Health and Student Services ESP —  Building a Quality Workforce

Health & Student Services ESP and the 21st Century Family

Cultural changes over the past several decades have altered the relationship between families and the public school. Health & Student Services ESP face new challenges and extra responsibilities that in the past would have been dealt with at home.

The workday challenges for health professionals in public schools have also increased due to the more complex nature of a student's school day. Much of the coverage for health issues that arise for children are addressed in the school setting and under the supervision and oversight of the Health & Student Services ESP.

The following are some of the new challenges Health & Student Services ESP face:

Sick Children at School — Children who in the past would have been kept at home due to illness or disability are now often sent to school anyway. This might be because both parents work and there's no one at home to care for the child, or because families have limited or no health insurance and rely on the school nurse or health professional to be the "family doctor." This phenomenon creates special problems for the health professional, who must care for the sick child in school. Health professionals must be diligent about curbing the spread of infection and administering medications to children who may already be taking some other form of prescription medication (up to 10% of school children, according to some estimates).

Special Needs Students — According to a survey of members conducted in 2000, well over 75% of Health & Student Services ESP work with special needs students in some capacity during the school day — speech and language therapists, physical therapists, respiratory therapists, medical technicians, health aides, nurses' aides, welfare services employees, licensed practical nurses, and occupational therapists, to name a few. In the past, because many of these professions did not even exist, children with special needs simply did not go to school at all. Without the dedication, training, and skills of these ESP, an entire population of children would not be able to learn or function in the school environment.

Student Sexuality Issues, including pre g n a n c y, birth control, HIV and STDs, and sexual orientation. In the past, many of these issues were ignored or trapped in a cultural "conspiracy of silence" by adults and educators. School health professionals are now a recognized and fully participating part of the school team that provides information and support for children struggling with the confusing process of maturing sexually.

Depression and Mental Health — According to the American Psychiatric Association (APA) and the Childhood & Adolescent Depression/Anxiety Association, childhood depression has exploded in student populations over the last ten years. Health professionals now consider it a public health epidemic. The APA provides extensive national training programs to public school staff in order to deal with the increasing mental health issues among students.

Health & Student Services ESP work with care and compassion to identify, support and help depressed or anxious children, interacting with parents/guardians, other staff, and the community as whole. Often they are the only school staff who are trained and capable of providing intervention in a mental health situation. Opportunities for meaningful training and professional support from administrations is essential in order for ESP to be effective and successful with children at risk.

Bullying — According to a study conducted by the American Medical Association, at least one in three children nationwide has been bullied or affected by bullying. The AMA defines bullying as "verbal or physical behavior designed to disturb someone less powerful," and notes that this predatory behavior is detrimental to both the victim and the perpetrator.

Health & Student Services ESP are often the first to observe student-on-student violence and are trained to deal with these difficult situations, monitoring, refereeing and if necessary, administering medical assistance. They develop and teach bullying intervention programs to children and staff. They should be consulted about, and participate in, the development and implementation of an anti-bullying policy for their school district.

Substance Abuse — Alcohol abuse by students is not a new phenomenon. Many of the alcohol-related problems caused by children who drink have been curtailed to some degree over the last few decades, thanks to Mothers Against Drunk Driving, among others. However, as Health & Student Services ESP know well, alcohol has not disappeared from schools and schoolyards. Health professionals in schools regularly deal with the ravages of alcohol abuse by children.

ESP also must be on the lookout for the many other substances that can incapacitate and even kill schoolchildren. To be effective, school health professionals must receive training and up-to-date information about the sea of drugs children can obtain, both in school and out. One new "drug phenomenon" is the use of unauthorized prescription medications in schools.

Many at-risk children bring drugs to school that have been prescribed for an adult family member. They sell or give them to other students, as happened recently in a public school in Philadelphia. A middle school student brought a bottle of anti-depressant medication that had been prescribed for his grandmother. Twelve students landed in the hospital emergency room after buying and taking the drug .

Health & Student Services ESP also must be trained to oversee medications that have been properly prescribed for students. "Some schools have hundreds of bottles of Ritalin and thousands of doses sitting around in drawers for children to get hold of," says Joyce Allers, Director of Health Outreach Programs for Children's Healthcare of Atlanta. (The Washington Post, April 2001). Serious medications that have been properly prescribed for children by physicians require serious and trained oversight.

Public Health Issues and Immigrant Student Populations — The rapid increase of immigrant student populations in some states has increased the risk of diseases being introduced into general school populations. Problems that have long been present in school populations, such as head lice, are on the increase. "Childhood diseases" like chicken pox, that have not been common for several decades, are also on the rise. Careful monitoring and medical intervention by trained, professional health providers is essential to reduce these risks.

Asthma — Asthma is the leading chronic illness in children in the U.S., according the American Medical Association, which reports that more than 3,000 school age children die from asthma attacks every year. It is very prevalent in urban school districts, but is increasing in suburban and rural areas as well. The dilapidated and dangerous condition of many of the nation's school buildings is considered to be one of the leading causes of this increase.

Whatever the causes, asthmatic children are monitored, treated, and supported every day by dedicated and diligent health professionals in public schools. They manage both chronic and acute ill-ness, and often are responsible for correct and timely treatment. They administer medications and nebulizer treatments and monitor progress for each affected child. They also provide invaluable information and patient training so that those children can succeed in the academic environment. Health & Student Services ESP work hard to ensure that students maintain their health in school and as they grow, so they can maintain their health independently as adolescents and adults.

Anger and Behavior Management — In response to referrals from teachers and counselors, and/or requests from parents or guardians, students participate in one-on-one counseling, peer mediation, mentoring, after-school support groups and extra-curricular activities designed by health professionals to teach anger management and behavior modification. These skills are critical for children to cope with an ever-changing and complicated academic environment.

All these 21st century challenges are constantly changing in their nature and scope. The increased responsibilities of Health & Student Services ESP and the exploding nature of their workload, should be recognized by school boards and should result in far greater opportunities for better salaries, appropriate and meaningful professional development, and timely skills training.

To Section 5: The Epidemic of Eating Disorders