Forging a Pathway for Quality Improvement in School-Based Health Centers: A Statewide Initiative.

School-based health centers (SBHCs) provide quality health services to the children and youth they serve. Numerous studies have validated the access provided by SBHCs. The School-Based Health Alliance has captured descriptive data on the services provided. However, no standardized quality measures to benchmark performance across SBHCs exists. An initiative to establish standards that would uniformly capture quality of care delivered was essential. This article describes how five measures developed by the School-Based Health Alliance were implemented as a state-based quality improvement initiative after being tested in four states. The initiative led to the adoption of these measures for all state-funded SBHCs.

Utilization of Mental Health Services in School-Based Health Centers.

BACKGROUND: We summarize utilization patterns for mental health services in school-based health centers. METHODS: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. RESULTS: Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. CONCLUSIONS: Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys.

Engaging African American and Latino adolescent males through school-based health centers.

African American and Latino males are less likely to seek mental health services and obtain adequate care than their White counterparts. They are more likely to receive mental health services in school-based health centers (SBHCs) than in other community-based setting. The purpose of this article was to understand the issues and reasons these adolescents sought mental health services at SBHCs and what their perceptions of the services were. A content analysis of 22 individual interviews was conducted using Krippendorff's method. Five themes emerged from the analysis of the data: the burdens and hurdles of my life, the door is always open, sanctuary within chaos, they get to us, and achieve my best potential. Each of the themes was explored in detail with rich quotations from the adolescents. The findings illuminated the daily struggles these adolescents faced and the impact mental health services in SBHCs had on their daily lives.