Terri Wright is the director of APHA’s Center for School, Health & Education Division of Public Health Policy and Practice where she provides leadership to the strategic development and integration of public health in school-based health care and education. Wright most recently retired from the W. K. Kellogg Foundation in Battle Creek, Mich., where she served for 12 years as a program director for health policy. In this guest commentary, Wright discusses the critical role of school-based health care in ensuring health and wellness among our nation’s children and reducing gun violence in our schools.
President Obama has led our nation in the development of a comprehensive response to gun violence and senseless loss of life. One essential component of the plan is increasing access to mental health services. The good news is that this work is possible by placing an enhanced focus on school-based health care, a proven method with bipartisan congressional support as well as that of Secretary of Education Arne Duncan and Secretary of Health and Human Services Kathleen Sebelius.
The nearly 2,000 school-based health centers in operation across the country are an evidence-based, front-line strategy. They cost-effectively identify and provide services for students in need of mental health services, hopefully averting future tragedy. Funding and expanding school-based health care must be part of the plan moving ahead.
President Obama is to be applauded for releasing an urgently needed plan to reduce gun violence earlier this year. It includes a host of common-sense policies that reinforce the notion that “enough is enough” while upholding our Constitution and Second Amendment rights.
Now, the real work begins, and no doubt it will be a tough road ahead, as he rallies the support of our lawmakers to make our streets, schools and communities safer for all of us but especially our children. All the more reason to seize this opportunity before us.
Nationwide, nearly one in five children and adolescents experiences symptoms of mental health disorders. Of those in need of help, only 15 to 20 percent receive services. Left untreated, mental health conditions in children and adolescents lead to higher rates of suicide, violence, school dropout, family dysfunction, juvenile incarcerations, alcohol and other drug use and injuries.
Because of their trusted relationships, SBHC staff, along with teachers and other school personnel, are often the first to notice signs that a student is having trouble. They provide on-site treatment and daily support, making mental health services accessible, proactive and effective.
SBHCs in 48 states and the District of Columbia deliver comprehensive primary and preventive healthcare 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 such barriers to graduation as teen pregnancy and chronic absenteeism.
School-based health centers are much more likely to provide mental health services for adolescents than are other providers. In fact, of the children and adolescents who do receive mental health services, 70 to 80 percent receive them in schools. Students report that they trust the confidentiality afforded by SBHCs, and it’s certainly easier to get there when the services are just down the hall. Beyond individual students, SBHCs support all students’ mental health by creating preventive, school-wide programs to address bullying, violence, anger, depression, and other social and emotional issues that impede academic achievement.
Congress included SBHCs in the Affordable Care Act as a key link in the nation’s health care safety net, recently providing $80 million for structural enhancements such as construction, renovation, technology upgrades and equipment for SBHCs. As important as that funding is to build new centers and make capital improvements in existing ones, it doesn’t pay for operations. It doesn’t fund the nurse practitioner, the mental health therapist, the medical assistant. They are the heart and soul of the centers, the reason students come in, trust the care they receive, and keep coming back.
To fully realize the potential of SBHCs in serving our young people, Congress must appropriate $50 million to support their operation and ensure that countless children and adolescents receive the mental health services they need. This is a specific, immediate step Congress and Secretaries Duncan and Sebelius can take.
It’s also one of our best chances we have to avert future violence and tragedy.