The clinic down the hall: How School-Based Health Centers help kids succeed

Updated 9.23.16

By Sara Rigel, School-Based Partnerships

Remember the school nurse’s office, where you could go lie down if you felt sick, or get an ice-pack for a bruise?

If you walk onto the campus of any public high school in Seattle, you’ll find not only a traditional nurse’s office, but also a full-blown medical clinic. Welcome to the School-Based Health Center.

The benefits are vast. Many students are unable to attend a medical appointment off-campus because they have no transportation and parents are working jobs that make it difficult to transport the child. In some cases, the parents don’t have resources to regularly access care.

teensStudents can access medical services such as:

  • annual checkups
  • vaccinations
  • asthma care
  • sports physicals
  • contraception
  • mental health counseling

When students can access care at school, they can get quickly back to class and focus on learning.

In addition to addressing health and mental health concerns, the school based health centers also promote good health for a lifetime, through nutrition education, promoting supportive relationships, and reinforcing of positive self-images. School based health centers also support academic achievement and students who use the services have better attendance and grades.

Expanding on campuses

The Rainier Beach High School, the newly remodeled health center, is just down the hall from the front office. It incudes a waiting room, two counseling rooms, a group meeting space and an exam room. It’s staffed by an Advanced Registered Nurse Practitioner and a mental health counselor.

At Garfield High School, a similar clinic is near the Commons/lunch area. At Ballard, it’s located just off the Commons, co-located with the School Nurse office.

In all Seattle high schools, five middle schools and eight elementary schools, the presence of school based health centers has grown as Seattle city residents voted repeatedly to expand the system through the Families and Education Levy. The first of these clinics opened back in 1988, and they’ve been expanding since 1992, adding dental services and now totaling 26 sites citywide – one of the most robust school-based clinic systems in America.

Outside the city, the Highline and Kent school districts have been adding health centers at high schools. They’re all part of a national movement ( to offer comprehensive primary care and mental health at public schools.

The top three… and the case for prevention

The three most requested services also happen to be high community priorities, because they have such a high prevention value: vaccinations, mental health counseling, and contraception.

By having these three available at schools, the students who most need these services – and lack resources to access them elsewhere in a timely manner – can be protected.

At the schools, the providers understand long-term success for students often depends on parental involvement and agreement. That’s one reason it’s standard practice to actively encourage each student to bring their parents into a discussion about their health, including birth control options and mental health concerns – and most of them do include a parent.

At the same, Washington state law assures that teenagers have confidentiality if they need it when it comes both to mental health and to contraception. In cases where they’re facing abuse at home, or other troubling situations, the law says teens can seek help without parental consent – and all medical providers must honor that. (Specifically, Washington law says birth control services are available at any age without consent, and mental health treatment starting at age 13.)

For all other health services — including flu shots and sports physicals — a parent permission slip is required.  Most schools sent them home with the “first day packets” of school materials.

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Sidebar: 8,187 students in Seattle Public Schools made about 22,000 medical visits and 17,858 mental health visits to their school based health centers (in the 2015-16 school year)