There were 3 siblings from out-of-state who had just come into guardianship custody of their great aunt. Two of the kids were planning on attending an elementary school with an SBHC and the older sister would be attending a high school with an SBHC. The children needed NC Health Assessments in order to attend school in NC. The SBHC was able to accommodate one visit for all 3 siblings. This was a huge help to their guardian meaning she did not have to search for a new doctor and try to find a time when they could be seen. The older sibling also needed additional services such as counseling services and nutritional services as she was a newly diagnosed diabetic and the SBHC was able to accommodate all those needs while she is at school. The guardian was so thankful and relieved that all these services were available to them.
A 14 year old student was brought to the school-based health center by their aid after noticing her skin color was “off.” She was visibly yellow but complained of no other symptoms. Mom was called and she was agreeable to labs, which were drawn at the time of visit. The next day the SBHC medical provider received several critical labs and called her parents to bring her to the hospital immediately to be evaluated. The student was admitted to the local hospital and was found to have an enlarged liver with very abnormal labs, but they were unable to figure out what was the cause. She was then transferred to a large children’s hospital about 2 hours away where she was seen by a liver specialist. She had a liver biopsy and was diagnosed with Autoimmune Hepatitis, something very rare for her age. She needs bi-weekly labs, lifelong medication, and close follow up. Her parents and the patient are so grateful to the school-based health center that they were able to see her immediately and get her the help that she needed. We continue to follow her closely and she can get her labs at the SBHC, so she doesn’t need to miss school.
Recently, a female student struggling with moderate depression and anxiety engaged in outpatient therapy with one of our SBHC therapists. After a couple of therapy sessions, the therapist recommended to the student and parent/guardian that they meet with me for further evaluation and to discuss whether a prescription medication should be started to treat the symptoms of depression and anxiety. The SBHC medical provider provided both patient and parent with education on SSRIs, a first-line medication to treat depression/anxiety in adolescents and answered all questions so they could make an informed decision. The patient and parent opted to trial a medication and the SBHC will be following up closely to ensure she is doing well with no adverse effects. Both the patient and parent were so grateful to have the option to be seen at school, which improves access to care and prevents the parent from
having to miss work for future visits. I have seen many of our patients go from being withdrawn and feeling hopeless, some even having suicidal thoughts, to being confident and successful both in and out of school.
A common occurrence is being able to provide medical care for a student with a minor issue and whose parent/guardian may find difficulty taking off work to get them to a medical appointment. For example, the SBHC saw a student recently for a “bump on the bottom of her foot” that was causing pain and discomfort, especially with running or participating in certain activities in PE class. It turned out that the patient had a plantar wart, and the SBHC was not only able to provide guidance on treatment but was also able to educate the patient on the diagnosis and provide reassurance that it would resolve. Medical visits like this one highlight how SBHCs meet students’ and families’ needs right at school.