The Need For Mental Health Support In Schools
According to the Return to Learn Tracker, which provides national data on chronic absenteeism, from 2018 to 2019 and 2021 to 2022, the percentage of chronically absent K-12 students nearly doubled, surging from 15% to 28%. Though the same data revealed a marginal decline in rates from 2022 and 2023, the numbers still far exceed pre-pandemic levels.
Given the wide range of potential contributing factors, such as bullying and housing insecurity, chronic absenteeism is too multifaceted to be solved with a singular approach. However, comprehensive school-based mental health support for students represents a promising way forward. Read on to learn more about chronic absenteeism, the role of mental health services in reducing it, and what steps schools can take to expand students’ access to mental healthcare.
Understanding Chronic Absenteeism
Chronic absenteeism is when a student misses 10% or more of the school year, whether excused or unexcused. For example, if a student misses 18 days in a 180-day school year, they’d be considered chronically absent.
Reducing chronic absenteeism requires an understanding of why it occurs. Reasons for a student’s absence are typically divided into four categories:
- Barriers to attendance (e.g., lacking transportation)
- Aversion to school (e.g., being anxious about attending school)
- Disengagement from school (e.g., finding instruction uninteresting)
- Misconceptions about the impact of absences (e.g., thinking absences don’t matter as long as they keep up with their academic work)
Addressing these root causes is important as chronic absenteeism can have a cascading effect on students’ development and overall life chances. For instance, the U.S. Department of Education found that:
- Children who are chronically absent in preschool, kindergarten, and first grade are much less likely to read on grade level by the third grade.
- Students who cannot read at grade level by the third grade are four times more likely to drop out of high school.
- By high school, regular attendance is a better dropout indicator than test scores.
- A student who is chronically absent in any year between the eighth and twelfth grade is seven times more likely to drop out.
Research has also shown that high school dropouts are up to four times more likely to experience negative outcomes like being arrested, fired, or having poor health.
The Link Between Mental Health And Chronic Absenteeism
Students who experience depression, anxiety, and other signs of mental illness are more vulnerable to chronic absence. They may feel unable or unmotivated to attend school because of their mental health challenges.
A 2023 student survey conducted by the EdWeek Research Center supports this. Survey results show that besides physical illness and bad weather, anxiety was a top reason high school students missed school.
A 2024 University of Southern California study on children’s mental health also found that chronically absent students are two to six times more likely to have an abnormal score in emotional symptoms, conduct problems, and peer problems compared to those with few absences.
It’s imperative, then, that schools address students’ mental health challenges. This will ensure they feel safe, seen, and supported, promoting better attendance and overall well-being. Administrators can start by expanding access to school-based mental health services, which range from school-wide prevention programs to more in-depth, individualized support.
The Role Of School-Based Mental Health Services In Reducing Chronic Absenteeism
Based on a definition provided by the National Center for School Mental Health (NCSMH), school-based mental health refers to interventions designed to improve students’ social, emotional, and behavioral well-being. Several examples of school-based mental health services exist, including:
- Individual-based interventions
- Case management
- External referrals
- Group-based intervention
- Needs assessment
- Family-based intervention
- Outreach
- Telehealth delivery
As revealed in a 2022 study evaluating the effectiveness of a school-based, universal mental health program in European countries, such services increase students’ social and emotional competence and prosocial behavior as well as reduce mental health issues. They also mitigate absenteeism, according to Dr Devika Bhushan, chief medical officer at Daybreak Health: “Such services will not only improve attendance but will actually move the needle on health and educational outcomes that really matter,” Bhushan explained in a 2024 webinar.
Bhushan cited a Daybreak Health case study, where the digital mental health company partnered with Simi Valley Unified School District to provide personalized, school-based mental health support for students. The partnership yielded a 3% increase in student attendance and a 50% reduction in disciplinary infractions and suspensions.
Collectively, these findings demonstrate the critical role school-based mental health services play in improving attendance and enhancing student outcomes. However, although school leaders are rightfully compelled to expand students’ access to these services, effectively doing so requires a strategic approach. The following section explores what this approach might look like.
5 Ways Schools Can Expand Students’ Access To Mental Health Services
Schools can take the following actions to help students get the mental health support they need:
1) Address Barriers To Providing Quality Mental Healthcare
Understanding the barriers to providing adequate and effective mental health services in schools will help administrators pinpoint ways to overcome these challenges. 2022 data from the National Center for Education Statistics offers insight into potential barriers. The data showed that 87 % of public schools who felt they couldn’t effectively provide mental health services to students in need reported 3 primary limitations:
- Insufficient number of mental health professionals
- Inadequate access to licensed mental health professionals
- Inadequate funding
After identifying barriers, administrators can develop a plan to address them. For example, if schools lack sufficient mental health professionals, they might create a plan that begins with determining the number of qualified professionals they need based on the number of students seeking support.
