This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

Thanks to expanded funding, more Michigan schools are supporting their students' mental and behavioral health. However, managing mental health support services for the hundreds or thousands of students enrolled in any of Michigan's intermediate school districts (ISDs) is no simple task. That's why the Michigan Department of Education (MDE) is making mdlogix bhworks behavioral health software available to all 56 of the state's ISDs. 

The software electronically manages and merges referrals, screenings, consent forms, assessments, treatment plans, and confidential communications among parents, teachers, and providers within one secure, HIPAA- and FERPA-compliant system. K–12 schools in 21 Michigan ISDs are already using the software to help therapists, counselors, and social workers streamline tasks and increase time spent actually seeing students. Another 10 Michigan ISDs are set to launch the software soon.
Diane Golzynski.
"Our goal is to streamline the work as much as possible so we can maximize the providers' time with kids," says Diane Golzynski, director of the MDE Office of Health and Nutrition Services. "This software really is meant to help us get to that point."

When Scott Hutchins joined Golzynski as school mental health and Medicaid consultant for the Office of Health and Nutrition Services in 2020, he began fielding a lot of questions from ISDs about how they ought to implement mental health supports in their schools. He discovered that they lacked a consistent way to organize referrals, utilize assessments, and share information. The bhworks platform helps providers serving the state's students to save time, work more effectively, follow evidence-based standards, and leverage best practices. The platform is designed to address students with depression, trauma, anxiety, substance use, and eating disorders — and reduce risks for self-harm, violence, and suicide.

"They were spending a lot of time really not doing what they were intending to do, which is providing direct services to students," Hutchins says. "They had a lot of ancillary things. We wanted to find a platform that would streamline best practices for standard operating procedures."

Building a better system

Copper Country ISD (CCISD) was the first ISD to pilot the software. CCISD oversees schools across a huge geographic area in the northern tip of Michigan's Upper Peninsula — Houghton, Baraga, and Keweenaw counties — serving approximately 6,600 students in 14 local school districts: nine K-12, one K-8, and four K-6 districts. With CCISD's feedback, mdlogix tweaked the software to better meet Michigan schools' needs. 

"We wanted a central referral system and a way we can keep all of the information in one area," says Natalie Morgan, CCISD mental health services coordinator. "We did have a spreadsheet to keep track of paper referrals that schools had to fax to an office. Sometimes, some of those fax machines were not working. Also, consent papers get lost when students take them home for parent permission signatures."
Natalie Morgan.
CCISD assigns each of its mental health therapists to only two or three schools. This allows them to build relationships with their schools' administrators and determine the best ways to service students in the school. Because CCISD covers such a large area, this also reduces what Morgan calls "windshield time." She believes bhworks software will reduce it even more.

"This past summer we were able to do [a social-emotional learning] screener with some students in a summer school program that helps us to gather information and have it all in one spot," Morgan says. "We want to do that with more classrooms and more schools to get a baseline idea where students are with social-emotional learning."

CCISD plans to use the software to facilitate more mental health screenings with individual students, classrooms, and even entire grade levels.

"If you use a screener that's within bhworks, it's automatically scored and sent back to the provider or the administrator," Morgan says. "They're going to get immediate scores back that says this student is indicating high for depression or anxiety, or the student has indicated substance use disorder, or possible suicide ideation. So again, instead of waiting long periods of time … all of that is instantaneous, as soon as that child hits 'submit' on the screener."

And, when screenings indicate an issue, referrals are made much more quickly. Hutchins says that before bhworks was implemented, "everybody was doing something different" for referrals. Referrals might be in the form of an email, a Google form, a fax, or a phone call.

"bhworks allows everybody to have a consistent referral process," he says. "Now they are starting to see students within 24 hours of a referral when before it could be days, if not weeks. … Now we're talking almost immediate treatment for these most vulnerable students, which is just again a complete game-changer for our ISDs."
Scott Hutchins.
The software also allows mental health providers to initiate virtual telehealth visits with students, overcoming another common challenge for ISDs.

"This feature allows students and providers to still meet if the student is absent from school or the provider is unable to be at the same physical location as the student," Hutchins says. "This has been utilized often by ISDs when students or staff have had to be quarantined for COVID protocols, and also to continue services for some students over the summer when school was not in session."

"This is about the future of Michigan's kids"

According to a brief by the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration, one of every six students copes with a mental illness that increases likelihood of school absences, suspensions, expulsions, and academic failures. Even before COVID-19 impacted mental health across the board, 17% of U.S. students in grades nine through 12 seriously considered attempting suicide. Only one-third of adolescents with mental illness go on to post-secondary education. On the bright side, the brief says, "early detection of mental health concerns leads to improved academic achievement and reduced disruptions at school."

"If we haven't taken care of the basic needs of that student, so that they feel safe and secure and wanted in that space, they'll never learn to their potential," Golzynksi says. "This is about the future of Michigan's kids. And if we believe in Michigan's future, we have to give the kids the best possible chance that we can."

According to the National Center for Biotechnology Information, COVID-19's impacts on Michiganders' mental health are extensive and have the potential to impact large swaths of the Michigan population, including children. The ultimate goal of implementing the bhworks software throughout Michigan's ISDs is to help those children overcome those challenges, do well in school, and succeed as adults.

"It's our job to help students to learn how to cope and manage their feelings. Bringing awareness and making mental health a lot less stigmatizing is one of the important parts, too, as well as letting students know that there are people that they can talk to, open up to, that there are adults that care about them," Morgan says.  "Studies have shown that students [getting mental health care] are more likely to attend school regularly and get better grades. For some students, the home environment is not where they can get that support. So being able to provide that at school is just essential to their overall well-being."

A freelance writer and editor, Estelle Slootmaker is happiest writing about social justice, wellness, and the arts. She is development news editor for Rapid Growth Media and chairs The Tree Amigos, City of Wyoming Tree Commission. Her finest accomplishment is her five amazing adult children. You can contact Estelle at Estelle.Slootmaker@gmail.com or www.constellations.biz.

Scott Hutchins photos by Doug Coombe. All other photos courtesy of the subjects.