School-based mental health centers provide services for children in rural areas

Providers per 10,000 children ages 0-17 in rural counties in Arizona.

Mental illnesses can be detected early in life, but school children in rural areas have limited access for the help they need compared to those living in urban centers.

According to the Centers for Disease Control and Prevention the shortage, combined with the unique socioeconomic and cultural factors associated with rural residence, make it more challenging for rural children to access behavioral health services.

The common mental health disorders that children face are attention-deficit/hyperactivity disorder, autism, anxiety, depression and trauma-related disorders.

 At Tombstone High School, Principal David Thursby aims for positive mental health for his students. However, they have recently gone from having two counselors to one. Because of this, they have to find other resources for the students.

“Students who have individual education plans state that they need counseling services and we get those services provided,” Thursby said. “We go through what is called the consortium, when all the schools in the area pull their money to combine resources. We go through the consortium and students that need counseling we bring someone in from the outside to be with those students so we can reach their goal.”

Some rural areas are also able to provide more than just a school-counselor. School-Based Health Centers (SBHC) are on-site care and health professionals that can range from wellness exams to mental health services and 45 percent of the programs are located in rural areas.

The SBHC alliance was founded in 1995 and has progressively grown throughout the US. The non-profit school-based health centers continue to get support from the U.S. Department of Health and Human Services, CDC and many more. 

“Every school in every district is different,” said Cassalyn David, president of the board for Arizona School-Based Health Alliance. “If a teacher notices that a student has changed or might be in some emotional or mental health risk they can use the particular form and keep track of that referral. The nurse and then informed and then through the school administration to the appropriate mental and behavioral health provider.”

The school-based programs come at a time when states  have cut vital services for tens of thousands of youth and adults living with mental illness, according to the National Alliance on Mental Illness.

In 2015, the demand for mental health services continued to grow. There were only 8.1 psychologists for every 10,000 children aged 0-17 years old in Cochise County compared to Pima County with 19.2 per 10,000 children aged 0-17 years old. According to the Milbank Memorial Fund nearly one in seven children ages 2 to 8 years have a mental, behavioral or developmental disorder.

But the SBHC programs are giving rural children the help they need. In 2014, there were 2,315 SBHCs across the the country and studies have shown that mental health counseling is the leading reason for visits by students. Arizona currently has 23 SBHCs and are located in rural areas including Yuma, Dateland, Patagonia and Buckeye.

Syrena Tracy is a reporter for Arizona Sonora News, a service from the School of Journalism with the University of Arizona. contact her at


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