Program History | Texas Tech University Health Sciences Center
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Telemedicine, Wellness, Intervention, Triage and Referral (TWITR) & CATR

In 2013, The Telemedicine Wellness Intervention Triage and Referral (TWITR) Project started as a testable model, designed to provide mental health services to rural school districts with limited mental health resources.

  • Licensed Professional Counselors (LPCs) screened at risk students referred by the schools
  • Using telemedicine technology, students who required additional screening and/or treatment were linked to a Board Certified Child and Adolescent Psychiatrist
  • Psychiatrists could provide oversight for any student who needed medical care referrals, including cases that involved medication management

Grant-funded by the Office of the Governor of the State of Texas, Criminal Justice Division, Juvenile Justice Delinquency Prevention Program, the TWITR Project lasted more than five years, growing from 10 school districts (around 30,000 students) to 22 school districts with more than 100,000 students enrolled.

Due to the success of the program, the 86th Texas Legislature appropriated $5 million dollars to TTUHSC in 2019 to grow and expand the TWITR Project. On September 1, 2019, the TWITR Project was renamed. In order to better represent its expanded services, the project is now the Campus Alliance for Telehealth Resources (CATR) Program. As of May 2021, CATR merged with Texas Child Health Access through Telemedicine (TCHATT) and is now referred to as CATR: Supported by TCHATT. 

Extensions for Community Healthcare Outcomes (ECHO®) Services

Beginning in the 2019-2020 school year, the CATR Program started offering Extensions for Community Healthcare Outcomes (ECHO®) Services:

  • ECHO® Services are created to connect ISDs with behavioral health specialists at centers of excellence in regular, real-time collaborative sessions.
  • The sessions are designed around case-based learning and mentorship.
  • ISD staff can gain the expertise required to provide needed behavioral health services for their students. 
  • As the capacity of the school-based mental health workforce increases, the model becomes a hybrid of TWITR, the legacy model and the ECHO® approach. 
  • Over time, TTUHSC will continue to serve the mental health needs of schools through CATR while scaling the program for wider distribution and replication.

TTUHSC is excited to begin this latest chapter in its service to Texas's independent school districts, communities, and school children throughout the state.