Volume 54 | Number 3 | June 2019

Abstract List

Simon Denny PhD, Sue Grant ME, Ross Galbreath PhD, Jennifer Utter PhD, Theresa Fleming PhD, Terryann Clark PhD


Our aim is to examine the unbiased association between use of school‐based health services () and student health outcomes.

Data Sources

Data are from a nationally representative health and well‐being survey of 8500 New Zealand high school students from 91 high schools.

Study Design

Student data were linked to the level of available to them: no , regular clinics from visiting health professionals, a health professional onsite, or a health team onsite.

Data Collection/Extraction Methods

Causal analyses are used to compare utilization of and their association with student‐reported health outcomes, including foregone health care, depressive symptoms, emotional and behavioral difficulties, suicide risk, substance use, and unsafe sexual behaviors.

Principal Findings

Results from the multinomial propensity score–weighted regressions show that the use of was associated with poorer health outcomes, suggesting that selection bias was present due to unmeasured confounders. Instrumental variable analyses found that that students using team‐based had a 4.7 percent (95% 0.5‐8.9) probability of high levels of depressive symptoms compared to 14.2 percent (95% 11.5‐16.8) among students not using team . For suicide attempt, students using team‐based had a 2.0 percent (95% −0.3‐4.2) probability of a suicide attempt in the previous 12 months compared to 5.6 percent (95% 2.6‐8.5) among students not using team .


These analyses suggest that team‐based are associated with better mental health among students who attend them.