She said it has become more common in the Boston area to have a psychiatrist affiliated with a school district because there are so many teaching hospitals in the region.
But that does not mean all districts use the expertise the same way. In Shrewsbury, Kusiak said, she observes students, meets with families, and provides strategies for parents and teachers.
“My job also is to help the people in the schools to understand how they might best come at a kid,” she said. “So if they’ve got a kid being oppositional, maybe that kid is so overwhelmed with anxiety that if you approached it this way instead of that way” the result might be better.
Kusiak leads monthly forums for parents on various topics and also runs a course every semester, with eight to 10 sessions, for parents who want to spend more time learning strategies.
She does not diagnose, but she can refer families to the type of professional, program, or even book that might help their child.
“It’s such a new realm that there really is no standard of care yet,” she said.
And Kusiak can troubleshoot. Psychiatrists are not trained to understand school rules or special education regulations, so sometimes they can make suggestions to patients that are impossible in a school setting, and that end up causing problems in the relationship between the school and family, she said.
So another element of what Shrewsbury does is work with psychiatry fellows in their training at the University of Massachusetts Medical School in Worcester to help them understand the intersection of medicine and public education.
“We’re trying to bridge that gap,” she said.
In its quest to provide as much help as possible, Shrewsbury has developed some partnerships, like one with Jewish Family Service of Worcester.
The agency sends staff for two hours per week into the schools to observe individual students or whole classrooms, and then offer advice to teachers to deal with whatever the situation might be, said Beth Greenberg, director of school-based services for Jewish Family Service.
Such work is largely preventative, she said, and the idea is to help the students who might otherwise fly under the radar because their behavior is not severe enough to warrant crisis intervention.
“Schools are forced to focus on the students with the greatest need,” said Greenberg. “The long-term goal is to cast a little bit more of a safety net over a broader population of students.”
Babigian said looking after a child’s mental health is just as important as academic support because the two are intertwined.
“If they’re not getting the support and resources they need in that area, they’re not going to be available for learning,” he said. “It’s a huge part of a student’s development, and it can’t be ignored.”