Youth Advisory Council Makes Recommendations for SBHC Care

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In December 2015, the Oregon School Based Health Alliance Statewide Youth Advisory Council (SYAC) partnered with FamilyCare CCO and the Oregon Public Health Division to facilitate a youth listening session in the Portland Metro area. Over 50 youth were in attendance. Below are key findings from the session and recommendations to SBHCs based on what the SYAC heard.

Overwhelmingly, youth identified sexual health and mental health as reasons they go to see a provider. Schools and SBHCs need to provide better sexual health education. Age-appropriate sexual health education should start earlier on, and the conversation needs to become more normalized so it’s not so awkward when talking about it with adults (some teachers are very awkward about the topic).
  • SBHC staff should be more involved in sexual health education that takes place in school. The SBHC is a trusted source of information in the school. Having a provider talk about healthy relationships and contraception is more conversational and less lecturing. Use of visual aids and a description of all of the different types of contraception is needed.
  • Increase the involvement of the YAC in health education done by SBHC providers. The YAC can provide peer-to-peer education. For example, an SBHC provider could lead the lesson on healthy relationships, anatomy, contraception, while YAC members lead group discussions and skits (vs. lecture) on how to apply the knowledge to their daily lives.
  • SBHCs need to increase education and awareness on minors' rights. Not all youth are aware of their rights when it comes to accessing services, especially those for sexual health.

Youth need to be more involved in school policy decisions that impact their lives. They need more opportunities and support to engage in the process.
  • SBHC staff should advocate that youth need to be more included in the policies of their school. A few options are:
    • Advocate that school boards notify students of meeting times – school board meetings are inaccessible to youth; youth voice is lacking in meetings where decisions that significantly impact adolescents’ health/future are being made. “How are we supposed to voice our opinions?” How are we expected to plan for the future if we’re not included in school board meetings?”
    • Advocate for a mandatory seat at the table for student representation.
Youth are hesitant to seek services because they are worried the provider will judge them. They might not share information about drug or alcohol use.
  • SBHC providers should provide their recommendation or treatment option, but honor the youth’s decision to do it or not. Provide a full range of options and keep the door open to more conversations in the future.
  • Inform youth that they can always get a second opinion.

Stigma associated with getting health care came up as a barrier for youth, and having a trusting relationship with a provider was key for youth to feel comfortable accessing health care. Consistent contact and communication with providers was one way to build trust.
  • SBHCs should be more involved in the school community to keep a pulse on the culture of the school and know what is impacting students. For example:
    • Hold regular table to talk with students about issues effecting their lives.
    • Reach out beyond just the students that might participate in the SHAC to all school students. 

Convenience of appointment times is hugely important for busy youth. SBHCs are easily accessible because they are at school, but could offer more convenient appointment times.
  • SBHCs should have more walk-in appointment times available to students or an opportunity for students to schedule an appointment right on the spot.
  • Offer more appointment times outside of the class day. Have appointments available during student lunches and right before or right after school.
  • “It seems like the SBHC in my school is closed for a large chunk of time over the lunch hour. I have to therefore miss class in order to receive healthcare. I thought that was kind of the point of SBHCs”. –SYAC youth member
  • “It’s hard to pick and choose which class period to miss to go to the SBHC – I’m in a lot of honors classes and I don’t want to fall behind”. – SYAC youth member