{MORE STORIES IN THIS SERIES}
- Social Workers Down the Hall: A Case Study of Integrated Care
- Project Gives Southern Miss Social Work Interns Real-World Experience
- For Coastal Family Health Center, Integrated Care is Just Good Business
- Every Tuesday, the Homeless are the Priority at This Biloxi Clinic
Natasha King is helping with bullying at schools in the Moss Point School District in Jackson County, Mississippi. But she’s not a school resource officer.
King helps with obesity and diabetes prevention, but she’s not a doctor. And she provides behavioral health care, but she’s not a psychologist.
King is actually a social worker, employed until recently by the University of Southern Mississippi but working with Coastal Family Health Center through a grant project. But she spends the majority of her work schedule in one of four Moss Point schools Monday through Thursday, part of an outreach program between Coastal and the school district.
Adding Behavioral Health Services
Coastal, a network of 13 facilities in 10 south Mississippi cities, has provided medical care such as immunizations and daily health visits at Moss Point for more than 15 years. But behavioral health services have been offered only since being added in January 2018 to a memorandum of understanding between the health care provider and the district.
What would it take to get into Moss Point with the medical team?”
King, in fact, helped get the MOU amended.
“I knew Coastal had behavioral health in Leakesville schools (in Greene County),” she says. “I went to our program manager at the clinic and said, ‘What would it take to get into Moss Point with the medical team?’ I got a meeting with the superintendent, myself, our program manager and our outreach coordinator. We got it approved by school board and had me added to the MOU.”
Helping Ease Counselors’ Workload
King says school counselors get pulled in so many different directions that they don’t typically have time to help with behavioral health issues.
“They’re doing crisis intervention one day and then maybe working on class schedules and state tests the next,” she says.
She spends one day at each of the district’s four schools: Moss Point High School (ninth grade through 12th; Magnolia Middle School (sixth through eighth); Escatawpa Upper Elementary (third through fifth); and Kreole Primary Elementary (kindergarten through second). Issues vary by age.
“At the high school, I would say it’s more depression and sometimes anxiety,” says King, a 2014 graduate of the School of Social Work at Southern Miss. “At the middle school, I noticed this year there are a lot of issues with bullying, kids going to self-harming, depression, some becoming suicidal. At the upper elementary, I see about five children, and the issues vary: behavioral, family dynamic issues such as divorce and grief. At the lower elementary, it’s more of children with behavioral issues.”
From February 2018 to mid-May and continuing through the new academic year in fall 2018, she had more than 180 behavioral health appointments. She has about 15 regular students whom she sees weekly.
Care at No Out-of-Pocket Cost to Families
Angelica Trieu, a pediatric nurse practitioner with Coastal, saw King’s work firsthand when she was working in the Moss Point schools as a medical provider.
If we can get into the schools early enough … rather than catching them at the other end … it’s a lot better.”
“It has been great, especially with the demographics there; it’s a low socio-economic area,” she says. “And it helps to have Natasha there for counseling, mental health, behavioral health.”
Coastal bills the insurance of students who have coverage, but uninsured students are not charged.
“Those are big benefits we sell to parents,” King says.
Dr. Michael Dorcik, Coastal’s chief medical officer, says the kind of care – both medical and behavioral – that is provided is not about financial gain. The opposite, in fact.
“You’re not in it to make money,” he says. “The money, I can assure you, is not worth it.
“I feel if we can get into the schools early enough and start helping them rather than catching them at the other end and things are starting to go bad for them, it’s a lot better for everyone all around.”
Eliminating Transportation Issues, Minimizing Lost Class Time
Because King sees students at the schools, transportation is not required. And scheduling is based around students’ activity periods, like physical education, so they do not miss academic class time.
They’re at a vulnerable age, especially in middle school.”
“The school district is very strict about kids being in classes,” she says. “We don’t pull them out of any core classes. Sessions are about 30 minutes; we don’t want to keep them out for too long. I want them to be in class as much as anyone else.”
Despite the free care to students and conveniences of onsite appointments, there are still occasional issues with consent forms that can limit King’s impact. Sometimes parents won’t sign, or forget to sign, to allow their children to be treated; sometimes when parents agree, the students misplace the forms or never return them.
“It’s frustrating knowing they have issues and need help,” King says. “They’re at a vulnerable age, especially in middle school, if you don’t follow up with all the steps to get them taken care of.
“I’ll get referrals, especially from the medical practitioner at the school; I’ll see a need, she’ll see a need, but the kid refuses to see me. I don’t force it. I call the parents, of course. If the parent says it sounds great … but if they say no, it’s a no. Sometimes they leave it up to the kid, which is also infuriating because I know they need help.”
A Continuing Presence in Moss Point
Measuring success is difficult because she doesn’t get access to behavioral reports from all schools. Anecdotally, she knows in some cases there has been a drop in reports, meaning students are behaving better. Her work is making a difference.
King is committed to continuing at the clinic. She has created her own behavioral health referral form that teachers, parents and administrators use when sending students to see her. She has utilized obesity- and diabetes-prevention programs developed at Coastal that can be tailored for children.
“I think social workers are needed in schools,” she says.
And that’s where she’ll be. Though she transitioned in December to a full-time Coastal employee as the grant project wrapped up, you’ll still find her four days a week in one of the Moss Point schools.
{MOSS POINT/MISSISSIPPI POVERTY & INSURANCE DATA}
Data from the nonprofit KidsCount show 28 percent of Moss Point students lived in poverty in 2017, the most recent year available; 82 of 149 schools statewide had a higher percentage in poverty. Other districts in the county had lower rates, including Pascagoula (27 percent), Ocean Springs (18 percent) and Jackson County (17 percent).
County-by-county data on uninsured children are not available from KidsCount, but statewide, only five percent of children were uninsured in 2016, compared to 13 percent in 2008. At a national level, the number of uninsured children was four percent in 2016. County Health Rankings & Roadmaps – an online database from the Robert Wood Johnson Foundation and the University of Wisconsin – rates Jackson County as the ninth-healthiest county in Mississippi based on a number of factors.
Mississippi had the sixth-lowest rate (4.8 percent) of uninsured children in 2017 among states that did not expand Medicaid, according to a November 2018 report from the Georgetown University Health Policy Institute’s Center for Children and Families. But it still had the 22nd-worst rate overall; 21 of the 22 with the lowest ranking of uninsured children were states where Medicaid expanded.
In terms of overall population, though, only six states have higher rates of uninsured than Mississippi’s 12 percent, according to 2017 U.S. Census data: Texas (17.3), Oklahoma (14.2), Alaska (13.7), Georgia (13.4), Florida (12.9) and Wyoming (12.3).
The Southern Miss School of Social Work 