Inside CHOC Children’s Well Spaces:
School-Based Mental Health in Youth
with CQC Steering Committee
Member Dr. Mike Weiss

PBGH’s California Quality Collaborative (CQC)’s Steering Committee comprises a diverse group of stakeholders from the health care industry — representing providers, health systems, payers, purchasers, government and advocacy organizations — whose leadership provides strategic direction and guidance for CQC’s quality improvement work to transform the delivery system. Dr. Mike Weiss, Vice President of Population Health at Children’s Hospital of Orange County (CHOC), has been a key member of the steering committee for over a decade, four years of which he served as committee co-chair. At CHOC, Dr. Weiss’ team leads the innovative Well Spaces program, a proactive approach to tackling youth mental health challenges within the school environment. This commitment to addressing the growing issue of behavioral health in young patients is also shared by CQC as exemplified by the upcoming launch of the currently recruiting program Behavioral Health Integration – Children and Youth Collaborative Learning Exchange.

The Genesis of Well Spaces

Recognizing the need to shift from reactive to proactive mental health care for youth and understanding that schools are the primary environment for children and families, Dr. Weiss’s team initiated the Well Spaces program. Developed in partnership with the Orange County Department of Education and the CHOC Mental Health Division, this innovative approach aims to deliver mental health support directly in schools, where children spend most of their time — as opposed to hospitals. Well Spaces is part of a multi-pronged effort at CHOC to address a mental health crisis among youth that has reached epidemic proportions. In 2021 more than 1 in 5 (22%) students in the United States seriously considered attempting suicide and 1 in 10 (10%) attempted suicide, according to the Centers for Disease Control and Prevention.

Design and Implementation of Well Spaces

Well Spaces are thoughtfully designed areas within schools that incorporate biophilic design — an architectural approach that connects occupants of a space more closely to nature — to create a calming and therapeutic environment. These spaces are equipped to facilitate stress-reducing activities, such as yoga and mindfulness, offering students proactive mental health interaction. The initiative began with a focus on middle and high schools and has since expanded to 40 locations with plans for more, demonstrating its scalability and effectiveness.

Operational Highlights

  • Staffing: Each Well Space is staffed by trained school personnel, such as social workers or counselors, ensuring that interventions are appropriately managed. CHOC nurses are available for care coordination as well.
  • Student Engagement: Students actively participate in naming and decorating the spaces, fostering a sense of ownership and involvement.
  • Integration: The program includes care coordination efforts to help students seamlessly reintegrate into school life after mental health visits to the emergency department or mental health unit.

Strategic Partnerships and Expansion

The success of Well Spaces is bolstered by robust partnerships with stakeholders within the educational system, including formal agreements that facilitate the ongoing involvement and feedback of students — a critical component for the program’s adaptability and growth.

Impact and Evaluations

Dr. Weiss and his team measure the impact of Well Spaces by tracking key indicators such as absenteeism, suspensions and overall school engagement. Initially targeting Title 1 schools, the program has yielded valuable insights into effective strategies for enhancing student mental health, leading to its broader implementation.

Guidance for Providers

Dr. Weiss offers valuable advice for other providers looking to implement similar initiatives:

  • Initiate the program at a single school to develop and refine the approach, starting small and scaling up as needed.
  • Involve educators, students and parents early to build support and gain momentum, a crucial element for community engagement.
  • Obtain dedicated funding sources critical for the program’s long-term success to secure funding and ensure sustainability.
  • Understand the local political landscape to align strategies with community expectations and needs, effectively navigating political sensitivity.

Dr. Weiss’s leadership in developing Well Spaces exemplifies the type of innovative thinking that CQC champions as a quality improvement program dedicated to creating lasting, positives change within the health care delivery system. This program not only addresses immediate community needs but also establishes a sustainable model for integrating health care into educational settings.

To learn more about Well Spaces and Dr. Weiss’s work, visit choc.org.