Expert Care for Your Child — Right at School

Christian was barely two years old when he watched his mother die from an injection of fentanyl-laced heroin.

Four years later, as he started first grade, the memories returned.

“He just fell apart in school,” his grandmother, Donna Jean Robertson, recalls. “He was crying and rolling on the floor, yelling about the needles and the blood.”

Donna Jean despaired as she remembered the frustrations of trying to find care for her daughter when she had struggled in high school. Back then, she had to wait two months for an appointment with a therapist 15 miles away. Donna Jean missed work. Her daughter missed school. Each session costs $100 in copays.

With her grandson, however, Donna Jean got a lucky break — thanks to a clinic run by Nemours Children’s at Christian’s elementary school, right around the corner from his home.

Help Just Down the Hall

At a health center based just a short walk down the hall from his classes at the Kathleen H. Wilbur Elementary School in Bear, Del., Christian was able to get help within a week. He was seen by a licensed clinical social worker, who also helped Donna Jean with her pent-up grief, referring her to a local support group for bereaved parents. And Donna Jean didn’t have to pay a penny out of pocket.

“Christian saw his therapist weekly for several weeks, and today he’s not crying in school anymore,” says Donna Jean, adding: “This has been a great help to the both of us.”

The number of school-based health centers has grown throughout the United States over the past few decades. At last count there were more than 2,500 of them, serving more than six million students in roughly 10,000 schools, in 48 states and Washington, D.C. We manage eight of these clinics in Delaware, in addition to the one that served Christian. And we intend to expand this program, which meets so many clear public needs. 

The centers offer services from flu shots and physicals to behavioral therapy. Although they’re not meant to replace a child’s primary care doctor, they may often be the only care children receive. And their benefits are striking.

Researchers have found that students at schools with such health centers tend to have lower dropout rates, fewer absences, and higher scores on academic tests. The centers also help to reduce health care costs, curbing visits to emergency rooms.

Filling a National Need

Despite their many benefits, only one in 10 public schools have access to the school-based centers. Many of the clinics operate at a loss and must be subsidized by hospitals, government agencies and nonprofits.

We’re stepping up to expand these centers to more elementary schools, in communities where most students are low-income, English learners, or people of color.

“This is a model for other schools,” says David Distler, the principal at Eisenberg Elementary School in New Castle, Del., where Nemours runs another school-based clinic. “As an administrator I couldn’t imagine going to a school that didn’t have it.”

How Nemours Children’s is Advancing School-Based Behavioral Health Across the U.S.

To support the adoption of school-based behavioral health services across the U.S., Nemours Children’s has released Fostering School-Based Behavioral Health Services, a set of two issue briefs described in this blog that provide recommendations for implementing school-based behavioral health services. The briefs also profile innovative and promising school-based behavioral health models from across the nation. The issue briefs were based on 40+ interviews with stakeholders experts as well as discussions with 150+ stakeholders from the Well Beyond Medicine: Implementing School-Based Behavioral Health Programs Virtual Convening held on May 9, 2023. During this convening, participants, including national pediatric and behavioral health organizations, state and local education agencies and philanthropic organizations shared best practices for implementing school-based behavioral health services.