Integrated Healthcare in a School-Based Health Center

By Laurel Lisovskis

Part 2 in our Share the Wealth series. Click to read other Share the Wealth posts.

Laurel LisovskisAt 6:30 on a Thursday morning, I found myself driving to Salem, Oregon, with a fellow intern and a small group of sleepy-eyed middle and high school students. What on earth would draw these teenagers to voluntarily wake before dawn and show up to the Bethel Health Center (BHC) to drive to Oregon’s fine capital city, you ask? To attend Oregon’s School-Based Health Center Awareness Day—an annual effort by the Oregon School-Based Health Alliance (OSBHA) to highlight the impact of school-based health services on student health and academic achievement—to advocate for their school district’s school-based health center, of course!

No. Seriously. They really did. They filled out a mountain of paperwork and even prepared advocacy statements for their governing officials to boot. I had to ask the question, so I set my coffee down, turned the music off, and turned to them. “Why did you guys decide to come to this today?”

“Because it seemed important.” That’s Mariah, a thirteen-year-old seventh grader. She designed an open group at Shasta Middle School called Hot Topic Lunch that meets during lunch to discuss relevant issues like bullying reduction, self-harm reduction, grief and loss, and how to be a better ally. Share the WealthMariah knows that if the Bethel Health Center hadn’t offered mental health counseling and links to services like girls’ empowerment groups, she wouldn’t have known there was this kind of mental health support for students—and she wouldn’t have had the brilliant notion and supportive adult networks to make Hot Topic Lunch come to fruition.

Another student, Samantha, explained, “I just moved here with medical issues, and the BHC saw me right away, helped me get my insurance, and sent me back to class quickly. And I’m interested in government.”

Research and common sense tell us that on-site school-based healthcare decreases absenteeism and increases the overall health of student populations. But did you know that it also pays for trips up to the capital where a girl who can appreciate this on a personal level can share her experience in a way that is educationally meaningful to her, and could potentially drive her academic success as well?

Rase, an eighth grader, came along as our journalist for the school newspaper, but he explained that his experience as a member of the Gay-Straight Alliance, implemented at Shasta Middle by a student receiving on-site counseling services through the health center, was his inspiration to attend. He felt like it was important for everyone to feel comfortable at school, and to be themselves.

Interns and Students meet witn Oregon legislators (c ) Free Spirit Publish by L Lisovskis

Well over half of the nearly 2,000 school-based health centers operating nationally today include mental health services. Integrated healthcare is innovative because it combines services like mental health in a primary care setting, allowing for a more holistic approach to wellness. Anyone who works within any healthcare system can understand the fragmentation that can occur as a result of the referral process. Access issues are significantly reduced when professionals are on site, and this saves time and money.

What I noticed while talking to folks in Salem, however, was that most people don’t know much, or anything, about this preventative piece of school-based healthcare—even those who seemed familiar with school-based mental healthcare. The OSBHA has provided funding for programs that address topics such as healthy relationships, teen dating violence awareness, youth research, education, action, and more. All of the programs I have had the pleasure of assisting at Shasta are eligible for funding through OSHBA grants. In fact, Mariah caught up with me this morning in the school library to talk about how we could enhance her Hot Topic Lunch group. T-shirts? Posters? Awesome Ally Awards? Stay tuned!

In the meantime, I hope I have roused your curiosity about what your state has to offer. To see our amazing School-Based Health Center Awareness Day, and to learn more about Oregon’s School-Based Health Alliance, visit the website. For more information about whether your state has an affiliate to contact, you can get links by visiting the National School-Based Health Alliance website.

Laurel Lisovskis, BSW, is in her second year of graduate school working toward clinical licensure in social work at Portland State University. Her field placement is at the school-based Bethel Health Center, one of the innovative programs conceived through an alliance between state healthcare initiatives and public schools to bring services directly to students and families at school sites. Her intern experience includes doing individual and group therapy, as well as traditional social work roles such as resource utilization, collaboration with internal and external supports, and case management. Laurel is also working within the clinical setting to streamline integrated care services. With over ten years of expertise in counseling in both healthcare and public school domains, she lends a unique perspective of the connectivity between mental health and the well-being of middle school student populations.

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