How One Pennsylvania School District Tackled Student Mental Health

Key takeaways from our conversation with Garnet Valley School District leaders

Terri Bracken, Director of Special Education and Student Services at Garnet Valley School District, described their approach to student mental health needs as a constant challenge to connect struggling students with care, only to face waitlists, insurance barriers, and family scheduling conflicts.

In our recent discussion, Terri and Dr. Kim Doyle, Supervisor of Social and Emotional Wellness, shared their district's journey to expand mental health services—amongst the many challenges districts are facing right now. 

The Reality on the Ground

Garnet Valley sits in southeastern Pennsylvania, bordering Delaware and the Westchester area. By all accounts, they have abundant community resources: CHOP, DuPont Hospital, numerous private providers. But as Terri explained, resources on paper don't always translate to accessible care.

The barriers were significant:

• Long waitlists: 3-6 month waitlists for community mental health services (a problem that persists well beyond COVID)
• Insurance limitations: Many private providers don't accept insurance or Medicaid
• Family logistics: Busy schedules make prioritizing mental health appointments difficult, especially for families with multiple children
• The ripple effects: Students unable to access care meant increased counselor office visits, nurse visits, classroom behavioral challenges, and truancy—overtaxing already stretched school staff

As Dr. Doyle put it: “We have this huge resource list...and parents were just coming up with 3-6 month waiting lists. That's frustrating to teachers, because if we're not able to get students into care as quickly as we would like, that filters into the classroom in terms of attendance and behavior.”

The Evolution to Comprehensive Mental Health Support

Garnet Valley's mental health support system evolved gradually:

• 8 years ago: 6 hours per week of contracted mental health services, primarily for re-entry support
• Post-COVID: Expanded to full-time, then 3 full-time mental health therapists
• Full-time hire: Created a dedicated Supervisor of Social and Emotional Wellness position
• Still needed more: Staffing instability remained a challenge

This is where teletherapy entered the picture. After connecting with Cartwheel at a local conference, the team saw an opportunity to fill critical gaps—particularly for their eSchool students and those struggling with school avoidance.

Why Teletherapy Made Sense

The decision to add teletherapy wasn't about replacing school-based services—it was about creating options that met students where they were.

The flexibility factor

Dr. Doyle highlighted a crucial insight: “Many of our students and families are very academically oriented. Students don't want to miss class, they're involved in sports and clubs...they were forgoing mental health treatment to stay on par academically. Virtual services created a better option where they could schedule around the things they were already doing—after school, in the evening, or on a Saturday.”

Reducing stigma

Despite increased awareness around mental health, Terri noted that stigma remains real: "There's still distrust—families worry everyone will know their child's business if they're seeing a therapist in school. Cartwheel is more private, even though therapists still participate in our team and IEP meetings to support students."

The team shared one particularly resistant student case where teletherapy helped break down walls and build trust in a way school-based services hadn't been able to achieve.

Reaching school-avoidant students

This was a game-changer. Terri emphasized: "If we have kids in eSchool because of social anxiety or school avoidance, that makes me nervous—they're sitting at home all day, sometimes home isn't a great place. If they can have additional support that still connects them to the school district, that's really important."

Teletherapy provided a bridge—allowing these students to access clinical support while staying connected to their school community.

Building the Internal Case

So how did they get buy-in from leadership and the school board?

Their approach:

1. Socialized the idea at cabinet level first
2. Gathered comprehensive data through universal screener results, counselor/nurse office visits, attendance patterns, reentry data, emotional support IEP data, SAP referrals
3. Created fictional student profiles based on real scenarios to help stakeholders understand the human impact
4. Presented authentically to different stakeholder groups

Terri noted that their school board is "very in tune with what's happening in our schools" and appreciated seeing both the data and the real-life context of what students were experiencing.

Shifting From Punitive to Supportive

One of the most powerful aspects of this conversation was Terri's candid discussion of how mental health support changes the district's relationship with families.

"The supportive measures available to us for truant students are very punitive," she explained. "Families have to go to court. It's intimidating and inconvenient, and that sets us up with an adversarial relationship. When we can't get a child to school, that often sparks a legal matter."

Teletherapy offers a different path: "We can say, yes, we still have to refer your child to truancy because that's the law, but we're not doing this in a punitive way. We have this support in the meantime—a quicker way to get support in the hands of families right away, rather than waiting six months for community-based resources."

Measuring What Matters

Garnet Valley tracks success through multiple data sets:

• Attendance data (especially for students with truancy concerns)
• Reduction in counselor/nurse office visits
• SAP referral trends
• Risk and threat assessments
• Teacher feedback
• Regular communication with therapists about student progress toward goals

Dr. Doyle emphasized the value of collaborative relationships: "The Cartwheel therapists are very open, flexible, and informative. They've attended IEP meetings and reentry meetings to give their perspective on what's happening outside of school and how we can bridge home and school."

Key Takeaways for Other Districts

If you're considering how to expand mental health support in your district, here's what stood out from Garnet Valley's experience:

1. Layer your supports, don't replace them: Teletherapy complemented rather than replaced school-based services. Even fully staffed, they still utilize teletherapy for students who need it.

2. Build your MTSS carefully: Dr. Doyle stressed making appropriate referrals: "We want to make sure we're not referring any and all students to mental health services. We're putting Tier 1 and Tier 2 interventions in place—groups, mentors—to make sure the student receiving a clinical referral really needs that level of care."

3. Address the insurance barrier: Medicaid acceptance was crucial. As Dr. Doyle noted: "We have a number of families with Medicaid or state insurance that isn't taken by many providers in the area. That's been a huge help."

4. Make it family-friendly: Services need to work with family schedules, not against them. Evening and weekend appointments reduce barriers.

5. Maintain school connection: Even when services happen outside school, collaboration keeps students connected to their school community and ensures coordinated support.

Interested in learning how teletherapy could support your district's mental health initiatives? Schedule a conversation with our team to explore what's possible.