December 8, 2017
Health Care Heroes Awards

IHS' early intervention addresses children's mental-health needs

(Pictured from left) Mindy D'Andrea, East Hartford school readiness administrator; Sarah Cabahug, IHS ADAPT coordinator; Robin Bucki, YWCA school readiness director; Debbie Poerio, IHS president/ADAPT; Brittany Butler, YMCA school readiness director; Manny Silva, Silva's Youth of Today.

Category: Advancement in Healthcare — Prevention

Integrated Health Services

Address: 63 Burnside Ave., East Hartford

Top Executive: Deborah Poerio, President & CEO

While birth-to-three programs provide support for babies and public elementary schools have special education, the preschool population is often left out of the early intervention conversation.

That's not the case in several schools in East Hartford thanks to Integrated Health Services' new preventative health ADAPT program.

Dr. Deborah Poerio, president and CEO of IHS in East Hartford, decided to look into the need for early intervention when her research showed massive increases in behavior-related referrals from IHS' school-based medical centers.

She based her doctoral thesis on creating a program to address the mental-health needs of young children. That, in turn, lead to the development of ADAPT: Assessing Development to Assist Preschoolers in Transition, which provides behavioral health screening and on-site treatment.

"Providers, for years, have been saying the kids have issues that are more severe than the typical early childhood teacher can handle in the classroom," said Mindy D'Andrea, East Hartford School Readiness Coordinator.

She and Poerio work in tandem to bring mental health diagnosis and behavioral plans to East Hartford preschool providers, including the local YMCA and YWCA. Sarah Cabahug serves as the coordinator embedded into the East Hartford schools to establish continuity, familiarity and trust. She identifies and creates treatment programs and coordinates out-placement referrals and services.

ADAPT was piloted in 2014 for a three-year period. Approximately 500 children were asked to participate and more than 400 parents agreed. According to Peorio, IHS determined that 21 percent of the children were at-risk for emotional and behavioral problems and 11.9 percent registered as high-risk (or clinically impaired). After working with a licensed social worker for customized intervention, leaders saw a significant improvement in classroom behaviors.

It's a preventative approach that brings the providers, parents, children and Cabahug together to identify and address emerging behavioral or learning issues that may become unmanageable if left untreated. Without the interventions, preschoolers are disenrolled, teachers burn out and other parents pull their children out of the programs because of the disruptions.

"We are really trying to keep these kids from getting expelled, now or in the future," said Jill Holmes, IHS' operations director.

Currently, ADAPT serves about 300 children, many of whom suffer the effects of domestic violence, family deaths, sexual abuse, parental incarcerations and removal from the home. Evidence-based and trauma-based preventative care helps them cope and stay in the school programs. Poerio plans to offer ADAPT at the Riverside Magnet School in East Hartford, which could help another 200 children.

"We need to identify these students early to get to the root of the behaviors and get these kids treatment," Poerio said. "It's important to grab the parents early, when they are young they want to be involved. They are getting their kids to medical care, but there's often no thought to behavioral health."

According to D'Andrea, the assistance "empowers parents to start the journey (for public school services) because parents can be intimidated. Now they can ask for these services."

Poerio credits the Hartford Foundation for Public Giving for investing $240,000 in the program and when the three-year funding expires, she is confident IHS can find money to keep it operating.

Still, it's more about the approach than the money, Poerio said.

"Oftentimes there are resources, but they need to be reallocated to fit the current need," she said.

Needs-based programming is a hallmark of IHS, which operates school-based health centers in the Connecticut River Academy and Riverside Magnet School. Funded since 2007 with $1.8 million in state, federal and foundation monies, all students (even those uninsured) receive immediate access to medical, behavioral and dental services.

The availability of on-site care results in reductions in absenteeism for doctor's appointments and sick days and overall healthier students. It's a service kids use. In fact, IHS reports 5,827 visits for medical, dental, and behavioral health services during the 2013-2014 academic year.

According to Poerio, a school nurse cannot diagnose and treat, but a nurse practitioner from IHS can treat asthma, give a child pain reliever for a headache or an antibiotic for an ear infection and send that student back to class.

IHS is branching out into college health services this year partnering with Goodwin College to provide individual and group counseling, medical services, acute and well care, immunizations and access to dental services at a new facility in East Hartford.

After serving more than 4,500 children and families, IHS is poised to grow into the future.

"I would love other communities to have access to programs like this," Poerio said.

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