Mobile clinic lowers barrier to behavioral health care for young people

Across the nation, the need for behavioral health care for young people is on the rise. A CDC survey found that “persistent feelings of sadness or hopelessness” increased 40% between 2009 and 2019 for U.S. high school students.¹

The disruption caused by the COVID-19 pandemic contributed to more children and teens experiencing a behavioral health crisis. During 2020, the proportion of mental health-related emergency department visits among adolescents ages 12 to 17 increased 31% compared with that during 2019.²

In Washington state, adults and youth report living with a mental illness at higher rates than the national average while also having lower rates of access to care.³ According to the Washington State Department of Health, suicide is the second leading cause of death in the state for youth ages 15 to 19.⁴

Behavioral and primary health care delivered at school

Faced with these statistics, North Olympic Healthcare Network (NOHN), a Federally Qualified Health Center serving Clallam County, Washington, wanted to find a way to improve young people’s access to behavioral and primary health care. The solution was to deliver care at schools, eliminating the transportation barrier for students and their families.

UnitedHealthcare Community & State invests in strategies that address the growing need for behavioral health care and resources for young people. With support from a three-year, $3.3 million grant from the United Health Foundation, NOHN partnered with the Port Angeles School District to deploy a mobile health clinic that serves the community’s 3,000 K-12 students⁵. The unit visits all five elementary schools in the district as well as Stevens Middle School, Port Angeles High School and Lincoln High School. It’s also available to students who attend school online. Medical professionals provide a range of on-site services including well-child checks, behavioral health counseling, sport physicals, and immunizations.

Students who visit the 38-foot motorhome find a space designed much like any standard clinic. A private examination room is used by nurse practitioners and physician assistants to provide primary health care. A small room at the front of the clinic serves as a confidential place for clinical social workers and mental health counselors to offer behavioral health support and education to students and their families.

Students need access, connection and support 

The program to integrate health care into the school setting in Clallam County began in 2017, with a dedicated room at Port Angeles High School serving as a clinic for students. The objective was to identify the health services with the greatest demand, as well as gaps in care.

“What we found was the need went beyond high school and what we had anticipated, particularly behavior health,” said Michael Maxwell, MD, CEO of NOHN.⁶

In the wake of this experiment, students, teachers, counselors and staff in the district supported the idea of a mobile health unit that would give the clinic greater reach. Offering mobile health services would allow the district to expand upon its mission to provide students with health, emotional and social support.

No student is turned away from the clinic. The cost of services is billed to the insurance of parents or guardians, and for uninsured students there is a financial assistance program with a sliding-fee scale to which parents or guardians may apply.

Destigmatizing behavioral health care

Greater accessibility to a clinic and health professionals makes it more likely that students will proactively seek support to build self-knowledge and resilience and to avert crisis. In Clallam County, a student receiving the medical and behavioral health care they need is now a common occurrence during a school day.