Expanding Trauma-Informed and Healing Centered Supports in Chicago Public Schools

• In Event: Trauma Informed and Subtance Use Mental Health Care

Abstract

Background: This qualitative study focuses on understanding Year 2 implementation of a new funding mechanism to support trauma-informed and healing-centered approaches to address student mental health. This funding mechanism, school Medicaid expansion (SME), is defined as the ability of schools to receive Medicaid reimbursement for a wider range of school-based services beyond Individualized Education Plan disability-related services. This study examines school Medicaid expansion in the case example of Chicago Public Schools from the perspective of district administrators and managers of school-based clinicians. Although the option to expand has been in place since 2014, Illinois recently expanded reimbursement for a wider range of school-based mental health services in 2023. This study focuses on understanding how administrators and managers 1) perceive the implications of Medicaid funding expansion on improving the provision of and access to mental health services, including trauma-informed and healing-centered supports, and 2) experience the process of implementing school Medicaid expansion. 

Methods: This study includes 30 semi-structured interviews with purposively selected district administrators and managers implementing school Medicaid expansion in Fall 2024. Qualitative interviews were designed using the Consolidated Framework for Implementation Research (CFIR) (Damschroder et al., 2022). CFIR was employed to capture the multi-level implementation process, which includes the perspectives of district administrators overseeing district-level offices dedicated to student well-being and managers overseeing school-level provision of trauma-informed and healing-centered supports. Thematic analysis was employed to analyze these interviews and followed the five-phase thematic analysis process (Nowell et al., 2017; Braun & Clarke, 2022). Interviews were deductively coded using the CFIR and inductively coded with codes developed from the interview transcripts. Themes were developed from the codebook and finalized through research team consensus.

Findings: Findings across the interviews with administrators and managers include the need to address school staff shortages in social work, psychology, and counseling and significant licensure-related challenges to expand the number and type of Medicaid eligible mental health providers in the district. This study elucidates strategies to bridge and expand supports by leveraging the unique strengths of the student health, student disability, counseling, and social-emotional learning offices to promote a continuum of mental health supports for students.

Conclusion: This is an important study in the context of the child mental health crisis and the newer role of Medicaid in paying for school-based services intended to promote child well-being (Panchal et al., 2022). Medicaid is a sustainable funding source for schools and presents a rare opportunity to expand and sustain services (Akkas & Corr, 2024). Additionally, this study underscores cross-sector alignment challenges, including aligning licensure, documentation, and training across the health and education systems, to receive Medicaid funding. 

Author

• Caroline Kelly, The University of Chicago
  Presenting Author