As Maine residents face challenges getting in at the doctor's office, some school districts are bringing providers into schools, making it easier and faster for students to access care. The Bangor School Department is expanding clinics to its middle schools, and offering care to students of all ages.
At the James F. Doughty School recently, students move between classes, stopping at their lockers and rushing past the unassuming entrance to the school's nearly complete health clinic.
It's one of two new clinics at the district's two middle schools, built with the help of the city after the success of a clinic at the high school.
"We have to really start rethinking what it is that we're doing and how we are supporting not only the whole child, but also families," said Marie Robinson, superintendent of the Bangor School Department.
"We are in a really challenging time," she said. "Families are busy. Health care is challenging. So if we can support that access to families and students, we feel that it's very important."
The Bangor School Department is one of 18 districts across Maine that have at least one school-based health clinic. And as the district prepares to fully open the new middle school clinics, it highlights the effectiveness of the in-school model and the importance of easy access to both physical and mental health care.
"It's a key piece of the learning process, because if children aren't healthy or need health care and aren't able to access it, it ultimately impacts their ability to learn," Robinson said. "So we're really working hard to reduce those barriers."
At the heart of the issue is the many logistical steps to get a student to the doctor. Parents need to take time off work, get the child from school and then the appointment itself.
That's a lot of class time missed, even if students return to school afterwards, which isn't a given.
And that's before factoring in Maine's challenging health care landscape, where long wait times could mean families are traveling even further to get to the doctor.
"The ripple effect is it goes wide," Robinson said. "So I think being able to cut that down, I know families are very appreciative of it."
The in-school clinic simplifies much of the process -- students don't need to leave the building or worry about drive time, ensuring that a 30-minute appointment really only takes 30 minutes, not all afternoon.
And families have been excited to get on board with the program, said Brendan Miller, family nurse practitioner at the high school clinic.
"They have loved the convenience of being able to either, bring their kid in, or if their kids already at school, we just call and get permission, and then we see them, and they the parent doesn't have to leave work, and this in the student can go back to their class," Miller said.
Parents consent to their children utilizing the clinic, and can attend appointments in-person, or staff will call parents before and after to keep them up to date.
While a school nurse manages medications and coordinates care for students with chronic conditions, the in-school clinic functions like a walk-in express care, testing and treating viral symptoms, and providers can refer students to other doctors in their system.
They can also fill in for a primary care physician for things like sports physicals, Miller said, a key service when those doctors are in high demand.
"A lot of their actual primary care providers are so full that they can't even get them in for their yearly physicals to do the sports physicals," he said. "So it has been much faster to get in through us."
Picabo Mower, a licensed clinical social worker, works at the middle school offering mental health counseling at the clinic. She said that working with young students can help them ease the transitions of middle school.
And physically being in the school removes some of the barriers, she said, helping her work directly with the school to find the best time in a students schedule to meet.
"And the school staff, I try to work with them as best as I can, because mine are reoccurring, so every week we're going to meet, so I try to meet with them during a study hall or during, like a free period, so it's like least disruptive to their education," she said.
It's especially helpful at this age, Mower said, as students themselves worry about missing class.
"They're starting at this age to get into, 'If I miss school, I'm behind on my work, and I'm going to fail, and my parents are going to be upset with me, and I'm not going to be able to play sports,' or whatever it is that in their life," she said. "So this cuts that out a lot."
Mower has already started meeting with students this year, and the finishing touches to the physical clinic space will wrap up in the coming weeks -- a successful example of the in-school model for other districts around the state.