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Academic, Psychosocial, and Demographic Correlates of School-Based Health Center Utilization: Patterns by Service Type

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Abstract

Background

Despite the promise of school-based health centers (SBHCs) as crucial source of mental health care for youth, accumulated literature describing how SBHCs are typically arranged, patterns of service utilization, and, ultimately, effects of services delivered through SBHCs is limited.

Objective

This study’s aim was as disentangle the types of services provided into determine unique predictors of service use with the overall goals of making an incremental step towards understanding SBHC intervention effects and implementation challenges.

Method

This study used student-level administrative and survey data to examine academic, psychosocial, and demographic correlates of SBHC utilization by type of service (i.e., medical services, general counseling, and behavioral health counseling). The sample includes all students from one high school with a SBHC in a large urban district (n = 658). Logistic regression models were used to identify factors that uniquely contributed to service use.

Results

The strongest predictors of SBHC utilization overall were race, special education participation, and GPA. With regard to behavioral health services, demographic background (i.e. Black and Latino), special education participation, and violence victimization or perpetration predicted use. With regard to general counseling, being female was the strongest predictor of service use. For medical services, age and special education participation predicted use.

Conclusion

Heterogeneous student characteristics (e.g., demographic, academic, and psychosocial) are related to utilization of school-based health and mental health services. Future research must address the student characteristics that predict service use in order to minimize selection bias which may skew the results intended to document the impact of SBHCs on student outcomes.

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Authors and Affiliations

  1. Education, Training, and Research (ETR) Associates, 1630 San Pablo Avenue, Suite 500, Oakland, CA, 94612, USA

    Kelly Whitaker

  2. School of Social Welfare, University of California at Berkeley, 222 Haviland Hall, Berkeley, CA, 94720, USA

    Susan I. Stone

  3. School of Social Work, University of Denver, 2148 South High Street, Denver, CO, 80208, USA

    Yolanda Anyon

  4. San Francisco Department of Public Health, Children, Youth and Families System of Care Behavioral Health Services, 1380 Howard Street, 2nd Floor, San Francisco, CA, 94103, USA

    Stacey Blankenbaker

  5. Placerville County Office of Education, 360 Nevada St, Auburn, CA, 95603, USA

    Alicia Rozum

Authors
  1. Kelly Whitaker
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  2. Susan I. Stone
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  3. Yolanda Anyon
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  4. Stacey Blankenbaker
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  5. Alicia Rozum
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Correspondence to Kelly Whitaker.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the [removed for peer review] for the Protection of Human Subjects (Protocol: 2012-12-4884).

Informed Consent

Parents were notified about the administration of the California Healthy Kids Survey at their child’s school and were invited to return an opt-out form in the event that they did not want their child to participate in the survey. All data was delivered to the researcher in a deidentified format.

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Whitaker, K., Stone, S.I., Anyon, Y. et al. Academic, Psychosocial, and Demographic Correlates of School-Based Health Center Utilization: Patterns by Service Type. Child Youth Care Forum 48, 545–562 (2019). https://doi.org/10.1007/s10566-019-09495-8

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