Program History | Texas Tech University Health Sciences Center
TTUHSC students walking through Lubbock campus courtyard.

Program History

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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 program.  On September 1, 2019, the project was renamed the Campus Alliance for Telehealth Resources (CATR) Program.  As of August 2020, CATR merged with the Texas Child Health Access Through Telemedicine (TCHATT) program, and was referred to as CATR: Supported by TCHATT.  As the result of the effort to standardize branding of the TCHATT program across the state of Texas, as of August 2023 our program will be referred to as TCHATT.

Texas Child Health Access Through Telemedicine (TCHATT)


Texas Child Health Access Through Telemedicine (TCHATT) is one of the five main programs developed by the Texas Child Mental Health Care Consortium (TCMHCC). 

In 2019 the Consortium was created by the 86th Texas Legislature to leverage the expertise and capacity of the 13 state-funded health related institutions of higher education in Texas. The goal of the Consortium is to improve mental health and the mental health care system for children and adolescents across the state.

The TCHATT program creates and builds off existing telehealth programs to assist public school districts with identifying mental health care needs and services across the state of Texas.

Extension for Community Healthcare Outcomes (ECHO®) Services

The program began offering ECHO sessions to independent school district (ISD) staff in 2020 in an effort to increase the knowledge and confidence in recognizing mental health in students.

  • ECHO services are created to connect ISDs with behavioral health expertise in virtual collaborative sessions.
  • Sessions include evidence-based strategies and case-based learning to increase awareness and develop a community of practice among ISD staff.
  • Beginning with a small number of ISDs in 2020, the School-Based Behavioral Health ECHO offered through TCHATT now offers sessions with over 179 school districts.