School-based Health Centers, Mental Health Care and the ACA
Posted Dec 04 2011 10:38pm
On October 20, 2010, Jamarcus Bell, a freshman at Hamilton Southeastern High School in suburban Indianapolis, hung himself. He was 14.
In a lawsuit filed last week, his mother, Natalie Moore, alleged that Bell was repeatedly bullied by other students because of his race, “perceived homosexuality,” and “emotional disability,” and that the school corporation was aware of the bullying and did nothing to stop it and prevent his death. Brian Smith, the district’s superintendent, responded this week, denying Moore’s allegations, and argued that “teachers and administrators took multiple steps to assist the student and his family.” Notwithstanding the merit of the lawsuit, this is yet another headline in what has clearly become a nationwide epidemic of bullying. Parents are concerned, schools are scrambling, and state legislatures are eyeing changing the laws: Michigan’s legislature just approved an anti-bullying bill which will likely be signed into law by the governor in the near future.
Mental health services are at the heart of the debate: are schools doing enough to not only prevent bullying, but also to ensure that students have an adequate support system?
Just 125 miles southeast of the Hamilton Southeastern School District, in Hamilton County, Ohio, Oyler School is also receiving public attention. But not because it is the latest in a string of schools marred by alleged bullying incidents; rather, the school on the west side of Cincinnati is a school that has instituted an innovative system that may represent the future.
Just more than a decade ago, Oyler represented much of what was wrong with schools located in impoverished urban areas: more than 80 percent of its students did not reach tenth grade, it had declared an academic emergency, and was the lowest performing school in Cincinnati. Last year, the high school graduation rate was 82 percent, and the attendance rate is now 94 percent. So how did the school turn its fate around so quickly?
Oyler adopted a community-based approach, in which the school persuaded various health care providers to relocate their offices directly at the school. Today, the providers are housed in a full-blown health center, complete with a full-time nurse practitioner and a part-time pediatrician. There is a vision clinic, a dental clinic, and six mental health counselors including three full-time psychologists. The clinic offers more than just healthcare services: preschool, daycare, and afterschool programs are available. It also assists families in applying for Medicare, attaining bus passes, and even provides dinner to families. Taxpayers do not foot the bill for the services; the school simply reorganizes resources to keep costs down. Of course, poverty still grips the school 92 percent of children are on subsidized lunches and 112 students are homeless but the students are having their health needs fully addressed. As a result, Oyler has become a model for other schools in Cincinnati, and officials from Tennessee and New York City have recently visited.
The federal government has picked up on the school-based health center idea. Under the Affordable Care Act, the federal government offered grants to schools to assist in creating and updating school-based health centers like the one at Oyler: these centers bring the services to the students, relocating health services, including mental health services, into schools. After receiving over 350 applications in 2010, the U.S. government awarded $95 million in grant money this past summer to 278 school districts and programs to expand such clinics.
This will build on the amount of school-based clinics that existed nationwide prior to the passage of the ACA. According to the National Assembly on School-Based Health Care, prior to the awards this summer, there were 1900 school-based health centers providing a spectrum of health care services to nearly two million children and adolescents in 44 states and the District of Columbia. School-based health centers offer everything: prescriptions, treatment, education, and screenings.
Additionally, for those wondering how to combat the nation’s growing problem of bullying, three-fourths of the school-based health centers offer mental health services: from completing assessments to crisis intervention to offering therapy. And, with more and more stories like those of Jamarcus Bell dominating national headlines, placing mental health services where they are most needed – our nation’s schools – could be a vital tool in the fight against bullying.