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Anyone working with students who receive therapeutic services both in and out of school has heard the term wraparound services. Most of us don’t even stop to think about what that means: they are services that wraparound the student, right? More or less, yes. But, what if we could take that concept, rethink it, and apply it to a larger group of children using modern strategies?
Wraparound services already have a history of evolving. They started as a way to coordinate care for significantly disabled students who needed considerable physical, academic, and behavioral support in all of their life settings. Because of its success and sheer common sense, the concept of wraparound services is now considered the standard of care for students whose current school, family, medical and community supports need to coordinate to ensure students are receiving cohesive services that are building off of each other and not independent or, at worst, actually contradicting each other. What if we evolve the idea even more specifically as it applies to mental health in schools?
Schools are the ideal place for delivering mental health services
Children spend large sections of their day there. They experience challenges, frustration points, successes, social interactions, and learn new skills: all the things that create opportunities to observe mental health skills. And, all that time they are observed by staff who interact with hundreds of other students and have many points of reference for “average” behavior. And completely independent of the above ideal learning conditions — children are IN school. School enrollment is required for children under each state’s designated age of majority. Once children are outside of the school day, they have various other engagements, life stressors, guardians who might work evenings, and mental health professionals with very few appointments outside of school hours.
So how do we get students the mental health services they need, provide them in the place they are, and coordinate with everyone in their lives so services are the most impactful and generalizable as possible?
The idea
What if we take this concept of wraparound services and apply it to all students? What if the student doesn’t have to have an identified disability in order for us to think about their care in this way? Okay, okay, let’s talk about the elephant in the room for a minute. Funding. The reality is that school funding is tight, and it is designated to go to certain places. There isn’t a lot of wiggle room to fund the staff and resources to build the school programs of our dreams. But, what if that’s the very reason wraparound services could work? We know that schools are the best place to provide the service, but rather than asking them to own, determine and organize ALL the services a student might need, let’s get the village involved.
How is this different from what is already happening? It’s not like parents aren’t involved in their child’s education or medical information doesn’t get relayed to school personnel. The difference is collaboration, very regular check-ins, the commitment of all parties to be active problem solving participants, and — most importantly — not limiting the services to special education. One thing the pandemic confirmed is that more children and adults are struggling with mental health than we previously identified. And, many who were not previously struggling are now. Many of them are still isolated.
On the positive side, the pandemic also let some people experience teletherapy, remote workplace collaboration, and an expansion of access to technology for many. All of those things really lend themselves to changing wraparound strategies, which is free. The very idea of wraparound services — connecting ALL the people in the student’s life that have relevant information and influence so the school can provide the best service possible — is conducive to teletherapy and remote services.
Where to start?
The only thing any of us can do is start where we are. Teachers, guardians, therapists, doctors and anyone involved in existing wraparound services can begin thinking how using remote resources can be implemented into existing services OR suggested as new children are identified.
Once we start to shift our thinking to efficient and effective ways to connect and coordinate care, we can start considering how we can apply that methodology to students who may not have identified disabilities but have current needs. How can the team coordinate that same cross functional care for students experiencing things like trauma or grief? The care has to coordinate from all directions. If a doctor has input (and permission) that can be useful for the school, the doctor should actively reach out to discuss with the wraparound team. Some guardians might prefer to get coaching remotely. Are there parents/guardians who may be more willing to engage in the services if they were offered remotely? Is there a parent/guardian who struggles to get to the school for team meetings and could really benefit from remote collaboration?
And what about the students themselves? Would offering teletherapy be beneficial for the student in all settings? What are the student’s preferences? Would teletherapy allow the school to contract enough staff to counsel students at the time of day that works best for them and their school schedule?
School might look different in the online age. There are traditional schools, fully virtual schools, hybrids, and many charter variations. Regardless of the setting — and maybe because of the number of options — teletherapy and remote coordination may be the only way we are going to reach our goals of truly coordinating mental health services. Schools are the right setting, and they can do it, they just need help. Let’s wrap around schools so they can wrap around children.
Stephanie Taylor, Ed.S, NCSP is the clinical director of psychoeducational services at PresenceLearning.
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