School Mental Health Services

three male teens talking


There is a huge unmet need for mental health services in children and young adults.

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 will:


  • Provide direct TA and training on the implementation of mental health services in schools and school systems.
  • Provide training/TA on the importance of mental health service provision in schools and linkages to such services where direct provision is not possible.
  • Disseminate information related to best models of school-based mental health provision, including ways in which these models can be implemented.

[1] Committee on School Health. (2004). School-based mental health services. Pediatrics, 113,1839-1845

[2] Kessler, R.C., 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, C. (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, Stephan, S. H., Weist, M., Kataoka, S., Adelsheim, S., & Mills, S. H. (2007). Transformation of Children's Mental Health Services: The Role of School Mental Health. Psychiatric Services, 58(10), 1330-1338.

[11] Weist MD, Mellin EA, Chambers KL, Lever NA, Haber D, Blaber C. Challenges to collaboration in school mental health and strategies for overcoming them. J Sch Health. 2012; 82: 97-105.

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