October 1st, 2011

Program provides rest stop for students after hospitalization

For teens who aren’t ready for their regular classrooms following a short- or long-term medical absence, a Massachusetts public-school program provides a safe place for them to ease back into the setting where they may learn while they heal.

The Brookline Resilient Youth Team (BRYT) is run by the Brookline Community Mental Health Center, which for 50 years has provided a safety net woven of treatment and advocacy services to children, adults and their families suffering serious mental health disorders.

BRYT started in 2003 when staff – comprised of medical doctors, licensed psychologists, occupational therapists and social workers – noticed a
rise in kids who had been discharged after medical or mental health hospitalizations and returned to school unable to handle their classes and overwhelmed by fears of failing.

“The expectation of school is that [students] will go back and take the English test that was scheduled for the day after their return,” says Henry White, M.D., BRYT’s clinical director. “We saw – often – kids having to repeat a year and suffering a decline.”

White has been at Brookline CMH Center since 1984 and with BRYT since its inception. He says that when kids are in crisis, they may physically be in school but can lack the focus to fully function. School positively lets them see friends and get back into a routine. But, there are times when they’re just not ready.

Housed inside Brookline High (the model is spreading to other locations across the state), when students feel overwhelmed by re-assimilating after treatment for depression, bipolar disorder or a serious sports injury, they may complete their assignments for either all or part of a day in a room staffed by two clinical coordinators (who are psychologists or social workers) and a classroom aide. Staff members monitor their day-to-day progress and help with classwork.

Any student returning to school after a psychiatric hospitalization or prolonged hospitalization may go to the BRYT room. Typical stays are two to three weeks for either a few hours to all day, with the time diminishing as kids get stronger. According to White, some 90 percent of those who use BRYT complete their schooling uninterrupted…a satisfying statistic when the normative relapse rate for hospitalized adolescents is between 20-25 percent.

White says BRYT’s school-based location makes it a welcome healing respite for children and at times has brought together unlikely students who wouldn’t have connected if not for their ailments.

“The captain of the football team recovering from a concussion and a kid with an autism spectrum disorder may never have seen each other, but they are able to see each other [through BRYT],” says White. About 20 percent of BRYT students are healing from strictly medical issues like cancer or mono. The rest were hospitalized for mental health issues.

The Brookline Mental Health Center funded BRYT from a grant from Blue Cross of Massachusetts. Part of its allure is that because BRYT staff members are located in

Brookline High, coordinating with the school nurse and guidance counselor lets them know when children will return from their hospital stays. They then can reach out to parents, students and their medical “team,” and notify them that there’s a place to go in school if their regular classroom – or even socializing in the cafeteria – becomes too much.

White says BRYT is creating a manual and is planning a major model evaluation to develop evidence-based data showing the cost savings to schools and communities by having in-school supports like BRYT available to all students. “In-school staff recognizes how important this is,” says White. “We know it’s effective. We want it to become a national model.”

By Jennifer E Chase

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