Assessing behavioral distress of high-risk student using an innovative school and community health approach of shared medical, educational, and economic data

The psychosocial needs of school children often can exceed the capacity of schools. Children and their families need to be identified expeditiously for appropriate intervention. Systematic identification, referral, and tracking of the highest-risk students can increase access to quality services and demonstrate the value of an integrated medical-educational approach in facilitating early detection and intervention towards improving children’s health and education outcomes.

Health Choice Network (HCN) operates 93 school health clinics in Miami Dade County Public Schools, in collaboration with member FQHCs, providing basic school health services to more than 75,000 students. HCN’s New Directions efforts targeted schools in Liberty City, which is an economically distressed community, with 60% of children living below the federal poverty level. These children also face academic challenges, with chronic absenteeism (>20 absences per year) being 40% higher in elementary, 138% higher in middle, and 115% higher in high school than district-wide averages. The goal of HCN’s New Directions project was to design an integrated medical-educational approach that facilitated early detection and intervention to improve children’s health and educational outcomes. Their project involved developing an algorithm to rapidly identify youth with behavioral problems using data from their integrated Electronic Health Record system and their CHEER (Children Health Education and Economic Resource) database, which tracked education progress and physical health of school children to link them to a collaborative network of services.

Through this, SBHC practitioners identified mental and behavioral health risks using the information in the CHEER system to pinpoint students in need of early intervention. HCNFL worked with the Miami Children's Initiative to develop a coordinated network of community-based organizations for services to children with characteristics for behavioral distress and their families. This approach aims to decrease physical and mental health disparities by targeting underserved and minority populations, creating a healthier environment for future generations.