Q&A: Vivian Carter Touts Digital Mental Health Tools in Rural Schools

Digital health technology isn’t just for grown-ups. New tools can help connect children with the private and personalized resources they need to better understand their mental health and keep it in check.

For one school district, adopting an online mental and behavioral health system has been an effective tool to better help students in a rural community overcome barriers to learning, says Vivian Carter, innovation coordinator at Hazard Independent Schools in Eastern Kentucky.

In 2014, the Kentucky Valley Educational Cooperative (KVEC), which includes Hazard Independent Schools, received a Project Prevent grant from the Education Department that included funding to deploy and use the Ripple Effects online tool. Ripple Effects is a "Social Emotional Learning technology-based software system" that teachers can use to deliver behavior interventions and students can use to access personalized guidance and emotional resources. The technology is now being used in 70 of the 140 KVEC schools as a way to fill the gaps in mental health care for students and already has seen success in dropping the number of mental health and behavioral referrals.

HealthTech spoke with Carter about how her district adopted and deployed the digital technology in middle school classrooms to bolster mental healthcare for students and produce measurable results.

SIGN UP: Get more news from the HealthTech newsletter in your inbox every two weeks

HEALTHTECH: Why did Hazard Independent Schools look to technology to support students’ mental health?

CARTER: Many students come to school with issues that end up being barriers to their learning. Further, the embarrassment and the stigma that’s attached with trying to find solutions often causes them to remain silent.

For this reason, we started learning about Ripple Effects and what it involved. The program doesn’t supplant the school counselor; it supplements the resources that we have by providing students with private resources and coping techniques through a digital tool. In the information age of technology, this was just another resource that we thought would be a wonderful asset for a school.

Ripple Effects covers over 400 issues. It ranges from stealing to bullying to pimples; it’s things that all teenagers worry about. So, it’s a wonderful program.

HEALTHTECH: How were you meeting student needs prior to using this online tool?

CARTER: Whether it’s a parent suffering from addiction, sexual abuse, emotional distress or homelessness, so often these students feel isolated and alone. We had interventions. We had guidance counselors and teachers involved. We had previously initiated an advisor-advisee class for students at the middle school so that they would have an adult mentor.

We do not have the same students that we had 20 years ago or even 10 years ago. It’s a new age and so you have to make adjustments and you have to tweak what works and what didn’t work or what used to work and might not work now. Any way we can, any resource we have that will make us better qualified to help our students achieve and be successful, then that’s what we want to do.

HEALTHTECH: What did it take to train staff to use the digital health tool?

CARTER: It was as easy as it could be. Lisa Garza, project coordinator for Ripple Effects trained the teachers in a computer lab at the school. With more than 400 scenarios available, the guidance counselor selected which would be used and the teachers at each grade level chose which issues they would address each day.

HEALTHTECH: How does Ripple Effects work in a rural setting?

CARTER: There was concern that this online program was urban-based and mostly had representation with an urban feel. So, Ripple Effects actually hired some of our students to do voice-overs and take photos of Hazard students to use in the online software so that it sounded and felt like our student population. This helped to make it more personal and realistic for rural students, because rural students and urban students have different needs and issues and there are different ways of reaching them.

HEALTHTECH: What adjustments were made to the school’s infrastructure to adopt a digital health initiative?

CARTER: The school decided to implement Ripple Effects into the advisor-advisee class as a tool. Many of the topics were definitely geared toward classroom discussion like organization, goal-setting and establishing a routine. The purpose behind using it in that classroom setting — which takes place once a week for 30 minutes — was so that the students would become familiar with this website, actually navigating and learning how to work through it. As far as restructuring, it really only required buy-in from the school administrators.

HEALTHTECH: What has made this a successful health program for students?

CARTER: I see the benefits of the program when I talk to students, teachers and guidance counselors. It is completely anonymous, so we have no idea who has been online, but we do know how much of the population is using it. Not only are students using Ripple Effects during the advisor-advisee class, but there are individual logins; they’re actually navigating and searching for different topics on their own.

HEALTHTECH: What approach would you recommend in adopting an online health program?

CARTER: The key is to have complete school immersion. Go through the guidance counselors; include it in the classroom so that the kids become familiar with the site. When students actively get their hands on and they start navigating the tool, and they start researching and working with it, it goes a long way to having a measurable impact on their health and behavior.

Health technology can do even more for children in the classroom. Check out how telehealth technology is at work to help keep kids in school and healthy.