Adolescents may have easier access to mental health care in a school-based health centre (SBHC), but according to a study in the Canadian Journal of Psychiatry, usage rates among students remain low despite high needs for mental health support.
Researchers surveyed 1,629 students from three high schools in Cape Breton, Nova Scotia to determine SBHC usage, as well as common characteristics among users of SBHC mental health services. Almost one-half of those surveyed reported a need for mental health support. However, only 20.4 percent of females and 5.3 percent of males used the SBHC for this purpose. A need for mental health support was measured using indicators that included risk for depression, suicidal behaviour, problem alcohol or cannabis use, and self-rating health scores. Common reasons for use of SBHC mental health support were personal relationships, substance abuse and emotional health. Students also used the SBHC for other reasons, such as sexual and physical health concerns.
The characteristics among users of SBHC mental health services that differed significantly from nonusers included lower school performance, sexual health risk-taking behaviours, suicidal behavior and risk for depression. Furthermore, among females, significantly more users reported parents with lower education levels than nonusers. Significantly more male users reported eating behaviour problems, confidentiality concerns, problem cannabis use and low self-rated health compared to non-users. The actual number of males who reported using the SBHC for mental health support was small (43), limiting the conclusions that can be made about this group. Nevertheless, the authors note that males are particularly underserved for a variety of reasons.
The study found confidentiality concerns to be a significant barrier for service use among students with mental health support needs. Further study is necessary to identify reasons for non-use of the SBHC for mental health support, which may include lack of awareness of the range of services, viewing the SBHC as a sexual health clinic, stigma associated with mental illness, as well as a lack of awareness of need.
See “Use of School-Based Health Centres for Mental Health Support in Cape Breton, Nova Scotia,” Canadian Journal of Psychiatry (May 2010; 55: 319-328), available at publications.cpa-apc.org.