Symposia
Dissemination & Implementation Science
Erum Nadeem, Ph.D.
Rutgers University
Piscataway, New Jersey
Whitney Greswold, MPA
Projects Administrator
La clinica de la Raza, Inc.
Oakland, California
Laura Zepeda Torres, MPH
Interim Senior Planner
La clinica de la Raza, Inc.
Oakland, California
Haley Johnson, Ph.D.
Researcher
McREL International
Denver, Colorado
In youth mental health, a critical area for improvement is the accessibility of high-quality, culturally responsive services. For adolescents, often the most universal points of contact with mental health care are schools and primary care settings (Lipari et al., 2016; Merikangas et al., 2011). School-Based Health Centers (SBHCs) are particularly promising for meeting comprehensive health needs and supporting educational success for marginalized and underserved youth (Knopf et al., 2016), and have increasingly started to conduct routine screening for behavioral health issues. These structures can be essential infrastructure in during times of crisis and increased need among vulnerable populations.
The goal of the current mixed-method study is to elucidate trauma-focused screening processes in a school-based integrated care setting that serves youth from diverse ethnic/racial, language, and immigrant backgrounds. The goal of this mixed-methods study was to characterize trauma screening rates and medical visits and behavioral health service use in school-based health centers (SBHC), serving a diverse group of urban youth. A second was to understand the experiences of SBHC personnel in providing culturally responsive trauma-informed care. Data included electronic medical record data (N = 4794) and qualitative interviews with medical providers, medical assistants, and behavioral health clinicians (N = 9).
Overall training screening rates were 69.2%, with higher screening rates for older and Spanish-speaking youth. Rates of behavioral health usage were 32.9%, with higher rates among girls, newcomers, and those who were screened for trauma at a medical visit. Additionally, English-speaking youth were more likely to use behavioral health than Spanish speakers. There were few ethnic differences. Qualitative themes highlighted how the trauma screening and behavioral health linkage hinged on perceived value of the trauma screening and behavioral health care, collaborative team practices, and clear workflows for screening and behavioral health linkages. Qualitative data also highlighted culturally responsive practices (i.e., interpreters, culture-specific assessment tools, knowledge of population needs), and issues related to preparedness and delivery of trauma-focused, behavioral health care in real time during the COVID-19 pandemic.