girl visiting with school psychologist

Children are six times more likely to get evidence-based mental health care when it’s offered in schools than they are in other community settings.

Enhancing School Capacity to Support Children’s Mental Health

By Tammy Jo Hill | Jan. 21, 2021 | State Legislatures Magazine

Before the COVID-19 pandemic and regardless of geography, age, gender and ethnic or racial background, an estimated 13.7 million children had been diagnosed with a behavioral health disorder, including anxiety and depression.

Behavioral health disorders can prevent children from developing coping and resiliency skills—abilities they need to help them learn, behave and handle their emotions, according to the Centers for Disease Control and Prevention (CDC). These skills are essential to healthy social development and help ensure children have a positive quality of life now and into adulthood.

Early identification of behavioral health disorders can lead to children receiving treatment sooner and can help mitigate some of the challenges related to coping and resiliency later in life. In a given year, an average of 7.4% of youth under age 18 in the United States will have a mental health visit in a community setting. However, studies have shown that children spend approximately 49% of their days in a school setting and are six times more likely to get evidence-based treatment when it’s offered in schools than they are in other community settings. By linking programs and supports that foster a comprehensive school mental health system, states can not only reduce the number of children experiencing behavioral health disorders but also save a considerable amount in economic costs. The National Academies of Sciences, Engineering and Medicine reports a national economic savings of approximately $247 billion per year.

A new NCSL policy brief, “Enhancing School Capacity to Support Children’s Mental Health,” explores legislative opportunities to create and cultivate school mental health programs that fit individual communities and their budgets. The brief highlights “Advancing Comprehensive School Mental Health Systems: Guidance From the Field,” a report produced by a partnership of national school mental health leaders and organizations.

The brief identifies eight core components of an effective school mental health system:

  1. Well-trained educators and specialized instructional support personnel—A full complement of school and district professionals, including personnel who can support the mental health needs of students in the school setting.
  2. Family-school-community collaboration and teaming—Partnerships among students, families, schools, community partners, policymakers, funders and providers to address the academic, social, emotional and behavioral needs of all students.
  3. Needs assessment and resource mapping—Ongoing evaluations of students and school and community resources to inform decision-making about needed support and services.
  4. Multi-tiered systems of support—A full array of tiered, evidence-based processes, policies and practices that promote mental health and reduce the prevalence and severity of mental illness.
  5. Mental health screening—Use of screening and referral as a strategy for prevention, early identification, treatment and recovery.
  6. Evidence-based and emerging best practices—Use of effective strategies to ensure quality in the services and supports provided to students.
  7. Data—Use of statistical information to monitor student needs and progress, assess quality of implementation, and evaluate supports and services.
  8. Funding—Use of diverse models and resources to track or identify new funding opportunities from federal, state and local sources to support a sustainable school mental health system.

For many states, competing priorities and limited resources can present barriers to identifying or implementing any core feature of a comprehensive school mental health system. Potential system-level strategies that policymakers at the local, state and federal levels can consider include:

  • Convening state departments of education or mental health staff with community representatives, families, students and professional associations to enhance communication and opportunities to collaborate.
  • Building agreements among stakeholder groups to determine priority issues and strategies in school mental health. Success can begin with finding a specific, manageable issue for immediate focus.
  • Reassessing practices and modifying approaches in an ongoing process of improvement in which youth and others are included.

Learn more about the core components and state-level strategies, along with state examples, here.

Tammy Jo Hill is a policy specialist in NCSL’s Health Program.

Support for this project was provided by the Bainum Family Foundation. The views expressed in this document do not necessarily reflect the views of the foundation.

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