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APPENDIX E

School-based Health Centers

School-based health centers are clinics located on a school campus staffed by qualified health care professionals such as nurse practitioners, physician assistants, and community health nurses. 67 Some centers also have social workers, dietitians, substance abuse counselors, and other professionals trained to meet the health care needs of children and adolescents. An advisory board, composed of parents, teachers, students, health professionals, community leaders, and religious leaders, develops and reviews the policies of each center. During the 1997-98 school year, students at 39 Oregon schools were served by school-based health centers.

Comprehensive primary health care services ranging from acute illness care to mental health counseling are available to all students in the school. The health centers work closely with the educational system to provide developmentally and age-appropriate care and advice. Consent for a student to utilize the health center is based on several factors, including Oregon minor consent laws, type of service, and local school policies.

School-age children and youth are at risk for a variety of health problems such as poor nutrition, substance abuse, emotional problems, unplanned pregnancy, sexually transmitted disease, violence, and suicide. By age 15, one-fourth of all adolescents are engaged in risky behaviors (e.g., smoking, substance abuse, or unprotected sex). Many students who are at risk of engaging in dangerous and health-compromising behaviors come to the health centers because of their convenience, reputation, and cost; services at a school-based health center are free and confidential. Over 60 percent of all students use school-based health centers, when they are present in their schools, and as many as 28 percent of students who use the centers have no other access to health care.

"I think that this is an excellent school, but I believe strongly that it needs a school based health center. I'm a junior and this is my first year here. When I attended my previous school we had a health center and it was a great asset. We have many people who are pregnant and suffering and many who are very unprepared to deal with the challenges of teenage life. A health center would be very beneficial."

Health promotion is an integral part of all health services. Students are taught to become aware of how their behavior affects their health, as well as the role of personal responsibility in maintaining good health. Health promotion and earlyintervention in health-compromising behaviors or practices are as salient to a student's visit as is the treatment of the presenting problem or condition.

"There is too much emphasis put on the idea that it is the school's fault there are so many problems with kids today. The blame should be placed on our decomposing family structure."

School-based health centers work closely with parents, school faculty, and staff in early identification and care of abnormal behaviors or indicators of personal problems. The clinics offer a variety of mental health services for students including: counseling (e.g., for eating disorders, substance abuse, relationship problems, and anger management); support groups; and, referrals to community health care specialists when necessary. Mental and emotional health services play a vital role in detecting mental disorders and diseases that could prevent the student from performing satisfactorily in school. Most health centers offer support groups that involve and benefit both the student and family.

"This shool need more programs of education no only alcohol or AIDS programs sphycologic some body need help for problems with father and mother"

For additional information about school-based health clinics call (503) 731-4771.

"we Need more money in schooLs To have a cLass in speLLing or some thng Like That."