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To Address Student Well-Being, States Increase Access to Mental Health in Schools

Recent state legislation focuses on the ratios of school psychologists and counselors to students.

By Autumn Rivera  |  May 24, 2023

According to the World Health Organization, half of all mental illnesses begin by the age of 14, making early intervention and support critical.

Many students periodically face challenges around social relationships, learning, difficult decisions or managing anxiety, depression, worry or isolation. School counselors and school psychologists provide services that support students and encourage healthy development. The difference is in their approach.

School counselors deliver fundamental services to a broad range of students, whereas school psychologists provide comprehensive mental health care services. School psychologists may help students and parents understand and resolve both long-term and short-term problems.

Much of the recent legislation focusing on school psychologists and counselors addresses ratios of students to mental health professionals.

Counselors tend to offer a more generalized service, while psychologists are more specialized. School counselors can also be helpful in supporting kids’ social and emotional needs while preparing them for the future, whereas psychologists directly serve students, groups of students, families and administrators to ensure students’ academic, social-emotional and mental needs are met.

NCSL leads a bipartisan Whole Child Policy Advisory Group of legislators and staff who examine state education systems and policies offer guidance on how to foster safe, healthy learning environments where all students can thrive and achieve academic success.

Kelly Vaillancourt Strobach, the director of policy and advocacy for the National Association of School Psychologists, told the group that mental health specialists are concerned about state strategies to alleviate hiring shortages. She cautioned against lowering standards and instead encouraged easing barriers to help make meeting standards more attainable. She suggested looking at various program types, such as online and hybrid programs, that can make graduate school more flexible and attainable. She also recommended states support ongoing efforts to make sure youth have access to what they need in a sustainable way.

State Actions

Much of the recent legislation focusing on school psychologists and counselors addresses ratios of students to mental health professionals. Strobach’s organization recommends providing one psychologist for every 500 students; the American School Counselor Association recommends one counselor for every 250 students.

In 2021, Delaware passed legislation implementing a three-year phased approach to reach a ratio of one full-time school counselor or school social worker for every 250 students and one full-time school psychologist or licensed mental health therapist for every 700 students in kindergarten through grade five. In 2022, enacted legislation extended the ratios to grades six through eight. Pending legislation would require the state to fund mental health professional and mental health coordinator positions for each district and charter school by the 2024-25 school year.

Since 2019, Utah has continued to add funding to school budgets to help pay for mental health experts. The funding initially focused on the state’s high rate of teen suicides but has since expanded to help evaluate and assist students dealing with potentially violent tendencies as well. Utah House bills 373, 32 and 323, all enacted since 2020, have helped provide new counselors, mental health screenings for K-12 students and financial assistance for students who seek counseling.

Additionally, in 2023, Utah passed a resolution recognizing the contributions and critical role of school nurses, psychologists, social workers and counselors in Utah schools. The resolution acknowledges that state mental health staffing ratios are below the national recommendations and calls for the Legislature and governor to commit to funding higher staffing ratios, training and retention measures.

Illinois, Missouri and Minnesota also focused on school mental health professionals in bills introduced in 2023.

  • Illinois adopted a resolution that urges its state board of education to expand access to mental health care for students. The legislation also urges the state board to recruit people into the school mental health profession and provide enough access to students to offer one hour of mental health counseling per semester.
  • Pending legislation in Missouri would provide a state supplement for public schools to hire a school nurse and a mental health professional.
  • In Minnesota, pending legislation would require mental health screening for students and provide revenue to school districts and charter schools to hire student mental health support staff.

For more, see this State Legislatures News article on student mental health trends in 2022.

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

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