Comprehensive School Health Care

Rune Simeonsson
Ronda Talley

Domain Description:

In recognition of the interrelationships among physical, psychological, social, and educational functioning, school psychologists are being called upon to address the physical and mental health needs of students through participation in comprehensive and coordinated school health services. For the purposes of this review, comprehensive and coordinated school health services includes school-based or school-linked services related to a broad spectrum of health-related problems, including chronic medical or health-related conditions (e.g., endocrine and seizure disorders, childhood cancer, asthma and allergies, diabetes, HIV/AIDS, fetal alcohol syndrome); psychiatric disorders (e.g., mood and behavioral disorders), and social problems (e.g., drug abuse, sexually-transmitted diseases, suicide, violence). Authors will review research related to comprehensive health care interventions in the school health areas adopted by the Centers for Disease Control and Prevention:

• Health education;
• physical education;
• health services;
• nutrition services;
• healthy school environments;
• health promotion for staff; and
• parent/community involvement.

To the extent that these areas overlap with previously defined sections (e.g., programs for social-behavioral problems, school-wide and classroom-based), they will be treated in their respective sections. The emphasis in this domain is on primarily health-related concerns. Current models of comprehensive health care suggest the need for attention to several key factors:

(a) integration of educational, health and social services;
(b) interdisciplinary and inter-agency collaboration;
(c) attention to ecological, contextual, and individual factors;
(d) developmentally and culturally appropriate services;
(e) a continuum of care ranging from prevention to treatment;
(f) provision of empirically supported care; and
(g) routine and systematic program evaluation.

I Health Education

Health education is defined as a planned, sequential, K-12 curriculum that addresses the physical, mental, emotional, and social dimensions of health. The curriculum is designed to be comprehensive and address such issues as personal, family, community, consumer, environmental, and mental/emotional health; sexuality education; injury prevention and safety; and prevention and control of disease. Health education should be provided by qualified teachers trained in this area.

II Physical Education

Physical education is also defined as a planned, sequential K-12 curriculum; service providers offer cognitive content and learning experiences in activity areas such as basic movement skills, physical fitness, rhythms and dance, games, sports, and gymnastics. Similar health education, physical education is taught by qualified, trained teachers.

III Health Services

Health services form the basic core of health care delivery. These services are designed to assess, protect, and promote health, and historically have been provided by medical personnel, such as nurses, physicians, dentists, and other allied health personnel. Health services are designed to insure access to primary health care services, prevent and control communicable diseases, provide emergency care for illness or injury, and provide educational and counseling opportunities for the promotion and maintenance of individual, family, and community health.

IV Nutrition Services

School nutrition services reflect the U. S. Dietary Guidelines for Americans; they are structured to promote the health and education of students by providing access to a variety of nutritious and appealing meals. In addition, school nutrition programs offer an opportunity for students to experience good nutrition and learn these precepts. Services are provided by qualified child nutrition professionals.

V Health Promotion For Staff

Health promotion programs are designed to provide school staff with health assessment, education, and health-related fitness activities so that they may display a greater commitment to the health of students and offer positive role modeling. While designed to improve productivity, decrease absenteeism, and reduce health insurance costs, staff health promotion can also generate a greater personal commitment by staff to maintain good health and to support the school's overall comprehensive health program.

VI Counseling, Psychological, And Social Services

Traditionally provided by psychologists, school counselors, and social workers, the school health component of counseling, psychological, and social services is conceptualized as discrete from the school health services component mentioned earlier. The services include broad-based individual and group assessment, intervention, and referrals that address mental, emotional, and social health issues for students. In addition, organizational assessment and consultation that contributes to the overall health of students and the health environment of the school are considered part of this component.

VII Healthy School Environment

A healthy school environment addresses the physical and aesthetic surroundings of the school, including the psycho-social climate and culture of the school. It includes the creation of a safe and physically comfortable environment as well as one that is free of hazards and violence. The psychological environment, which encompasses the interrelated physical, emotion, and social conditions that affect the well-being and productivity of students and staff, is also part of a healthy school environment.

VIII Parent/Community Involvement

This school health component seeks to support the concept of an integrated school, one which brings the community and families into a dynamic partnership designed to enhance the health and well-being of students. Schools are encouraged to actively solicit parent involvement and engage community resources to respond in a services integration model to the health-related needs of students.