National Report Card Examines State Policies That Support School Mental Health

by Alex Mays

The last two years have been intensely difficult for school children. Prior to the pandemic, children already struggled with a variety of mental and physical health issues that impacted their ability to learn. The isolation and trauma brought on by the pandemic only intensified these issues, causing soaring rates of school disconnection, anxiety, depression and suicide among children and youth.

Health experts have declared a national mental health crisis affecting young people. To cite just one statistic, the proportion of mental health-related emergency room visits for children ages 5-11 and 12-17 increased by 24 percent and 31 percent, respectively, from 2019 to 2020.

The pandemic also widened the already glaring disparities in the kinds of support and services that are provided in schools serving low-income Black and Latinx students versus wealthier, majority-white schools.

In the wake of this information, Healthy Schools Campaign joined with 16 national organizations to bring attention to the youth mental health crisis through the Hopeful Futures Campaign, an effort to identify strategies and solutions to improve school mental health services.

The Campaign recently released the first-ever mental health report card for U.S. schools that scores every state on policies that support school mental health, with recommendations for improvement. The report looks at a variety of markers, from a state’s ratio of school mental health professionals to students, to state policies, including whether K-12 health education includes instruction on mental health.

“Our research reveals that there are enormous gaps in every state, which are leaving our children shortchanged,” Angela Kimball, senior vice president for advocacy and public policy at Inseparable, the national mental health nonprofit that spearheaded the development of the report card, told MindSite News. She added that the investigation “also found surprising amounts of innovation.”

This is the first major report to recognize state policies that support funding of school mental health services for all students covered by Medicaid. States that score highest in this area have aligned with federal policy, ensuring state Medicaid programs cover school-based mental health services for all Medicaid-eligible students.

This data point draws on HSC’s school Medicaid map to provide information on Medicaid coverage, including eligible students and behavioral health staff, in all 50 states and Washington, D.C.

In its coverage of the Hopeful Futures Campaign report, NPR highlighted how Colorado has “leveraged Medicaid to cover school-based mental health care – including telehealth services – for all eligible students.”

We’re excited to see Colorado get recognition; it’s one of 15 states in HSC’s Healthy Students, Promising Futures Learning Collaborative, which brings together state teams committed to increasing access to Medicaid services in schools. After a pilot study, Colorado added school psychologists to its list of Medicaid-eligible providers and now estimates receiving an annual increase of $8 million in federal funding.

Schools are a natural place to offer coordinated, comprehensive and equitable access to behavioral health care. One in five children between the ages of 13 and 16 experience mental health issues, yet less than 20 percent of these children receive the help they need. Of those receiving care, nearly 80 percent do so in a school setting.

As U.S. Secretary of Education Miguel Cardona stressed in his Vision for Education in America earlier this year, schools must offer increased access to mental health supports for students. We look forward to working with more states and school districts to help maximize their efforts to ensure students receive the healthcare they need.