Role of school-based health care in integrating social-emotional learning as an alternative to suspension

Pushing students out of school due to disciplinary issues is public health concern nationwide.  Schools should be a place where students feel safe and are not pushed out because of minor disciplinary issues.  There has been a negative trend in involving the police to arrest students, for what otherwise could be handled within the school setting.  Instead of helping students, many schools across the nation, particularly in urban and impoverished areas are contributing to the school-to-prison pipeline by suspending students, referring them to local law enforcement, and even referring students to court for truancy related matters.  According to the American Civil Liberties Union (ACLU), school disciplinary policies disproportionately affect African American students with a staggering number of 31% making up school-related arrests and being three times more likely than white students to be suspended or expelled.  Furthermore, research has shown that students who are suspended at least once are at a higher risk of dropping out of school.  

Loyola University School of Nursing runs the SBHC in Proviso East High School (PEHS), an urban high school located in a poverty stricken suburb adjacent to one of the poorest and most dangerous neighborhoods in Chicago. PEHS is one of the lowest performing high schools in the state; only five percent of students who graduate are considered college ready and the chronic truancy rate is 73%. Risk assessment data, as well as disciplinary data from the school, indicated that many students are exposed to a considerable amount of violence in their families and/or community and may lack stability and support in the home. This results in high rates of depression, post-traumatic stress disorder, and adjustment disorders, which often manifest into a variety of behavioral issues, such as substance use/abuse, unintended pregnancies, high risk sexual behaviors, chronic truancy and poor academics. Loyola’s New Directions public health project was designed to counteract the negative social determinants of health in the community through early identification of mental health and behavioral problems among students and interventions designed to increase resilience and decrease behavioral problems leading to disciplinary actions and/or school suspension. Specifically, Loyola’s project consisted of three components: 1) identification of high need youth for mental health interventions from a large cohort of students with disciplinary problems who were referred to a new in-school suspension classroom and connection of these students to SBHC mental health services; 2) development of a comprehensive curriculum delivered by SBHC mental health clinicians in the in-school suspension classroom as a way to teach students positive behaviors and to avoid further disciplinary involvement; and 3) “Lunch and Learn” educational seminars for PEHS teachers and nearby District 89 elementary school teachers to learn about mental health issues, warning signs of suicide and de-escalation techniques in the classroom.

School-based health centers (SBHCs) can play an important role in addressing many of these disciplinary issues and concerns by integrating programs and offering mental health services to students as an alternative to suspensions and expulsions.  This presentation will help explore ways in which SBHCs can integrate mental health services for students with the most disruptive behaviors in the school.