During the 2019–20 school year, 55 percent of public schools (or 45,600 schools) reported providing diagnostic mental health assessments to evaluate students for mental health disorders. Forty-two percent of public schools (or 35,200 schools) reported providing treatment to students for mental health disorders.
It is estimated that, among children under 18 years old in the United States, approximately 16.5 percent had at least one mental health disorder in 2016. Of these children, about 49.4 percent did not receive needed treatment or counseling from a mental health professional.1 Studies also show that school mental health resources may facilitate mental health service use for children with mental health disorders.2
Using data primarily from the 2019–20 School Survey on Crime and Safety (SSOCS), this indicator examines the prevalence of mental health services in schools, as well as the limitations on schools’ efforts to provide mental health services. SSOCS asked whether and where schools provided two types of mental health services: diagnostic mental health assessments3 to evaluate students for mental health disorders4 and treatment5 for mental health disorders. SSOCS also asked about the extent to which various factors limited schools’ efforts to provide mental health services to students.6 For each factor, respondents could choose from the response options “limits in major way,” “limits in minor way,” and “does not limit.” This indicator focuses on the responses indicating that a particular factor limits such efforts in a major way.
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1 Elementary schools are defined as schools that enroll students in more of grades K through 4 than in higher grades. Middle schools are defined as schools that enroll students in more of grades 5 through 8 than in higher or lower grades. Secondary/high schools are defined as schools that enroll students in more of grades 9 through 12 than in lower grades. Combined/other schools include all other combinations of grades, including K–12 schools.
NOTE: A diagnostic mental health assessment is an evaluation conducted by a mental health professional that identifies whether an individual has one or more mental health diagnoses. This is in contrast to an educational assessment, which does not focus on clarifying a student’s mental health diagnosis. Treatment is a clinical intervention—which may include psychotherapy, medication, and/or counseling—addressed at lessening or eliminating the symptoms of a mental health disorder. Schools were instructed to include only services provided by a licensed mental health professional employed or contracted by the school. Mental health professionals were defined for respondents as including providers of mental health services within several different professions, each of which has its own training and areas of expertise. The types of licensed professionals who may provide mental health services may include psychiatrists, psychologists, psychiatric/mental health nurse practitioners, psychiatric/mental health nurses, clinical social workers, and professional counselors. Mental health disorders collectively refer to all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. Responses were provided by the principal or the person most knowledgeable about school crime and policies to provide a safe environment.
SOURCE: U.S. Department of Education, National Center for Education Statistics, 2019–20 School Survey on Crime and Safety (SSOCS), 2020. See Digest of Education Statistics 2021, table 233.69a.
NOTE: A diagnostic mental health assessment is an evaluation conducted by a mental health professional that identifies whether an individual has one or more mental health diagnoses. This is in contrast to an educational assessment, which does not focus on clarifying a student’s mental health diagnosis. Treatment is a clinical intervention—which may include psychotherapy, medication, and/or counseling—addressed at lessening or eliminating the symptoms of a mental health disorder. Schools were instructed to include only services provided by a licensed mental health professional employed or contracted by the school. Mental health professionals were defined for respondents as including providers of mental health services within several different professions, each of which has its own training and areas of expertise. The types of licensed professionals who may provide mental health services may include psychiatrists, psychologists, psychiatric/mental health nurse practitioners, psychiatric/mental health nurses, clinical social workers, and professional counselors. Mental health disorders collectively refer to all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. Responses were provided by the principal or the person most knowledgeable about school crime and policies to provide a safe environment.
SOURCE: U.S. Department of Education, National Center for Education Statistics, 2019–20 School Survey on Crime and Safety (SSOCS), 2020. See Digest of Education Statistics 2021, table 233.69a.
1 Licensed mental health professionals may include psychiatrists, psychologists, psychiatric/mental health nurse practitioners, psychiatric/mental health nurses, clinical social workers, and professional counselors.
2 A diagnostic mental health assessment is an evaluation conducted by a mental health professional that identifies whether an individual has one or more mental health diagnoses. This is in contrast to an educational assessment, which does not focus on clarifying a student’s mental health diagnosis. Treatment is a clinical intervention—which may include psychotherapy, medication, and/or counseling—addressed at lessening or eliminating the symptoms of a mental health disorder.
3 Examples of legal issues provided to respondents were malpractice, insufficient supervision, and confidentiality.
4 Mental health disorders collectively refer to all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.
NOTE: To estimate the margin of error, the standard error is scaled based on the desired level of confidence in the estimate. Throughout the Condition of Education, margins of error are produced based on a 95 percent level of confidence. Margin of error is calculated as 1.96*standard error. Respondents were asked to indicate the extent to which each factor limited the school’s efforts to provide mental health services to students. For each factor, they could select “limits in major way,” “limits in minor way,” or “does not limit.” Estimates in this figure represent only those schools reporting that a factor limited their efforts in a major way. Responses were provided by the principal or the person most knowledgeable about school crime and policies to provide a safe environment. Although rounded numbers are displayed, the figures are based on unrounded data.
