Commentary: School Psychologists as Health-Care Providers: A Means to Success for All

Efforts to improve school performance that ignore health are ill-conceived, as are health improvement efforts that ignore education. National Commission on the Role of the School and the Community in Improving Adolescent Health (1990, p. 9) the necessary coordination across systems reflects an opportunity for school personnel to stop talking about not being able to “do it all. ” More importantly, it places the focus upon taking concerted actions to achieve the shared outcome It is a well-supported contention that schools of productive and capable students. In schools alone cannot solve and should not address the we often espouse a desire to promote success for problems of today’s students. Collaboration with parents and community is imperative. Nothing all. There is little doubt that comprehensive health care broadens our use of this phrase. If we say illustrates this point better than the sheer number success for all, then how can we turn our backs of concerns that surface for high-risk adolescents. on students with medical, health, and mental Six preventable behaviors (social morbidities) account for the majority of serious illnesses and health concerns? Hopefully, when stated, success for all includes students who are facing chronic premature deaths in the U.S.: tobacco use, poor medical or health-related conditions (e.g., HIV/ eating habits, abuse of alcohol and other drugs, AIDS), psychiatric disorders (e.g., mood and intentional or unintentional injury (e.g., suicide), behavioral disorders), and social morbidities (e.g., physical inactivity, and sexual behaviors that drug abuse). Do we believe children and youth result in HIV infection other sexually transmitted with these presenting concerns can learn? Do we diseases or unintended pregnancy (Kolbe, 1990). believe good health is essential for optimal According to the recently released annual report learning? If we ignore health problems that reduce from the Federal Interagency Forum on Child and attendance and contribute toschool failure, then Family Statistics (Star Tribune, 2000), teen we must recognize that our school practices are pregnancy and juvenile violence have dropped not only ignoring the link between national to the lowest point in 20 years whereas rates for initiatives such as Healthy People 2000 (U.S. binge drinking, drug use, or cigarette smoking Public Health Service, 1991) and National for the nation’s 70.2 million children younger Educational Goals 2000 (U.S. Department of than 18 years of age have shown no decrease. Education, 199 1) but also are depriving some These same adolescents are often suicidal, youth from equal access for an education. dropouts, and substance abusers. Clearly, the Consistent with the vision described by complexity of these social concerns requires Nastasi (2000) is the 8-component model of integrated services. coordinated school health programs: The call by Nastasi (2000) for school Comprehensive school health education; physical psychologists to have an integral role in education; school health services; school nutrition comprehensive health care for children and youth services; school counseling, psychological, and is an excellent example of intervention based social services; healthy school environment; upon systems-ecological theory (Bronfenbrenner, school-site promotion for staff; and family and 1979). Furthermore, her call for school community involvement. The 1995 meeting of psychologists to assume leadership in facilitating representatives from more than 60 organizations,