About School Based Health Services

Information on School Based Health Services in Aotearoa New Zealand.

Improving the well-being and resilience of young people will give them a better sense of connection and help to ensure they are ready to learn and more likely to achieve at school. Young people should be supported to develop the confidence they need to reach out for help and support when they need it.

School Based Health Services (SBHS) take a holistic approach to supporting young people. The most common presentations include, but are not limited to, trauma-based health impacts, particularly family harm, mental health, addictions, and sexual and reproductive health. SBHS nurses provide clinical primary health care (both student requested and nurse initiated), referrals onto required services and support health promotion campaigns.

SBHS ensures that young people entering secondary schools meet the school nurse in person to develop a personal connection and have a private and confidential psychosocial assessment (Year 9 health check). A common form of the Year 9 health check is HEEADSSS: Home, Education/employment, Eating, Activities, Drugs, Sexuality, Suicide and Depression, and Safety from injury and violence).

The Year 9 health check can identify a young person’s strengths and resilience factors as well as flag areas of concern. Appropriate support or interventions can be provided in the school setting, and with the young person's agreement, referral can be made to other support services. 

SBHS deliver services for young people using a positive youth development approach to support the mana of young people and recognise the right of a young person to have agency in their lives and over the decisions that affect them.

Supporting people to develop healthy habits when they’re young can have ongoing benefits to their health and wellbeing throughout their lives.

The experiences, changes and challenges encountered by young people means, health professionals who have an interest in young people require an expert relational and cultural skillset beyond the clinical qualifications and knowledge expected in general nursing and medical practice.

Where are SBHS available?

SBHS are available in lower decile (decile one to five) secondary schools, Teen Parent Units (TPUs), and Alternative Education sites (AE) nationally. This means SBHS are available to around 97,000 students across approximately 300 schools.

Other school health services may also be available in schools, for example, where schools pay for their own nurse, or where the district health board (DHB) or primary health organisation (PHO) have chosen to supplement services with a GP.

On this page we are specifically focusing on the SBHS services. For more information on the other health services provided in schools see the Child health and Youth health sections.

How are SBHS managed?

DHBs are responsible and managing SBHSs in their district. Models of delivery vary, and are mostly through DHBs, PHOs, public health nurses and Youth One Stop Shops. The Ministry provides DHBs with guidance (as per the service specification) as required and/or requested.

In 2006, the Ministry developed the School and Pre-School Health Services Specification. This is a Tier 2 Service specification under the Services for Children and Young People Tier 1 Service Specification. In 2013, the Ministry published the Tier 3 Service Specification to define additional School Based Health Services.

You can access the child and youth service specifications on the Nationwide Service Framework Library website.

History of SBHS

SBHS originated from the Achievement in Multicultural High Schools Initiative (AIMHI) by the Ministry of Education in 2001. AIMHI funded the development of ‘full-service facilities’, including health services, on site at nine Decile 1 secondary schools.

In 2007, the Ministries of Health and Social Development jointly took over the role of funding AIMHI within these schools. The service grew in 2008 following Government investment over 4 years. This investment enabled phased expansion of SBHS, beginning with decile 1 and 2 secondary schools, TPUs and AE sites.

In 2012, the Government committed to funding the maintenance of existing SBHS services and expansion to Decile 3 secondary schools.  

In 2018, through Budget 18, the Government funded expansion of SBHS to Decile 4 secondary schools.

In 2019, through Budget 19, the Government funded: expansion into Decile 5 secondary schools; a nurse salary increase (to MECA rates); a nurse: student ratio decrease; and enhancements to SBHS.

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