(PS10-44) Exploring Changes in Mental Health Services Needs and School-based Behavioral Health Services Utilization Following the Maui Wildfires

Abstract Text: In January 2023, Hawaiʻi’s Department of Education (DOE) School-Based Behavioral Health (SBBH) system implemented an electronic health record (EHR) system in which therapists document behavioral health services and activities provided to students across the state. This EHR system permits analyses to examine data on service utilization and identify trends that may assist the DOE in anticipating changes to SBBH service needs. In August 2023, the island of Maui was devastated by wildfires that destroyed over 3000 properties, displaced over 9000 people, and caused 101 deaths.

Research exploring the impact of natural disasters generally suggests that affected youth experience increases in behavioral health symptoms, including depression, suicidal ideation, and post-traumatic stress (e.g., Brown et al., 2019; Tang et al., 2014); however, several studies have noted that acute symptoms are likely to spontaneously improve within six months post-disaster, and those not showing signs of psychological recovery by the six-month marker are more likely to require behavioral health services (e.g., Newnham et al., 2022; Shi et al., 2016). Thus, maintaining access to SBBH services for youth in the months following natural disasters is likely critical in supporting their psychological recovery (Hassan & Mahmoud, 2023).

This study aims to further our field’s understanding of how EHR systems can support and inform SBBH program planning and services to meet student mental health needs following a disaster. Per 2021-2022 DOE census data, students enrolled in Hawaiʻi’s public schools are ethnically diverse (e.g., 23.6% Native Hawaiian, 22.3% Filipino, 19.8% White, 8.9% Japanese), with 50% of students identified as economically disadvantaged. This study will analyze trends in EHR data collected from January 2023 until May 2024 and explore changes in patterns of service utilization before and since the Maui Wildfires. The dataset will include all SBBH encounters from 278 DOE elementary, middle, and high schools across six Hawaiʻi islands (i.e., Kauaʻi, Oʻahu, Maui, Molokaʻi, Lānaʻi, and Hawaiʻi). Data will be aggregated at the island level to account for displaced Maui youths who either permanently transferred to the other Maui school district or temporarily attended another school but later returned to their original school after it re-opened. Descriptive time series analyses will explore for changes in:

1.     Student absences from scheduled treatment sessions

2.     Relative percentages of Encounter Types (e.g., SBBH encounters with students with formal qualifications vs. not identified under IDEA/504)

3.     Relative percentages of ‘Contact Methods’ (e.g., walk-in, crisis, consultation, in-class, parent sessions)

4.     Session lengths (i.e., mean session minutes by Contact Method)

5.     Most endorsed treatment targets and practice elements per month

Results will help guide local and national school mental health efforts for supporting the behavioral health needs of students following a disaster, inform administrative decisions that serve the mission of delivering effective and timely school mental health services, and help mitigate the negative effects of disasters on youth mental health.