2017. Now, as communities across the globe still try to settle into life with COVID, alternate ways of connecting are all the more valued.

Parents of children using this new primary care-based, telehealth-enabled referral process to community mental health clinics had three times the odds of completing the initial referral process—and additionally, “the work that the clinics did for telehealth implementation put them ahead of the game when COVID happened,” says Tumaini Coker, MD, MBA, the study’s Principal Investigator.

“This project helped our clinic convert to telehealth overnight,” agrees Alpa Patel, MD, the Director of Psychiatry Services for the participating Child and Family Guidance Center. “We actually stopped seeing people in person on March 13, [2020], and by March 18 we were already seeing about 70 percent of our patients on video.” To this day, Patel explains, clinics operated directly by the California Department of Mental Health are still using phone visits to help facilitate care for kids.

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During what was often a challenging, uncertain time, parents could rely on a more personal connection via telehealth to help them navigate the referral process. This is where the newly developed role of a Telehealth Coordinator became especially useful. This primary care-based care coordinator was one of the most important pieces of solving the referral process puzzle.

Gina Johnson, MD, Medical Director of Pediatrics at community partner Northeast Valley Health Corporation (NEVHC), shares that their team now also uses technology to connect primary care providers and behavioral health specialists to “unify holistic care… and ensure exceptional communication between care teams.” The project also helped the team discover that parents and their children were well-positioned to use technology to enhance their health care, even beyond interactions with a coordinator.

As new ways of connecting were established among providers, patients, and their families, providers and researchers were engaging with one another in new ways, too. “The biggest benefit from a research perspective,” explains Coker, “is that this project created relationships between the primary care clinics and community health clinics that didn’t exist before.” Just as setting up telehealth services provided useful knowledge for a future pandemic, the relationships built among clinics provided a benefit that has outlasted the original study as well.

Clinicians, staff, and leadership of the clinics worked closely with parents to develop the intervention, and through this process, built trust and relationships that enabled them to improve behavioral health services for the children and families in their communities.