Implementing and Sustaining Rural School-Based Integrated Health Services Through University–Community Partnerships

Purpose: Rural communities often have a high incidence of medical and behavioral health problems along with more limited access to care. This paper describes an innovative approach to providing integrated care in rural school-based health clinics in which graduate students serve as behavioral health interns. The purpose of this manuscript is 1) to describe a model for providing school-based integrated health services in a rural community and 2) to evaluate services provided by graduate interns embedded in school-based clinics. Materials and Methods: Graduate interns completed a session checklist to track services provided in each session and collected data from participating students who received behavioral health services. Students completed the Outcome Rating Scale (ORS) after each session. Repeated measures MANOVAs were used to analyze the data for changes over time. Results: Services provided most often by interns included assessment, engagement, positive reinforcement, coping skills, goal setting, and clinical intervention. The data suggest that students receiving at least three sessions improved over time on self-reported wellbeing. Discussion: The results demonstrate the feasibility of providing integrated health care via school-based clinics that rely on graduate internships for behavioral health services. Challenges to implementing and sustaining school-based integrated health clinics are discussed. Conclusion: The ongoing challenges to meeting the medical and behavioral health needs of rural communities call for innovative approaches to providing integrated care. The clinics described here responded to these challenges through teamwork and strong university–community partnerships.