Priority #1: Provide More Specialized Mental Health Professionals and Paraprofessionals on Campus
In this blog series, we examine the different priorities that school leaders might address—despite limited resources and reduced federal investments—to respond to the ongoing youth mental health crisis (American Academy of Pediatrics, 2021). In the 2023-24 school year, 84% of public school administrators across the country reported that their school staff provided students with individualized mental health services (National Center for Educational Statistics, 2024). Historically, in fact, a vast majority (70-80%) of children and youth receiving mental health services received them at school (Mental Health America, 2020). However, state and district leaders now worry that especially with reduced federal funding to support school-based mental health services and professional development, there are not enough specialized mental health staff to meet students’ current or future needs (EAB, 2023a). Further, in the wake of the youth mental health crisis, classroom teachers do not feel prepared to support students’ well-being and address mental health problems on their own (EAB, 2023b).
With limited resources where should leaders put their money?
Mental health programs delivered in schools are more likely to have a real-world impact if the selection, adoption, and implementation processes are informed by the perspectives of students, families, and school staff (Sprague Martinez et al., 2018). The communities’ voices need to be heard.
Knowing that, SRI researchers met with a group of students, parents, and school staff from a large, diverse county in California in fall 2022 to talk about their experiences, preferences, and challenges related to mental health services in schools. Through these conversations, coupled with survey responses from more than 1,000 school staff, these school community members shared several important ways they think their schools can better support student mental health.
Number of Survey Respondents by Role
| Leadership | Behavioral Health Staff | Educators | Classified Staff* | Total |
|---|---|---|---|---|
| 199 | 200 | 618 | 67 | 1,085 |
* Classified staff are employees of a school, district, or county office of education who are in a position not requiring certification. Classified staff include paraprofessionals, office/clerical staff, as well as other classified staff, such as custodians, bus drivers, and business managers.
Number of Interview or Focus Group Participants by Role
| CBOs & CCPs* | Behavioral Health Staff | Educators & Other Staff | Care-givers | Students | Directors, Managers, Coordinators | District Administrators | Total |
|---|---|---|---|---|---|---|---|
| 13 | 69 | 56 | 41 | 122 | 15 | 4 | 320 |
* Community-Based Organizations (CBOs) and Community Care Providers (CCPs) are staff from outside organizations that partner with schools to provide direct services such as clinical care and case management.
What was the school community’s first priority?
Priority #1: Employ More Staff with Training in Mental Health Services
School community members unanimously agreed that schools need more staff on campus with specialized mental health training and cultural competence to meet the needs of students. According to national school data, only about half (56%) of school leaders reported they could provide adequate mental health services to students in need, and 57% admitted that a shortage of licensed mental health professionals accounted for reduced access to services. Although the American School Counselor Association recommends that school counselors serve no more than 250 students at large, the 2021 national average was 66% higher than suggested—with a ratio of 415 students per counselor.
In addition, school community members echoed what research tells us is a critical best practice: mental health providers who understand their clients’ cultural backgrounds and speak their languages are significantly more effective in reducing stigma, building trust, and enhancing treatment outcomes.
Who is considered specialized mental health staff?
Specialized mental health staff refers to school counselors, social workers, therapists, or psychologists who are licensed, certified, and present on the campus to offer counseling for immediate needs. Behavioral health interns who have completed graduate level courses can also assist in providing counseling to students while working towards obtaining their license to practice independently.
How do schools provide mental health professionals on campus?
School state and district leaders utilize a combination of federal, state, and local funding, as well as grants and partnerships, to finance mental health services in schools. With the recent cancellations of many federal programs (such as the School-Based Mental Health Services Grant Program), schools must now rely more on state appropriations, Medicaid reimbursements, and local funding mechanisms like the Local Control Funding Formula (LCFF) in California—all of which may be subject to budget shortfalls. Schools can also partner with community organizations and healthcare providers to leverage resources, expertise, and cultural and linguistic knowledge and experiences; unfortunately, the mental health workforce suffers from a shortage of culturally competent and diverse therapists. It’s only through initiatives to attract, train, and retain diverse individuals in mental health professions that we will ultimately be able to increase access to high-quality care for all students and school staff.
How can other school staff contribute?
Beyond prioritizing the provision of more mental health professionals on campus, focus group participants acknowledged the critical roles that paraprofessionals and other school staff have in delivering mental health resources. Support staff (who are not certified to provide direct services) can help in multiple ways, including organizing and distributing mental health program information; participating in training and professional development to increase their knowledge of signs and symptoms of mental health distress; and linking students, families, and staff to community providers. For instance, participants described some of the roles support staff played, such as school liaisons who are responsible for communicating with healthcare organizations in the community; intake personnel to sign students in and out at campus wellness centers, and; directors of student life who can advocate for more mental health services and spread the word about services to students and families.
In addition, schools can ensure that all staff members receive professional development and training that builds knowledge and awareness about youth mental health and provides guidance on concrete actions that everyone can take to respond to student mental health concerns. Examples of established training models that are not too cost prohibitive include Youth Mental Health First Aid (https://www.mentalhealthfirstaid.org/population-focused-modules/youth) and Classroom Well-Being Information and Strategies for Educators (Classroom WISE; https://www.classroomwise.org). Currently, 21 states and the District of Columbia have laws requiring that school staff receive professional development in youth mental health. National requirements and standards for training in youth mental health for all educators have the potential to ensure that all school staff are prepared to make a difference.
Check out our next post: What Should Schools Prioritize to Support Youth Mental Health? Priority #2: Provide Training and Wellness Centers.
Topics: Mental health School-based supports and systems School-Community Partnerships