Characteristics of school-based health services associated with students’ mental health

Author:

Denny Simon1,Howie Hamish2,Grant Sue3,Galbreath Ross4,Utter Jennifer5,Fleming Theresa6,Clark Terryann7

Affiliation:

1. Associate Professor, Department of Paediatrics, Child and Youth Health, University of Auckland, New Zealand

2. General Practitioner, Centre for Youth Health, Counties Manukau District Health Board, New Zealand

3. Professional Teaching Fellow, Department of Paediatrics, Child and Youth Health, University of Auckland, New Zealand

4. Research Associate, Department of Paediatrics, Child and Youth Health, University of Auckland, New Zealand

5. Senior Lecturer, School of Population Health, University of Auckland, New Zealand

6. Senior Lecturer, Department of Paediatrics, Child and Youth Health, University of Auckland, New Zealand

7. Senior Lecturer, School of Nursing, University of Auckland, New Zealand

Abstract

Objective School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students’ mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students’ mental health. Methods A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March–November 2012. Students’ mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. Results After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p = 0.002), emotional and behavioural difficulties (p = 0.004) and suicidality (p = 0.008). Services with greater levels of nursing hours (p = 0.02) and those that performed routine, comprehensive psychosocial assessments (p = 0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Conclusions Although a causal association between school-based health services and students’ mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial.

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Health Policy

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