US schools failing in fight against youth mental health crisis, new report card finds

• The first-of-its-kind “America’s School Mental Health Report Card,” released Wednesday, found that all 50 states are struggling to empower schools amid the country’s worsening crisis.
• Nearly 1 in 3 parents say their children’s mental health is worse now than it was before the COVID-19 pandemic, according to a Kaiser Family Foundation poll.
• Only Idaho and Washington, D.C., exceed the nationally recommended ratio of one school psychologist for every 500 students, the report card shows.

Young people’s mental health is in such bad shape that several of the country’s leading pediatric groups called it a national emergency last fall.

U.S. Surgeon General Vivek Murthy even issued an advisory – a move reserved for the most urgent public health challenges – highlighting the COVID-19 pandemic’s devastating impact on the already-dire state of children’s mental health.

“It would be a tragedy if we beat back one public health crisis only to allow another to grow in its place,” Murthy wrote, outlining recommendations on how agencies such as schools can take action. 

Experts agree that schools play various key roles in stymieing the crisis. But according to a first-of-its kind report card released Wednesday, all 50 states are failing to implement at least some of the policies that enable schools to fulfill those roles. 

“Everyone cognitively gets that this is a crisis, but I don't think we’ve moved as if it is,” said Lishaun Francis, the director of behavioral health at Children Now, an advocacy and research organization. Children Now is among the 17 school mental health groups comprising the Hopeful Futures Campaign, the coalition that produced “America’s School Mental Health Report Card.”  

OUR KIDS' MENTAL HEALTH IS SUFFERING:And America's schools aren't ready to help.

Most Americans – 87% –  are concerned about the mental health status of young people, with 2 in 3 parents saying they’re “extremely” or "very" worried, according to a Harris poll to be released Thursday. Yet less than a quarter of Americans feel their state legislators, governor or congressional representatives are doing enough about the crisis. 

The crisis isn’t new. In 2019, 1 in 3 high schoolers reported persistent feelings of sadness or hopelessness, a 40% increase from 2009. About 7.7 million young people in the U.S. experience a mental health condition annually. Suicide is the second-leading cause of death among people ages 10 to 24. 

But the problem appears to have worsened with the pandemic, which for many children exacerbated or introduced new traumas. From 2019 to 2020, the rate of mental health-related emergency department visits increased by 24% for children ages 5-11 and 31% for adolescents ages 12-15.

Nearly 1 in 3 parents say their children’s mental health is worse now than it was before the pandemic, according to a Kaiser Family Foundation poll.

“Everybody is going through something,” said Jaylen Waithe, 16, a junior at Battlefield High School in Virginia. 

Student-to-mental-health-professional ratios are 'astonishingly bad' across US

One role schools play is in early intervention. Half of all mental illness presents itself before age 14. 

“The earlier you intervene with effective treatment outcomes, the lower the cost, and the greater the opportunity for a life well-lived,” said Angela Kimball of Inseparable, a mental health care policy advocacy group that spearheaded the report card. “The longer you wait, the worse outcomes. And typically when conditions get worse, they get more complex, and they get harder to treat.” 

But the vast majority of states lack the recommended ratios of school mental health professionals, including counselors, psychologists and social workers. 

Only Idaho and Washington, D.C., exceed the nationally recommended ratio of one school psychologist for every 500 students. In five states – West Virginia, Missouri, Texas, Alaska and Georgia – each school psychologist serves significantly more than 4,000 students.

Access to school-based social workers is even worse: No state meets – let alone exceeds – the recommended ratio of one social worker for every 250 students. 

“The ratios are so astonishingly bad it’s almost inconceivable,” Kimball said. 

Understaffing is just one part of the problem. States tend to be lacking in other areas, too, according to the report – rarely do they require regular mental health screenings, for example, or fully leverage Medicaid dollars to fund certain services. 

States are also inconsistent in their teacher training and school climate requirements. Culturally competent educators and healthy, inclusive school climates are especially important for marginalized populations such as LGBTQ+ youth. 

“We all could be doing a better job in supporting the the needs and unique challenges experienced by LGBTQ young people,” said Preston Mitchum of The Trevor Project, which provides crisis support to queer youth. Suicide-prevention training, LGBTQ+-inclusive curricula and policies honoring students’ preferred pronouns contribute to healthier school climates. 

Having at least one accepting adult can reduce the risk of a suicide attempt among LGBTQ young people by 40%.

New Jersey, Kansas, Virginia among few states to show marked progress

There are bright spots. New Jersey last year created a grant program that allows schools to do annual depression screenings on children in grades 7-12, for instance. And Kansas formed an advisory council that brings together lawmakers, family members and providers to guide the state board of education on student mental health.

Another area that’s seen some progress is mental health education. While many states include mental health as a topic in general health curricula, it often falls by the wayside. But some states have passed legislation that deepens the focus on mental health education, including Virginia and New York. 

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Waithe, the Virginia high schooler, is working on a project with Active Minds, one of the organizations in the coalition, to bring mental health education to young children in his area. By normalizing such conversations before they’re in high school, the hope is they’ll be better equipped to navigate their own mental health as they get older. 

In addition to pushing for more robust mental health education, the Hopeful Futures Campaign is launching a website where students and parents can learn about policies in their area and how to effect change through petitions, letter-writing and other advocacy. 

"When students know about mental health, they feel more empowered," Kimball said. "They feel better able to seek help."

Contact Alia Wong at (202) 507-2256 or awong@usatoday.com. Follow her on Twitter at @aliaemily.