Estimated read time: 6-7 minutes
As students head to their classrooms for the 2024-2025 school year, a growing number of them will arrive without completing a crucial step toward better learning and participation in school activities. Lack of access and affordability means many will start classes without a back-to-school physical and mental health checkup.
"When we do our check-ups, our physicals, and our sports exams, screening for mental health and other physical issues is critical. A lot of these kids have not seen doctors in years," said Kimberly Hansen, MD, FAAP. Hansen is a pediatrician with University of Utah Health and Medical Director of the West High School Clinic, which opened earlier this year in Salt Lake City.
The clinic is really a special place, and that is why I jumped at the chance to be involved with it
–Kimberly Hansen, MD, FAAP, University of Utah Health
"The clinic is really a special place, and that is why I jumped at the chance to be involved with it. We know if there is a clinic at the school, students will spend three times more time in their classrooms. They also have a four percent increase in their graduation rates, and it lowers their dropout rates by a third," Hansen said.
There are now over 2,500 school-based health clinics across the country, and they are steadily becoming a model for more equitable and effective delivery of physical and mental health care. Today, the challenges for school counselors are overwhelming due to the sheer amount of mental health care needs their students face.
Hansen emphasized that "what makes the West High Clinic even more innovative is that a lot of these school programs have some social work components but not the mental health push that we're making at West." U of U Health psychologists and graduate students are embedded with school counselors, and the primary care providers who staff the clinic have had extra training in mental health care.
U of U psychiatrists are also on site to see the kids with more complicated issues. "These psychologists and psychiatrists are doing mental health screenings on the whole student body population, and working with the school counselors to identify students who are at risk. Students can be referred to our clinic by school counselors, by school faculty, parents, and even by themselves, which we find happening a lot," Hansen said.
The West High Clinic is open to high school students throughout the Salt Lake City School District with parental approval, regardless of ability to pay with or without insurance coverage. Pediatricians like Hansen know the need has never been more critical.
"Especially since the pandemic, suicide has been the number one cause of death for kids here in Utah, and the state has the ninth highest suicide rate in the nation," Hansen said. "Right now, we only have six child psychiatrists for every 100,000 children who have mental health needs. It's really fallen onto the schools, the private primary care doctors, and the parents to try and make up this gap."
With over 25 years of clinical experience, some of it as a private primary care provider, Hansen knows the pressure on today's health care providers to diagnose mental health conditions and then find the proper care and treatment for young patients.
"When you do screening on these kids, which is recommended at all our pediatric visits since the pandemic, sometimes you screen and then you don't have anywhere to send them to get the services and the counseling that they need. To get counseling here in the state of Utah there's usually an eight to nine-month waiting list," Hansen said.
If a back-to-school checkup is accessible to a student, the U.S. Preventative Services Task Force recommends screening kids eight and older for anxiety and those 12 to 18 years old for both anxiety and depression. These screenings by pediatricians and primary care doctors could help to identify potential problems before they reach a more critical stage.
The demand for mental health care professionals at all levels of Utah's educational system is extremely high, and another goal of the clinic at West High is to fill that gap by training the workforce. "There are residents and medical providers as well as school psychologists, school social workers, and nursing students here," Hansen said. "They are all coming through this clinic. And the outcome data from this effort is designed to show it can work and it can make a real difference."
Positive data and real-life results can also support the effort to fund and staff additional school clinics in the future. "We would like to be able to replicate this model in other districts, and part of this whole thing is working out the kinks in terms of funding and manpower," Hansen said.
Integrating U of U Health professionals and students into day-to-day life at West High has other advantages as well. "We are trying to incorporate ourselves into and make ourselves accessible to the students at West to talk about careers in medicine and what that looks like," Hansen said. "And we have undergrads who are interested in medicine who are working on some of the clinic research and some of the outreach to students."
The crisis in youth mental health is not a problem Utahns can afford to ignore, especially when there are solutions like the West High Clinic, according to Hansen. "So many kids are really struggling, and the frustrating part is that we do have ways to help them, but how do we create a pathway for them to get to that help with all of the barriers that exist?"
As Hansen and others on the front lines of treating our children's physical and mental health clear the path to solutions, there is optimism for the future. "Improving their health will improve their quality of education and their graduation rates," Hansen said. "The ripple effect of that will be amazing."
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