School Based Health Centers: A Unique Service System. Andrea Kuebbeler, LCSW Alternatives, Inc. IL Children’s Mental Health Partnership School Mental Health Conference June 27, 2012 Andrea Kuebbeler, LCSW Alternatives, Inc. firstname.lastname@example.org. Objectives.
Andrea Kuebbeler, LCSWAlternatives, Inc.IL Children’s Mental Health PartnershipSchool Mental Health ConferenceJune 27, 2012Andrea Kuebbeler, LCSWAlternatives, Inc.email@example.com
Overview of School Based Health Center’s (SBHC)How do they benefit students, parents, school and the communityHow are behavioral health services integrated into this model of service in schools
Many of the most significant and costly national health problems are caused by behaviors established during adolescence:
47 serve low income districts
Data sources: IDHS FY10 SHC Annual Report; ISBE FY10 eReport Card
Common CharacteristicsLocated in schools or on school grounds.Work cooperatively within the school to become an integral part of the school.Provide a comprehensive range of services that meet the specific physical and behavioral health needs of the young people in the community.Employ a multidisciplinary team of providers to care for the students: nurse practitioners, registered nurses, physician assistants, social workers, physicians, alcohol and drug counselors, and other health professionals.
Provide clinical services through a qualified health provider such as a hospital, health department, community health center or medical practice.Require parents to sign written consents for their children to receive the full scope of services provided at the SBHC.Have an advisory board consisting of community representatives, parents, youth, and family organizations, to provide planning and oversight.
Fundamental Principles of SBHC’s:1. Supports the School2. Focuses on the Community3. Focuses on the Student4. Provides comprehensive care5. Advances health promotion activities
SBHC BenefitsStudent:Provides medical, mental health, dental and health education services.Provides confidential, culturally sensitive and youth friendly services.Promotes health decision-making.Helps students stay in school.
SBHC Benefits Parents: Provides services their children need such as mental health, health education and treatment for acute and chronic diseases.Reduces lost work time.Promotes parental engagement in health care.Provides family assistance for benefits enrollment and other supportive services such as state health insurance programs, food stamps and Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
SBHC BenefitsSchool: Integrates health and education to address barriers to learning and promote academic success.Collaborates with school personnel to ensure that students are healthy and ready to learn.Participates in the school’s crisis intervention team to provide assistance in times of school crises and community disasters.Promotes health behaviors throughout the school.
SBHC Benefits Community:Links the students and families to community resources.Engages the community in health promotion activities.Respects family values and diversity within the community.Involves the community in improving the health of students and families
Recommended SBHC Staffing is:
Around 20% of youth present with an emotional/ behavioral disorderAround 10% of youth experience significant impairmentLess than 50% receive adequate or any servicesOver 75% of youth who receive services, receive them in schools
Goal/Approach: Comprehensive, interdisciplinary and integrated Partnership basedFull range of primary and secondary prevention, early intervention, and treatment services
Standardized Test Scores
Health & Mental
Mental Health Problems
(e.g. Substance use )
Family Strengths/ Issues
Positive Attitudes Toward
BehaviorsMental Health and Academic Outcomes
ADAPTED FROM: Geierstanger, S. P., & Amaral, G. (2004). School-Based Health Centers and Academic Performance: What is the Intersection? April 2004 Meeting Proceedings. White Paper. Washington, D.C.: National Assembly on School-Based Health Care.
SBHC hires on-site behavioral health staff.SBHC partners with local behavioral health agency.SBHC partners with school to collaborate with school social workers and other behavioral health staff because of lack of ability to hire on-site SBHC staff.
Efficiency:Access to teachers in child’s lifeAbility to work collaboratively with systemScreening more prevalent when primary care and behavioral health working together in same space
Effectiveness:Services able to be more immediate as providers can work and observe youth in their natural environmentImprove prevention and early intervention efforts in the school by behavioral health staff serving as consultants to school staff
ScreeningAssessmentCase ManagementCrisis InterventionIndividual, Group and Family TherapyTobacco Use CounselingSubstance Abuse CounselingReferralsClassroom InterventionsSkill BuildingConflict Resolution/MediationPsycho-educationMediation Management/AdministrationConsultation
Adapted from the ICMHP Interconnected Systems Model for School Mental Health, which was originally adapted from Minnesota Children’s Mental Health Task Force, Minnesota Framework for a Coordinated System to Promote Mental Health in Minnesota; center for Mental Health in Schools, Interconnected Systems for Meeting the Needs of All Youngsters.
Coordinated systems for promoting healthy social and emotional developmentSEL curricula for all studentsSafe and Caring EnvironmentsPartnerships with school, home and community
Tier 2-Early Intervention For Some
Pull Out Groups: -Psychoeducational groups -Skill building groupsIndividual Skill BuildingParent Support Groups/Skill Building GroupsSBHC Staff Participation in School Behavioral Teams
For Greatest Level of NeedIndividual Student and Family SupportsSchool Team Identified to Support StudentIndividual Plan for Interventions
Tier 3-Intensive Interventions for FewIndividual, family and group treatmentSubstance Abuse Assessment and TreatmentPsychiatric Evaluation and Medication Monitoring
Cognitive Behavioral Therapy (CBT)Trauma-Focused CBTAdolescent Community Reinforcement Approach (A-CRA) for substance using behaviorGroup Work Models:-Think First-Cognitive Behavioral Intervention for Trauma in Schools (CBITS)
Center of School Mental Health http://csmh.umaryland.eduSchool Mental Health Connection www.schoolmentalhealth.orgCenter for Health & Health Care in Schools www.healthinschools.orgUCLA Center for Mental Health in Schools www.smhp.psych.ucla.edu