title: Mental health characteristics and health-seeking behaviors of adolescent school-based health center users and nonusers.
abstract: BACKGROUND
  The purpose of this study is to compare the mental health risk profile and health utilization behaviors of adolescent school-based health center (SBHC) users and nonusers and discuss the role that SBHCs can play in addressing adolescent health needs.
  
  
  METHODS
  The sample included 4640 students in grades 9 and 11 who completed the California Healthy Kids Survey between fall 2000 and spring 2005 at 4 high schools in Alameda County, California. Chi-squared tests of significance and multivariate logistic regression were used to compare characteristics of SBHC users and nonusers and identify demographic, health status, and behavioral characteristics predictive of SBHC use.
  
  
  RESULTS
  Controlling for demographic variables and general health status, students who reported frequent feelings of sadness, trouble sleeping, suicide ideation, alcohol or marijuana use, the recent loss of a close friend or relationship, or other difficult life event were significantly more likely to seek SBHC services than their peers. Neither health insurance status nor a student's "usual" source of health care was predictive of general SBHC use, but being on public assistance or having no insurance was predictive of a student seeking SBHC mental health services.
  
  
  CONCLUSIONS
  These findings suggest that SBHCs are able to attract students with the most serious mental health concerns and can play an important role in meeting needs that might otherwise go unmet. The provision of SBHC mental health services in particular may fill a need among adolescents with public or no insurance.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143-0936, USA.
authors.forename: Gorette
authors.initials: G
authors.lastname: Amaral
authors.forename: Sara
authors.initials: S
authors.lastname: Geierstanger
authors.forename: Samira
authors.initials: S
authors.lastname: Soleimanpour
authors.forename: Claire
authors.initials: C
authors.lastname: Brindis
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002140:California / Q000453:epidemiology; D003155:Community Mental Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008603:Mental Health; D012572:School Health Services / Q000706:statistics & numerical data*; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires