Tue Jul 2

If the NZ government wants to improve student outcomes, it needs to invest more in school-based healthcare

Written by Sarah Williams, Senior Lecturer (Nursing), School of Clinical Sciences, Auckland University of Technology

New Zealand’s school achievement is currently front and centre with the government’s plans to invest NZ$67 million into structured literacy ^[1]. But what has been largely missing from the discussion on education is the impact health can have on learning and academic achievement.

In New Zealand and elsewhere, increasing numbers of children are entering schools with specific health needs ^[2]. And school staff, trained primarily in education, are frequently being tasked with meeting these needs alongside the demands of their daily teaching roles.

Teachers have reported student health and wellbeing ^[3] is an ongoing concern.

But they also said they are under-resourced, under-trained and stretched by the wide array of demands on them. These range from managing challenging student behaviours, to identifying and supporting students with physical and mental health needs.

Increasingly, teachers are having to navigate the challenges of neurodiversity ^[4] and educational disparities (which are, ironically, sometimes the result of unmet health needs).

Resolving the tension between teachers as pure educators and teachers who support the health and wellbeing of children is going to require investment well beyond literacy – particularly if the government is serious about improving overall educational outcomes.

New Zealand’s teachers are not alone in feeling overwhelmed.

A recent study ^[5] from the United States, for example, noted increasing calls for improved mental health literacy among school staff. These teachers reported being challenged by time constraints, communication barriers and insufficient professional development. They also expressed their need to be better prepared to recognise mental health issues and provide classroom support.

Likewise, an Irish study ^[6] found initiatives aimed at promoting student health and wellbeing were hampered by teachers’ lack of appropriate education and work-related time constraints.

Health and wellbeing as a subject

New Zealand’s initial teacher education programmes limit considerations of health and wellbeing to the health and physical education learning area, where there may be opportunities for communicating messages about healthy eating, drug awareness and aspects of physical hygiene, for example.

A recent report on the readiness of teachers ^[7] limited its references on “health” to the health and physical education curriculum.

And the standards for the teaching profession ^[8] fail to mention student health, although the code does state teachers are to “establish and maintain professional relationships and behaviours focused on the learning and wellbeing of each learner”.

Teachers feel conflicted

Despite limited training in the area, teachers face increasing demands to address and support the health needs of students. This is largely due to an increased understanding of the correlation between health and education. It is clear supporting students health and wellbeing ^[9] helps them to meet their academic goals.

And yet, in a recent New Zealand study ^[10], not all teacher participants agreed that promoting and supporting student health and wellbeing was part of their role.

Some believed concerns with students’ health and wellbeing detracted from their key teaching focus. These findings align with an Australian study which asked whether teachers were health workers ^[11].

Providing teachers with skills to better support their students’ health needs can be an effective way to improve policy outcomes ^[12].

Schools have already been used by successive governments to implement and support health and wellbeing goals. Under Labour, the sale of “junk food ^[13]” in school tuck shops and canteens was sharply curtailed with the aim of improving the health of students. And more recently, the government banned cell phone use in schools ^[14], in part to reduce online bullying and mental health issues.

Health and education working together

Much more can be done without solely relying on teachers.

Collaboration between the health and education sectors ^[15] can enhance student learning and health outcomes.

Globally, nurses have a long history of delivering health services in schools ^[16] and are considered a valuable resource for teachers, students and their families.

Currently New Zealand’s school based health services (SBHS ^[17]) provide clinical healthcare services to around 115,000 students in 300 secondary schools. But this is often in a limited capacity and is targeted to vulnerable communities. It is also only aimed at older students.

While there are some nurses working in primary schools across the country, this service has diminished over time, is fragmented and lacks national leadership and direction.

A greater investment in school health services can address barriers to student learning and bring together otherwise separate sectors. It is also an opportunity to review the role health professionals can play in assisting teachers to identify, understand, and support the health needs of students.

While investing $67 million to improve literacy in schools is an important and significant policy step, so is investing in developing a national school health service that serves early childhood through to secondary school.

This service will support both teachers and students by helping to identify, manage and alleviate health-related barriers to learning. And in doing so, will have the double benefit of supporting education outcomes.