Gorette Amaral, MHS¹, Sara Peterson, MPH¹, Samira Soleimanpour, MPH¹, and Claire Brindis, DrPH². (1) Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143, 415-476-0746, gorette@itsa.ucsf.edu, (2) Center for Reproductive Health Research and Policy, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143

According to the Surgeon General's 1999 report on mental health, less than one in five children and adolescents with a mental health disorder receive care for their condition. Cost containment efforts in health care, which have often occurred at the expense of services such as mental health assessment and treatment, present barriers to access. Other reasons for underutilization include reluctance to seek services and stigma. School-based health centers (SBHCs), however, are uniquely positioned to serve adolescent mental health needs by providing low- or no-cost services (including counseling) in a teen-friendly, accessible environment.

To determine how effectively SBHCs attract adolescents with the greatest mental health needs, this study examines characteristics of adolescents who choose to use SBHCs compared to their peers who do not. Using data on 4,483 students who completed the California Healthy Kids Survey between 1999-2002, this study conducted a multivariate logistic regression analysis to identify predictors of SBHC use in a county-wide coalition of seven high school SBHCs. Findings demonstrate that adolescents who experienced frequent sadness (Odds ratio=1.43; 95% CI, 1.06-1.95), trouble sleeping (Odds ratio=1.71; 95% CI, 1.30-2.24), suicide ideation (Odds ratio=1.52; 95% CI, 1.26-1.84), alcohol use (Odds ratio=1.21; 95% CI, 1.02-1.44), marijuana use (Odds ratio=1.33; 95% CI, 1.09-1.63), or experienced a personal loss or difficulty were more likely to seek SBHC services than their peers. These findings suggest that SBHCs are able to attract students with the most serious mental health concerns and can play an important role in meeting adolescent needs that might otherwise go unmet.

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