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Better health services in schools help student wellbeing

Better health services in schools help student wellbeing

Results from the latest Youth 12 Survey reveal considerable variability in health services for New Zealand secondary schools.

A significant proportion (12 per cent) of secondary schools reported no health services beyond the minimum requirement of first aid provision; this was more common among private schools than integrated or state-funded schools.

The other 88 per cent of schools reported some level of health service.

The report was launched this week at a Youth Health Symposium at the University of Auckland.

The most notable results were in mental health where there was less depression and suicide risk among the students in schools that had higher levels of health services.

“As comprehensive school health services are not available in most secondary schools, further investment and resourcing of school health services could have a positive impact on the health and wellbeing of secondary school students in New Zealand,” says lead study author, Associate Professor Simon Denny from the University of Auckland.

As part of Youth’12, (the survey of 8500 students in a random sample of 125 secondary schools), the health services in the same 125 schools were also surveyed.

“Overall these results suggest that high quality school health services, (those that have on-site staff well trained in youth health, with sufficient time to work with students and to perform tasks like routine health assessments), do impact positively on student health and wellbeing outcomes in areas such as depression, suicide risk, sexual health, alcohol misuse and school engagement,” says Associate Professor Denny.

“There is also evidence that high quality school health services lessen the use of hospital Accident and Emergency departments by students.”

This reduced hospital A & E use reported by students in schools with health services occurred especially where the health services had sufficient nursing time and performed routine comprehensive health assessments.

The most common model of health service provision, in 56 per cent of schools, was by visiting health professionals. Other schools had on-site health professionals: 20 per cent had a health professional (a school nurse) and 12 per cent had a collaborative health team of health and other professionals on site for most of the week.

Schools with higher levels of health service (an on-site school nurse or health team) were more likely to have more facilities, to be better integrated with the school, the community and local Primary Health Organisations, and to provide routine comprehensive health services.

Registered nurses were the most common health professionals working in schools, with slightly more public health nurses (who visit schools) than primary care nurses (who are based at schools). There were a small number of doctors (5 per cent of the health professionals) also working in school health clinics.

Analysis of survey data on the health and wellbeing of students at schools with and without school health services gives some evidence of the effectiveness of those services, although such survey results did not allow any unequivocal finding in this regard.

The improved mental health results with less depression and suicide risk among the students occurred in schools that had more health services, says Dr Denny.

The specific qualities of the school health services that were particularly associated with improved mental health outcomes, such as depression and suicide risk among students, were in schools with health professionals on site; where the hours of health professionals time per week per 100 students was higher; where the health professionals were trained in youth health and well supported through professional peer review; and where the health professionals were well integrated with the school and with the local community.

There was also some evidence of effectiveness of school health services in the domain of sexual and reproductive health: there was better contraceptive use by female students in schools that provided sexual health services and where the health professionals had received training in youth health.

“A commom theme running through the report was that nurses and doctors working in schools needed sufficient time in order to work effectively and improve health outcomes among students,” he says.

Schools with visiting health professionals reported the lowest hours per week per 100 students: on average less than one hour of nursing time per week per 100 students and less than 0.05 hours of doctor time per week per 100 students.

By contrast, schools with an on-site health team reported on average 4.8 hours of nursing time per week per 100 students and 0.18 hours of doctor time per week per 100 students.

There was also better school engagement among students in schools with a health team on site, with sufficient nursing time, and that the performed routine health assessments.


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