Kids, parents see shortage of mental health care in schools. Shaheen bill seeks to help.

In January, Sen. Jeanne Shaheen, D-New Hampshire, sat in the Dover High School library. She was surrounded by a circle of 20 students who had just completed mental health first aid training, and were gearing up to train more students.

Students formed a Mental Health Initiative this school year, sparked by student leaders eager to change the culture at DHS regarding mental health and suicide awareness. Members of the DHS senior class were motivated to act after they had lost three classmates to suicide. 

Shaheen listened to students share stories of their own struggles with mental health, and heard from administrators and mental health advocates on how the district is doing its best to address mental health needs of students. It's a common theme in high schools around the nation.

Now Shaheen is joining a bipartisan group of senators to introduce legislation that could help fast track the pipeline of graduate students trained to become school psychologists, counselors and social workers to address the shortage of mental health providers in schools. Tens of millions of dollars would be dedicated to covering the cost of graduate school.

“We can’t ignore the devastating impacts this pandemic has had on our children. My recent visit to Dover High School only strengthened my resolve to address this epidemic, after hearing directly from students about their struggles with mental health and the trauma of watching their classmates take their own their lives,” Shaheen said in a prepared statement. "That’s why I’m introducing this bipartisan bill to train and deliver more mental health professionals to help students process and heal."

Shaheen, along with Sens. Todd Young (R-Indiana), Gary Peters (D-Michigan) and Kevin Cramer (R-North Dakota), have introduced  the Mental Health Excellence in Schools Act.

The bill would increase the recruitment and retention of mental health services providers by authorizing the Department of Education to partner with higher education institutions to help cover students’ costs at relevant graduate programs. 

“There’s agreement across party lines in Congress that our students should not be left alone suffering with mental health challenges, and I’m pleased to already see the bipartisan support this bill has garnered," Shaheen said. "I’m hopeful Congress acts swiftly on this legislation to deliver the help our students desperately need and deserve.”

What’s happening in our schools?

Christine Boston, assistant superintendent for student services for the Dover School District, said as the coronavirus pandemic subsides, the district is seeing an uptick in anxiety, depression, suicidal ideation and other mental health challenges in students. The district is also seeing an increase in concerned parents requesting counselors check in with their child at school.

“We have to look at the root source and recognize that we don't have enough mental health providers in schools, yet we don't have enough in the community to refer students out to either,” Boston said. “Some area mental health agencies aren't even keeping a waitlist anymore because the need, it's too deep. Finding long-term mental health care requires a lot of tenacity right now to even get through the door. You have to keep calling back, waiting for an opening, and if they don’t take your insurance you’re paying out of pocket. That's a huge barrier.

Currently the district, which has 4,200 students, has 11 guidance counselors, two counselors focused on special education, four school psychologists, two full-time social workers and one part-time social worker.

The National Association of School Psychologists recommends schools have a guidance counselor to student ratio of 1 to 250, Boston said, noting Dover has two school buildings where that is not the case. For school psychologists it’s recommended to have one psychologist for every 500 to 700 students, and Boston said Dover doesn't come close to that, underscoring the unmet need. According to the National Association of School Psychologists, the national average ratio is estimated to be approximately one school psychologist per 1,211 students. 

Boston said while there is a great need for more staff, it comes with a cost. Boston said she could double her staff to help close the gap but expects that they would still have just as heavy of a workload. It isn’t just Dover, she said, noting she has heard of many other districts locally facing the same challenges.

Boston said the proposed legislation is an important step in addressing the pipeline issue that limits the number of people in the mental health field, but notes that it will take a few years before the full impact would be realized. 

“Outside of this, we are going to need to address the gap in the meantime because in the best-case scenario, these new professionals aren't going to be able to enter into the field for another two to four years," Boston said. "This kind of effort will help long-term and is a fantastic start, but locally we still need to keep looking short term as well to help those who need it right now.”

One way the Dover School District is doing that is through the high school’s Mental Health Initiative group Shaheen met with earlier this year. 

“Especially within the high school, there is an incredible interest and will to change the culture around mental health and reduce the stigma and that is what is moving forward,” Boston said. “They are training their peers in things like suicide prevention and mental health awareness. The more we talk about mental health and recognize that everyone has mental health, and it is a fluid state, the better we all will be because we'll be able to reach out for support, there won't be stigma. It's not a bad thing that kids are talking about it, and we're seeing more of it because that means they're recognizing it.”

What’s next for the bill?

Shaheen said the legislation is meant to be an “investment” in the next generation of mental health professionals serving in schools.

“By helping more students afford graduate programs centered on school-based mental health, we can attract more workers to this critical field,” Shaheen said. “The mental health crisis isn’t going away, and it’s past time we dedicate resources and energy towards holistically helping those in need. We owe it to our children to empower them with tools to heal and succeed.”

The bill has been introduced and referred to the Senate HELP Committee. 

“The pandemic put a spotlight on just how many students across New Hampshire and the nation struggle with isolation, depression and mental health challenges,” said Shaheen. “Unfortunately, we don’t have a strong pipeline of mental health providers, leaving many kids and teenagers vulnerable and without the help they need.”

If the legislation moves forward, the Department of Education would match what the institution provides, up to as much as 50% each to fully cover the cost of attendance for a student enrolled in a relevant graduate program. The bill would authorize $20 million for FY 2023; $30 million for FY 2024 and $50 million each for FY 2025-2027 to be appropriated to support the program.

Four years after the legislation is signed into law, the Department of Education would be required to provide an independent national evaluation of the effectiveness and outcomes of the program, including a report to Congress with the findings. 

Kathleen Minke, executive director of the National Association of School Psychologists, said the association is "thrilled" to see bipartisan support for the Mental Health in Schools Excellence Program Act.

“Our students need more support than ever, but without enough school psychologists and other school-based mental health providers, our schools aren’t equipped to meet their growing needs," Minke said in a statement.