Schools and health

October 11, 1993

Baltimore's school-based health clinics have been criticized recently for making available the contraceptive implant Norplant. One recent episode involved an odd alliance between the Nation of Islam and Lyndon LaRouche supporters. These critics focus on one issue, contraceptives, while ignoring the vast array of services these clinics offer to young people who desperately need them.

Critics who want to create controversy ignore the fact that only about 16 percent of visits to the clinics have anything to do with family planning services, which includes tests for pregnancy as well as inquiries about Norplant or other contraceptives. So far, fewer than a dozen girls have actually gone ahead with Norplant -- all of them enrolled at a school for teen-agers who are expecting babies or who have already given birth.

Slightly more students -- 17 percent -- come in for preventive care, routine check-ups and sports physicals rather than for family planning. And both categories are dwarfed by requests for acute care (41 percent) and mental health visits (28 percent). Clinic officials say that many acute care visits are in fact prompted by mental health concerns, such as suicidal tendencies or abuse.

Baltimore's school-based health clinics provide essential services for a sadly neglected segment of the population. Even at the peak of health, adolescents need preventive care which they often don't get. For instance, clinic officials say one of the most pressing needs among the young people they see is routine dental care. But in some cases, nurses detect serious physical problems that have gone undiagnosed. However healthy they many seem, teen-agers are vulnerable in many ways -- especially in a society plagued by violence, unemployment and scattered families.

One of the more eagerly sought after services in school clinics is group counseling. The list includes groups to help young people deal with grief, groups dealing with family conflicts, groups for young people disturbed by a family member's abuse of drugs or involvement in selling drugs and groups to encourage abstinence. The list is a litany of contemporary ills -- and without school-based clinics many young people plagued by these problems would get no help at all.

There is much more involved in school-based health care than simply making contraceptives available. The Norplant criticism is prime example of adults showing more concern with arguing ideology than with meeting young people's needs.

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