What Can We Do?

• Access to mental health services in school-based health centers leads to a tenfold increase in treatment for mental health or substance abuse.²⁷
• Expulsions in prekindergarten are reduced by more than 47% when classrooms have regular access to a psychiatrist or psychologist.²⁸

47% Reduction in preschool expulsions with access to mental health professional

However, a dedicated mental health presence in school-based health centers has not yet become a reality on a national scale. A critical shortage of mental health professionals like child and adolescent psychiatrists and clinical child psychologists translates to a knowledge gap in schools concerning how to best manage and mitigate mental health disorders. There are approximately 8,300 practicing child psychiatrists in the United States; the estimated number needed to satisfy demand is 12,600.²⁹ ³⁰

8,300 Number of practicing child psychiatrists: 8,300

12,600 Estimated number needed to satisfy demand: 12,600

Today, schools rely on referrals, community partnerships and universal prevention programs to address the demonstrated need and decrease risk for poor outcomes.

In the following section we look at promising interventions at various levels that help children to stay in school and improve mental health, both generally and in terms of specific disorders and symptoms. In their own way, each of the following examples of school-based interventions can address one of the persistent problems and poor outcomes described in the previous section. If educators, policymakers, parents and mental health professionals come together to advocate for sensible integration of these approaches, mental health promotion in school may provide a stunning return on investment.

²⁷ Kaplan, D.W., Calonge, B.N., Guernsey, B.P., Hanrahan, M.B. (1998). Managed care and school-based health centers. Use of health services. Archives of Pediatrics and Adolescent Medicine. 152: 25–33.

²⁸ Gilliam, W.S. (2005). Prekindergarteners Left Behind: Expulsion Rates in State Prekindergarten Systems. Yale University Child Study Center.

²⁹ Association of American Medical Colleges (2014). 2014 Physician Specialty Data Book.

³⁰ Substance Abuse and Mental Health Services Administration (2013). Report to Congress on the Nation’s Substance Abuse and Mental Health Workforce Issues.