More mental health services are now available in US public schools

A student indicates her feelings in a sensory room at Williams Elementary School on November 3, 2021 in Topeka, Kansas. (Charlie Riedel/AP)

Citing an “unprecedented mental health crisis” among young people in the United States, the Biden administration recently announced new funding to expand mental health services in the nation’s K-12 schools. While school mental health services have become more common in recent years, many K-12 schools lack such resources, according to the most recent government data available.

Bar chart showing that, in the US, school mental health services are more common in schools with older students, in cities, or with larger enrollments

Overall, just over half of U.S. public schools (55%) provided students with diagnostic mental health assessments to evaluate them for mental disorders in the 2019-20 school year, according to the National Center for Education Statistics’ survey of schools ( NCES) Crime and Safety. These evaluations were performed by a licensed mental health professional employed or employed by the schools.

Among public schools that provide mental health assessments to students, 61% provide them both in school and outside of school, and 29% offer them only in school. Only 11% provided them only outside of school.

Fewer public schools are provided treatment of students for mental disorders. In the 2019-20 school year, 42 percent of K-12 schools offered mental health treatment to reduce or eliminate symptoms, such as psychotherapy, medication, or counseling through a licensed mental health professional. Most schools offering this type of treatment (62%) provide it both in school and outside of school. Three in ten provide treatment only in school, and only 7% provide it only outside of school.

The share of public schools that have mental health services for students has risen somewhat since the 2017-18 school year, when 51 percent of schools provided mental health assessments and 38 percent offered treatment.

Whether and what mental health services were offered during the 2019-20 school year varied by different school characteristics:

  • In 2019-20, middle and high schools were more likely than primary schools to provide school-based mental health services. Approximately two-thirds of middle (64%) and high schools (65%) offer mental health assessments, while half of elementary schools do. And 47 percent of middle and high schools provide treatment, compared to 40 percent of elementary schools.
  • Mental health services are more common in schools with larger enrollments. For example, 71% of schools with at least 1,000 students offer mental health assessments, compared to 43% of those with fewer than 300 students.
  • About six in ten schools in cities (61%) and suburbs (60%) provide mental health assessments, while 45% of those in rural areas do. Urban schools are also slightly more likely to offer treatment: 45% offer it, compared to 40% of suburban schools and 41% of rural schools.
  • There were also some differences based on the racial and ethnic composition of the student body. Six in ten schools where more than 75% of students were racial or ethnic minorities provided ratings for mental health disorders in the 2019-20 school year, compared with half of schools where a quarter or less of students were were racial or ethnic minorities.
  • Schools with a higher proportion of students from lower-income households were slightly more likely than other schools to provide mental health treatment to students. One proxy measure of household income level is the share of students who qualify for free or reduced-price lunch. Just under half of schools (46%) where more than three-quarters of students are eligible for this program had mental health treatment available in 2019-20, compared to 39% of schools where a quarter or fewer qualify for free or reduced-price lunch.

Limiting factors

Bar chart showing that inadequate funding and access to licensed professionals significantly limit schools' ability to provide students with mental health services

The School Survey on Crime and Safety also asked schools to what extent several factors limited their efforts to provide mental health services to students. The largest share of schools reported that their efforts were largely limited by insufficient funding (54%) or inadequate access to licensed mental health professionals (40%). Another 26% reported that funding limited their efforts in a minor way, while 35% said that access to mental health professionals was a minor limiting factor. About one in five schools (19%) say funding does not limit their efforts at all, and a quarter say the same about access to professionals.

Smaller shares of schools said their efforts were largely limited by written or unwritten policies about requiring the school to pay for a student’s mental health diagnostic evaluation or treatment (19%); potential legal issues for the school or district, such as abuse, inadequate supervision, or confidentiality (15%); lack of community support for providing mental health services to students in their school (10%); concerns about parents’ reactions (8%); or reluctance to label students with mental disorders to avoid stigmatizing the child (8%).

About two-thirds of schools (64%) say a lack of community support does not limit their efforts at all – the largest share of any factor included in the survey.

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