School-based health services (SBHS) including pastoral care can play a pivotal role in addressing adolescent health and wellbeing; including their tobacco and other drug use. To maximise the benefits of these services, they need to be accessible, useful for, and acceptable to students. This formative, qualitative study involved 12 focus groups within nine lower socio-economic Western Australian Government secondary schools. The purpose was to identify student (n = 59) perceptions of the availability and usefulness of SBHS (and other identified caring staff) to reduce students’ harm associated with tobacco and other drug use. The findings suggest students were aware of the SBHS available to them, but considered them less useful if staff were regularly unavailable; presented a ‘don't care’ attitude; held solely disciplinary roles; and were based in an area of the school unfamiliar to the student. Services were considered useful when staff members built rapport with students; took time to listen; followed-up with students and displayed a general concern for the student's wellbeing. Interestingly, students acknowledged trusting health teachers more than SBHS staff for tobacco information and support. These findings have important implications for school counsellors and other school health/pastoral care staff who want to increase the likelihood of students approaching and using school support services to reduce harm associated with tobacco and other harmful drug (OHD) use.
