School Mental Health


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There is a huge unmet need for mental health services among children and young adults. School mental health services can help meet that need.

According to the American Academy of Pediatrics, more than 20% of children and adolescents have a mental health condition.[1] Most chronic mental illness begins by age 24, including half by age 14,[2] making this time of life critical for beginning to receive mental health services.


However, only about half of school-age children with a mental health condition actually receive mental health services,[3] and most (70-80%) of those who receive services obtain them through school.[4] [5] Schools are a natural setting to promote student well-being and address mental health concerns. Mental health services and supports are increasingly integrated into education systems because of the documented link between mental health and educational success.[6] In addition, some argue that schools have an ethical imperative to attend not just to the academic success of students, but also their social, emotional and behavioral development.[7]


Yet, there are often very few mental health service providers in schools: the ratio of students to school counselors in the US is 481:1,[8] and the ratio of school-age children to school psychologists is 1506:1.[9] Furthermore, while strategic collaborations between school systems, the mental health workforce, and community programs are imperative to the success of school mental health programs,[10] effective interdisciplinary teamwork is a common challenge. [11]


In August 2018, the MHTTC Network, which includes 10 Regional Centers, a National American Indian & Alaska Native Center, a National Hispanic & Latino Center, and a Network Coordinating Office, received supplemental funding to address the need for further implementation of mental health services in school systems. The MHTTC Centers are:


  • Providing direct TA and training on the implementation of mental health services in schools and school systems.
  • Providing training/TA on the importance of mental health service provision in schools and linkages to such services where direct provision is not possible.
  • Disseminating information related to best models of school-based mental health provision, including ways in which these models can be implemented. 
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Responding to COVID-19: School Mental Health Webpage

In-person learning opportunities are postponed until further notice, the MHTTC Network continues to offer numerous school mental health related virtual learning opportunities and other resources through its School Mental Health Initiative. Access to our special collection of back-to-school mental health programming brought to you by the Network on our Responding to COVID-19: School Mental Health webpage. In addition to back-to-school resources, we have compiled other MHTTC products and resources specific to school mental health that can be useful when coping with the effects of widespread public health crises. A compilation of school mental health resources from other organizations is also available.

For a summary of our activities from 2019-2020, please click here.

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1. Committee on School Health. (2004). School-based mental health services. Pediatrics, 113, 1839-1845.
2. Kessler et al. (2005). Prevalence, severity, and comorbidity of 12-Month DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62(6), 593-602.
3. National Institute of Mental Health. (n.d.). Retrieved at:  
4. Rones & Hoagwood. (2000). School-based mental health services: a research review. Clinical Child & Family Psychology Review, 3, 223-241.  
5. Burns, Costell, Angold, Tweed, et al. (1995). Children’s mental health service use across service sectors. Health Affairs, 14, 149-159.
6. Fazel, Hoagwood, Stephan, & Ford. (2014). Mental health interventions in schools. Lancet Psychiatry, 1(5), 377-387.  
7. Stephan, Sugai, Lever, & Connors. (2015). Strategies for integrating mental health into schools via a multi-tiered system of support. Child and Adolescent Psychiatric Clinics of North America, 24(2), 211-231
8. Gewertz.(2018). School counselors responsible for 482 students on average, report finds. Retrieved from  
9. Jimerson, Shane, et al. (2009). How many school psychologists are there in each country of the world? School Psychology International, 30, 555-567.  
10. Stephan, Weist, Kataoka, Adelsheim, & Mills. (2007). Transformation of children's mental health services: The role of school mental health. Psychiatric Services, 58(10), 1330-1338.
11. Weist, Mellin, Chambers, Lever, Haber, & Blaber. (2012). Challenges to collaboration in school mental health and strategies for overcoming them. Journal of School Health, 82, 97-105.




School Mental Health Activities

Check out the mental health activities planned by the MHTTC Network!

School Mental Health Resources

Want to learn more about school mental health?

Wondering what else we’re up to?

Learn about the National School Mental Health Collaborative and Curriculum