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Michelle Gonzalez (gesturing) and her peers on the Student Health Advisory Committee talked last Tuesday, Feb. 9, with state Rep. Susan McLain (left) and state Sen. Chuck Riley in Salem as part of the statewide 2016 SBHC Awareness Day.Michelle Gonzalez’s family had little money, no insurance and no family doctor when they moved to Forest Grove two summers ago.

So the high school junior spent the first two weeks of school at home because she knew of no way to get required vaccinations that would allow her to attend classes.

Then someone heard about her plight and suggested she visit the School Based Health Center

(SBHC) located at Forest Grove High School.

Impressed with the concept of the SBHC, Gonzalez joined the Student Health Advisory Committee (SHAC) so she could do for others what someone did for her: inform them about the wide array of affordable services at their fingertips.

“Not a lot of people get together to talk about health,” said Gonzalez, now a senior. “But health is so important. It’s something you’re going to need all your life.”

With its seventh anniversary approaching, Forest Grove’s center has expanded the mental-health staff’s hours from three days a week to five. And a similar expansion of hours for physical-health staff will follow soon. The clinic will also open three days a week during the summer.

Some students would like the center to also add new services, such as birth control.

But first the dedicated members of the SHAC are trying to help some peers move past negative stereotypes about the clinic and inform them about the services it already offers.

Even more basic, they’re trying to make sure people know the center exists.

‘Here to serve everyone’

Forest Grove’s SBHC — operated and financed by the Cornelius-based Virginia Garcia Memorial Health Center — offers counseling and physical health services to all students and staff in the Forest Grove, Banks and Gaston school districts on a sliding-scale fee.

“We perform mostly the same as any other clinic would,” said John Fitch, a SBHC medical assistant — except, he pointed out, staff can really take time to chat with patients about health and prevention.

Fitch said students mostly come in for sports physicals, sore throats, coughs and vaccinations. There’s also the chance to see a dental hygienist once a month.

Gonzalez considers spreading the word her most important challenge, she said, because most students don’t know the SBHC exists.

Out of about 50 random Forest Grove High School students asked about the SBHC last week, only one said he had crossed its threshold. About half asked blankly, “What is that?”

SHAC member Katie Vega Garibay said she once overheard a student who wasn’t feeling well ask a teacher where to go. The teacher didn’t know. Vega Garibay stepped forward and told them both about the SBHC.

Those who know about it may still be afraid or embarrassed to go, though, because of a negative stereotype SHAC members hope to change.COURTESY PHOTO - Members of Forest Grove High Schools Student Health Advisory Committee stand in the Oregon House chamber gallery Feb. 9. Students Michelle Gonzales, Victor Chavez, Katie Vega, Jairo Vega, Hunter Lozyinski and Emma Coffey attended the 2016 SBHC Awareness Day event in Salem with district nurse Donna Wellington, School Based Health Center Mental Health Therapist Alma Garibay and SHAC Coordinator Paje Stelling.

“Kids think, ‘Oh, that’s for Mexicans. That’s for migrants,’” said Vega Garibay.

“People think of it as a low-income place to go,” Gonzalez said. “They’re not going to say, ‘Yeah, I go there.’”

SBHCs do “tend to have a stigma around them,” said Paje Stelling, the advisor for the student clubs across Washington County through Virginia Garcia. “It’s a constant battle we’re facing. We’re here to serve everyone.”

Depression, stress, weight

Of the approximately 450 students who have visited the clinic so far this school year, Fitch said about eight in 10 patients are Spanish speakers. So Stelling is working with her colleagues to develop effective advertising to reach all students, but she has also noticed the most effective publicity by far is word-of-mouth.

“It’s the easiest place for anyone to come in and get the care they need,” said SHAC member Emma Coffey, who has a lot of friends who think it’s embarrassing to go to the SBHC. “We want to try to show people it’s for everyone, and everybody can and should use it.”

That’s why she and the other SHAC members are hoping to create a presentation in the next month and make the rounds to all students’ required advisory classes.

Gonzalez wants to break through the center’s negative image. “We won’t start making a difference until we set an example by telling people what services they provide and saying we aren’t ashamed to go there,” she said. The School Based Health Center on Forest Grove High Schools campus serves students of all ages and staff from the Forest Grove, Banks and Gaston school districts on a sliding-scale fee.

That’s especially important for mental health services, she said. One of Gonzalez’s friends who was feeling suicidal visited the center, she said, and knows others who’ve gone because they’re feeling bad about their weight.

Alma Garibay (not related to Katie Vega Garibay), the bilingual full-time social worker who provides counseling at the SBHC, said a lot of students come to see her to discuss stress, family changes or problems at home.

Some students come to the SBHC first to see the nurse practitioner for headaches, insomnia or low energy, but end up in Garibay’s office because they realize they’re actually struggling with physical symptoms of depression. Youths are often afraid to go to therapy, Garibay said, because they don’t want to be labeled as crazy or to have their friends find out.

“I’m not here to fix you; we’re here help you build new skills and learn new things,” Garibay said. “We’re not going to force anything on you.”

More clients each week

Word is slowly getting around. Garibay has been at the SBHC for about four months and is seeing more clients every week with the expanded hours, she said. She’s seeing four to six students each day and has room for more.

Lacey Beaty, Virginia Garcia’s countywide SBHC manager, added the clinic is one of the only safe places for many kids to discuss their sexuality.

Because of Forest Grove’s high number of low-income and migrant students, said Beaty, “there was no doubt it was going to be in Forest Grove” when Virginia Garcia officials were deciding where to open their second school clinic in the county about seven years ago. (The first one opened in Tigard.)

Counseling is too expensive for many families, Garibay said, and getting to appointments can be difficult for students who can’t drive and have two working parents. The district only provides the space, utilities and custodial services. Virginia Garcia Memorial Health Center provides the rest of the funding and staffing.

Garibay intervenes when students are having mental health crises and helps students who are disruptive in class. That’s a huge help, Beaty said, since budget cuts in recent years have kept many schools staffing a less-than-ideal number of counselors.

Beaty said SBHC services are particularly important for low-income kids since two of Washington County’s free health clinics that provided vaccinations and family planning services shut their doors last year.

Birth control huge issue

Birth control is one thing the SBHC still can’t adequately address, even though the center gets requests for contraceptives daily, Fitch said. “If it were up to us we would provide them without question.”

But during school board meetings held before the clinic’s opening, community members were strongly opposed to the SBHC distributing contraceptives, said FGSD Chief of Staff Connie Potter.

Lilly Mejia, FGHS senior and school board student representative, wants to see the clinic start offering birth control to students, citing Forest Grove’s high low-income and teen pregnancy rates.

Between 2012 and 2014, 163 teens living in the 97116 (Forest Grove) and 97113 (Cornelius) zip codes between the ages 10 and 19 got pregnant, according to data from the Oregon public health division. That’s 13 percent of the state’s teenage pregnancies — coming from an area with only .9 percent of the state’s population.Members of Forest Grove SHAC sat with Sen. Chuck Riley last week about their School Based Health Center.

The Latino population had the highest rate of teen pregnancy in Washington County, accounting for 58 percent. The Forest Grove district enrolls about 52 percent Latino students.

Discussing such issues is the whole idea behind the Student Health Advisory Committee.

Mejia is planning to work closely with the SHAC this spring, hoping its members can come up with a plan to change peoples’ minds. “It affects a lot of lives,” Mejia said. “We’re going to use the student voice to our advantage.”

SHAC members are not graded and they don’t receive extra credit, Stelling said. “They’re just really passionate about it and have the internal drive to make their community a better place.”

Stephanie Haugen
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