When a school is more than just a school: Improving school-based health in the wake of COVID-19

Original scientific article was written by Simon F. Haeder, Emily Maxfield, Kara Ulmen, and Sara Anderson and published in the World Medical & Health Policy Journal.


The ongoing COVID-19 pandemic has laid bare the blatant and growing inequities that many individuals, particularly children, are confronted with on a daily basis. With communities in lockdowns and schools going virtual in many parts of the United States, the important role that schools and school-based services play in the lives of many children have gained new attention. Nonetheless, only 3% of American schools have school-based health centers on campus, and they remain relegated to the fringes of both health care and education.


One key limitation has been the lack of appropriately trained health-care professionals. Over the past 2 years, researchers interviewed dozens of individuals about their experiences in school-based health centers. Based on this study, researchers explore what it means for a health-care professional to work in school-based health care and how it differs from more traditional health-care settings. Their analysis particularly focuses on training and education, work environments, and their unique demands that come from being embedded within the educational setting. The authors conclude by addressing the important role that governmental policies could play in augmenting this crucial workforce.


The SBHC staff in this study discussed the characteristics and skills, like flexibility and proactive communication skills, that are needed to work effectively in the SBHC setting. They also discussed how traditional provider training may not sufficiently prepare staff for working in the school setting and offered suggestions to support SBHC staff, like formal rotations in SBHCs or local trainings on available community resources.


The SBHC providers and administrators described the ideal characteristics of SBHC staff, and the two most common qualities highlighted were flexibility and an ability to work well with children. Moreover, staff also discussed the need for SBHC staff to have the ability to work well with students living in stressful and potentially hostile environments, maintain their own mental health in a challenging work environment, and to be proactive communicators and relationship builders.


In addition to certain personality characteristics, the interviewees discussed how school-based health-focused training during providers' education could also support SBHC staff. Several SBHC administrators and providers discussed the challenges associated with recruiting adequately prepared SBHC staff. These challenges include a lack of SBHC-focused components in provider education, a lack of awareness of SBHCs among providers, and the need for continued and local-context specific training.


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