Expanded school-based health services making a difference

Teenage boys can be tight-lipped and keep their feelings and emotions to themselves. Tairawhiti District Health public health nurse Sarah Brown uses a little humour to encourage them to open up during health and wellbeing assessments as part of School Based Health Services (SBHS).

Photo of Sarah with student Liam.
Sarah Brown and Liam Boyle.

‘A bit of a laugh normalises things, releases tension and helps me to relate to the student and find that common ground.’

Sarah has been working at Gisborne Boys’ High School, checking on the health and wellbeing of its year 9 students using the HEEADSSS wellness assessment as part of the Prime Minister’s Youth Mental Health Project.

SBHS helps improve student access to a range of health services. A HEEADSSS assessment is carried out for all year 9 students. This helps assess youth wellbeing through a series of questions relating to home, education/employment, eating, activities, drugs, sexuality, suicide and depression, and safety (HEEADSSS). Any medical or mental health issues can be identified at an early stage, and students can be referred for treatment.

Sarah says there are some challenging subjects to discuss with the boys during the assessment, and they can be nervous when they first arrive.

‘They look a bit tense at the start, but by the end of our session, they are sitting much more comfortably because the fear has gone.’

Assistant Principal Tom Cairns, who is also the First XV rugby coach and a former student, says that the HEEADSSS assessments for year 9 students are making a difference to student welfare.

‘We take the pastoral care of our boys very seriously and had no hesitation in coming on board with this service. We’ve asked the boys, and they tell us that the assessments are a good thing to do. So it’s been a positive thing for our school.’

Tom says that two students are getting help to quit smoking; new glasses are being arranged for a couple of other boys; and just recently, a student who was frequently absent from school has begun attending more regularly.

Sarah carries out a medical check for each student that includes assessing height, weight and blood pressure. Then she and the student talk about hearing, vision, dental health and any recent visits to the doctor. Sarah then introduces more difficult topics, such as sexuality and drugs. ‘If I do it in that order, they begin to relax and I can bring in questions around tobacco, alcohol, self-harm and anything else that might be happening.’

Sarah treats students’ comments seriously, and the discussion is confidential. When a student needs extra support, such as for anxiety or low mood, Sarah can refer them to a GP, school counsellor or external support service.

Gisborne Boys’ High School student Liam Boyle enjoys BMX riding, soccer, playing guitar and listening to heavy metal music. He says talking with Sarah was easy, and although he was a bit nervous at the start, he didn’t mind her queries.

‘It wasn’t a big deal. My mates had already done it, and it turned out alright because they can track what’s happening and they can come in and help.’ Liam, who is short-sighted, reckons the assessment was a good reminder for him to wear his glasses more often – ‘It makes life easier and stops any headaches.’

Sarah says that the decile 3 school has a strong reputation for looking after its boys and has embraced the HEEADSSS assessments, making her job much easier.

‘Tapping into students in Gisborne early is the key. We can see what is going on for someone and help them out before a little issue becomes a big issue. It’s a great service.’

Evaluation of health services in secondary schools

Health Services in New Zealand Secondary Schools and the Associated Health Outcomes for Students

In early 2014 Auckland UniServices completed an evaluation of the effectiveness of health services in secondary schools. The report can be found on the University of Auckland website under Youth ’12 Health Services and Health Outcomes.

Overall the results of this evaluation indicate that high quality school-based health services (SBHS) impact positively on student health and wellbeing outcomes. SBHS had the strongest associations with improved student outcomes for depression, suicide risk, female contraception use, school engagement, and fewer emergency department presentations. 

In this section

  • Nurses from around New Zealand have shared their stories of quality improvement initiatives in School Based Health Services.  These case studies provide ideas for nurses, schools, district health boards and others to improve students’ health. Read more
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