School-Based Health Center Use for Mental and Behavioral Health Disorders Before and After the COVID-19 Pandemic: A Mixed-Methods Study.

IF 1.8 4区医学 Q2 EDUCATION & EDUCATIONAL RESEARCH

Journal of School Health Pub Date : 2025-09-16 DOI:10.1111/josh.70090

Connie Cai, Alvina Pan, Brandon M Smith, Gabriela Calderon, Sara B Johnson, Katherine A Connor

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引用次数: 0

Abstract

Background: School-based health centers (SBHCs) provide accessible healthcare for children, but not all have dedicated mental health providers. The COVID-19 pandemic and school shutdowns were associated with worsened student mental health, but the impact on the utilization of SBHCs without mental health providers remains unclear. This study examines utilization before and after school shutdowns at one such SBHC.

Methods: Data are from a SBHC at a school serving 1600 K-8 students and includes electronic health records (EHR) and staff interviews. Visits between 2016 and 2023 (n = 6223) were characterized by whether the student had a mental and/or behavioral health diagnosis (MBHD) and whether the visit addressed a mental health concern. Negative binomial regression was used to compare visit rates, controlling for age, gender, and MBHD. Staff interviews (n = 9) were analyzed for emergent themes.

Results: The proportion of visits by students with a MBHD rose from 11.2% to 17.6% (p < 0.01) post-shutdowns. These students visited the SBHC more frequently than peers before (IRR 1.5 [1.25-1.94]) and after shutdowns (IRR 1.39 [1.14-1.69]). Qualitative findings underscored increased needs post-shutdowns.

Implications for school health policy, practice, and equity: Additional support for SBHCs includes expanded partnerships with teachers and mental health providers.

Conclusions: Students with MBHDs increasingly relied on their SBHC, emphasizing the link between physical and mental healthcare.

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基于学校的健康中心在COVID-19大流行前后使用精神和行为健康障碍：一项混合方法研究

背景：以学校为基础的健康中心（shhcs）为儿童提供可获得的医疗保健，但并非所有的学校都有专门的心理健康提供者。COVID-19大流行和学校停课与学生心理健康状况恶化有关，但对没有心理健康服务提供者的shhcs使用率的影响尚不清楚。本研究考察了一个此类shbhc在学校关闭前后的利用率。方法：数据来自一所招收1600名K-8年级学生的学校的shbhc，包括电子健康记录（EHR）和工作人员访谈。2016年至2023年期间的访问（n = 6223）的特征是学生是否有心理和/或行为健康诊断（MBHD），以及访问是否解决了心理健康问题。采用负二项回归比较访视率，控制年龄、性别和MBHD。对员工访谈（n = 9）进行突发主题分析。结果：患有MBHD的学生的就诊比例从11.2%上升到17.6% (p对学校卫生政策、实践和公平的影响：对shbhcs的额外支持包括扩大与教师和心理健康提供者的合作关系。结论：mbhd学生越来越依赖于他们的shbhc，强调身心健康之间的联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of School Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.70

自引率

9.10%

发文量

134

审稿时长

6-12 weeks

期刊介绍： Journal of School Health is published 12 times a year on behalf of the American School Health Association. It addresses practice, theory, and research related to the health and well-being of school-aged youth. The journal is a top-tiered resource for professionals who work toward providing students with the programs, services, and environment they need for good health and academic success.