School-based health centers (SBHCs) fill a critical gap in children’s mental health care in Connecticut, and funding should be expanded to underserved school districts.
In December 2021, the U.S. Surgeon General’s Advisory, “Protecting Youth Mental Health,” reported that symptoms of anxiety, depression, and other mental health disorders have increased among youth on a global level. But even before the pandemic, we had a mental health crisis brewing. According to the Centers for Disease Control, up to one in five children ages 3 to 17 in the United States had a mental, emotional, developmental or behavioral disorder between 2013 – 2019, but fewer than 15 percent of children ages 5 to 17 received mental health treatment in 2019.
In December 2021, the Courant and the Connecticut Mirror reported that children with psychiatric needs were overwhelming hospital emergency departments across the state. Parents have struggled for years to access quality mental health services for their children, often stymied by clinician shortages, fragmented care, insurance issues, and other barriers. School-based health centers, licensed by the Connecticut Department of Public Health, remove these obstacles and give students access to free mental and physical health services (with parental permission) within the schools, even if they have limited or no insurance. SBHCs minimize disruptions to learning and eliminate transportation, financial, and other barriers to mental health care that is needed now more than ever.
Since January 2021, InterCommunity Health Care’s seven SBHCs in the East Hartford school system have provided an estimated 10,000 mental health and primary care visits to students. Nearly 6,000 are mental health services that include counseling, crisis intervention, and mental health screenings. The remaining include primary care services such as physicals, vaccines, treatment of ongoing conditions, and lab testing. Since students have returned to the classroom, we have seen an uptick in anxiety and depression, trauma, and aggression. Reintegration has been difficult for many young people, particularly those most severely impacted by the pandemic. Some children lost parents, economic security, and even housing. Nearly 20 percent of the kids we serve experience borderline food insecurity. We have seen firsthand the heightened need for mental health services. In January and February 2022 alone, we provided 1,400 mental health services despite shortened school days, snow days, testing days, and increased absenteeism.
Children learn best when they’re healthy, mentally and physically. SBHCs offer a safe space and a lifeline for children who face barriers to care due to lack of insurance and difficulty accessing care outside of the school environment. Their parents may work two jobs and lack the time or means of transportation to get them to appointments. While the SBHCs do not replace pediatricians, they do provide essential care for hundreds of kids without insurance. There is no cost to the family and no co-pays even if the student has private insurance. In fact, without SBHCs, many students would never get care for mental health issues or other chronic illnesses such as asthma or diabetes.
SBHCs are a lifeline for children who often unjustly experience disparities in health care and difficulty accessing care outside of the school environment because of their race, ethnicity, or family income. SBHCs are a valuable community resource that fill a vital role, offering efficient and cost-effective services to keep kids healthy mentally and physically.
H.B. 5001, An Act Concerning Children’s Mental Health, was introduced by the Public Health Committee in February 2022 and has been signed by Gov. Ned Lamont. The bill is intended to improve the availability and provision of mental health, behavioral health, and substance use disorder treatment services to children. We strongly recommend adequate funding to expand SBHCs in regions of the state that lack access to school-based health centers and support the staffing that is needed. Certainly, in these challenging times, our children deserve no less.
Tricia Orozco is the Director of Practice Management and School-Based Health Centers at InterCommunity Health Care.