This paper describes the mental health services provided at a high school based health center that integrates mental health and medical services. Five years after the inception of the center in 1988, mental health visits had quadrupled. In 1992 alone, students made 1,002 mental health visits. Strikingly, one-third of these students reported problematic substance use among other family members. Other leading reasons for utilizing mental health services included pregnancy (19%), past or present suicidal ideation (14%), obesity (8.7%), ongoing depression (8%), and issues related to sexuality (7.5%).

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