Serving High-Acuity Needs and Improving Student Mental Health Outcomes with a Telehealth Emergency Response Team

By Mantra Team

Posted: June 07, 2023

Concerns over student mental health have risen on campuses across the country. According to the latest Healthy Minds Study, 23% of students reported severe depression, 18% reported severe anxiety, and 15% reported suicidal ideation. Among LGBTQ+ young people, in particular, 41% seriously considered suicide in the past year. 

Higher education institutions continue to face an increased demand for higher levels of care, but are far too often constrained by budget, resources, and limited access to psychiatrists and therapists with expertise in working with the college population. Looking for additional ways to support students with moderate to severe depression, bipolar disorder I and II, complicated ADHD, suicidal ideation, and other psychiatric conditions, many institutions are considering or already turning to innovative partners.

The challenge is finding the right partner who understands the nuances of collegiate mental health, has established crisis response best practices, and is equipped with the right team, systems, and resources to meet the complex needs of students with psychiatric conditions, as well as students at risk or in crisis. 

“Nobody knows the students and the community better than the people on campus,” says Nora Feldpausch, MD, Medical Director at Mantra Health. “Which is why external providers need to be transparent about their systems and protocols, be prepared and able to quickly and effectively collaborate with on-the-ground providers, and have the ability to integrate their crisis response protocols into the institution’s existing campus model.” 

Following a Standard Level of Care 

Mental health crises are inevitable. Even with preventative measures in place, clinicians must always be trained and prepared to assess for crisis or suicide risk, especially in a telehealth setting. 

At Mantra Health, we’ve built a level of care into our clinical model and proprietary software systems to ensure that students are protected and the right stakeholders in our clinic and our campus partners are notified should a crisis situation arise or require de-escalation. Our approach helps on-the-ground clinical teams continuously monitor students in care, manage safety risk, collaborate directly with our team, and ultimately support student well-being and persistence. For universities and colleges without those resources, our systems reassure campus leaders that their students are being supported with the highest level of evidence-based resources and care. 

Mantra Health leads the industry in supporting students with high-acuity needs. We have created our own crisis response best practices, which include, but are not limited to the following:

  • Rigorous safety planning that meets or exceeds evidence-based standard of care requirements is available to on-the-ground clinicians and our providers during video sessions and in the student’s electronic health record (EHR). This means it can be accessed by the student or any member of the treatment team either within Mantra or on-the-ground at any time.
  • An alert system notifying on-demand, highly-trained Mantra Health crisis intervention experts if a clinician is navigating a student crisis and needs immediate support. Our clinical risk support expert or, if appropriate, a university crisis team member can also join the video call to support a crisis intervention. 
  • A trained on-demand crisis intervention team that can first guide the provider in determining if hospitalization can be safely avoided and second, if needed, ensure that the hospitalization process follows university-established protocols. 
  • A culturally informed script for interacting with emergency responders which equips the right people with the right information to quickly, safely  and effectively transport a student to the appropriate local crisis resources while minimizing the potential trauma of transport.  
  • A comprehensive record of resources that is co-developed with our partner institutions, ensuring that every Mantra Health provider understands what on-the-ground and community resources are available to each individual student and can share that information with students or family as appropriate as part of our holistic student-centered approach. 
  • A post-hospitalization care continuation plan personalized to each institution’s needs and resources, which is implemented upon a student’s return to campus. 
  • A patient population monitoring system available to clinical leaders at our partner institutions, and followed closely by our clinical team, enabling ongoing visibility into the risk levels, safety plan status, diagnoses and appointment attendance for all higher risk students in our care. This allows partner institutions the transparency needed to understand the status of every student as well as the level of support being offered that those students are getting. It also gives partners and our clinical team the information needed to collaborate effectively and efficiently on these cases when needed.
  • Access to the Collaboration Portal where safety plans, patient progress, and prevalent data is shared between providers in our system and our clinical partners at the college counseling center, so decisions can be made around patient care and student population needs and communication is easy, fast, and HIPAA and FERPA compliant.

Our clinical staff work closely with board-certified psychiatrists (MDs) who have experience in assessment treatment of higher risk students as well as training in telehealth crisis response. These experienced psychiatrists are also available to work with students with bipolar I and II, severe depression, suicidal ideation, and other high-risk mental health conditions. 

“No matter if a student is going in-person to their counseling center or showing up to a virtual session, you want them to have an equitable experience and receive the same high-level of care,” says Dr. Feldpausch. “We made this happen at Mantra by starting with established in-person evidence based standards and from there building out our experienced team of crisis responders, an integrated system of communication, and a standardized protocolized response that also took into account local needs and services. This ensures every student is offered the support and attention that they deserve. When a campus is looking at life and death, this quality of response is critical.” 

Supporting Students with Psychiatric Conditions

Not every student at risk is in crisis – and quality mental health care can help prevent decompensation and hospitalization. For students with complicated mental illnesses or psychotic disorders such as Bipolar I, telehealth needs to involve the right people and processes that can safely treat higher risk disorders. 

Since launching our clinical program, we have successfully supported students with complex conditions, including those with Bipolar I who developed manic symptoms, and, in many cases, were able to treat them without having them hospitalized. We have also cared for students post-hospitalization (in collaboration with campus supports) for bridged care or ongoing care, supporting student retention and success.  

Students with complex conditions can easily slip through the cracks, if collaboration doesn’t exist between telehealth providers, counseling center staff, academic supports, and others in the community. Our crisis response and collaborative systems at Mantra Health, as well as the high-level visibility that we have built for partners makes it possible to keep these students safely in telehealth care. As a result, we’re able to break down barriers to access that have historically prevented students with these mental health concerns not just from staying enrolled in school, but also from achieving their academic and personal potential. 

“It's been a pleasure collaborating with Mantra Health on telepsychiatry services. Through our partnership, we've been able to access a psychiatric provider who treats bipolar and other psychiatric conditions and an MD who consults on high-acuity cases. This has allowed us to provide additional high-quality care to students with significant needs,” says Jeffrey E. Goldstein, MD, FACEP, Director of Health Services at Lafayette College.

Want to learn more about our approach to high-acuity care? RSVP for our July 19th webinar Tackling High-Acuity Cases in Higher Education with Telepsychiatry