Coughs, colds, fevers, strep, sports physicals, well visits, vaccinations, anxiety, depression, concussions, ADHD and more.

Since 2021, students have been walking in the door for those conditions or services at school-based health clinics in Haysville and Valley Center run by the KU School of Medicine-Wichita Department of Pediatrics with a strong assist from the Department of Psychiatry & Behavioral Sciences.

Once the clinics opened, trainees soon followed to help treat elementary, middle and high schoolers, with pediatrics and internal medicine/pediatrics residents, child psychology interns, and child and adolescent psychiatry fellows from KUSM-Wichita programs now training at one or both school-based health clinics in rotations ranging from three weeks to a year.

The clinics are funded by direct and pass-through federal grants, the school districts and local donations and vary in the locations and services. They operate four days a week in alternating morning and afternoon sessions, typically seeing six to eight patients for health care each session. Haysville’s clinic adjoins an elementary school and offers mental health therapy sessions; Valley Center’s clinic is in the high school and offers mental health screening and support but not direct psychology services.

No matter the variation, the intent is to improve access for patients, including the insured, uninsured, foreign exchange students, those in foster care, and those limited by time, money and distance. Siblings and teachers can obtain care, too.

“Some of the parents are really grateful to be able to get their kids in,” says Elizabeth Lewis, M.D., the clinical assistant professor regularly staffing the clinics. “I saw a high school kid today with strep, so mom didn’t have to come. I talked to her over the phone, and we were able to diagnose him and send a prescription to the pharmacy. He’ll be able to have his 24 hours on the antibiotic and get back to school without missing as much class.”

“You’re stepping into their world as opposed to them stepping into ours. The teenagers especially just seem much more comfortable in that kind of environment,” says Austin Cook, M.D., third-year med/peds resident. “It speaks to kind of how well they know Dr. Lewis. They are more open and willing to discuss their health in a more collaborative way, as opposed to just answering our questions while they’re in a doctor’s office.”

Emphasizing mental health care

Increasing mental health access through interprofessional care and training is built into the school-based approach, which dovetails with grants to improve pediatric behavioral health training and the KSKidsMAP program to train and support primary care clinicians delivering such care.

“There’s a huge shortage of experts, especially in pediatric mental health care, and primary care has been asked to step into that gap to care for patients. But we wanted to do it in a way that wasn’t just flying blind and instead provide high-quality evidence-based and expert-informed care,” says pediatrician Kari Harris, M.D., professor and director of school based-health care.

Some of that care involves weekly therapy sessions in Haysville, where a total of up to a dozen patients are seen by three or four trainees under the consultation and supervision of Nicole Klaus, Ph.D., ABPP, associate professor and associate director of school-based health care.

Other pieces include twice-monthly interprofessional meetings where physicians, psychiatrists, psychologists, trainees, a social worker and others meet to discuss cases (250-plus since 2023) and treatment plans.

“One thing that makes it a great training site is that the patient population is different than we see in our regular clinic,” Klaus says. “We see a lot of the trauma impacting kids. Some of it is the population, some of it is access. We are continuing to see the impacts of COVID-19 years later. These kids are still in need of high-quality support and services.”

Britt Plato, M.D., a first-year child and adolescent psychiatry fellow, says the clinic has provided the opportunity and time to deepen therapy skills. “This experience puts the principles of evidence-based therapy into practice, things like CBT (cognitive behavioral therapy), DBT (dialectical behavioral therapy), trauma-focused therapy and a whole bunch of others,” says Plato. “I love the idea that we can provide therapy, and it doesn’t have to be 15-minute med checks, which is sometimes what time allows.”

“I’ve had parents tell me their kids are not going to engage, that their trauma or anxiety is way too strong, way too deep,” says Plato, who wants to remain involved in school-based care in some way. “But then the kids do engage, and it’s really, really cool to share that with parents, and the kids are proud of what they’ve done and how hard they’ve worked. And the parents say, ‘Oh my gosh, this would have been a meltdown six months ago.’”

Providing medical care and training

For pediatrics and med/peds residents, training at the school clinics is part of their monthlong adolescent health rotations. They work with Lewis and Krista Weaver, an APRN who often has an APRN trainee along, and school nurses as well.

The residents have had a good amount of medical training already but appreciate the opportunity to deliver care in students’ natural environment.

“I was someone who struggled with medical needs as a child, and that’s what led me into pediatrics in the first place,” says Jordan Camp, M.D., third-year pediatrics resident. “I just have a drive to help as many kids as possible, so the school-based clinics helping increase that access aligns with that goal.”

“What surprised me was the degree of mental health needs that we were seeing during our school-based clinics,” Camp says. “We were just seeing so much anxiety, depression and kids that don’t regularly have a doctor that they can follow up with to help address these concerns. And so I feel like the experience helped me a little bit more with my mental health skills.”

Since the clinics began providing mental health and medical care, they’ve treated hundreds of patients and possibly contributed to an increase in attendance. The Haysville schools have seen absentee rates fall 34.2% since 2022, a drop Klaus believes can be attributed to not having to venture far for care or missing school because they aren’t getting it.

Melissa Shadoin, M.D., third-year pediatrics resident, has seen the benefits of the location and the relationships Lewis and other team members have built.

“It’s a unique opportunity to see how we can meet the needs of students, and their siblings as well, directly at the school,” says Shadoin, who worked in a Kansas City school clinic during medical school and will continue to do work in schools when she joins KU Wichita Pediatrics faculty. “They only have to step out of class for 20-30 minutes for the appointment, and then they go straight back. It’s not nearly as far as the drive to go to their doctor’s office and the wait times.”

Above, left: Elizabeth Lewis, M.D., clinical assistant professor, and Krista Weaver, APRN, show Haysville student Cash Parson an elbow ligamentous injury test called the Milking Maneuver.

Learn more

To learn more about the School-Based Health Clinics, visit the School-Based Health Care website.