Re: School Models Issue 3 Download
Joe Brennon
In this analysis, we explore the landscape of mental health services in schools during the 2021-2022 school year, barriers to offering services, and how recent policies facilitate the expansion of school-based mental health care. We draw upon data from the new 2022 School Pulse Panel, a study by the National Center for Education Statistics and the U.S. Census Bureau that surveys staff of public primary, middle, high, and combined-grade schools monthly on a variety of topics, including school mental health services.1
School-based mental health services can improve access to care, allow for early identification and treatment of mental health issues, and may be linked to reduced absenteeism and better mental health outcomes. School-based services can also reduce access barriers for underserved populations, including children from low-income households and children of color.
The delivery of mental health services in schools has evolved over time and continues to vary across schools. Some students access in-person mental health services at schools or near campus while others access services through telehealth. Service delivery can range from a single provider (who is not necessarily a licensed mental health professional) to a team of providers, including psychologists, social workers, and academic or guidance counselors. A growing number of schools have also integrated social and emotional learning and other mental health literacy programs into their curriculum.
SERVICES OFFERED
Most public schools offer mental health services to students, although utilization remains unclear. In the 2021-2022 school year, 96% of public schools reported offering at least one type of mental health service to their students. As shown in Figure 1, the most frequently offered services are:
Only one-third (34%) of schools provide outreach services, which includes mental health screenings for all students. These universal behavioral health screenings are considered a best practice and allow for schools to better identify all students with needs and tailor services to their specific student population. However, many schools do not offer these screenings often due to a lack of resources or difficulty accessing providers to conduct screenings, burden of collecting and maintaining data, and/or a lack of buy-in from school administrators.
Staffing models for school-based mental health care can vary across schools. Sixty-eight percent of public schools have a school or district-employed licensed mental health professional on staff and 51% employ an external mental health provider (Figure 1). While general or academic school counselors can provide mental health services to students as well, they typically focus on short-term and preventive services and are not equipped to offer long-term care. The School Pulse Panel does not include information on the number of mental health providers on staff; however, other research indicates that most schools do not meet the recommended ratios of counselors and/or psychologists to students.
Other school staff, particularly teachers, often play a role in identifying students with mental health needs and linking them to care. However, research prior to the pandemic found that many teachers did not receive adequate training to identify and provide support to students with mental health needs. Since the pandemic began, nearly three out of four schools (73%) have reported providing trainings and professional development to staff in order to help them identify growing mental health concerns among school students. However, data on the impact of these trainings is unavailable and it is unclear what share of schools were providing trainings prior to the pandemic.
In light of the pandemic, 27% of schools added classes for their students on social, emotional, and mental well-being since March 2020 (Figure 2). Additionally, for the 2021-2022 school year, 28% of schools made changes to their academic calendar to address mental health concerns for both staff and students. Examples of these changes include providing additional days off and allocating time to focus on mental wellness during the school day. Several states have introduced or passed measures allowing students excused absences related to mental health.
Among school staff that did not strongly believe they could provide mental health services to all students in need during the 2021-2022 school year, 48% cited inadequate funding as a barrier (Figure 3). Funding challenges for school mental health services have long existed. In order to provide and sustain services, many schools use funding from multiple sources, including at the national, state, and local levels, as previously mentioned. However, this presents several challenges as schools navigate varying specifications of how to utilize funds based on the source and changes to funding streams over time.
The American Rescue Plan Act and recent state policies have provided pathways to expand mental health and wellness services in schools. In 2021, the American Rescue Plan Act (ARPA) was passed and designed to provide relief from the continued impacts of the pandemic. A portion of funds from the ARPA ($122.8 billion) were allocated for the Elementary and Secondary School Emergency Relief (ESSER), and many states are using some of these funds to support school-based mental health care. Some ways states and schools are using these funds include growing the school mental health provider workforce (e.g. funding positions for mental health counselors and social workers in schools), partnering with community-based mental health agencies to expand access to care for students, providing trainings for school staff, and providing technical assistance for school mental health programs. However, one study has also found that lower-income schools and schools in rural areas are less likely to use ARPA funds toward school-based mental health services than their counterparts. Some schools (22%) reported using ARPA funds to create new staff positions during the 2021-2022 school year, although a large share of schools did not know (37%) if funds were used for these purposes. Among the schools that did use ARPA funds toward new staffing, 35% reported using a portion of these funds for school mental health professionals (e.g. psychologists and social workers). The ARPA also included funding to support students with disabilities and youth experiencing homelessness. Separately, some states have passed legislation to address growing mental health concerns, including the implementation of suicide prevention programs and mental health screening programs.
The recently passed Bipartisan Safer Communities Act also allocates funds to support school-based mental health services. In response to increasing gun violence and mass shootings, the Bipartisan Safer Communities Act was signed into law in June 2022. This legislation focuses on both gun reform and youth mental health, including provisions to support and expand school-based mental health services, highlighted below.
The EDUCAUSE 2023 Top 10 IT Issues help describe the foundation models that colleges and universities will develop next year and beyond, acting on what was learned in the pandemic and framed by the three building blocks of leadership, data, and work and learning.
Recent times have brought about a Great Rethink that is upending previous models of management and working. Higher education is no exception. In 2023, institutional and technology leaders are ready for a new approach. They are responding to what we've learned from the COVID-19 pandemic, what we were beginning to address before the pandemic, and our shared, enduring beliefs in the power of higher education:
This notion of foundation models is inspired by recent developments in artificial intelligence. Foundation models are the basis of a new AI approach that applies vaster scale and scope to existing AI techniques.Footnote1 Previous approaches were limited in flexibility. They were task-specific. They worked with prelabeled datasets and examined the data element by element. Each model learned the rules for its particular purpose and was optimized for that. AI foundation models develop new capabilities on their own. This makes them flexible and reusable beyond the original, specific purpose for which they were used. Scale matters: the bigger a model gets, the better it works.
But something as powerful as foundation models carries serious ethical risks, and these risks need to be considered now, rather than when it's too late. The risks include biased algorithms and incentives, uses that replace rather than augment people, investment and development needs on a scale that edges out small organizations, and imperiled privacy and cybersecurity.
The concept of foundation models needn't pertain only to artificial intelligence. We can apply it, metaphorically, to higher education. Many institutions are working to address such issues as enrollment, affordability, and graduation rates and to improve areas such as decision-making, staff engagement, students' success, and diversity. Ongoing structural challenges can make this work more difficult and expensive. Data is often siloed, but the questions leaders need data to inform transcend the siloes. Systems are focused on addressing specific tasks and thus provide a splintered, perplexing experience for the students and other people who use them. Scaling solutions across the institution, or beyond it, by adopting cloud services could increase efficiency, but many existing processes or locally developed technologies don't easily lend themselves to off-the-shelf solutions. As hybrid forms of working and learning take hold, existing technologies, support models, and learning strategies need to be broadened beyond their original purposes. As staff bring to their work changed expectations influenced by the pandemic and socioeconomic concerns, new models of leadership and management need to be fostered. Progress in all these areas could be accelerated with more flexible, reusable, and scalable models.
aa06259810