Students push for expanded mental healthcare at school-based clinics

February 8, 2018

As Oregon lawmakers returned to Salem this week, students from Roosevelt, Centennial, Parkrose, David Douglas, Cleveland, Franklin, and Gresham high schools joined students from nine other Oregon schools to speak with their legislators about the importance of mental health services at school-based health clinics.

Cleveland students (left to right) Grace Oh, Camille Christensen, Emily Swinth, and Caroline Diamond walk through the state capitol.

“A lot of teens need someone to talk to who is not a parent,” a Cleveland freshman told Rep. Rob Nosse. The student went to see a counselor through the school’s Student Health Center after he tried to commit suicide, he told the lawmaker. “They helped me get back into school and helped me get my life back together,” he said.

“Good for you,” Nosse replied. “I didn’t realize they offered mental health services.”

“Thanks for sharing that,” chimed in Tom Eby, nursing supervisor for Multnomah County’s Student Health Centers.

This was Eby’s sixth trip to Salem for School Health Advocacy Day.

“It’s my favorite day to come to work, to watch these students advocate for their health and wellness,” he said. “That’s what our program is all about. We’re trying to provide not just primary care, but public health, because the exam room only has so much impact.”

Multnomah County operates 12 student health centers, where any resident ages 5 to 18 can see a primary care provider, receive sexual and reproductive health services, get their vaccinations or see a behavioral health provider. The services are always available at no out-of-pocket cost.

Eby has worked in student health centers for 19 years, and he’s watched the services expand. In his early years, teen pregnancy rates were high, and there was an emphasis on family planning, he said. But as teen pregnancy rates have plummeted, the county clinics have been able to focus on other vital services, like behavioral health. “We now have mental health providers specially trained to go into the exam room and do a brief assessment as part of a medical visit,” he said. “Behavioral health is a big part of physical health.”

Nosse, like other legislators in the Portland metro area, is a staunch supporter of student health centers.

The annual student health awareness day is organized by the Oregon School-Based Health Alliance. The alliance is seeking an additional $995,000 to fund a mental health program through the Oregon Health Authority. Currently the program can only support services in 12 school districts out of more than 200 in the state.

“These are things I agree with,” Rep. Nosse told the teens. “I’m a big supporter of these systems.”  But Oregon is facing a budget shortfall of between $200 and $300 million, so it will be a battle to beef up spending on school-based mental health services, he said.

The students from Multnomah County are members of Youth Advisory Councils within each school. The councils promote school-wide health and give input and make recommendations on services offered through student health centers.

Students Raylene Kisor, Vy Nguyen and Marian Mumin from Parkrose gathered in the office of Rep. Barbara Smith Warner with school health center nurse Danaya Hall.

Juan Romero, a senior at Roosevelt, has made three trips to Salem as part of his health center’s advisory council. He wants lawmakers to continue funding outside experts, including Planned Parenthood, to guest teach in sex education classes, he told House Speaker Tina Kotek. And he wants to see a diversity of providers at his school health center.

“It doesn’t always feel the same talking to a white person as it does when you talk to someone who looks like you,” he said. “They may have gone through the same struggles as you so they understand.”

His classmate Kassandra Ferrusca said that’s how she felt when she went to see a counselor at school. “I’m glad I went, but I didn’t feel comfortable because she didn’t look like me,” she told Kotek. “We need more people who look like me.”

Speaker Kotek agreed. “That’s a challenge everywhere,” she said.

Down the hall, students from Parkrose gathered in the office of Rep. Barbara Smith Warner.

Vy Nguyen, 16, describes a plan to install a question box near the student health center, where youth can drop anonymous questions for clinic staff to answer.

“That’s a great idea,” Rep. Smith Warner said. “Would you put answers on a bulletin board? Or you could contact the student paper to see about having a column.”

The students smiled at her enthusiasm.

Raylene Kisor, 18, said she would like to see mental health treated more like physical health, where students go in for their mental health check-up the way they do for their annual physical.

“The idea of a check up, that makes a lot of sense, especially for teenagers,” Smith Warner said. “A big part of brain development happens during those years. The idea of someone being able to say what’s normal, healthy, and offer some strategies, that makes a lot of sense.”