The bell rings at 7:45 a.m. at Muskegon High School, on the eastern shore of Lake Michigan. Students make their way to class. Some linger for the click of the Teen Health Center door to open. Taylor will get her teeth cleaned. Nick needs a sports physical. Emily is here with a stomachache, but confides to the nurse that she thinks she may be pregnant. Tyler has a headache. The physician assistant finds out Tyler took a big hit at Friday’s football game—time to call his parents and the team’s athletic trainer.
In 2005, the Hackley Community Care Center in Muskegon, Michigan received a state grant to work in three middle schools. Through the grant we were able to provide health education to students in an area where 87 percent of students qualified for free and reduced lunch and the teen pregnancy rate was about 10 percent. Nothing could prepare us for the differences between the healthcare and school worlds—we had to get used to the school calendar, students, testing, and bells, bells, bells! .
In the spring of 2010, I became the School Program Manager for Hackley Community Care Center. I moved my office to Muskegon High School, where two science labs were completely renovated to make a state-of- the-art medical and dental facility. The Teen Health Center opened its doors for students that November. Some teachers remained skeptical, many were positive. After working through the logistics of getting students to and from class, teachers began to see the benefit of having us here on campus. A typical doctor or dentist appointment that normally would keep a student out of class for three or four hours now takes less than 60 minutes. Students feeling ill can be sent to the Center, get medical treatment, and return to class ready to learn, rather than automatically going home for the day.
Initially, the biggest challenge we faced was building trust with teachers and school staff. They’ve seen many programs come and go over the years and expected us to quickly disappear like any number of previous initiatives and partnerships. Once teachers realized we were committed to the kids—just like them—they began to let us come into their classrooms and talk to students about nutrition and substance abuse.
Students then began to trust us as well. At the Teen Health Center, it quickly became clear that some teens weren’t comfortable talking to their parents about health issues and many felt awkward going to their family doctors now that they were no longer “children.”
By far the biggest surprise has been the number of students who access our services for sports physicals. It is helpful that we offer the least expensive sports physical in town, but it’s also crucial to teens because they typically do not plan ahead. Getting into the family doctor for a last minute physical is unheard of. We know that teens who are involved in sports and extra-curricular activities do better in school. Knowing we are helping kids do something positive with their time is gratifying.
Many students tell us that the Teen Health Center makes them feel special and safe. Teachers refer sick students here, where to our surprise, they are not always sick. Some students are worried and need a trusted adult to talk to. Two physician assistants and a behavioral health therapist are available to listen. These students often come from homes where parents are stressed, working hard to pay the bills. They don’t want to bother their parents with their problems. These are perceptive teens that care deeply.
Some students throw up at school—maybe they ate something that disagreed with them, and maybe they didn’t have anything to eat. Previous school policy stated that if you threw up you went home. If the Teen Health Center determines a student threw up for reasons other than the flu, they might have a snack, and then be sent back to class.
Many teens have more serious health issues than needing to eat a snack, like Sarah, whose asthma is uncontrolled. We communicate with her parents and her doctor and address these issues so she can stay in school. Alex has so much anxiety it takes weeks to convince him to involve his parents so we can get him on medication that can help. Jacob has a lump in his armpit that doesn’t get smaller despite several rounds of antibiotics. It turns out to be an early stage of cancer, which since has been removed, and he now has a good prognosis.
About 10 percent of the students that we test for sexually transmitted infections test positive. One of the first teens we tested for a sexually transmitted infection tested positive for HIV—devastating news for a 16 year old to face. We encouraged her to discuss this with her parents and referred her to a specialist to get the care she needs.
The Center offers reproductive health education and treatment. On a Friday afternoon (or any day), we dread a positive pregnancy test that can change a life forever. We help pregnant students face these obstacles and challenges with hope and compassion. We can set up the first OB appointment, draw labs, and offer to help them tell their parents and partner. Michigan state law prohibits us from prescribing or dispensing birth control on school property and we cannot discuss or refer for abortions. Our students and community understand this; students know we are here to answer their questions and listen, and they also understand our legal limitations.
The Teen Health Center brings education and health care together to support student success. While some people may be overwhelmed by the situations we face at the Teen Health Center, I love my job. Reducing time students miss from class, identifying illness, providing appropriate follow up and addressing health concerns, and simply listening to a teen who is worried and paralyzed with fear, are some of the things we provide our students so they can focus on learning and making it through adolescence.
For the health, happiness, and success of our young people, wouldn’t it be great if every school could have a teen health center?
Judy Pruim wrote this article for YES! Magazine, a national, nonprofit media organization that fuses powerful ideas with practical actions. Judy, who serves as the School Program Manager for Hackley Community Care Center (HCCC) in Muskegon, Michigan, has dedicated the last eight years to bridging school and health cultures for the wellness of youth in her community. She has been with HCCC for 20 years, where her expertise has been instrumental in starting the Maternal and Infant Health Home Visiting Program, Integrated Behavioral Health Program, and the School Wellness Program.