Many Doors, One Care Team: How School-Based Health Centers Support Integrated Care 

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Student health and learning outcomes are fundamentally interconnected. Access to health care, behavioral health support, and preventive services improves students’ ability to attend school consistently, engage in learning, and navigate daily challenges. School-Based Health Centers (SBHCs) strengthen this access by delivering care in or near schools and reducing barriers such as transportation, scheduling, cost, and time away from school or work (National Association of Community Health Centers, 2026).

Across the country, SBHCs reflect the communities they serve. While SBHCs vary in their staffing models, services, and partnerships, they share a common goal: improving access to care and supporting student health, wellbeing, and success. Although no two are exactly alike, many offer a range of services that help students access care, address physical and mental health concerns, and connect to additional support when needed.

SBHCs: An Integrated Approach to Student Health

Integrated health care is defined as a collaborative approach to care in which “healthcare professionals from multiple disciplines work together, communicate regularly, and share information to develop a comprehensive treatment plan.” This model addresses a patient’s physical, psychological, and social needs through coordinated care delivered by an interprofessional team that may include physicians, nurses, psychologists, and other health professionals (American Hospital Association, 2026).

SBHCs are one example of how integrated care can be implemented. Many SBHCs bring together primary care, behavioral health services, prevention, and care coordination in a single setting, helping students and families access more coordinated and comprehensive support (National Association of Community Health Centers, 2026). By integrating these services, SBHCs can help address the interconnected nature of students’ physical, behavioral, and social needs through a more collaborative approach to care.

Through integrated physical and behavioral health care, SBHC teams can identify and respond to needs beyond the reason for a student’s initial visit.

Integrated care is not simply about offering multiple services in the same location; rather, it involves communication, coordination, and collaboration among professionals who support a student’s health and wellbeing (American Hospital Association, 2026). This may include helping families navigate services, coordinating referrals and follow-up care, conducting routine screenings to identify any emerging concerns, and facilitating warm handoffs that connect students with additional support during the same visit. Because physical and behavioral health are closely connected, challenges in one area can often impact the other. Through integrated physical and behavioral health care, SBHC teams can identify and respond to needs beyond the reason for a student’s initial visit. A student who visits an SBHC for a routine physical health concern may also benefit from behavioral health support, while a student receiving behavioral health services may have physical health needs that warrant attention.

Integrated Care in Practice

Consider an elementary school student experiencing persistent tooth pain from an untreated cavity. The pain may make it difficult to focus in class, contribute to missed school days, and affect the student’s mood or stress level. At an SBHC with on-site dental services, the student may receive treatment for the cavity. In other settings, the SBHC can assess the concern and coordinate a referral to a dental provider. The team can also consider other factors affecting the student’s well-being, such as access to nutritious food, previous challenges of obtaining care, or other psychosocial concerns identified by the student or family. By coordinating physical and behavioral health support, the SBHC can address the student’s health needs while connecting the student and family to appropriate care and resources.

For older students, integrated care can address concerns related to vaping, alcohol use, or other substance use. Consider a high school student who regularly vapes during the school day. Through conversations with the SBHC care team, providers learn that the student has been experiencing symptoms of depression related to academic pressures and challenges at home. Rather than focusing only on the vaping behavior or relying exclusively on disciplinary responses, the SBHC can use evidence-based approaches, such as Screening, Brief Intervention, and Referral to Treatment (SBIRT) to assess substance use, provide timely support, and determine whether additional treatment is needed (School-Based Health Alliance, 2019). With primary care and behavioral health services integrated within the SBHC, the student can receive coordinated support for both substance use and related mental health concerns.

Whether addressing a younger student’s oral health needs or supporting an older student experiencing substance use concerns, integrated care extends beyond the exam room. SBHC teams may also coordinate with families, school staff, and community partners to help students stay connected to care, while following consent, confidentiality, and local policy requirements. By bringing together the people and resources that support students, SBHCs can create a more coordinated approach that recognizes the connections between health, wellbeing, and educational success.

Looking Ahead: CoCM and the Future of Behavioral Health Integration

SBHCs are well-positioned to offer integrated care. The Collaborative Care Model (CoCM) may be one structured approach that SBHCs can explore to further strengthen behavioral health integration. CoCM is a team-based approach that integrates behavioral health into primary care through shared care planning, regular follow-up, and consultation among medical and behavioral health providers. While CoCM has been implemented in a variety of primary care settings, including pediatric settings, its use in SBHCs is still developing.

Our recent webinar, Collaborative Care in Action: Introducing CoCM and Planning for SBHC Implementation in the Carolinas, which took place on May 26, 2026, explores CoCM and key considerations for applying this model in school-based health care. As schools, health centers, and communities continue exploring ways to strengthen behavioral health supports for students, CoCM may offer an additional framework for coordinating care around concerns such as trauma-related symptoms, mental health needs, and substance use risk. By emphasizing collaboration among primary care providers, behavioral health professionals, and other members of the care team, CoCM may build upon the integrated care approaches already used in many SBHCs (Howard et al., 2019).

Key Takeaways

Many SBHCs advance integrated care by providing or coordinating primary care, behavioral health services, preventive care, and referrals in school-based or nearby settings. This approach helps children and adolescents access coordinated services that address interconnected physical and behavioral health needs. At the intersection of health and education, SBHCs demonstrate how coordinated services can address students’ range of health and support needs while supporting their ability to learn, grow, and thrive. Looking ahead, approaches such as the Collaborative Care Model may offer another pathway for strengthening the integrated, student-centered services that many SBHCs already provide.

Sources

Guest Authors

Addie Van Zwoll, PhD
Vice President, School-Based Health Alliance

Donnie Greco, BA
Associate, School-Based Health Alliance

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