Adverse Childhood Experiences and Resilience: Addressing the Unique Needs of Adolescents

Adolescents exposed to adverse childhood experiences (ACEs) have unique developmental needs that must be addressed by the health, education, and social welfare systems that serve them. Nationwide, over half of adolescents have reportedly been exposed to ACEs. This exposure can have detrimental effects, including increased risk for learning and behavioral issues and suicidal ideation. In response, clinical and community systems need to carefully plan and coordinate services to support adolescents who have been exposed to ACEs, with a particular focus on special populations. We discuss how adolescents' needs can be met, including considering confidentiality concerns and emerging independence; tailoring and testing screening tools for specific use with adolescents; identifying effective multipronged and cross-system trauma-informed interventions; and advocating for improved policies

Expanding Organizational Advocacy Capacity: Reflections From the Field

· Organizational advocacy capacity is an increasingly important area of inquiry, raising questions about the opportunities (and limits) for achieving and sustaining policy change. · The California Endowment implemented the Clinic Consortia Policy and Advocacy Program to expand grantee advocacy capacity to support the policy and operational needs of California’s community clinics. · In-person meetings with decision-makers and developing working relationships were among the key advocacy activities undertaken by 19 grantees. Grantees secured several policy wins through a variety of strategies, including mobilizing member clinics to be potent advocates. · The “return on investment analysis” indicates that grantees secured policymaker support for clinic programs and services that brought member clinics a total of $1.63 billion from 2001 to 2009 to increase access to care. · Longer-term outcomes achieved by grantee policy and program initiatives included a strengthened health care safety net and increased access to health care for medically underserved Californians. · Funders of advocacy and policy change initiatives are encouraged to consider the resources needed to build and sustain advocacy capacity, including grantee technical expertise, partnerships with stakeholders, and time required to expand advocacy capacity

Mental Health Service Provision at School-Based Health Centers During the COVID-19 Pandemic: Qualitative Findings From a National Listening Session.

IntroductionSchool-based health centers (SBHCs) provide health services to more than six million youth annually. When schools throughout the United States closed in spring 2020, many SBHCs were also forced to close physical operations..MethodThis study uses qualitative data collected from SBHC representatives nationwide to examine supports and challenges affecting mental health services provision during the COVID-19 pandemic, changes in the provision of these services, and priorities for assessing and supporting student mental health needs in the 2021-2022 school year.ResultsPartnerships, community and stakeholder buy-in, and student access were key supports to continuous care throughout the pandemic, whereas lack of available staff and lack of in-person access to students were key challenges. Patients demonstrated increased acuity of presenting mental health problems, more immediate and complex mental health challenges, and greater co-morbidities.DiscussionSBHCs pivoted, even with limited resources, to meet students' increasing needs for mental health care

Adverse Childhood Experiences and Resilience: Addressing the Unique Needs of Adolescents

Adolescents exposed to adverse childhood experiences (ACEs) have unique developmental needs that must be addressed by the health, education, and social welfare systems that serve them. Nationwide, over half of adolescents have reportedly been exposed to ACEs. This exposure can have detrimental effects, including increased risk for learning and behavioral issues and suicidal ideation. In response, clinical and community systems need to carefully plan and coordinate services to support adolescents who have been exposed to ACEs, with a particular focus on special populations. We discuss how adolescents' needs can be met, including considering confidentiality concerns and emerging independence; tailoring and testing screening tools for specific use with adolescents; identifying effective multipronged and cross-system trauma-informed interventions; and advocating for improved policies

Case Management for Social Needs of Youth and Families in School‐Based Health Centers

BackgroundSchool-based health centers (SBHCs) are ideal settings to address social needs of youth and families. Case managers can play a vital role in social care interventions.MethodsWe piloted a program to incorporate a Case Manager into the care team of 1 SBHC serving 2 local schools with over 900 students and their surrounding communities. This project's purpose was to evaluate program feasibility, utilization, and acceptability. Our mixed-methods evaluation included analyses of data from electronic health records, client satisfaction surveys, and staff interviews.ResultsDuring the 6-month pilot, the Case Manager served 133 clients (about one third of all SBHC clients served) through 593 contacts. Most contacts included referrals to support services (90%) and 37% addressed newcomer immigrant adjustment. All 37 respondents to the satisfaction survey during the 3-month administration period (44% response rate) reported that the Case Manager made them feel comfortable asking for help; 95% reported getting the help they needed. The 7 SBHC staff interviewed shared many program benefits, including increased time for clinical services.Implications for school health policy, practice, and equityInequities in children's health and educational achievement are influenced by structural factors. Results from our pilot program demonstrate that SBHCs may be well-positioned to deliver social care interventions and that case managers enhance the ability to deliver quality care.ConclusionsSchool-based programs to address unmet social needs are critical to supporting learning and wellness for all youth. Robust studies are needed to further test the impacts of case management in SBHCs