title: Use of school-based health centres for mental health support in Cape Breton, Nova Scotia.
abstract: OBJECTIVE
  To determine whether students with self-reported needs for mental health support used school-based health centres (SBHCs) for this purpose.
  
  
  METHODS
  A secondary analysis was conducted on self-reported data collected from 1629 high school students from Cape Breton, Nova Scotia. Descriptive statistics and logistic regression analyses were employed to determine the influence of sex, grade, sexual orientation, socioeconomic status (SES), school performance, social involvement, and health risk-taking behaviours on need for mental health support and use of SBHC for that purpose.
  
  
  RESULTS
  One-half of surveyed students reported needs for mental health support. Risk for depression was the most commonly reported indicator of need. Only 13% of students visited a SBHC nurse for mental health support, and 4 times as many females than males used the SBHC for this purpose (20.4%, compared with 5.3%, P < 0.001). There was a significantly increased likelihood of use of SBHC for mental health support, given the presence of a greater number of need factors. Multivariate logistic regression determined that female sex (OR 5.57, 95% CI 3.07 to 10.09), lower SES factor (OR 1.19, 95% CI 1.11 to 1.28), sexual health risk-taking behaviours (OR 1.72, 95% CI 1.28 to 2.31), and suicidal behaviour (OR 1.83, 95% CI 1.48 to 2.27) were significantly associated with the use of SBHCs for mental health support.
  
  
  CONCLUSIONS
  Substantial need for mental health support and significant unmet need were observed. In particular, male students underused the services relative to their self-reported need. Implications for SBHCs and directions for future research are discussed.
authors.affiliation: Dalhousie University and IWK Health Centre, Halifax, Nova Scotia. magdaszumilas@dal.ca <magdaszumilas@dal.ca>
authors.forename: Magdalena
authors.initials: M
authors.lastname: Szumilas
authors.forename: Stan
authors.initials: S
authors.lastname: Kutcher
authors.forename: John C
authors.initials: JC
authors.lastname: Leblanc
authors.forename: Donald B
authors.initials: DB
authors.lastname: Langille
mesh_terms: D000293:Adolescent; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009674:Nova Scotia; D012573:School Nursing / Q000706:statistics & numerical data*; D012737:Sex Factors; D012917:Social Adjustment; D012959:Socioeconomic Factors; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*