In October 2021, when former U.S. Surgeon General, Vivek Murthy declared youth mental health the “crisis of our time,” something shifted in the hearts and minds of educators across the country. Educators and parents knew it was happening; they could see the mental health of their children and teens worsening in their homes and classrooms. They read stories in the news that teen anxiety, depression and suicide were rampant and exposure to social media and gun violence was making matters worse. They hoped the decline was tied to the pandemic and its aftermath, but two years later, the data shows that aside from a slight shift in 2023, little has changed over the past decade.
The Prevalence of Mental Health Challenges in Schools
In the past ten years, youth mental health issues have been steadily climbing in the United States. According to data from the 2023 CDC’s Youth Risk Behavior Survey, about 40% of teens reported persistent feelings of sadness/hopelessness in 2023, down from 42% in 2021 but still significantly higher than 30% in 2013, according to the report.
Alarmingly, attempted suicide rates amongst teens have continued to hover at 9%. While there were small improvements among Black and Hispanic students, the rate of attempted suicides in the teen population as a whole remains flat.
The number of students reporting violence and safety issues at school has also increased. Approximately 9% said they had been threatened or injured with a weapon at school, up from 7% in 2021. And 19% said they were bullied at school, up from 15%.
The pandemic heightened the need for comprehensive, school-based mental health services but it was this call-to-arms from Dr. Murthy, this moment of truth for school districts and communities, that signaled youth mental health had become an epidemic and districts began to intensify their efforts.
Since then, mental health in schools has been on an upward trajectory with 96% of school districts reporting offering at least one type of mental health service to their students and we acknowledge their progress. But is it enough? Schools agree they are still struggling to meet the mental health needs of their students. In fact, a 2024 New York City DOE audit highlighted that “Approximately one in five students who could benefit from additional mental health support did not receive it, underscoring the need for improved access and resources.”
Common Mental Health Issues Among Students
One of the challenges in meeting the mental health needs of students is the sheer magnitude of students who need services and support. Half of all mental health conditions begin by age 14 and 1 in 6 youth aged 6 – 17 will experience a mental health disorder each year. That means in a classroom of 30 children, at least 5 of them will be struggling with some type of mental health condition. In a classroom with one teacher, depending on the severity of the students’ mental health disorders, the situation can easily become unmanageable.
Mental Health America reports that in 2021, 15 percent of teens suffered at least one major depressive episode, an additional 306K compared to the prior year; and almost two-thirds of teens with major depression claim they received no help.
Types of mental health challenges recognized in K-12 school settings have been steadily increasing, including anxiety, depression, ADHD, eating disorders, trauma-related disorders and Seasonal Affective Disorder. According to the latest data from the CDC, “10% of children aged 3-17 have anxiety, 7% have diagnosed behavior disorders while 4.4% have diagnosed depression. ADHD is even more prevalent with 9.8% affected in the same age group.”
The number of students facing mental health challenges has increased, and the types of mental health disorders and challenges have expanded. But have staffing and services kept up? Unfortunately, they haven’t.
The Impact on Academic Performance and Social Development
Mental health disorders can have a significant impact on a student’s academic performance and success. Mental health challenges disrupt a child’s ability to focus and engage in the classroom and impair their ability to communicate and advocate for themselves. Mental health issues can affect peer relationships, contribute to chronic absenteeism and school refusal, and ultimately disarm a student’s academic goals contributing to lower grades and increased dropout rates. In fact, according to The Association for Children’s Mental Health, “Only 40 percent of students with emotional, behavioral and mental health disorders graduate from high school, versus the average of 76%. In the 14 and older age group, over 50% of students diagnosed with a behavioral or emotional disability, drops out of school.”
Why Schools Play a Key Role in Supporting Children’s Mental Health
School districts have a unique opportunity to play a critical role in supporting the mental wellbeing of our youth. Preparing students for academic and professional success is just the tip of the iceberg. Schools are where students learn social skills – acceptable behavior and good manners – to provide them with the “soft skills” they will need to succeed personally and professionally. Schools serve the whole child, requiring gym and sex education to ensure students are physically and sexually healthy. Schools offer students the opportunity to participate in field trips to provide culture and a broader understanding of the world around them. It stands to reason that schools should also ensure students are mentally healthy by providing effective, evidence-based mental health services in the district.
Another opportunity schools can take advantage of is educating and empowering school staff with mental health awareness and training. Deborah Offner, a Boston-area clinical psychologist who works with middle and high school students at schools, says in an EdWeek article on the topic, “Another strategy is to equip all school staff, particularly teachers, with basic knowledge on responding to kids when they have mental health difficulties and referring them to the right place for help.”
With the right services and qualified staff in place, schools have the ability to create a supportive, school-wide community that can significantly impact the outcomes and future of students with mental health disorders.