2) Take Advantage Of Funding Opportunities
Providing effective and comprehensive mental health services to students requires sufficient funding. Luckily, schools have several funding options, including:
- Federal funding
- State and local funding
- Grants
- Public-private partnerships
- Innovative funding models
- Education-related mental health grants
The Bipartisan Safer Communities Act (BSCA), signed into law by President Joe Biden, is of particular interest as the bill includes multiple grant programs dedicated to improving access to school-based mental health services. These include:
- Project AWARE (Advancing Wellness and Resiliency in Education)
Focuses on promoting students’ awareness of mental health issues, expanding access to school and community-based mental health services, and training staff to respond to mental health needs. - School-Based Mental Health services (SBMH)
Focuses on increasing the amount of qualified mental health professionals delivering school-based services in districts with demonstrated need. - Medicaid billing improvements grants
Focus on improving the accessibility of school-based services by making it easier to bill Medicaid and the Children’s Health Insurance Program (CHIP).
Schools should stay abreast of these and other funding opportunities by closely following grant announcements, deadlines, and application requirements.
3) Partner With Community Organizations And Agencies
Community partners can help schools expand and strengthen their mental health services by providing guidance and assisting with the recruitment of qualified professionals. They can also point schools in the right direction in terms of funding and even demystify the billing process. The Collaborative for Academic, Social, and Emotional Learning (CASEL) suggests the following organizations as potential partners:
- Out-of-school time providers
- Community-based nonprofit organizations
- Hospitals
- University research centers or colleges of education
- Mission-driven foundations
- Governmental agencies
- Local businesses
As far as choosing who to collaborate with, Joe English—CEO of mental health partner Cartwheel—recommends ten criteria to keep in mind. Among them are whether a partner has an in-house team of licensed clinicians and whether they use evidence-based practices.
4) Recruit More Mental Health Staff Members
To ensure students have consistent, comprehensive, and quality mental healthcare, schools should consider increasing the number of staff members dedicated to this initiative. This is especially the case if districts don’t meet recommended ratios.
For example, the National Association of School Psychologists recommends a ratio of 1 school psychologist per 500 students. Meanwhile, the American School Counselor Association advises schools to have 1 counselor per 250 students.
Since different types of school-based mental health professionals exist, it might be beneficial to examine them and their roles within comprehensive school mental health systems. This will ensure that different types of professionals are hired to meet the diverse needs of students. The following list from a 2022 research study focuses on the functions of four professionals in particular:
- School counselors
Provide mostly short-term mental health services as well as advising, counseling, and referrals for students who need more extensive support. - School nurses
Offer health education and address health concerns like mental health issues, physical and emotional disabilities, and social determinants of health. - School psychologists
Work with families, educators, and other stakeholders to ensure safe and supportive learning environments. - School social workers
Provide different types of interventions, implement prevention efforts, and create safe and fair school environments.
5) Implement Multitiered Systems Of Support
A multitiered systems of support (MTSS) is a framework used by schools to improve outcomes for students and address their academic, social, emotional, and behavioral needs. Following this framework allows schools to identify struggling students and provide targeted support in a timely manner.
Under MTSS, students receive three tiers of support: tier 1, tier 2, and tier 3. Tier 1 includes supports and services designed for all students. Tier 2 encompasses targeted support for smaller numbers of students. Lastly, tier 3 consists of individualized support for those with the greatest need.
By implementing MTSS, schools will be able to meet the full spectrum of students’ needs. They’ll also be able to tackle absenteeism, disruptive behavior, and other issues early on so they don’t become bigger problems in the future.
Combatting Chronic Absenteeism Through School-Based Care
When schools provide quality mental healthcare to students, they mitigate chronic absenteeism by addressing students’ disparate needs. Whether they’re struggling academically or showing signs of depression—among a myriad of other root causes of chronic absence—educators, administrators, and qualified school-based mental health professionals can intervene early on and either provide or direct students to the personalized care they need. However, none of this is possible if school leaders don’t commit to expanding the mental health support offered in their districts.
The first step is to identify and address any barriers that could prevent students from receiving rigorous, high-quality support. From there, secure funding, consider community partnerships, increase the number of mental health professionals on staff, and establish multitiered systems of support to provide holistic and continuous care. The outcome will be a larger number of students who attend school regularly and are well-positioned for long-term success.
