More Telehealth Could Be Among Policy, Practice Implications of COVID-19 Pandemic

In a remarkably short period of time, the COVID-19 pandemic has required us to change almost everything about how we live and work. It has also exposed significant fault lines in our understanding about, and delivery of services to, the most vulnerable in our communities. During this time, many of our systems have been challenged to handle complex crises and rapidly changing circumstances. Just as our health care systems have strained to meet acute medical needs, our education, justice, housing and child-serving systems are also navigating unprecedented challenges.

Four Stoneleigh Foundation Fellows shared their preliminary observations on the impact COVID-19 is having on our communities’ young people in a virtual convening in spring. Dr. Nadia Dowshen and Meredith Matone, who holds a doctorate in public health, reflected on the clinical and public health ramifications of this crisis, including challenges in accessing urgent and emergent care, disruptions in mental health supports, and increases in domestic violence, among others. 

Adam Serlin and Sangeeta Prasad discussed the effects of the pandemic on the juvenile and adult criminal justice systems, including the dangerous spread of the virus in confined facilities, increased social isolation, court closures and decreased support services for both probationers and those within jails and prisons.

The discussion revealed how this crisis has exacerbated significant needs but also created new opportunities for the way we serve young people. Three key takeaways emerged for practitioners, policymakers and philanthropies interested in how we might prepare for a new normal post-pandemic:

Short-term system and service delivery disruptions can have long-term consequences. Disruptions to our education, health care and justice systems — precipitated by stay-at-home orders and physical distancing guidelines — have reduced or eliminated important support networks for young people. With schools out of session and access to remote learning highly variable, many students are missing out on a critical period of academic, social and emotional growth. 

Similarly, with in-person home visiting programs currently halted, many adolescent parents who cannot access virtual services are left without essential social supports during this highly stressful time. Court closures and hearing delays have proven especially challenging for young people on probation, who may be unable to seek early terminations or fulfill their court-ordered sentencing requirements. The repercussions of these disruptions will be felt long after the immediate public health crisis has abated. 

The pandemic has exposed substantial fault lines but also opened the door to new opportunities. As health providers have sought innovative ways of administering care during the pandemic, telehealth has emerged as a promising new approach. Previously, reimbursement and privacy concerns prevented telehealth from being widely adopted, but the COVID-19 crisis has required its swift and widespread implementation, with several positive consequences. For transgender and gender non-conforming youth, for example, telehealth has been a welcome alternative to in-person office visits, which can often feel intimidating, unwelcoming, or unsafe.

In the future, telehealth could also be an effective intervention for justice-involved youth, many of whom have mental health needs that go untreated during the course of their system involvement. While issues of technology access and confidentiality persist, telehealth holds real promise as a way to expand and improve access to care after the pandemic. 

Lessons from the pandemic should inform and influence broader systems reform efforts. The inequities highlighted and intensified by this crisis should drive policymakers, practitioners and researchers to fundamentally rethink our systems of care for young people, employing more human-centered and holistic approaches. One way to accomplish this is by drawing upon the expertise of different sectors, including using a public health lens to analyze our criminal justice procedures or prioritizing mental health services across all youth-serving systems.

The impact of COVID-19 will continue to reverberate across nearly every aspect of our collective and individual lives. We hope that, as we move from immediate crisis response toward longer-term recovery efforts, leaders from government, advocacy, philanthropy, social services and industry will work together to enact meaningful systems change that improves the life outcomes of our communities’ young people for generations to come. 

Anne Marie McGrory, who has a master’s of science in statistical practice, is the communications manager at the Stoneleigh Foundation. She has spent her career working on local, regional and international economic development and social change issues. 

Marie N. Williams, J.D., is senior program officer at the Stoneleigh Foundation. Before that she was immediate past executive director of the Coalition for Juvenile Justice and a longtime advocate for social justice causes.