Goal: Invest in every student's mental health and well-being by increasing school-based health services for students and building schools that support students' overall well-being.
The Problem:
When students feel connected to school, their mental health and academic performance improve; however, the consequences of the pandemic—social isolation, illness, and family hardship among them—have led to decreased feelings of connectedness for students. For example, approximately 1 in 3 high school students have experienced poor mental health amid the pandemic, and rates of poor mental health have been higher for historically marginalized groups of students. For students to thrive in school, they need a strong foundation of overall wellness.
Our Strategies:
The Department is committed to working with parents, families, educators, and others to meet students’ mental health needs. We are assisting state and local leaders to grow the knowledge and skills of professionals currently in schools, expand the supply of mental health professionals who work with students in schools, and increase access to funding through the Medicaid program to support school health services, including mental health services. Robust investments and strategic action in the areas below represent key levers to address the youth mental health crisis.
Increasing the Supply and Capacity of School-Based Mental Health Providers:
Personnel shortages are among the leading factors that limit schools' ability to effectively provide mental health services to students. Many schools do not meet recommended ratios for psychologists to students (500:1) or counselors to students (250:1). During the 2023-24 school year, 59% of school districts indicated they had insufficient mental health professional staff coverage to manage their caseload. At the same time, with the help of American Rescue Plan (ARP) funds and previous rounds of pandemic relief dollars, the number of mental health professionals working in schools has increased significantly relative to the pre-pandemic period. In the infographic below, vacancies reflect shortages as well as new efforts by districts to hire these staff.
School-based Mental Health Professionals as of April 2024
(download data as a spreadsheet)
To meet President Biden's goal of doubling the amount of mental health professionals in schools, the Department will continue to assist states so they may recruit and retain these vital school staff members and offer professional development for teachers around trauma-informed and other mental health practices. The Department has awarded $286 million to date across 264 grantees in 48 states and the District of Columbia to support mental health services in schools—investments that are estimated to support more than 14,000 new mental health professionals in schools in the coming years.
This work is necessary when the Centers for Disease Control and Prevention (CDC) has conveyed alarming findings regarding the prevalence of mental health or substance use disorders among our nation’s youth. These findings support the critical need for schools to expand school-based services and to connect youth and families to community-based sources of care.
Simply put, schools are a gateway to needed services that otherwise might be inaccessible for many young people. Community health centers are part of the solution. These centers provide comprehensive primary-care services, and many are located in our nation’s schools and facilitate access to essential services for both students and other members of the community. Roughly 50 percent of school-based health centers are supported by the Health Resources and Services Administration (HRSA). The map below demonstrates the significant variation in the number of HRSA-funded school-based health sites per 100 Title I schools. The table that follows shows that the number of these centers has increased significantly in many states.
The Department also will continue to provide guidance, oversight, and technical assistance to states to implement efforts supported by $2 billion in funding through Stronger Connections grants, the School-Based Mental Health Services program, and the Mental Health Service Professional Demonstration program under the Bipartisan Safer Communities Act. More information about these programs is provided below.
Increasing Access to Reimbursement for School-Based Health Services:
Medicaid funding can be leveraged to provide crucial health and mental health services at schools. The Department of Education is collaborating with the Center for Medicare and Medicaid Services to increase access to school-based health services by assisting state educational agencies and local educational agencies to maximize the benefits of the Medicaid program by providing health and mental health services at school to Medicaid-enrolled children. The Department has created a resource for states to understand the value of accessing Medicaid dollars and how to get started.
The Departments released a technical assistance guide on Medicaid school-based services to help schools work with their Medicaid agencies. The Departments also established a technical assistance center to help states shape policies that allow them to financially sustain essential health and mental health services.
Sampling of ARP Funding Highlights:
- From the 10 percent of funds set aside for state use through the Elementary and Secondary School Emergency Relief (ESSER) fund, approximately $1 billion has been dedicated to support the mental health and overall well-being of students and school staff across the country, according to calculations by the Council of Chief State School Officers' COVID Relief Data Project. For example:
- The District of Columbia has committed $1 million in ESSER II funds to Educator Wellness Technical Assistance grants. These grants will be used to address root causes of educator stress and to adopt and implement educator wellness programs in 25 public and public charter schools.
- The Illinois State Board of Education has committed $23.5 million to launch the Resilience Education to Achieve Community Health (REACH) initiative and to establish seven regional Social-Emotional Learning (SEL) Hubs. Through this statewide initiative, school communities participate in a trauma assessment and action planning to address the mental and social-emotional health needs of students and staff. Teams at 270 schools participated in professional development collaboratives to better understand and address trauma.
- The Iowa Department of Education committed up to $20 million to support a partnership with the University of Iowa's College of Education Baker Teacher Leader Center to develop the Iowa Center for School Mental Health. The center will expand training opportunities for student teachers and practicing teachers, provide professional development resources and services to support mental health needs in schools, and support research on the effective delivery of these services to students. As part of this partnership, the University of Iowa asked institutions of higher education to apply for grants to support research that can help improve social, emotional, or behavioral outcomes for students in P-12 schools.
Grants and Resources:
- Nearly $1 billion in funding through the Bipartisan Safer Communities Act's Stronger Connections program is helping states to support safe, inclusive, and welcoming learning environments for all students.
- The Department awarded $46 million in competitive grants to 67 states, school districts, and institutions of higher education through the Mental Health Service Professional Demonstration program. Nearly half of the awardees included a partnership with a Minority Serving Institution, Historically Black College or University, or Tribal College. With these funds, grantees will train school-based mental health services providers for employment in schools and districts.
- Through the School-Based Mental Health Services program, $141 million is helping 103 grantees—including states and districts—to increase the capacity of school-based mental health service providers to deliver services to students.
- Through the Full-Service Community Schools program, the Department is investing in integrated health, education, and other comprehensives services. The Department has released several guidance documents to support schools in implementing community schools. And because of the President’s commitment to this model, federal funding for the Full-Service Community Schools program has increased five-fold over the course of this administration. While the program supported 170 schools before 2021, it is now reaching more than 1,700 schools, serving almost 800,000 students.