Tens of thousands of New York City children rely on school-based health centers—welcoming, convenient places to receive comprehensive primary, behavioral, and oral healthcare. Yet, despite the safety net provided by these programs, particularly in high-risk communities, they function continually under the threat of losing critical funding from federal, state, and local agencies.
Family Health Centers at NYU Langone operate 41 school-based health centers in preschool, elementary, middle, and secondary schools—one of the largest networks of its kind in the state—for more than 20,000 children and adolescents. The majority—32 sites—are in Brooklyn schools. Additionally, NYU Langone oversees six in Manhattan, one in the Bronx, and two on Staten Island. Combined, the clinics provide more than 42,000 medical visits, 19,000 behavioral health visits, and 25,000 dental visits.
“By placing health centers directly in schools in underserved neighborhoods, we are eliminating one of the largest barriers to healthcare: geographic location,” says Larry K. McReynolds, executive director of the Family Health Centers at NYU Langone.
Providing Services in At-Risk Communities
School-based health centers provide much needed primary and preventive physical and mental health services in preschool, elementary, middle, and secondary schools in high-risk areas, says Adrienne McMillan, MD, NYU Langone’s medical director for school health. Having school-based medical resources means parents do not have to miss work and children do not have to miss school to access care.
“Students and their families, some homeless or living in shelters, face many daily challenges,” Dr. McMillan says. “School health programs offer a unique opportunity to provide healthcare services, address unmet health needs, and serve as a public health safety net and critical healthcare access point to a population of children that is often difficult to reach outside of the school day.”
School-based health centers, which are open during regular school hours, are staffed by nurse practitioners, physician assistants, social workers, and medical associates who work with physicians, psychiatrists, psychologists, health educators, nutritionists, dentists, dental hygienists, and optometrists. When they are closed, students can access care in the network of nine family health centers NYU Langone operates throughout Brooklyn.
Dental care for as many as 4,000 children in Brooklyn and another 1,500 in the other boroughs is provided by school-based dental centers at the Family Health Centers at NYU Langone. “Teaching children basic oral care, such as how to brush and floss properly, helps reduce dental decay and significant problems down the road,” says Lynn Gargano, DDS, director of dental school health at the Family Health Centers at NYU Langone.
Social Impact of School-Based Clinics
Statistics show that school-based health centers are doing their job. The independent School-Based Health Alliance, a group advocating for high-quality healthcare for children and adolescents, reports fewer school absences among children with asthma in schools with school-based health centers; a decline in school discipline referrals; and a decreased incidence of absenteeism and tardiness among students who received counseling in school-based health centers. Sexually active students also are more likely to turn to on-site clinics for information on sexually transmitted diseases and pregnancy prevention.
Behavioral health problems also often are the root of school violence, high dropout rates, bullying, high suicide and homicide rates, and increased levels of high-risk behaviors. According to the School-Based Health Alliance, students who reported depression and suicidal thoughts or past suicide attempts are more willing to use school-based health centers for counseling.
“To meet the growing demand for mental health services, we are piloting a telepsychiatry service at two sites this year,” says Rebecca Gallager, senior director of youth and adolescent services at the Family Health Centers at NYU Langone. “This remote video teleconferencing with a mental health professional will provide easier access to psychiatric assessment and treatment.”
Funding Threats and an Ambiguous Future
Despite that children rely on school-based health centers and the convenient, cost-effective care that they provide, the New York State Department of Health announced this past July massive cuts in funding for school-based health centers. The Family Health Centers at NYU Langone program alone received a 45 percent funding cut. With more reductions expected, their future is uncertain.
“The critical role of school-based health centers in our communities must not be underestimated,” says McReynolds. “The future of young people is at stake if the resources that can help improve their lives are imperiled or diminished.”