Reprinted from the Winter 2020 Issue of The Ohio Family Physician
By: Melanie Biegler, OMS IV, AT Still University, and Mary E. Krebs, MD, FAAFP, Cohere Health
Without question, the COVID-19 pandemic has changed many aspects of our lives. In particular, it has stressed our healthcare system and challenged its leaders in creating ways to deliver health care services despite the threat of a novel virus. Telehealth has quickly advanced as a modality by which to provide this care. However, for those without access to services such as the internet or a computer, and the need to be seen in person, telehealth is falling short. In addition, with new stresses and change comes the possibility of worsening mental health conditions. The Center for Disease Control and Prevention states that children and teens are one of the groups particularly at risk.1 One way the Cincinnati Public School System and the Cincinnati Health Department work to combat these issues is through the utilization of school-based health centers.
School-based health centers are primary care clinics run by the Cincinnati Health Department and based within Cincinnati Public Schools. There are currently 25 school-based health centers with six of them present in the high schools. In 2018, they served over 10,000 students. They provide full spectrum services and allow students to access care and their medications during the school day. Services include vision, dental, school physicals, asthma management, and sick and injury care. Allowing students to access these services during the school day eliminates the need to travel to another location and decreases the amount of time the student is out of the classroom. In addition, some of the sites provide care for family and community members as well.2
As guidelines for the best and safest way to deliver education this school year continuously change, access to these health centers will remain a constant. This includes when school is conducted virtually or within a hybrid model. Although families may need to travel to access care in this regard, continuity of care will be maintained for the students and their families. By maintaining this continuity, we ensure the students of the Cincinnati Public School system are still receiving comprehensive care, despite not being physically in the classroom. Likewise, if educational instruction moves to an in-person setting, students will once again be able to visit the health centers during the school day. Access also becomes important when providing mental health services.
Even without the stress of a pandemic, mental health services and diagnosis amongst adolescents are lacking. The World Health Organization reports that one in six adolescents ages 10-19 has a mental health condition. Despite this high prevalence, most cases go undetected and do not receive treatment. With suicide being the third leading cause of death in 15-19 year-olds, it is important that we recognize the impact of mental health, especially in light of a stress and anxiety inducing pandemic.3
Cincinnati Public Schools are making an active effort to address this issue through the use of MindPeace Cincinnati, an organization that pairs students in need with therapists located at their school-based centers. By meeting with therapists at school, not only will students have better access, but the stigma surrounding mental health care may be lessened as care is conducted in a safe and familiar environment. In addition, for students that do not wish to see a therapist but are looking to develop mental resilience, MindPeace Cincinnati, in conjunction with 1N5, an organization attempting to decrease the stigma surrounding mental illness, developed the State of Mind Speakers series– a variety of videos that can be watched in the comfort of one’s own home that cover a variety of topics aimed to promote mental health and wellness.4,5
Although there remains much to be done to increase access to health care and mental health resources, Cincinnati Public Schools are taking the necessary first steps despite these uncertain times. Not only has the pandemic revealed the need for increased access to mental health services, but access to health care in general. School-based health centers are more readily available to some students and their families and have become increasingly important during the era of COVID-19.
References available on the OAFP website.