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Student Mental Health Legislative Trends

By Autumn Rivera | Aug. 25, 2021 | State Legislatures News | Print

COVID-19 changed in-person learning and access to school-based services across the United States, significantly affecting children’s and youths’ mental health and well-being. Below is a look at recently enacted legislation addressing student mental health.

Mental Health and Wellness Curricula

Both prior to COVID-19 and moving forward from it, student mental health has continued to be a focus for policymakers across the country, including states connecting physical and mental health through mental health curricula. For example, in 2019 Maine enacted Senate Paper 303 requiring K-12 health education curricula to address the relationship between physical and mental health to reduce stigma and enhance students’ understanding of attitudes toward and behavior relating to mental health. Additionally, in 2020 South Carolina enacted House Bill 3257, which requires state educational agencies (SEAs) to revise existing age-appropriate standards and concepts that address mental, emotional, and social health. This also relates to coursework and adds additional requirements for seventh- and ninth-grade students.

Suicide Prevention Programs and Services

As suicide continues to be a leading cause of death for youth, many states have turned to student suicide prevention policies. These include promoting awareness, creating intervention plans, providing support services, and requiring professional development. With the passing of California Assembly Bill 1767 in 2019, local education agencies (LEAs) in California are required to adopt and update a policy for students grades one to six on suicide prevention that specifically addresses the needs of high-risk groups. This bill requires the suicide prevention policy be age-appropriate and delivered sensitively to the needs of young people. In 2019, Illinois focused on teacher in-service training with Senate Bill 1731. This legislation requires the teacher in-service training program be evidence-based and educate teachers on the warning signs of mental illness and suicidal behavior in youth. In 2019, Oregon enacted Senate Bill 52, which requires school districts to develop comprehensive plans on suicide prevention for K-12 students. The plans must include procedures for suicide prevention, intervention, and activities that promote healing after a suicide.

Staff Training and Professional Development

Over the years, states have enacted legislation requiring staff training and professional development around trauma-informed care. In 2019 Oklahoma enacted House Bill 1905, which requires candidates in the teacher preparation system to study trauma-informed responsive instruction. Similarly, Indiana requires teacher’s license applicants to provide evidence they have completed training in trauma-informed instruction through  Senate Bill 205 in 2021. Also in 2021, Louisiana passed Senate Bill 211 which requires in-service training for teachers and certain other school personnel on adverse childhood experiences and trauma-informed education. 

Mental Health Screening

Research has shown mental health screenings allow for early identification and intervention for youth. For example, Tennessee enacted Senate Bill 7019 in 2020, which requires LEAs to develop a plan to conduct mental and behavioral health screenings for all students in kindergarten through eighth grade during the 2021-22 school year. These screenings aim to evaluate the impact of the COVID-19 pandemic on students’ mental and behavioral health. In 2020, Utah enacted House Bill 323, which allows the implementation of an evidence-based mental health screening program. It also sets standards for participating LEAs to implement approved mental health screening programs for participating students. This legislation also prevents mental health screening without parental consent.

Mental Health Professional Staffing Ratios

States have looked at policies around staffing ratios for professionals in schools. Virginia passed House Bill 1508 in 2020, which requires local school boards to employ school counselors with a predetermined ratio. The ratio differs between elementary, middle and high school students, with the most concentrated number being at the high school level. Maryland required every local school system to submit an interim report on the ratio of students to psychologists in each school, strategies to increase the numbers of psychologists and strategies to increase psychologist retention with House Bill 844 in 2019. Recently, Delaware passed House Bill 100 which establishes a mental health services unit for Delaware elementary schools. The unit is at a ratio of 250 full-time-equivalent students grades kindergarten through five for a full-time school counselor, school social worker or licensed clinical social worker; the unit ratio is 700 full-time-equivalent students for grades kindergarten through five for employment of a full-time school psychologist. This act defines “mental health services” as prevention, response and coordination services delivered to students in elementary schools.

School-Based Mental Health Programs and Services

Another trend is policies focused on providing school-based mental health programs and services. Safe2Tell Colorado is a statewide anonymous reporting tool available 24 hours a day. With the passing of Colorado House Bill 20-1113 in 2020, the state made enhancements to the Safe2Tell program. These include training dispatch centers, school districts, individual schools, and other entities on appropriate awareness and response to Safe2Tell tips. Additionally, it includes providing Safe2Tell awareness and educational materials to all elementary and secondary schools in Colorado. In 2020, Iowa school districts and schools, through Senate Bill 2261, are now able to provide behavioral health services via telehealth to students on school premises. Washington required the development of comprehensive school counseling programs with Senate Bill 5030 in 2021. This legislation requires that by the 2022-23 school year, every school district has developed and implemented a written plan for a comprehensive school counseling program that is regularly updated.

Mental Health Related Absenteeism

A newer trend has been states adding mental health to the list of valid reasons for school absence. Nevada Senate Bill 249 passed in 2021, states that a qualified mental health professional or behavioral health professional can provide a certificate to excuse a student from attendance. In 2020 Maine enacted legislation that includes student absences for mental health or behavioral health needs as excusable absences. In 2020, Colorado enacted Senate Bill 20-014, which requires the school district’s written attendance requirements include a policy for excused absences for behavioral health concerns.

Workgroups, Pilot Programs, and Commissions

In many states, policymakers have used workgroups, pilot programs, and commissions. In 2021 Senate Resolution 45 in Hawaii requests that SEAs convene a working group to create a model statewide school policy on K-12 student suicide prevention, intervention and postvention. New Hampshire used House Bill 131 in 2019 to establish a commission to develop and promote mental health programs and behavioral wellness programs in K-12. In 2020, Wisconsin Assembly Bill 644 creates a school-based mental health consultation pilot program. This legislation assists participating school-based providers in offering enhanced care to students with mental health care needs, provides referral support for those students, and a variety of additional services.

Looking Forward

Student behavioral health and wellness has been of increasing interest for states over the last several years as students continue reporting high levels of stress, depression and anxiety. Additionally, as policymakers continue to prioritize supporting student mental health during and after the COVID-19 pandemic, it is likely these eight policy trends may continue to receive attention. NCSL will continue to track student mental health legislation.

Autumn Rivera is a policy associate in NCSL’s Education Program.

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