One-Third of Public Schools Implement Mental Health Evaluations: Subsequent Actions

Mental health screenings for students have become a top policy priority for school, district, state, and federal leaders in the United States, as record-high rates of depression and anxiety among young people continue to rise. However, a recent study from RAND, a nonprofit research organization, has revealed that nearly one-third of K-12 public schools in the country require mental health screenings for students, yet there are significant challenges in implementing these screenings.

The study, based on a nationally representative survey of 1,019 K-12 public school principals conducted in October 2024, found that just 10% of district and school leaders said their district used universal mental health screenings for students in every grade level. The main reasons for this shortfall are a lack of resources and parent pushback.

The American School Counselor Association recommends a ratio of 250 students to 1 school counselor, but the national average ratio is 376 to 1. Similarly, the National Association of School Psychologists recommends a ratio of 500 students to 1 school psychologist, but the national average ratio is 1065 to 1. This shortage of school mental health professionals can prevent schools from implementing screenings, as they struggle to find the necessary staff.

Some districts are turning to telehealth to provide mental health services, but this comes with its own challenges. For instance, less than 20% of schools offer telehealth treatment, and there are no relevant search results available regarding organizations of school superintendents in Ohio or at the national level advocating for more resources for implementing mental health screenings in schools.

Districts near big cities tend to have more access to mental health services than those in more rural areas or smaller towns. However, Colorado had a law creating a mental health screening program for students in grades 6-12, but it was repealed during the 2025 legislative session due to concerns about parental rights.

If a student is identified as having anxiety or depression, most principals reported their school typically notifies their parents (79%), offers in-person treatment (72%), and/or refers the student to a local mental health care professional (53%). However, about 40% of principals surveyed said it was very hard or somewhat hard to ensure that students receive appropriate care, while 38% said it was easy or very easy to find adequate care for students.

Jonathan Cantor, a policy researcher at RAND and the lead author of the study, said the results provide researchers with a baseline and that there needs to be more research into the barriers schools face when addressing mental health challenges. He emphasized that the study did not ask about the quality or effectiveness of the mental health services offered or whether the available resources match student demand.

Principal organizations are pushing policymakers for more resources to address the mental health crisis in schools. In fact, only two states (Illinois and New Jersey) have laws that provide funding and resources for schools to implement mental health screenings. New Jersey has a grant program for schools to provide mental health screening, and Illinois requires schools to offer universal mental health screening for students in grades 3-12.

The findings of this study were published in the journal JAMA Network Open on July 18, highlighting the urgent need for more resources and support to ensure that all students have access to mental health screenings and the care they need.

One-Third of Public Schools Implement Mental Health Evaluations: Subsequent Actions