As we approach the fourth anniversary of the Covid-19 pandemic which reshaped how health and mental health care are delivered to those in need, I’ve been reflecting on our journey in delivering mental health services to students and families. Together with our partner districts, we are innovating the model of how schools and community providers partner to address the student mental health crisis. We are immensely grateful to be on this path with our school partners.

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Fall '23 semester at a glance:

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60 school systems working with Cartwheel of all shapes and sizes

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1,500 students and families referred for clinical services

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Under 1 day between referral from the school and Cartwheel’s outreach to the family

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Under 10 days to the first available appointment with a licensed clinician

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10 languages represented in our Cartwheel Care Team

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What we’re learning – and how we’re responding:

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1. We received more referrals more quickly than expected. Our planning meetings with school teams over the summer allowed us to hit the ground running in the fall, which helped us get services to more kids more quickly than anticipated. However, this rapid increase in referrals created some short-term delays in families getting their services. We responded quickly by hiring more clinicians and working with school staff to triage needs. Moving forward, we’ll proactively flag to school staff when the volume of referrals is pacing ahead of schedule, and we’ll work together to ensure all students' needs are met.
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2. After being referred for services, families benefit from hands-on support to get to their first session. Our care coordinators play a crucial role in building trust with families, answering their questions, coordinating with health insurance, and providing appointment reminders. For many families, this extra support makes all the difference in getting the care they need. To ensure families continue getting this level of personalized support, we’ve hired 5 more full-time Spanish and English speaking bilingual care coordinators and implemented a new email and texting platform to help our care coordinators track outreach to families. This spring, we are also introducing a new web-based onboarding experience for families where they can submit all of their paperwork, consent forms, and insurance information in one sitting.

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3. School staff are eager for more collaboration with Cartwheel’s clinicians. We’ve seen particular interest in collaborating with our team to get the student to that first intake session (e.g., helping the family complete their paperwork or find insurance info) and generally staying in the loop as the student progresses through care. Our clinicians really appreciate this collaboration as well. To this end, we’re making a number of improvements to the Cartwheel Portal this spring to make communication easier and faster. For example, when school staff sign on to the Portal, they’ll be alerted to timely updates that they can take action on in collaboration with our care team.‍

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4. Afternoon and evening availability is in very high demand. We see the most interest in appointments between 3-8pm. To meet this need, we’ve brought on a dozen new clinicians who focus their clinical schedules during this time of day.

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5. More support for building administrators in setting up spaces to deliver clinical services on campus via telehealth. Some students do not have reliable access to a private space or wifi at home, so it can be helpful to receive their telehealth during the school day on-campus. We are getting more requests from administrators to assist with the logistics of setting up semi-private spaces on campus where certain students can receive services during the day. We hope to grow this program to ensure equitable access to care.

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6. Make resources and content more accessible. We’ve heard positive feedback on content we’ve provided including webinars for parents/guardians and worksheets for counselors to use with their students. In an effort to share widely, we have created a Resources Library on our website where you can access these resources.

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We greatly appreciate the collaborative partnerships we have built with our districts and we look forward to continuing to grow and improve our program. Together, we are helping kids get back to being kids. It is amazing to hear of the trusting, therapeutic relationships growing between students and clinicians. We look forward to connecting more students with our skilled providers this spring.

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Here’s to a bright 2024,

Joe English

Co-Founder and CEO, Cartwheel

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