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

• Published in: Child & youth care forum 2019-08, Vol.48 (4), p.545-562
• Main Authors: Whitaker, Kelly, Stone, Susan I., Anyon, Yolanda, Blankenbaker, Stacey, Rozum, Alicia
• Format: Article
• Language: English
• Subjects: Academic achievement; Access to Health Care; Age Differences; Behavioral Science and Psychology; Bias; Child and School Psychology; Clinical outcomes; Counseling; Counseling services; Demography; Ethnicity; Gender Differences; Grade Point Average; Grades (Scholastic); Health behavior; Health facilities; Health research; Health services; Health services utilization; Help seeking behavior; High School Students; Implementation; Medical schools; Medicine; Mental Health; Mental health care; Mental Health Programs; Mental health services; Original Paper; Outcomes of Education; Participation; Physical Health; Predictor Variables; Psychology; Psychosocial factors; Race; Racial Differences; School Counseling; School Health Services; Secondary school students; Secondary schools; Selection bias; Sociodemographics; Special Education; Student Characteristics; Students; Victimization; Victims; Violence; Youth
• ISSN: 1053-1890; 1573-3319
• DOI: 10.1007/s10566-019-09495-8

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.