School-Based Clinics Empower Teens

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As a teenager, I didn’t know how to talk about my health or my body. When I had questions about my period, my changing body, or my mental health, I didn’t know who to ask or how to form the questions. I didn’t know how to make a doctor’s appointment on my own, so I resorted to Google to figure out why my body did what it did. My high school health class in 2013 provided only a basic outline for mental health topics, and the curriculum barely touched on sexuality or reproductive health.

Because I struggled to understand my health needs as a teenager, I decided to pursue a career in adolescent health care. Currently, I work as a registered dietitian for Minneapolis Public Schools’ (MPS) School Based Clinics, a program run by the Minneapolis Health Department that provides medical and mental health care at no cost to MPS high school students, regardless of their insurance status.

Clinics located within schools help to remove barriers such as insurance status, cost, and transportation, all of which can create and reinforce disparities in health outcomes. According to the Minnesota School-Based Health Alliance, students who utilize school-based health centers have fewer absences and a higher graduation rate than students who do not. In a survey of Minneapolis School Based Clinic clients, 45 percent of respondents stated that they wouldn’t have been sure what to do, or would have done nothing, to take care of their health problems if their school did not have a clinic.

Adolescent medicine became established as a distinct discipline in the 1950s, when Boston Children’s Hospital formed the United States’ first comprehensive medical section for patients from 12 to 21 years old. Today, adolescent- centered health care entails directly educating the patient on their health needs, rather than providing that guidance exclusively to the parent or guardian.

My clients under 18 need a parent or guardian’s consent to see me, but they schedule and attend their appointments independently. My clients are smart, passionate, and curious about their health. They ask questions and advocate for themselves during our appointments in ways that I never imagined possible when I was their age.

I work with my clients on a variety of issues, including sports nutrition, iron-deficiency anemia, food allergies, and disordered eating. I often hear my clients express confusion and uncertainty — feelings that I can empathize with given my own struggles. Teenagers today access an incredible amount of information about health care on social media. Unfortunately, misinformation spreads rapidly.

Recently, I worked with a client who wanted to know how she could eat better while balancing a full course load and a part-time job. She said the advice she found online and received from her family was not helpful. She was visibly overwhelmed while telling me: “It’s so confusing. I don’t know what I’m supposed to do.” While working with this client, I first validated her frustration and acknowledged that her schedule doesn’t allow much time for eating well. I affirmed the positive things that she already does for her body, like staying hydrated and eating a well-balanced dinner. We talked about the functions of different nutrients and identified foods that will help keep her full, focused, and energized. Finally, we brainstormed grab-and-go breakfast and snack ideas to help her eat well during her busy days. My client ended our session by saying, “That sounds so much easier when you explain it.” I could see the relief on her face.

Providers, educators, parents, and community members can empower teenagers, too. Parents and guardians can encourage their teens to attend appointments alone when appropriate, or they can offer to step out. When developmentally appropriate, providers and educators can give teenagers the evidence-based information they need to make decisions about their bodies and health. Communities can support public health programs, such as universal free school breakfast and lunch, the Supplemental Nutrition Assistance Program (SNAP), school-based health clinics, and Minnesota’s Child and Teen Checkups program.

As adolescent-centered health care continues to expand, I hope that teenagers today will feel more confident about treating their health needs than I did. I love witnessing the moments when my clients make connections between their choices and the way their body feels.

Natalie Nation (photo by Sarah Whiting)

Natalie Nation (she/her) is a registered dietitian living in the Twin Cities. The opinions expressed in this article do not represent the City of Minneapolis or Minneapolis School Based Clinics.