What Works In Schools: Health Services

CDC’s What Works In Schools Program improves the health and well-being of middle and high school students by:

  • Improving health education,
  • Connecting young people to the health services they need, and
  • Making school environments safer and more supportive.

With direct daily access to more than 50million students attending grades 9-12, schools can play an important role in ensuring adolescents get recommended health services, including behavioral and mental health services.

Research has shown that when schools provide services on site or have referral systems in place to link students to community-based sources of care, students are more likely to receive care.

Referral systems require knowledge of existing community-based sources of care and work best when there is engagement between school staff and care providers.

The role of schools in improving access to health care is particularly important in communities where adolescents lack access to consistent sources of high-quality health care and can help advance health equity.

Teenage student meeting with a guidance counsellor

On-site services can be provided through school-based health centers, school nurses, and school mental health providers.

What kind of services do adolescents need?

Just like adults, all adolescents need regular preventative health care visits where they can get recommended screenings, counseling, and immunizations. Based on individual circumstances, adolescents might also need additional health care, such as treatment for a chronic health condition. There are a range of health services that adolescents need. This can include:

  • Preventative care, like vaccinations and screening for depression and suicide risk.
  • Treatment for chronic health conditions, such as diabetes.
  • Sexual and reproductive health services that can help prevent HIV, sexually transmitted infections, and unintended pregnancy.
  • Mental and behavioral health services.

What can schools do to educate students about health services?

  • Provide students and parents with essential information about the need for recommended adolescent health services, and how and where to access health services through various communication channels (e.g., emails, flyers).
  • Incorporate skill-based instruction into health education lessons on how students can access health services.
  • Increase knowledge on adolescent health care needs by providing professional development and medically accurate information to district and school staff.

What can schools do to link students to health services?

  • Form partnerships with organizations focused on delivering adolescent health services. Partners can include community providers, health departments, and community-based organizations.
  • Establish a referral system that helps link students to youth-friendly providers.

How can schools offer health services directly on-campus?

Various models of school-based health care exist, and the appropriate model depends on the school’s health services infrastructure. School can:

  • Offer onsite services by a school nurse, school mental and behavioral health providers, or at school-based health centers.
  • Identify students who need services through screening programs.
  • Organize health events or “health days” for delivering health services, such as having a school-located vaccination clinic day for recommended vaccines.
  • Dittus, P. J., De Rosa, C. J., Jeffries, R. A., Afifi, A. A., Cumberland, W. G., Chung, E. Q., … & Ethier, K. A. (2014). The project connect health systems intervention: linking sexually experienced youth to sexual and reproductive health care. Journal of Adolescent Health, 55(4), 528-534.
  • Dittus, P. J., Harper, C. R., Becasen, J. S., Donatello, R. A., & Ethier, K. A. (2018). Structural intervention with school nurses increases receipt of sexual health care among male high school students. Journal of Adolescent Health, 62(1), 52-58.
  • Ethier, K. A., Dittus, P. J., DeRosa, C. J., Chung, E. Q., Martinez, E., & Kerndt, P. R. (2011). School-based health center access, reproductive health care, and contraceptive use among sexually experienced high school students. Journal of Adolescent Health, 48(6), 562-565.
  • Wang, L. Y., Vernon-Smiley, M., Gapinski, M. A., Desisto, M., Maughan, E., & Sheetz, A. (2014). Cost-benefit study of school nursing services. JAMA pediatrics, 168(7), 642-648.