One way to address student mental health? Bring the clinic to school

The school provides office space — often rent free — while the healthcare system provides medical workers such as licensed therapists and nurse practitioners. In some cases, a school nurse will share the space with health system employees.

If students have health insurance, the center can bill their insurer. If not, grants from the state help cover the cost of care, or the center can bill Medicaid. Students never have to pay out of pocket.

“The centers eliminate barriers of transportation and cost,” said Kim Baron, director of health services for Grand Rapids Public Schools. She also noted that students who get medical care in their school building don’t miss as much school as they would if they left during the day for a doctor’s appointment.

Why are school-based health centers getting so much attention now?

The first school-based health centers in Michigan opened in the 1980s, and their funding increased slowly but steadily for decades.

There are 124 centers across Michigan, with one in nearly half of the state’s 83 counties, according to the School-Community Health Alliance of Michigan, a nonprofit advocacy group.

The pandemic spotlighted the strengths of school-based health centers, said Deb Brinson, executive director of the School Community Health Alliance, which is pushing for a major new funding expansion to serve more students.

The centers stayed open even when many schools closed their doors, Brinson said. They offered medical expertise and infrastructure at a time when many school administrators were struggling to coordinate their community’s public health response. In many cases, the centers offered COVID testing and vaccinations.

As administrators across the state saw what the centers could do, “We started getting calls: How do we get a school based health center?” Brinson recalled.

Funding shot up last year, with an additional $5 million for mental health services. Now Whitmer is proposing an even larger increase.

Whitmer and legislative leaders will consider funding for the centers as part of this year’s budget negotiations, which will take place over the next few months.

Do the centers make a difference?

Students who used school-based mental health centers reported less risky behavior, better emotional coping strategies, and reduced physical stress, according to a 2018 study.

Various national studies have come to similar conclusions. A study of 168 schools in Oregon found that students at schools with health centers were less likely to report depression and suicide attempts.

Administrators in districts with centers say they are effective.

“There are hundreds of kids walking down the hall and getting the care that they need from a medical, dental, and behavioral health aspect,” said Tom Livezey, superintendent of Oak Ridge Public Schools near Muskegon.

“I can’t imagine having to go through the pandemic without this service.”

Before the pandemic, the Oakridge school health center typically served more than 700 unique students per year, including more than 1,000 mental health appointments. The district enrolls roughly 1,900 students.

How do the centers support mental health?

School-based health centers in Michigan are required to have a mental health staff person on site in addition to a medical professional such as a nurse.

Students can attend therapy or seek help if they are having an emotional crisis.

“From a mental health standpoint, we’re seeing kids act out in classrooms, and the anger and anxiety can turn into physical altercations in the schools,” Livezey said.

Given the lack of mental health providers for young people in the surrounding community, Livezey says school-based mental health centers are “the only way our kids are going to get adequate care.”

Chalkbeat is a nonprofit news organization covering public education.