The Brookline Center School-Based Telebehavioral Health (TBH) Program

Massachusetts School-Based Telebehavioral Health (TBH) Project.

About the Project:

The Brookline Center has assembled a diverse team and partnerships dedicated to:

• Increasing access to quality youth-centric behavioral health with a focus on mental health and substance use services in partnership with MA school districts and telebehavioral health service providers.

• A collaborative and culturally responsive approach across all statewide pilot planning, designing, implementation, and evaluation aspects.

• Integrating existing and innovative technology.

• Working closely with an Interagency Work Group with representatives from the MA Department of Public Health, Department of Elementary and Secondary Education, Department of Mental Health, and Executive Office of Health and Human Services.

Learn more about our project today:

• It is estimated that over 20% of all Massachusetts children aged 0-17 have a mental health disorder, and approximately half of all children with a mental health disorder are not receiving formal care (Whitney & Peterson, 2019). 
• Over 1 in 3 Massachusetts youth reported depressive symptoms in the past year and almost 1 in 5 seriously considered suicide (CDC, 2019). 
• Hispanic/Latino students in Massachusetts reported elevated feelings of being sad or hopeless as compared to all youth and Asian and Hispanic/Latino students were almost twice as likely to report having a serious suicide attempt than White students (10.9% and 10.8%, respectively, compared to 5.7%). LGBTQ+ youth reported the highest rates of suicidal ideation and attempts (CDC, 2019). 
• The rate of suicide attempts rose significantly for Black youth from 1991-2017 while their White peers experienced significant decreases in attempts during the same period (Lindsey et al., 2019). 
• Behavioral health problems among racial and ethnic minority youth often lead to school punishment or even incarceration, but rarely lead to mental health care intervention (Marrast et al., 2016). 
• According to a 2021 survey by Mental Health America, Massachusetts ranked 39th out of 50 states in terms of youth with major depressive episodes who did not receive mental health services (61.2% of youth, compared to 59.6% national average). Although the survey found that the majority of Massachusetts youth have insurance coverage for their mental health needs, there are significant barriers to accessing services for school-aged youth (Mental Health America, 2021). 

Development and Implementation 

Directly support the planning, development, and implementation of pilot sites through a facilitation process with each site to meet the needs of the community and school district.  

• This process involves coordinating all aspects of the pilot development and capacity building in partnership with the community service provider(s), school district, and other key stakeholders. 
• Establishing contractual memorandums of understanding and action plans. 
• Ensuring spaces for services in schools are adequate and confidential. 
• Facilitating the process in collaboration with service providers, school district leads, and other identified key stakeholders. 
• Developing an onsite TBH Coordinator role to ensure efficiency and support for students through their TBH journey with an eye toward sustainability. 
• Training and technical assistance 

Training and Technical Assistance

Creation and facilitation of a virtual and interactive Learning Collaborative website allowing for process improvement and peer-to-peer information exchange, highlighting lessons learned and identifying and demonstrating best practices. 

Directly or indirectly via content expertise, providing training, personnel, and technical assistance to the pilot sites to best meet the identified TBH competencies, using the identified Interprofessional Framework for TBH Competencies. Including the following domains: 

• Clinical Service Delivery and Evaluation (Includes Cultural Responsiveness) 
• Virtual Environment and Telepresence 
• Technical Expertise 
• Legal and Regulatory Compliance 
• Evidence-Based Practices 
• TBH Standards and Guidelines 
• Mobile Health Technology (Including Apps, Digital Access Portals, and Service Delivery Platforms) 
• Telepractice Development 
• Infrastructure and Sustainability 

Carla Azuakolam

Carla (she/her) is a healthcare leader with 25+ years of experience, specializing in clinical quality improvement, regulatory systems, health equity, social determinants of health, integrated care management, and policy alignment. In her current role as the Director of School-Based Tele-behavioral Health at the Brookline Center, Carla leads the strategic expansion of the program. Her focus is characterized by a commitment to excellence and a nuanced understanding of healthcare payor, provider, and population health dynamics.

Harnessing her equity-driven healthcare subject matter expertise, Carla plays a crucial role in empowering communities through the facilitation of key partnerships and impactful conversations that drive meaningful change. Her educational background includes Masters degrees in Expressive Therapy (art, music, and dance) and Clinical Mental Health Counseling.

Outside of her professional pursuits, Carla values quality time with her family, teaching mindfulness meditation, and studying human design

Bri Dewalt

Bri (she/they), CAPM, is the Program Manager for the MA School-Based Telebehavioral Health Program at the Brookline Center for Community Mental Health. She started as a Project Coordinator in January 2022. They filled in the project management function of the team. Bri became a Certified Associate Project Manager through the Project Management Institute in August 2023. In July 2024, she was promoted to Program Manager taking over the day-to-day management of the program and the team. They graduated with a Bachelor of Arts in English (with a minor in gender studies) from Suffolk University in 2016 and completed the William James Behavioral Health Service Corps program in 2023. She has experience in data analysis (2017-2019) and production coordination in international education (2019-2021). As a member of the queer community, they hope to highlight the needs of this at-risk group of youth while servicing the MA School-Based TBH program.

Melanie Rice

Melanie (she/her) joined the MA School-Based TBH team as the training and technical assistance specialist in May 2022. She holds a MA in Psychology with a concentration in Clinical Mental Health Counseling from Antioch University Seattle and a BA in Psychology from Clark University. Her past work includes research and event coordination, grant management, UX/UI, and education. She is passionate about increasing youth access to mental health support, social-emotional learning programs, and prioritizing communities’ needs.