LIU: From minor mental/behavioral health service to regional epicenter
Feb. 20—There was a time, say 15 years or so ago, when "Behavioral Health Services" was a small part of what the Luzerne Intermediate Unit did. The agency, which aids schools in all of Luzerne and part of Wyoming counties, primarily provided special education services to districts that couldn't afford to create and maintain their own special ed departments.
In 2005, Jennifer Runquist came on board at the LIU, soon put in charge of the Behavioral Health offerings. A 2009 story in the Times Leader archives about a monthly meeting of the LIU board of directors gives a hint at what it was like then. Runquist proposed the creation of a "Behavioral Health Team" to provide support to students throughout the region as needed. The board approved the plan.
Today, Runquist still runs the department, though she is working for her third LIU executive director, Tony Grieco. But a lot has changed. "It's a rather large department with a ton of offerings," Grieco said. For starters, "Behavioral Health Teams" have become common, now set up within schools to offer support, interventions and referrals to appropriate services on a daily basis.
"School-based health teams, we probably have about 500 students in those programs," Grieco estimated adding that it is usually paid for through insurance.
Other Offerings?
"We now run 20 outpatient sites. We have four partial hospitalization classrooms and two dual diagnostic classrooms, every one of them providing different layers of mental health services. We have a school-based partial hospitalization service at the new Wilkes-Barre Area High School. "
School-based outpatient support, in fact, "is one of our fastest growing services." It gets help more quickly to students because "they don't have to leave the school for a therapy."
Runquist noted the agency now has a full-time Board Certified Behavioral Analyst who "0ffers Applied Behavioral Analysis services" a form of behavioral interventions backed by "a lot of data." ABA once was primarily used for students with autism, but is proving effective with a wider range of student special needs.
And those issues can start young. "The largest growing population with ABA services is starting as early as three years old," Runquist said. "We get a lot of calls for kids in Head Start and pre-school."
The LIU's long history with special education students may have made it well prepared to expand behavioral and mental health services. Grieco points out that in both cases, the goal is to provide a "continuum" of care, trying to help the student in "the least restrictive environment."
And the demand keeps growing. "I came to the LIU in 2005," Runquist said. "We weren't seeing then what we see now. Now they come knocking at our door.
"Now we have a shortage of staff. There's a huge problem of families calling for services and having to go on a wait list."
The COVID-19 pandemic dramatically increased mental health problems in many ways, she said. Children lost their day care, parents lost jobs and agencies that provided services often found it hard to keep workers willing to go out into the community to provide needed help.
"The biggest problems now are depression and anxiety," Runquist said. "Kids are anxious more than ever before. And anxiety can lead to depression, and depression can lead to suicide."
The closing of First Hospital in Kingston made the supply and demand problem bigger. The LIU saw a surge in "the amount of referrals we get to partial and outpatient services." And the demand creates its own problem. "There is high burnout" among the therapists, social workers and specialists trying to deal with so many cases, Runquist said.
There is something on the horizon that may help. The LIU recently announced it will be part of a $7.2 million, four-year competitive grant program called Project AWARE, being done in partnership with the Montgomery and Carbon/Lehigh Intermediate Units.
An acronym for Advancing Wellness and Resiliency in Education" the AWARE grant was awarded by the Substance Abuse and Mental Health Services Administration. There are three components:
1) Expanding Suicide awareness training opportunities for students.
2) Developing and implementing a "universal mental health screening tool" for school use.
3) Creating an electronic data system that will quickly connect school mental health practitioners with community-based mental health providers who are immediately available to help students.
The universal assessment tool and mental health electronic data and referral proposals are essentially being designed from the ground up. While most schools and behavioral/mental health agencies have some form of assessment, Runquist and Grieco said it tends to be a patchwork, or it may not be adequate in all cases. A universal, online screening tool would speed up detection and potential decisions on services.
Those involved in Project AWARE are working with Children's Hospital Of Philadelphia (CHOP) on developing an electronic referral system. Runquist said CHOP has a similar system already in place for medical care. The idea is to have a real-time database "that has all of the agencies available for children that need mental health services," identifying those with available beds for inpatient, partial hospitalization or available professionals for other needs.
"The nice part will be having people there to help the families get services in a much more efficient manner, not by calling a number of different providers and waiting to get an appointment," Runquist said. "We get calls from families, they tell us it is taking six to eight weeks to get an appointment."
The electronic system and universal screening tool would better streamline student services among different agencies and professionals, Grieco said.
"We want to have standardized assessment and tiers of service. The new database can move student records with the student, rather than starting at step one each time a student gets a new service or agency."
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Reach Mark Guydish at 570-991-6112 or on Twitter @TLMarkGuydish