School-based health centers can be central to identifying students’ mental health needs.
Nationally and locally, policymakers and community members are wrestling with ways to prevent future gun violence. While attention has focused on weapons bans and background checks, there is another side to the story and an immediate action we can take: Fund school-based healthcare as a proven mental health system for young people.
The nearly 2,000 school-based health centers (SBHCs) in operation across the country are an evidence-based, front-line strategy to identify and address students’ mental health needs. Because of their trusted relationships, SBHC staff, along with teachers and other school personnel, are often the first to notice signs that a young person is having trouble. They provide on-site treatment and daily support, making mental health services accessible, proactive and effective.
Too many times after staggering gun violence we’ve heard teachers, parents and friends say of the shooter, “I knew something just wasn’t right.” Lucinda Roy, who tutored Virginia Tech gunman Seung-Hui Cho, wrote in her recent book about her unsuccessful attempts to get help for her dangerous student. Newtown shooter Adam Lanza has been described as troubled. By connecting other intrepid observers of student behavior to expert SBHC staff who can take immediate action when warning signs emerge, we may be able to avert future tragedies.
Nationwide, nearly one in five children and adolescents experience symptoms of mental health disorders. Of those in need of help, only 15 to 20 percent receive services. Left untreated, mental health disorders in children and adolescents lead to higher rates of suicide, violence, school dropout, family dysfunction, juvenile incarcerations, alcohol and other drug use, and injuries.
School-based health centers are much more likely to begin mental health services for young people than are other providers. In fact, of the children and adolescents who do receive mental health services, 70 to 80 percent get them in schools, according to a 2001 study reported in the Journal of Psychiatric Services. The centers offer confidentiality, safety and trust, and it’s certainly easier for students to get there when the office is just down the hall.
SBHCs in 48 states and the District of Columbia provide health care to more than 2 million students – regardless of their ability to pay – in their schools. Not only does this help improve mental health and stop violence, it helps students stay in school and graduate, combats rising obesity and diabetes rates, and provides the social supports to move past barriers to graduation such as teen pregnancy and chronic absenteeism.
State governments, foundations, the private sector and leading nonprofits from The American Public Health Association to the NAACP champion school-based healthcare. Congress included SBHCs in the Affordable Care Act as a key link in the nation’s health care safety net, providing $80 million for structural enhancements such as construction, renovation, technology upgrades and equipment for SBHCs.
As important as that funding is, it doesn’t provide money for the centers to function day-to-day. It doesn’t fund the nurse practitioner, the mental health therapist, the medical assistant. These positions are the heart and soul of the centers, the reason students come in, trust the care they receive, and keep coming back. The authorization for these operating costs was also included in the Affordable Care Act, but Congress must appropriate the funds each year. To fully realize the potential of SBHCs in serving our young people, the Center for School, Health and Education and others are asking President Obama and Congress to include $50 million in this year’s Federal Appropriations Bill to support the operation of our nation’s SBHCs.
This is a specific, immediate step our legislators can take to ensure that countless children, especially those without access to other services, receive mental health care, stay in school to learn and graduate, and succeed. It’s a strategy with strong support from both sides of the aisle and endorsement from Secretary of Education Arne Duncan and Secretary of Health and Human Services Kathleen Sebelius.
Improving mental health services, and offering them through school-based health centers, is one of our best chances to avert future violence and tragedy.
Terri D. Wright is director of the Center for School, Health & Education at the American Public Health Association, which advances school-based healthcare as a comprehensive strategy for preventing school dropout and improving graduation rates for K-12 students. A national expert on the topic, Terri previously managed the School-based Healthcare Policy Program for W. K. Kellogg Foundation.
All statements and opinions expressed on this blog are those of the individual contributors, and not of the Bill & Melinda Gates Foundation or NBC News.