Thursday, 30th of May, 2019 saw the release of the 2019 Budget, dubbed the first 'Well-being Budget' focusing on improving the well-being of all New Zealanders.
There was much build up and speculation about the content prior to its release. This budget sees significant investment in mental health, which many argue is long overdue, along with increases in funding for hospitals, railway, children, and welfare recipients. Notably for School Health, while the finer details are yet to be disclosed, this 'Well-being Budget' extends the nurses in schools programme to a further 5,600 students by commencing the roll-out to decile five secondary schools at a cost of $19.6 million over four years.
We welcome the additional funding in Budget 2019 for not only SBHS, but also the additional funding announced for improving equity for Maori and pacific communities, for primary mental health and for youth. School nurses provide an essential advocacy and front line primary health service within a youth development framework. More school nurses means greater access by students attending Secondary Schools, Alternative Education facilities and Teen Parent Units, to free, confidential and accessible youth health services. Roughly 23000 students attend decile 5 secondary schools across NZ. Yet this budget is only extended to include another 5,600 students, so roughly three quarters of students at decile 5 schools will miss out on this essential service, not to mention those at decile 6-10 schools. Newly published research suggests team-based (Multidisciplinary) SBHS are associated with better mental health among students who attend them (Denny et al, 2019). Mental health doesn't discriminate by decile, and for this reason we would advocate for the need for Multi-disciplinary SBHS in EVERY school in New Zealand, not just some decile 5 schools, in line with this labour-led governments' campaign promise in 2016.
The previous extension of funding from decile 1-3 schools to include decile 4 has had some challenges.
For schools entering the MoH funded service, facilities have posed some challenges. Schools are often strapped for space, and budgets are tight to begin with. Equipping facilities to meet requirements to provide appropriate health services that are confidential, appropriately located and fit for purpose comes at a cost, and there has previously been no allocation of funding to meet this challenge.
Relationships between health and education take time and understanding from both parties to form a strong partnership. This can be challenging to achieve in schools that are typically busy doing what they do best: focusing on the educational attainment of students, and for nurses who are frequently visited by students throughout the day requiring health care and sometimes urgent attention. It requires a desire on both parts to want to work through some of the tension points to best support young people/students and staff to be intentional about creating time for these important conversations to take place.
On a positive note, Support for Nurses has featured in the funding arrangement previously, which allocates some funding for Professional Development, Supervision for the Nurse/s, and Nurse Educator support. We hope to see this same allocation in the future contracts to ensure nurses are offered support and can do their best to support students.
Denny, S., Grant, S., Galbreath, R., Utter, J., Fleming, T., & Clark, T. (2019). An observational study of adolescent health outcomes associated with school‐based health service utilization: A causal analysis. Health services research.