Mental health screening for students is now required by almost one-third of K-12 public schools in the U.S., but receiving appropriate follow-up care after a diagnosis is often problematic, according to a recent study from RAND described in an Education Week article.
Most principals reported their school typically notifies parents (79%), offers in-person treatment (72%), and/or refers a student to a local mental health care professional (53%) if anxiety or depression is diagnosed, according to the report.
Principals were split on access to care. About 40% said it was very hard or somewhat hard to ensure that students receive appropriate follow up, and 38% said it was easy or very easy to find adequate care for students, the report found.
The findings are timely as many young people struggle with record-high rates of depression and anxiety. Youth mental health is now a top policy priority for school, district, state, and federal leaders.
Overall, educators and school-based mental health professionals who spoke with Education Week said the Rand study results are encouraging.
“You wouldn’t have gotten those numbers five years ago. There’s still a lot of work to be done, but it looks like we’re making some progress,” says John Gies, the principal of Shelby High School in Shelby, Ohio
Most schools offer in-person treatment or refer students to community-based resources, but the RAND report didn’t question the quality or effectiveness of those services or whether available resources match student demand.
Screening students for signs of poor mental health is one of the best ways to support students, according to experts. But conducting screenings has been slowed due to a lack of resources, and, in some cases, because of parent pushback.
Access to appropriate mental health services can depend on a district’s location, experts say. Districts near big cities likely have more access than those in more rural areas or smaller towns. Some districts are turning to telehealth to provide services to students, but that is a distinct minority.
School mental health professionals are often swamped by demand. The NASP recommends a ratio of 500 students to 1 school psychologist — the national average ratio for the 2023-24 school year was 1065 to 1 psychologist. The American School Counselor Association recommends a ratio of 250 students to 1 school counselor, but the national average ratio for the 2023-24 school year was 376 to 1 counselor.
Gies’s 400-student Shelby High School has two counselors with wide-ranging responsibilities. They check in on students’ mental health and also ensure students are meeting graduation requirements, help students with picking classes, and talk to students about post-high school plans.
“Sometimes they don’t get the opportunity to just be counselors, and so we have to be aware of that and try and take some things off of their plates,” Gies says.
Principal organizations in Ohio and nationally are pushing policymakers for more resources, Gies says.
Only two states currently have laws providing funding and resources for schools to adopt mental health screenings. Illinois requires schools to offer universal mental health screening for students in grades 3-12. New Jersey funds grants to schools to provide mental health screening. A Colorado law that created a mental health screening program for students in grades 6-12 was repealed — the bill sponsors cited concerns that the law infringed on parents’ rights.
“Even though we’re making some strides, we still need help,” Gies says. “We need continued funding to help us with this mental health crisis in our schools.”
Education Week