SOURCE: U.S. Department of Education, National Center for Education Statistics, 2019–20 School Survey on Crime and Safety (SSOCS), 2020. See Digest of Education Statistics 2021, table 233.69b.
1 Elementary schools are defined as schools that enroll students in more of grades K through 4 than in higher grades. Middle schools are defined as schools that enroll students in more of grades 5 through 8 than in higher or lower grades. Secondary/high schools are defined as schools that enroll students in more of grades 9 through 12 than in lower grades. Combined/other schools include all other combinations of grades, including K–12 schools.
2 The term “students of color” is being used synonymously with “minority students,” the latter of which appears in Digest table 233.69b. Students of color include those who are Black, Hispanic, Asian, Pacific Islander, American Indian/Alaska Native, and of Two or more races.
NOTE: To estimate the margin of error, the standard error is scaled based on the desired level of confidence in the estimate. Throughout the Condition of Education, margins of error are produced based on a 95 percent level of confidence. Margin of error is calculated as 1.96*standard error. Respondents were asked to indicate the extent to which each factor limited the school’s efforts to provide mental health services to students. For each factor, they could select “limits in major way,” “limits in minor way,” or “does not limit.” Estimates in this figure represent only those schools reporting that a factor limited their efforts in a major way. Schools were instructed to include only services provided by a licensed mental health professional employed or contracted by the school. Licensed mental health professionals may include psychiatrists, psychologists, psychiatric/mental health nurse practitioners, psychiatric/mental health nurses, clinical social workers, and professional counselors. Responses were provided by the principal or the person most knowledgeable about school crime and policies to provide a safe environment. Although rounded numbers are displayed, the figures are based on unrounded data.
SOURCE: U.S. Department of Education, National Center for Education Statistics, 2019–20 School Survey on Crime and Safety (SSOCS), 2020. See Digest of Education Statistics 2021, table 233.69b.
1 Whitney, D.G., and Peterson, M.D. (2019). US National and State-Level Prevalence of Mental Health Disorders and Disparities of Mental Health Care Use in Children. JAMA Pediatrics, 173(4): 389–391. Retrieved January 12, 2022, from https://doi.org/10.1001/jamapediatrics.2018.5399.
2 Green, J.G., McLaughlin, K.A., Alegría, M., Costello, E.J., Gruber, M.J., Hoagwood, K., Leaf, P.J., Olin, S., Sampson, N.A., and Kessler, R.C. (2013). School Mental Health Resources and Adolescent Mental Health Service Use. Journal of the American Academy of Child and Adolescent Psychiatry, 52(5): 501–510. Retrieved January 12, 2022, from https://www.jaacap.org/article/S0890-8567(13)00150-0/fulltext.
3 A diagnostic mental health assessment is an evaluation conducted by a mental health professional that identifies whether an individual has one or more mental health diagnoses.
4 Mental health disorders collectively refer to all diagnosable mental disorders or health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.
5 Treatment is a clinical intervention—which may include psychotherapy, medication, and/or counseling—addressed at lessening or eliminating the symptoms of a mental health disorder.
6 These seven limiting factors were included in the survey: inadequate access to licensed mental health professionals; inadequate funding; potential legal issues for school or district; concerns about reactions from parents; lack of community support for providing mental health services to students; written or unwritten policies regarding the school’s requirement to pay for the diagnostic mental health assessment or treatment of students; reluctance to label students with mental health disorders to avoid stigmatizing the child.
7 The coronavirus pandemic affected the 2019–20 data collection activities. The change to virtual schooling and the adjusted school year may have impacted the data collected by SSOCS. Readers should use caution when comparing 2019–20 estimates with those from earlier years. For more information, see Crime, Violence, Discipline, and Safety in U.S. Public Schools in 2019–20: Findings From the School Survey on Crime and Safety (NCES 2022-029; forthcoming).
8 Elementary schools are defined as schools that enroll students in more of grades K through 4 than in higher grades. Middle schools are defined as schools that enroll students in more of grades 5 through 8 than in higher or lower grades. Secondary/high schools are defined as schools that enroll students in more of grades 9 through 12 than in lower grades. Combined/other schools include all other combinations of grades, including K–12 schools.
9 The term “students of color” is being used synonymously with “minority students,” the latter of which appears in Digest tables 233.69a and 233.69b. Students of color include those who are Black, Hispanic, Asian, Pacific Islander, American Indian/Alaska Native, and of Two or more races.