Supporting Positive Opportunities with Teens, more commonly known as The SPOT, is a drop-in clinic located at the Washington University School of Medicine campus and Jennings High School. They offer free services to youth aged 13 to 25 for check-ups, mental health counseling, STD/HIV testing, prevention health care, wellness education, and other services. The SPOT has a very clear mission: to create safe and healthy communities, provide primary care for older youth, support and engage youth in leadership opportunities, integrate social services and healthcare into a single setting, and improve healthcare delivery for youth in the St. Louis area.
The SPOT hopes to remove barriers that youth face when seeking healthcare services such as financial burdens, stigma of health conditions or infections, distance-related inaccessibility to healthcare. By combining social services and healthcare into a single setting, The SPOT practices a convenient and efficient healthcare delivery system for students and provides free or cheap healthcare services that are integral to helping students’ wellbeing.
Services at The SPOT are funded by various local healthcare organizations. Since Missouri opted out of Medicaid expansion, much of youth older than the age of 19 lack coverage for healthcare. An example of how The SPOT works to reduce this limitation is a program called COACH (Creating Options and Choosing Health) that provides foster youth with continued primary health services until the age of 25. COACH is a partnership that The SPOT has with the children’s division with the Child Welfare Agency. They also provide case management, sexual health education, and psychiatric services. By partnering with the health department, The SPOT hopes to provide better services and make treatment more effective, accessible, and affordable for youth.
The SPOT medical director Katie Plax, MD states that “The SPOT makes it as accessible and easy as possible to get these things done.” Staff and computer infrastructure are set up to be efficient, effective and patient-centered. For example, if someone wanted STD testing and did not exhibit any symptoms, The SPOT would use “an evidence based model called Express Testing in which the patient will come in, get their test, leave, and come back for any necessary treatment later” says Plax.
Programs at The SPOT also provide safe spaces for youth of the St. Louis area to seek help or develop skills needed for adulthood. Dr. Plax states that “we believe once you come through our door, you are our SPOT family. It is our job to make the things you want to happen for you happen that day. That’s an important paradigm and strategy in our structure.”
The SPOT makes sure to truly listen to the voices of the students of St. Louis. They have a youth advisory committee that will regularly work with youth who come to the drop-in space to input advice to the clinic about different programs that The SPOT is considering.
“If we’re going to do any program development, recruitment, or a check on whether our services are meeting the needs of young people, we generally run sessions with youth who are in our programs to listen to their feedback and make sure that we are being true to our model: to do things with youth and not just for youth” Plax said.
The SPOT provides a stocked kitchen, laundry and shower facilities, computers, and recreational stress-reducing activities allowing youth to build new relationships and hang out. Such provisions, like providing a safe space for the day-to-day aspects of students, are important to the holistic wellbeing of the patient. Dr. Plax says The SPOT wants to “know who you are. We want to provide a spectrum ways people express themselves at the SPOT.”
When asked about the importance of social determinants of health in a patient’s wellbeing, Plax replied, “education, housing, poverty, racism, and trauma all affect people’s wellbeing… Case managers will help patients deal with and provide resources for whatever they need whether it’s lack of food at home or challenges with housing or finding a job.” An integral part of The SPOT is that it looks at the whole patient and not just the biomedical needs of the patient. The clinic considers the patient’s background and circumstances a crucial aspect of their services.
“There are gaps when services don’t have resources to meet the current needs of patients,” Plax says. “And so many staff at The SPOT have engaged in advocacy for system and policy change at local and state levels.”
The SPOT has made an enormous impact on the St. Louis community and provided youth-centered care that addresses health care barriers that many youth in the area face. By providing these opportunities, the clinic engages youth through evidence-based and well-demonstrated models that provide treatment that is effective and accessible.
Edited by: Katrianna Urrea
Illustrated by: Allen Chen