Community-wide Collaboration to Keep Schools Open

Two months after being closed, the Port Chester School District reopened its doors.
The reopening was certainly good news for the county’s first village to be designated as a code orange cluster zone. A well-coordinated collaboration among the county and state departments of health, the Port Chester School District, and the Open Door Family Medical Center’s School-Based Health Center program provided expanded Covid testing that enabled the Village to bring students back to the classroom.
However, the risks of social isolation are significant, and this continues with many students still attending in-person classes on a limited basis in Port Chester and around the country. This was most pointedly reported in a recent New York Times article on student suicides in Clark County in Las Vegas. From March through December, 18 students in that county committed suicide – including students as young as nine years old.
“We see high rates of depression among both students who are home full time and those who are attending school within the hybrid model – from elementary school through high school,” said Sara HodgdonAssociate Director of Open Door’s School Based Health Center (SBHC) program embedded in the Port Chester school system. “We also see substantial weight gains among elementary school children, particularly those whose families who are food insecure and rely on food distributions. The uncertainty about when the next meal may be available causes so much anxiety and fluctuations in health and weight, which is compounded by the very limited access to extracurricular sports and outdoor activities.”
This is most evident in underserved communities, like those supported by the Open Door.
“Parents are stretched at the best of times,” she said.  “When they have young children who are only in school for two and a half hours a day, and they have no additional child care, it forces them to make some really difficult choices.”
According to the Health Resources & Services Administration, students and their families rely on SBHCs to meet their needs for a full range of health care services, including behavioral health screenings. SBHC team members collaborate with the school’s staff to keep at-risk children and their families from falling through the cracks.
“The consequences of the lack of in-person learning point out the importance of addressing all of the factors that are needed to keep kids healthy – nutritious food, stable housing, employment, and education,” Hodgdon said.
Shonny CapodilupoOpen Door’s Sr. Director of Behavioral Health, said that her clinicians see increased depression, social anxiety and bullying among students due to the loss of structure that comes with attending school daily. Some kids, she said, are struggling to engage in learning because they don’t want to be seen on camera during remote sessions for fear of being bullied.  Remote learning has led to a new form of bullying where the tormenter will capture weird or awkward expressions of classmates on Zoom and post them on social media, ridiculing their peers.
“For a child dealing with social anxiety or attention issues, remote learning already poses challenges for them to keep up with their academics,” she said. “But if you are worried about how others see you – or you typically struggle to pay attention even with additional supports around you – remote learning is going to be extra challenging.  And for kids who have parents who are stressed or are not coping well with their own emotional and mental health issues – where does that leave the child?”
Open Door’s behavioral health clinicians work with families to coach them through difficult times like this and offer real-time solutions.  However, not all the outcomes are negative.
“There can also be a real strengthening of family bonds across ages,” said Capodilupo. “People are saying they love having family dinners rather than everyone going in a thousand different directions. We are working to capitalize on the strength of the family unit to mitigate some of the negatives we have in front of us.”
Capodilupo believes that partnering with the school districts through the SBHC program has mitigated some of the challenges by screening and identifying issues and connecting to care early during these challenging times. “People are resilient and I see these pockets of positivity coming out of what would otherwise be a pretty negative situation.”
“At the end of the day,” she adds, “it’s this alliance with the communities and the trust we have with our patients that are our best hopes to keep from having more unwanted outcomes.”

About Open Door Family Medical Center and Foundation
Open Door Family Medical Center provides health care and wellness programs to individuals and families in need throughout Westchester, Putnam and Ulster Counties. A pioneer Federally Qualified Health Center, Open Door provides more than 300,000 patient visits annually and serves nearly 60,000 individual patients who might not otherwise have access. Open Door offers integrated services and a holistic approach to building healthier communities. Primary medical care, dental care, integrated behavioral health care, clinical nutrition, wellness programs, and chronic disease management are the foundation of its clinical programs. Founded as a free clinic in 1972, Open Door’s mission of building healthier communities through accessible, equitable, culturally competent health care has led to site and service expansions. Today, Open Door operates centers in Brewster, Mamaroneck, Mount Kisco, Ossining, Port Chester, and Sleepy Hollow, in addition to eight School-Based Health Centers in the Port Chester and Ossining School Districts, a mobile dental van in Mount Kisco, and a dental practice in Saugerties, NY. Open Door is accredited by the Joint Commission and is recognized by the National Committee on Quality Assurance as a Patient-Centered Medical Home. Open Door achieves clinical results that consistently surpass national benchmarks for patient outcomes. For additional information, please contact Elisabeth Gilbert, Senior Director of Development, at 914-502-1417.

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