Adolescent Centered Environments

“I kind of felt disrespected.” … ”I felt like they were babying me.” … “My doctor assumes [things] sometimes, and it’s kind of awkward. She talks to my mom, my mom talks to her, I’m just there. I’m just there to get poked.” If you ask a group of teens about whether they have had negative experiences at a health center or not, most of them will have at least one story that illustrates to providers and staff what NOT to do.

The Adolescent Health Initiative (AHI) did just that – we talked with our youth council, The Adolescent Champion Teen Advisory Council (TAC TAC) to hear about their areas of concern around adolescent health care. Many issues were raised, from the importance of confidential care for adolescents, to adults helping teen patients navigate payment systems and referrals, to the simple request that providers and staff behave non-judgmentally and treat teens with respect.

For professionals who work with adolescents (ages 10-21) in health centers, the fact that they often have negative experiences is probably not a surprise – but the negative experiences happen to adolescents somewhere else. Most providers and staff usually believe that they are adolescent-friendly and respectful of their adolescent patients. So where’s the disconnect? Why do teens so often still feel like they are treated as “less than” when it comes to their health care? And what can centers do to make sure they’re objectively reviewing their services, policies and standards of care to be as inclusive of all young people as they can be?

To address these questions, AHI developed the Adolescent Centered Environment self-assessment tool, a thorough, detailed, twelve section survey that is intended for regular assessment using a Plan/Do/Check/Act cycle, utilizing the accompanying recommendations guide and planning tool for improvement. The toolkit includes sections such as Access to Care, Parent Engagement, Adolescent Appropriate Environment, and Mental Health Clinical Practices, looking at a wide range of factors that make a clinic experience comfortable for adolescents. As AHI has piloted the toolkit, it’s become apparent that even the highest quality centers have areas of improvement.

This summer, all six of RAHS’s centers will conduct self-assessments using the ACE toolkit, looking at ways adolescent patients can feel at home in their school-based health center. The ACE review process encourages this through thoughtful reflection on ways policy and care can become even more centered on adolescents and their needs.

And of course, teens have a lot to say about positive experiences in their health centers too! A favorite quote from one of our TAC TAC members, talking about how she feels about her doctor, Maggie Riley (who is a RAHS provider), sums it up: “She’s absolutely amazing, and every time she sees me, she just makes sure that I’m healthy, she’s like, ‘If you ever need to come in, call me, this is my number,’ so it makes me feel she cares and she’s not just there for a paycheck. She’s actually there to help.”

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