K–12 students’ mental health continues to be in crisis. Since 2013, outcomes have consistently worsened. In 2018, suicide became the second-leading cause of death for children and young adults ages 10 to 24, and the COVID-19 pandemic only intensified mental health challenges. And students from households with low incomes are more vulnerable to these challenges than their higher-income counterparts.
During the pandemic, the federal government made several investments in mental health services and supports in schools. The Bipartisan Safer Communities Act authorized funds to hire counselors, social workers, and psychologists, and 20 percent of Elementary and Secondary School Emergency Relief funds went toward student physical and mental health. But there have been continued changes to the support provision, including which departments oversee student mental health, and the funding has become inconsistent: $1 billion in planned funding has been discontinued (though this is being litigated), and the funds were replaced with two smaller competitive grants that award less than a third of the original amount.
Adequate mental health supports in schools can begin to address these challenges. To help state and federal policymakers understand the impacts of investments in school mental health, we examine how mental health coverage changed in Pennsylvania schools after they received investment and how those effects differed by schools’ poverty levels.
Pennsylvania invested $100 million in school mental health services to fill widespread coverage gaps
Pennsylvania increased student mental health funding through Act 55 of 2022, creating a $100 million investment through the Ready to Learn Block Grant that took effect in 2024. Of the total funding, $95 million supported hiring, training, community partnerships, and telehealth. School districts each received grants of $100,000 plus $15 per student, and charters, intermediate units, and career technical centers received $70,000 each.
These investments were intended to help with widespread gaps in mental health coverage statewide. Before receiving the grant, nearly one in five Pennsylvania elementary schools and one in six secondary schools had no counselors at all. Across all schools, only 17 percent had a social worker, and about 45 percent had a school psychologist—both of whom support students with intensive needs, crisis response, and special education evaluation requirements.
Even when schools had these professionals on staff, student-to-staff ratios were typically far above recommended levels. While the American School Counselor Association suggests a ratio of 1 mental health professional to 250 students, average ratios for elementary and secondary school counselors in Pennsylvania were 1 to 515 and 1 to 410, respectively. And Pennsylvania educators and school leaders have testified (PDF) that these ratios are the most imbalanced in low-wealth districts.
Source: Authors’ analysis of 2023–24 and 2024–25 Common Core of Data, accessed via the Education Data Portal, and full-time equivalent professional and support personnel data on on-site counselor, psychologist, and social worker roles in Pennsylvania schools. Ninety-nine percent of schools entities received a grant in 2023–24, and our analysis is based on the 91 percent of them with complete data for school years 2023–24 and 2024–25.
Notes: The American School Counselor Association recommends a student-to-staff ratio of 250:1. In Pennsylvania, 2,029 schools serve prekindergarten through 6th grade and therefore would have a need for an elementary counselor; 1,386 schools serve grades 7 through 12 and would therefore need a secondary counselor; and 2,821 schools could hire social workers and school psychologists.
Schools’ access to mental health supports differed by poverty level
Using the Model Estimates of Poverty in Schools 2.0 dataset, we assigned schools to poverty quartiles to understand differences in mental health support availability by school poverty level. As the figures below show, we found that social workers are the most likely and psychologists are the least likely to be in high-poverty schools—a pattern consistent with districts prioritizing social work supports for higher-need student populations. Among schools missing each type of mental health professional, high-poverty schools are the most likely to be missing every type of professional except social workers.
Source: Authors’ analysis of 2023–24 and 2024–25 Common Core of Data, accessed via the Education Data Portal, and full-time equivalent professional and support personnel data on on-site counselor, psychologist, and social worker roles in Pennsylvania schools. Ninety-nine percent of school entities received a grant in 2023–24, and our analysis is based on the 91 percent of them with complete data for school years 2023–24 and 2024–25.
Notes: Among schools with elementary, secondary, social worker, and psychologist coverage. The following schools have coverage per profession: 1,728 had elementary counselors; 1,152 had secondary counselors; 472 had social workers; and 1,244 had psychologists. The following schools are missing coverage per profession: 365 lacked elementary counselors; 229 lacked secondary counselors; 2,321 lacked social workers; and 1,549 lacked psychologists.
After investment, hundreds of Pennsylvania schools increased mental health coverage, and student-to-counselor ratios dropped
Pennsylvania’s investment in students’ mental health allowed 583 schools across 287 districts to increase existing full-time equivalent mental health staff or to add positions. Among schools with no prior coverage in each role, high-poverty schools were most likely to hire counselors, and low-poverty schools were most likely to hire social workers.
Source: Authors’ analysis of 2023–24 and 2024–25 Common Core of Data, accessed via the Education Data Portal, and full-time equivalent professional and support personnel data on on-site counselor, psychologist, and social worker roles in Pennsylvania schools. Ninety-nine percent of school entities received a grant in 2023–24, and our analysis is based on the 91 percent of them with complete data for school years 2023–24 and 2024–25.
Notes: Among schools with no prior coverage in the respective position, 30 hired elementary counselors, 19 hired secondary counselors, 130 hired social workers, and 86 hired psychologists.
After coverage increases, schools with existing services saw improved counselor ratios. Ratios dropped, on average, by 377 students for elementary school counselors and by 150 students for secondary school counselors, and psychologist ratios fell by 607 students. Social worker ratios declined slightly but not significantly, and there were no detectable differences by school poverty level because of sample size limits.
States can take three steps to meaningfully invest in students’ mental health
Beyond improving children’s well-being, taking care of student mental health can improve discipline, attendance rates, and teachers’ ability to operate a functional classroom. Yet only about half of schools feel able to meet students’ needs because of shortages of licensed professionals, limited access, and inconsistent or insufficient funding.
Overcoming these obstacles and supporting students’ mental health requires collective support and multifaceted strategies—and states can play a leading role. They can take the following steps to make meaningful investments in student well-being.
- Prioritize sustained funding. States can follow Pennsylvania’s lead by making student mental health a budget priority and building on bipartisan federal support for sustained funding.
- Make evidence-informed investments where needs are greatest. With limited funding, states should consider directing investments to students and schools with the greatest need, using tools like annual mental health surveys (PDF) to identify gaps or, where data are limited, prioritizing schools with little or no existing mental health coverage.
- Facilitate a pipeline of school mental health professionals. States can address mental health workforce shortages by funding internships and service commitments, similar to Pennsylvania’s PA HELPS program.
Let’s help communities build more secure, hopeful futures.
Today’s complex challenges demand smarter solutions. Urban brings decades of expertise to understanding the forces shaping people’s lives and the systems that support them. With rigorous analysis and hands-on guidance, we help leaders across the country design, test, and scale solutions that build pathways for greater opportunity.
Your support makes this possible.
