Selina Pierrot remembers 2016 as the year she saw noticeable changes among the students at the middle school where she and her colleagues taught.
“We were like, ‘Is it just me or are the kids really nervous?'” Pierrotto recalled. “That year, we had a lot of kids who were exhibiting some kind of school avoidance and other behaviors that we haven’t really seen before. There were times when my colleagues and I were like, ‘This year is going to be a lot harder.’ I remember looking at each other like, “Oh, and fast forward to the pandemic.”
In response to increased mental health needs among students since the beginning of the COVID-19 pandemic, the U.S. Surgeon General declared: Youth mental health crisisthe federal government has since committed billions of dollars to help schools respond.
But Pierrot, who now works as associate director of student health for the National Association of State School Boards. I got it. The policy brief cites the lack of mental health professionals, particularly those qualified to work in schools, as a major hurdle to getting students the support they need.
Here, she shares what the obstacles are and how the state is finding solutions.
slim picking
One problem is that increasing the number of mental health professionals in schools takes time. Investments made to increase the pipeline now will take years to pay off in the form of employable mental health workers.
Pierrottet’s investigation found that Nevada State Board of Education officials noted last April that the state’s mental health professional preparation program graduates only 12 students each year. At the time, the state had a shortage of 2,863 school mental health professionals.
“This continues to be difficult because it is a profession that requires advanced learning,” Pierrot says. “No one is saying these requirements need to change, but it takes time to invest.”
They also need to ensure that school mental health professionals, such as school psychologists, social workers and counselors, reflect the demographics of the students they serve, she added. One of her challenges is that, like her fellow teachers, mental health professionals in training must complete hundreds of hours of unpaid training.
Pierrot 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. Her report said Virginia’s 2019 program “placed graduate students in district positions and gave 200 trainees financial incentives to work in schools.” Ohio has a similar, decades-old program for school psychologist interns.
“Slow and steady wins the race here to ensure schools attract a diverse pool of candidates who meet the diverse needs of their students,” Pierrot says.
Managing workloads
However, pressing mental health needs impose an enormous workload on counselors.
In a policy document, Pierott said national trade associations have set student-to-professional ratios at 1:250 for school social workers, 1:250 for school counselors and 1:500 for school psychologists. It says that it is recommended to do so.
There is a long way to go to reduce the workload of all three job types. While no state meets the recommended ratio for social workers, Pierrot found that only New Hampshire and Vermont have more cases than the recommended ratio for counselors. For school psychologists, only Idaho and Washington, DC exceed the recommended ratio.
Some states are getting creative to increase the presence of mental health professionals in schools, including switching counseling services to telehealth.
School staff are no longer the only ones alerting counselors that students need mental health support. She points out that one of the factors driving increased demand for services, as evidenced by federal research, is simply that students are seeking them out. school pulse panel. The latest results show that 69% of schools have reported an increase in students seeking mental health support since the start of the coronavirus pandemic.
“Schools are saying they’re seeing more calls for more mental health services in schools, with students actually expressing more anxiety at school,” Pierrot said. “When students say, ‘I need this,’ but they can’t get that connection not just within school, but sometimes outside of school, that can be a problem.”

Drafting a bill
A win for increasing staffing levels, Pierrot said, is that states have been able to get funding for school mental health services through a huge infusion of federal money. $188 million From the Bipartisan Safe Communities Act of 2022. The U.S. Department of Education projects that one of its grants will add more than 14,000 mental health professionals to schools, according to a policy document, and new federal guidelines may lead schools to increase mental health services. It has become easier to bill Medicaid without having to pay for it. We take the money out of our own budget.
That doesn’t mean it’s been easy to get the state to fund mental health services. But Pierrot said the programs she highlights in her report benefit from the state having what one analysis calls a “policy.” “Best ever” Lack of financial cushion due to budget surpluses — a result of the following factors: New Coronavirus Infection Relief Fund and higher than expected tax revenue.States like Michigan and Texas both billions of in surplus This year, some of that money is being earmarked for mental health spending. The report found that Michigan has hired more than 2,700 full-time licensed behavioral health workers in schools since 2019, and Texas has hired more than 280,000 licensed behavioral health workers in schools starting in 2024 for telehealth counseling. He emphasizes that he has secured $1,000,000.
“I think we’re having more success now than usual because of this crisis, right?” Pierrot offers. “If we don’t have the budget right now, it’s going to be even more difficult. I think the stars are aligning now. There’s the will and the motivation and there’s been some movement toward funding, at least in the last year.”
Pierotte added that it’s important not to think of students’ mental health needs as something that can be solved with funding alone. Rather, she said it was a problem that needed to be tackled from multiple angles. For example, some teachers are keen to receive further training on how to support the mental health of their students, and they are equally likely to look after their own mental health in order to be effective in the classroom. She says she needs support for this.
“It’s important to think about this holistically,” she says. “When students are healthy and don’t have anxious emotions, they’re there and they’re able to learn. So it’s important for state leaders to simply say, ‘Oh, give us more mental health staff.’ It’s important to think instead of thinking, “I need to do this.” It’s about the whole continuum, a comprehensive school mental health system, and looking at it through the lens of the whole child. ”
