Blending School Health Services and Community Supports for Students
One in five youth suffer from a diagnosable behavioral health condition.1 As such, one of the priorities identified by the Colorado Alliance for School Health (the Alliance) is to behavioral health needs of students, including mental health and substance abuse and misuse.
Addressing behavioral health means meeting the needs of the whole child, which includes providing social emotional supports, identifying social determinants of health and connecting them to resources for family systems.
Aligning providers to better serve students
Often times, students may seek out a school nurse or another school staffer with a health complaint or behavior issue, but may not know how to ask for help. It is in the best interests of the child and family to have effective two-way communication between school health providers and community providers to implement consistent and coordinated care. This requires aligning the education and behavioral health sectors through communication and information sharing on a need-to-know basis while protecting the confidentiality of students and families. This is a key area in which community providers can work with school health providers.
The work of the Alliance hopes to highlight this type of collaboration as a strategy that benefits students and families when addressing behavioral health. By building relationships and effective communication, the Alliance members are learning from one another about how to align themselves, address advocacy issues related to behavioral health and create a replicable model of integrated systems of care for students.
Meeting complex needs through better training and communication
Almost half of all mental health disorders begin by the mid-teenage years.2,3 School health professionals like counselors, psychologists, contracted behavioral health staff, school nurses and additional staff that work with students while they’re in this age range can benefit from appropriate professional development so they can better support students. Mental Health First Aid and Trauma Informed Care are two of multiple professional development training offerings in Colorado. The Colorado Department of Education has granted funds to districts under the school health professional grant to hire school health professionals (school nurses, counselors, social workers and psychologists) to work on social emotional issues including prevention, screening and referrals. However, challenges still remain. Because the school nurse is often the first person a student or family member may approach with behavioral health issues, they, along with other school staff, need to be included in the comprehensive system of professional development, support and communication.
The Alliance envisions the establishment of inter-agency communication processes based on evidence-based practices to meet the complex needs of students and families. This includes blended, collaborative services with confidentiality and the preservation of the social emotional wellbeing of students at its core. Multi-tiered systems of support are familiar to school systems and can be broadened to support the behavioral health of students and to include school nurses, counselors and psychologists. The Alliance will continue to advocate for such systems and hopes to participate in future legislative processes supporting behavioral health for students and families.
Kathy Patrick, RN Ast. Director, Health and Wellness, Colorado Department of Education
Karen Hecker, RN Nurse Consultant, Regional Nurse Specialist, Denver Metro Region
1 Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., ... & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980-989.
2 Kessler, R. C., Amminger, G. P., Aguilar‐Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007). Age of onset of mental disorders: a review of recent literature. Current opinion in psychiatry, 20(4), 359.
3 Kessler, R. C., Angermeyer, M., Anthony, J. C., De Graaf, R. O. N., Demyttenaere, K., Gasquet, I., ... & Kawakami, N. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World psychiatry, 6(3), 168.
