States tackle student mental health needs through common policies

Mental health challenges among students have been deeply exacerbated by the pandemic, and many state and local policymakers have acknowledged a need to implement strong mental health services to better support children.

Thus far in 2021, more than 200 bills in state legislatures that address student mental health, according to the Education Commission of The States, which has provided a depository of resources to support policymakers deliberating these issues.

“Each year, millions of children experience mental health concerns that affect not only their well-being, but also their ability to fully engage in the learning environment,” according to the commission’s website. “Of children who access the treatment they need, at least 70 percent do so in a school-based setting — underscoring the role of K-12 schools in addressing student mental health.”

In addition to resources shared earlier this year (“State Funding for Student Mental Health” and a “Glossary of Student Mental Wellness Concepts”) the commission has published two more resources — “State Approaches to Addressing Student Mental Health,” which includes 14 legislative and programmatic examples, and “Student Mental Health Services Ecosystem,” a one-pager illustration of the agencies involved in coordinating supports for students.

Read a CSBA breakdown of “State Funding for Student Mental Health” here.

State approaches to addressing student mental health

Student mental health services and supports are typically provided through a tiered system that includes universal prevention strategies for all students, targeted support to a smaller group of students and intensive services to specific students identified through screening and referrals.

Every state, the District of Columbia and Guam have statutes or other policies to implement a multi-tiered system of support, according to the Health Policy Database from the National Association of State Boards of Education. One common model highlighted in the Education Commission report — “State Approaches to Addressing Student Mental Health” — “Positive Behavioral Intervention and Support,” focuses on positive behaviors to prevent mental and behavioral health issues in all students.

According to the commission, recent state action has focused primarily on the following areas:

Mental health and wellness curricula:

Many states include mental and emotional health and wellness in health education curricula across the K-12 spectrum. Research suggests that teaching students about mental health and wellness may reduce stigma, help children recognize issues within themselves and peers and provide students the tools to reach out for help should they need to.

Suicide prevention programs and services:

States across the country have adopted policies to help prevent youth suicide through programs that promote awareness, intervention, support services, training and partnerships. Some states require schools to include contact information for suicide lifelines and crisis text lines on student identification cards. In others, such as Utah, the State Board of Education collaborates with the state departments of health and human services to establish, oversee and provide model policies and programs for districts and training for parents.

Staff training and professional development:

Enacting policies that require staff training and professional development is one of the most common approaches taken to support student mental health, according to the report. Often, state legislation focuses on requiring training on specific topics, including trauma-informed instruction, mental health and social-emotional wellness and suicide prevention.

Mental health screening:

Screening for early identification and needs assessments can provide school officials the opportunity to connect students to targeted supports and services that can address difficulties children face. In some cases, early intervention can mitigate the need for future services. Common screening strategies include universal screening, high-level statewide surveys of student experiences and behaviors and evaluation of individual students to identify specific needs.

Mental health professional staffing ratios:

Some states have sought to provide more effective services and supports to students and families by increasing the number of professionals who are available to students. Professional organizations representing those in these roles recommend one school counselor for every 250 students and one school psychologist for every 500 to 700 students. In California, the most recent available data shows the ratio of students-to-counselors is at 612-to-1. While experts note this is still far too high, it is a marked improvement from the 1990s, during which time the ratio was closer to 1,100 students per counselor.

School-based mental health programs and services:

Increasingly, the commission notes that states are expanding mental and behavioral health services through the community school model, which combines academics with a wide range of vital in-house services, supports and opportunities to students and their families that are integral to promoting whole child development. Such schools often partner with local agencies, non-profits and more to provide physical and mental health services and other programs for children and families.