Key Elements to a Successful School Mental Health Program
A successful school-based mental health program should utilize a Multi-Tiered Systems of Support (MTSS) as a framework. The MTSS continuum of care typically includes three tiers of support:
- Tier 3 – Intensive, in-school clinical support for students with high acuity needs
- Tier 2 – Clinical support for students with mild to moderate mental health challenges
- Tier 1 – Professional development to educate and train school staff to recognize the signs of mental health illness, understand the impact of trauma on student’s mental health and direct students to the appropriate care
School mental health programming can also include an array of additional services such as:
School Avoidance/Chronic Absenteeism Intervention Programs – An intensive, in-school clinical support program to support students and their families with chronic absenteeism and school refusal challenges. School refusal programming seeks to determine the underlying cause of school avoidance (such as bullying, academic pressures or separation anxiety from the student’s parents) and provides structured support to students and their families to reintegrate students into the classroom.
Behavioral Support Interventions – An intensive, in-school behavioral support program that combines mental health and behavioral services, including in-classroom support, de-escalation interventions, and student crisis management.
Crisis Response and Re-Entry – A comprehensive intervention program that coordinates school staff, families and caregivers, and external mental health providers to provide crisis, response and re-entry treatment recommendations in a safe and supportive environment.
School-based mental health services, delivered in a school setting, ensure access for students and are more effective when provided within the school environment. A landmark study administered in New Orleans following Hurricane Katrina found that “Youth are six times more likely to complete a course of mental health treatment when it is delivered in a school setting.”
The benefits of school-based mental health services are clear. When students struggling with mental health challenges complete a course of treatment in a school setting, families and schools typically see an improvement in social and emotional challenges, a decrease in suspensions, increase in grade point averages, a reduction in absences and improved behavior at school and at home.
Prevention and Early Intervention Strategies
Recognizing the signs of mental health issues and intervening early can have far-reaching implications for a child’s future. While it is never too late to treat a student with mental health challenges, early treatment can make a difference in the effectiveness of treatment and contribute to a better quality of life for a child while they are learning and growing. Conversely, delaying treatment can lead to worsened conditions and take longer to treat. Early intervention strategies include:
Universal screening, defined as “The assessment of students to determine whether they may be at risk for a mental health concern,” can be the first line of defense for identifying and supporting students at risk for a mental health condition.
Teacher training and professional development is an essential component of prevention and early intervention strategies. Teachers trained in trauma-informed practices are able to create a safe and supportive environment for early learners which leads to better outcomes.
How to Strengthen Staff Capabilities Through Mental Health Training
Researchers have identified the crucial role teachers and support staff play in supporting students’ mental health. However, challenges like insufficient staffing and a lack of proper training continue to hinder the ability of teachers to effectively impact students’ mental wellbeing. Providing teacher training and workshops through professional development and coaching can help bridge the gap and enhance teachers’ ability to address and manage mental health challenges within their classrooms.
Professional development can enhance teachers’ knowledge of mental health warning signs, equip them with practical strategies for managing challenging behaviors, and train them how to integrate social-emotional learning into the classroom. Teacher coaching, including trauma-informed models, educator coaching, restorative practices group coaching, counselor coaching and school avoidance coaching can help educators manage the effects of trauma and other student mental health issues.
By empowering teachers with the foundational knowledge and skills to meet the needs of students with mental health challenges, schools provide a learning environment that supports healing and encourages social and emotional wellness.
Enhance Your School’s Mental Health Support with ESS
There is no greater gift school districts can offer their students than an education that nurtures every aspect of their development, including academic goals, social growth, and emotional wellbeing.
For teachers, professional development and coaching gives them the tools they need to meet the increasing demand and challenges of supporting the estimated 1 in 6 students in their classroom who may present with mental health challenges.
Effective School Solutions provides in-person mental health and behavioral support programs to help students, particularly the 3%–5% of students with the highest intensive needs, reach their full potential. We deliver in-person, evidence-based, comprehensive clinical programming directly within K-12 schools. Through our programs, we remove barriers to care and provide equitable access to mental health treatment so every student can thrive emotionally, academically and contribute positively to your school environment.
Are you considering enhancing or implementing mental health services in your district? Effective School Solutions offers comprehensive mental health programs that can be tailored to your school’s unique needs. Contact us today to learn how we can help your school community thrive.
FAQs About Mental Health in Schools
How is mental health a problem in schools?
Mental health challenges in the school setting contribute to chronic absenteeism and school refusal, poor academic performance, and an increase in disciplinary actions. Research shows that “The risk of developing an internalizing or externalizing mental health problem can be lessened by changes in the school environment and by the implementation of evidence-based school programs.”
What are the most common mental health problems in schools?
The most common mental health issues in schools are anxiety, depression, ADHD, and less common but still extremely prevalent are bipolar disorder, self-harm issues, eating disorders and substance abuse disorder.
What effect does school have on mental health?
School can be a difficult place for a child or teen to navigate. The pressure to succeed academically can weigh heavily on a student along with the pressure to “fit in” socially. Learning how to advocate for themselves and communicate with teachers in a positive way can be difficult. On top of that, building relationships and managing transitions can be a balancing act for many students.
Resources:
CDC: Teens’ mental health worse than a decade ago despite small improvements in 2023 | AAP News | American Academy of Pediatrics
Mental Health in Schools: The Kids Are Not All Right | NEA
