School-Based Health Centers, Depression, and Suicide Risk Among Adolescents

Introduction: This study examined whether increasing availability of mental health services at school-based health centers in Oregon public schools would be associated with a decrease in the likelihood of depressive episodes and suicide risk among adolescents. Methods: The study included 168 Oregon public schools that participated in the Oregon Healthy Teens Survey in 2013 and 2015. Twenty-five schools had a school-based health center, and 14 of those schools increased the availability of mental health services from 2013 to 2015. The Oregon Healthy Teens Survey included questions about having a depressive episode, suicidal ideation, and attempting suicide in the past year. Multilevel logistic regression analyses were conducted in 2017 to examine associations between increasing mental health services and the likelihood of past year depressive episodes, suicidal ideation, and suicide attempts. Analyses also compared student subgroups defined by demographic characteristics (e.g., gender). Results: Students at school-based health center schools that increased availability of mental health services were less likely to report depressive episodes (OR=0.88, p < 0.01), suicidal ideation (OR=0.84, p < 0.01), and suicide attempts (OR=0.82, p < 0.01) from 2013 to 2015 compared with all other schools. Significant risk reductions in past year depressive episodes and suicidal ideation were also observed in school-based health center schools that increased availability of mental health services relative to other schools with school-based health centers. No significant differences were observed for student demographic subgroups. Conclusions: This study suggests that increasing availability of school-based mental health services can help to reduce depressive episodes and suicide risk among adolescents. (C) 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.