Johnson: Texas is neglecting students in alternative schools

If your child was in the intensive care unit, or ICU, and the nurse only checked their vital signs and lab work once or not at all, you would probably be concerned. In fact you might wonder – how would the health care team know what was wrong or what treatments were working?

That same analogy could be used for students in alternative schools in Texas. Like patients in the ICU, they need intensive care as they work to stay healthy and graduate from high school.

As a public health nurse, educator and nurse scientist, I can tell you that we all must have more concern for these students. We are neglecting these young people during a vulnerable crossroads in their lives.

Similar to the health of an individual patient, monitoring the health populations of youths is an important step toward keeping young people healthy. Health-risk behaviors such as smoking, attempting suicide and having multiple sex partners obviously pose great threats to adolescents’ health and educational success.

The Centers for Disease Control and Prevention (CDC) recently released the Youth Risk Behavior Survey that showed mainstream high school students’ involvement in many health-risk behaviors decreased in 2015. That’s good news. But it comes with a caveat. Nationally and in nearly every state including Texas, no one is consistently monitoring the “vital signs” of students in alternative schools.

The only time the CDC did a national survey in alternative schools was in 1998, and the news was not good. More than twice as many students in alternative schools than in mainstream schools reported substance use, suicide attempts and risky sexual behaviors.

In 2015, my research team conducted a Youth Risk Behavior Survey in alternative schools across Central Texas. Our findings were consistent with what the CDC found nearly 20 years ago. For example, 54 percent of students reported using marijuana, 40 percent reported depressive symptoms, and 25 percent contemplated suicide, all much higher than students who attend mainstream high schools. More than two-thirds were sexually active, and only 36 percent used a condom the last time they had sex.

Many of these students also face challenges outside the classroom. In fact, more students said they know an adult who sells drugs (55 percent) than agreed a parent talks with them about their problems (41 percent). Three out of four students (71 percent) reported adverse child experiences, such as living with someone who drinks too much alcohol or experiencing abuse.

All this says that, like patients in the ICU, students in alternative schools need intensive care. Yet, despite incredible support from school staffers, many alternative schools in Texas do not currently have the capacity or resources to address student health needs.

Despite national recommendations, fewer than half of the alternative schools across our region have a school nurse. And only 1 in 5 alternative schools provide tobacco cessation services or prenatal care despite high levels of substance use and unprotected sex among their student populations. No schools provide condoms or pregnancy testing.

We can do better. We must support students’ health so that an untreated mental illness, addiction, or unplanned pregnancy does not prevent them from achieving their goals.

How? First, we should use the Youth Risk Behavior Survey to consistently check the “vital signs” of our students in alternative schools, just as we do in mainstream schools. Doing so will give us a needed finger on the pulse so we can provide education, programs and services to address their needs. And we need lawmakers to allocate more financial resources and workers to help schools reduce health-risk behaviors. For example, allocating funds to staff each alternative school with substance use counselors and a school nurse.

Many students at alternative schools have aspirations for the future, with 61 percent saying that they want to go to a two-year or four-year college. It’s up to all of us to give them the tools they need to succeed. In addition to support from their teachers and principals, let’s make sure they also have intensive care they need from health professionals to stay healthy and graduate from high school.

Johnson is an assistant professor and a Robert Wood Johnson Foundation Nurse Faculty Scholar in the School of Nursing at The University of Texas at Austin.

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