Characteristics of school-based health services associated with students' mental health
Abstract
Objective School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students' mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students' mental health. Methods A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March-November 2012. Students' mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. Results After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p = 0.002), emotional and behavioural difficulties (p = 0.004) and suicidality (p = 0.008). Services with greater levels of nursing hours (p = 0.02) and those that performed routine, comprehensive psychosocial assessments (p = 0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Conclusions Although a causal association between school-based health services and students' mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial.
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There is a widespread public and political belief that educational settings are a logical and appropriate place in which to provide prevention and treatment.
“There is a widespread public and political belief that educational settings are a logical and appropriate place in which to provide prevention and treatment, and a growing expectation that well-being support will be provided within educational settings (Barry 2017; Denny 2018; Ministry of Education 2017).”
From Prevention of self-harm and suicide in young people up to the age of 25 in education settings (2024) · cites this paper as Denny 2018
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“While SBHS have been shown to improve access to mental health services,(5) evidence of its effectiveness in terms of students’ mental health is limited.(6,7) Studies in this field face methodological and ethical challenges.”
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Knowles, S., Sharma, V., Fortune, S., Wadman, R., Churchill, R., & Hetrick, S. (2022) · Health Expectations · doi:10.1111/hex.13479 · Cited by 49 · see citing works
Prevention of self-harm and suicide in young people up to the age of 25 in education settings
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- Authors
- Denny, S., Howie, H., Grant, S., Galbreath, R., Utter, J., Fleming, T., & Clark, T.
- Affiliations
- University of Auckland (NZ)
- Counties Manukau District Health Board (NZ)
- Corresponding author
- Denny, Simon
- Venue
- Journal of Health Services Research & Policy
- Publisher
- SAGE Publications
- Published
- 2017-06-29
- Volume
- 23
- Issue
- 1
- Pages
- 7-14
- ISSN
- 1355-8196 (ISSN-L)
- 1758-1060
- OpenAlex
- W2725301283
- Cited by
- 13
- References
- 22
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2019: 1
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Health Services Research & Policy (publishedVersion)
- PubMed (publishedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- school health services, student mental health, depressive symptoms, suicidality, emotional and behavioral problems, nursing time, psychosocial assessment, access to mental health care, high school students, New Zealand
- MeSH terms
- Adolescent, Affective Symptoms, Mental Disorders, Child, Cross-Sectional Studies, Depression, Female, Health Services Accessibility, Humans, Male, Mental Health, Mental Health Services, New Zealand, School Health Services, Socioeconomic Factors, Students, Time Factors, Suicidal Ideation
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