Celina Pierrottet remembers 2016 as the year when she and her colleagues at the high school where they taught noticed a marked change among their students.
“We were just like, ‘Is it just me, or are the kids really nervous?’ “, remembers Pierrottet. “That year we had a lot of children who showed a kind of avoidance of school and other behaviors that we had not seen so much. I remember my colleagues and they looked at me like, “It’s more this year” – and then fast forward to the pandemic.
The rise in mental health needs among students following the onset of the COVID-19 pandemic has catalyzed the US Surgeon General to declare a youth mental health crisis, and the federal government has shared billions of dollars since then to help schools respond.
But Pierrottet, who now works as associate director of student welfare at the National Association of State Boards of Education, noted in a policy brief a major obstacle to getting students help that they need: an inadequate supply of mental health professionals, especially those credentialed to. work in schools.
Here’s what she found is in the way – and how states are finding solutions.
One problem is that increasing the number of mental health professionals in schools takes time. Investments made to increase the pipeline now will not see results—in the form of hired mental health workers—for many years.
During Pierrottet’s research, he found that Nevada State Board of Education officials noted in April of last year that the state’s preparation programs for mental health professionals only graduate 12 people each year. At that time, the state had a shortage of 2,863 school mental health professionals.
“It continues to be a challenge because it is a profession that requires advanced courses,” says Pierrottet. “Nobody’s saying they have to change these requirements, but it’s a slow investment.”
There is also a need to ensure that school mental health professionals — whether school psychologists, social workers or counselors — reflect the demographics of the students they serve, he adds. One of the challenges is that, like their classroom teacher colleagues, mental health professionals in training must complete hundreds of hours of unpaid practice.
Pierrottet points to Virginia and Ohio as examples of states that have responded to that hurdle by creating programs that pay graduate students studying mental health care to work in schools. The 2019 program in Virginia “places graduate students in school district positions and provides 200 interns with financial incentives to work in schools,” according to its report, and Ohio has a similar, decades-old program for school psychologist interns .
“Slow and steady wins the race here to ensure that schools attract diverse applicants, who meet the diverse needs of their students,” says Pierrottet.
But immediate mental health needs have created overwhelming workloads for counselors.
Pierrottet writes in his policy document that national trade organizations recommend a student-to-professional ratio of 1:250 for school social workers, 1:250 for school counselors and 1:500 for psychologists. the school
There is a long way to go to ease workloads for all three types of positions. No state met the recommended ratio for social workers, while Pierrottet found only New Hampshire and Vermont have a better caseload than the recommendations for counselors. For school psychologists, only Idaho and Washington DC do better than the recommended ratio.
Some states are getting creative to increase the availability of mental health professionals in their schools, such as turning to telehealth for counseling services.
It’s no longer just school staff who alert counselors that students need mental health support. One of the forces driving the increase in demand for services is simply that students are asking for them, he notes, as evidenced by the Federal School Pulse Panel. The most recent results show that 69 percent of schools are reporting an increase in students seeking mental health support since the start of the COVID-19 pandemic.
“Schools say there’s actually a growing demand for more mental health services in schools from students themselves who are just expressing more anxiety in schools,” says Pierrottet. “Sometimes it can be a problem if students say, ‘I need this,’ but they can’t get that connection in school or maybe even outside of school.”
Take the Bill
One win for increasing staffing levels is that states have gotten funding for school mental health services from massive infusions of federal money, Pierrottet says, such as $188 million from the Bipartisan Safer Act Communities Act 2022. The US Department of Education projects that one of its grants will lead to more than 14,000 additional mental health professionals in schools, according to the policy document, and the new federal guidelines make easier for schools to bill mental health services to Medicaid instead of pulling them. money from their own budget.
That doesn’t mean getting states to fund mental health services has been easy. Yet Pierrottet says the programs he highlights in his report have benefited states that have what one analysis called an “all-time high” of financial buffers due to budget surpluses — a result of factors that include COVID-19 relief funds and higher than – expected tax revenues. States like Michigan and Texas — both of which are looking at billions in surplus dollars — this year — are putting some of those funds toward mental health spending. Michigan has hired more than 2,700 full-time licensed behavioral health providers in schools since 2019, the report highlights, while Texas has set aside $280 million for telehealth counseling in schools starting in 2024.
“I think now it’s been more successful than in previous years because of this crisis, right?” Pierrottet offers. “It would be more difficult if there was not a surplus now in the budget. I think that now, the stars are aligned. There is will, there is motivation, and so at least in the last year there has been some movement towards the financing”.
Pierrottet added that it’s important not to think of students’ mental health needs as something that can only be solved with funding. Rather, he described it as a problem that needs to be addressed from many sides. For example, some teachers are excited to get more training on how to support students’ mental health, she says, and those teachers also need support for their own mental well-being to be effective in the classroom.
“It’s important to think about it holistically,” she says. “When students are healthy and when they don’t have these anxious feelings, they are present, they are able to learn. So it is important for state leaders to think about it as not only “Oh, we need to provide more health personnel It’s about the whole continuum, the whole school mental health system, and looking at it through a healthy lens of the child.
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