%0 Journal Article
%T Characteristics of school
%A Hamish Howie
%A Jennifer Utter
%A Ross Galbreath
%A Simon Denny
%A Sue Grant
%A Terryann Clark
%A Theresa Fleming
%J Journal of Health Services Research & Policy
%@ 1758-1060
%D 2018
%R 10.1177/1355819617716196
%X School-based health services (SBHS) have been shown to improve access to mental health services but the evidence of their effectiveness on students¡¯ mental health is lacking. Our objective was to examine associations between variation in the provision of SBHS and students¡¯ mental health. A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted in March¨CNovember 2012. Students¡¯ mental health is related to data on school health services obtained from clinic leaders and clinicians from 90 participating high schools. After adjustment for socio-demographic differences in students between schools, increasing levels of services were associated with progressively lower levels of student-reported depressive symptoms (p£¿=£¿0.002), emotional and behavioural difficulties (p£¿=£¿0.004) and suicidality (p£¿=£¿0.008). Services with greater levels of nursing hours (p£¿=£¿0.02) and those that performed routine, comprehensive psychosocial assessments (p£¿=£¿0.01) were both associated with lower levels of student-reported depressive symptoms. Greater levels of nursing hours and doctor hours were associated with lower self-reported suicidality among students. Although a causal association between school-based health services and students¡¯ mental health cannot be demonstrated, these findings support the benefit of such services and the need for a cluster randomized trial
%K adolescence
%K depression
%K mental health
%K school health
%K suicide
%U https://journals.sagepub.com/doi/full/10.1177/1355819617716196