Experts discuss how schools act as a hub for community health

State of Reform brought together a panel of experts focused on schools as a hub for community mental and physical health at the 2021 Michigan State of Reform Health Policy Conference. The panelists discussed the Whole Child model, the continued increase with mental and behavioral health challenges in Michigan children and the function of school nurses and clinicians in schools. 


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The panelists included Sara Lurie, CEO of the CMH Authority of Clinton-Eaton-Ingham counties, Rachel VanDenBrink, president-elect of Michigan Association of School Nurses, and Debbie Brinson, interim executive director of the School Community Health Alliance of Michigan. 

The panelists first discussed the whole child model presented by Brinson.


Image: Debbie Brinson


This model encapsulates the whole of a child’s wellbeing, in and out of school, to address the root causes of their health concerns. It acts as a framework for school nurses to address the social determinants of health for students and allows the nurse to assist the child in a more meaningful way. Lurie said:

“This really does capture all the roles that are so important to supporting the health and wellbeing of students and families.”

The panelists then highlighted the increased prevalence of depression, anxiety and other mental health challenges in Michigan children throughout the pandemic. According to Brinson, 1 in 4 children have insomnia, depression, anxiety and loss of confidence. This is due to quarantine isolations and limited social interaction and growth. 

Disparities in physical health are presenting themselves, too. Brinson said young people in cities are 15% more likely to report poorer health indicators than in rural areas, and Asian and Latinx youth are significantly more likely to report poorer health than Black and white youth. 

These challenges, along with lack of connection to behavioral health services through schools, have led to high volumes of crisis cases in children and a rise in demand for child psych beds. 

VanDenBrink said:

“The physical symptoms that manifest from the mental health load are more evident now than they ever were before. When you think about the schools, those kids with the tummy aches and with the headaches are not necessarily physical. They are caused by the mental stress load that these kids are dealing with. While we know kids can be resilient, they are really struggling.”

The Michigan Legislature has invested funds to implement programs to help children within their school environment. According to Brinson, the state has used Medicaid funds to help implement these programs. This will allow schools to expand on programs to assist Medicaid member students within school grounds. 

“This is the stuff that confirms and reaffirms the importance of the work that we are doing. It’s one thing to bring in services for kids for a period of time, it’s another to bring and build a system of care. And for the first time we are building a system of care for all Michigan’s children, particularly our most at risk kids, often those kids in Medicaid in underserved communities.”

The panelists then discussed the role of school nurses and their efforts to bridge the gap between providers and the school. 


Image: Rachel VanDenBrink


According to VanDenBrink, having this liaison is extremely important in accessing care and not falling between the cracks. Registered nurses study mental health symptoms in college which allows them to translate the physical symptom to the underlying mental or behavioral health problem.