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School-Based Health Center Use for Mental and Behavioral Health Disorders before and after the COVID-19 Pandemic: A Mixed-Methods Study

Title: School-Based Health Center Use for Mental and Behavioral Health Disorders before and after the COVID-19 Pandemic: A Mixed-Methods Study
Language: English
Authors: Connie Cai (ORCID 0000-0001-9067-791X); Alvina Pan; Brandon M. Smith; Gabriela Calderon; Sara B. Johnson; Katherine A. Connor
Source: Journal of School Health. 2026 96(1).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 9
Publication Date: 2026
Document Type: Journal Articles; Reports - Research
Education Level: Elementary Education; Junior High Schools; Middle Schools; Secondary Education
Descriptors: School Health Services; Access to Health Care; COVID-19; Pandemics; School Closing; Mental Health; Elementary School Students; Middle School Students; Mental Disorders; Student Characteristics
DOI: 10.1111/josh.70090
ISSN: 0022-4391; 1746-1561
Abstract: Background: School-based health centers (SBHCs) provide accessible healthcare for children, but not all have dedicated mental health providers. The COVID-19 pandemic and school shutdowns were associated with worsened student mental health, but the impact on the utilization of SBHCs without mental health providers remains unclear. This study examines utilization before and after school shutdowns at one such SBHC. Methods: Data are from a SBHC at a school serving 1600 K-8 students and includes electronic health records (EHR) and staff interviews. Visits between 2016 and 2023 (n = 6223) were characterized by whether the student had a mental and/or behavioral health diagnosis (MBHD) and whether the visit addressed a mental health concern. Negative binomial regression was used to compare visit rates, controlling for age, gender, and MBHD. Staff interviews (n = 9) were analyzed for emergent themes. Results: The proportion of visits by students with a MBHD rose from 11.2% to 17.6% (p < 0.01) post-shutdowns. These students visited the SBHC more frequently than peers before (IRR 1.5 [1.25-1.94]) and after shutdowns (IRR 1.39 [1.14-1.69]). Qualitative findings underscored increased needs post-shutdowns. Implications for School Health Policy, Practice, and Equity: Additional support for SBHCs includes expanded partnerships with teachers and mental health providers. Conclusions: Students with MBHDs increasingly relied on their SBHC, emphasizing the link between physical and mental healthcare.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1491980
Database: ERIC