Advancing state policy to support school mental health
- Grow State Investment in Dedicated School Mental Health Funding
- Build Our School Mental Health Workforce
- Advance Parity Coverage for Student Mental Health
Over the past decade Wisconsin schools in collaboration with local communities have made substantial progress toward the development of comprehensive school mental health systems in alignment with the WI DPI School Mental Health Framework. A combination of federal, state, local and philanthropic expenditures coupled with a focus on state guidance and policy innovation have empowered school/community collaborations to build resources to advance mental well-being as a central component of student success.
- Continued expansion of state grants
- Investments in school social workers
- Increased Medicaid payment rates for therapy and reduction in barriers to teletherapy
- Adoption of Medicaid support for consultation services to help coordinate student treatment strategies and goals with teachers, staff and parents.
- Support for the mental health workforce through grants to help masters level therapists in training achieve full licensure.
While the programmatic gains are significant, the past few years have taken a toll. Data cited in the Surgeon General’s 2021 Youth Mental Health Advisory tells us that “rates of depressive and anxiety symptoms among youth doubled during the pandemic, with 25% of youth experiencing depressive symptoms and 20% experiencing anxiety symptoms.” In addition, “[in] early 2021, emergency department visits in the United States for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same time period in early 2019.”
In the wake of the pandemic Wisconsin students reported increased levels of stress, anxiety, and depression. Many Wisconsin students expressed a need for more mental health resources at their school, specifically counselors, therapists, and psychologists.(Voices of WI Students, WIPPS, 2021).
According to data from the recently released WI Youth Risk Behavior Survey (Dec 2022):
- More than half of all students surveyed (52.2 percent) self-reported “significant problems with anxiety”
- 80.5 percent of students who identify as lesbian, gay, or bisexual (LGB) say they have anxiety challenges.
- Two of every three female studentS surveyed (66.2 percent) also reported experiencing anxiety.
- Over one-third of all Wisconsin students surveyed (33.7 percent) reported feeling sad or hopeless almost every day for more than two weeks in a row, a statistically significant increase of 5.2 percentage points since 2019 and the highest rate since the YRBS was first administered.
- Nearly half of LGB students surveyed (48 percent) reported they seriously considered or attempted suicide – four times higher than their peers – and at 24.6 percent, female students were more than twice as likely than males to seriously consider suicide.
- 18.1 percent of all students surveyed seriously considered attempting suicide in the past 12 months, the highest rate since 2003.
- Among all students, 8.5 percent said they physically attempted suicide, with 22.4 percent of LGB students and 11.4 percent of females saying they have attempted suicide.
Grow State Investment in Dedicated School Mental Health Funding
The state should invest in the long-term sustainability of school mental health services and supports by providing dedicated allocations for every school district based on student enrollment.
- Categorical aid for school mental health will enable schools to build on the foundational programs they have developed and provide for sustainable mental health programs and services in every district across the state.
- The bipartisan support for school mental health grants over the past three legislative sessions has been critical to lay the foundation for school mental health. More than half of Wisconsin school districts have received funding through the grant program.
- The current grants are capped at $75,000 per district which limits the impact of these grants on more populous school districts. In addition, the grant process itself can be a barrier for smaller school districts.
- While school mental health efforts have been initiated in districts across the state, there continue to be significant inequities with some schools developing robust comprehensive, tiered supports and other schools lacking capacity and resources.
- The DPI budget recommends a base of $100,000 per district with a $100 per pupil allocation annually which would increase equitable access across Wisconsin’s school districts.
- Long-term sustainability of equitable access to school mental health services for all students depends upon a permanent, continual commitment of state resources.
Wisconsin students deserve robust commitment that promises to strengthen school climate, enhance mental health literacy, expand mental health services coordination, increase school staff competencies and expand coordination of care with mental health therapists when students need higher levels of support.
Build Our School Mental Health Workforce
The school mental health workforce is comprised of both school services professionals and community-based therapists who work in concert with schools to ensure an array of mental health supports for students. Investment in expansion of both workforces is essential to student well-being.
Support Growth of Critical School Services Professionals
- Wisconsin falls far short of nationally recommended ratios for school nurses, psychologists, counselors, and social workers.
- These pupil services staff provide the backbone for mental well-being in our schools and are critical partners for connecting students to community mental health providers working in collaboration with schools.
- These professionals often also serve as the “navigators” for our students and families – helping families with insurance coverage challenges, overcoming barriers like high deductibles, and facilitating student and parent consents.
- The DPI budget seeks $36 million over the 2023-25 biennium to support these critical professionals
Support Grants for Qualified Treatment Trainees
- Created by the legislature in the 2019-21 biennial budget, the Qualified Treatment Trainee (QTT) grant program supports new mental health interns and emerging therapists as they complete their training and prepare for full professional licensure.
- In the 2021-23 biennial budget the legislature expanded this small grant program to $750,000 annually.
- There has been high demand for this program which has been able to capitalize on the infusion of additional federal dollars to substantially increase the number of QTTs serving traditionally underserved populations and geographically divers regions of the state.
- By the second year of the grant, grantee agencies were able to increase the average number of QTTs supported by 40%.
- At a minimum, the state should double the annual funding of this successful grant program to $1.5 million annually.
Move Wisconsin forward by engaging more school-based mental health services professionals and create more paid opportunities for the development of a high-quality mental health workforce with special focus on our underserved regions of the state and for the development of clinicians of color who are historically underrepresented in the workforce.
Advance Parity Coverage for Student Mental Health
The state should address one substantial barrier to student access to mental health therapy by adopting a requirement that insurance plans cover master’s level mental health therapists in-training, who are licensed/certified by the MPSW Joint Board.
- Across the board, schools identify lack of sufficient insurance coverage as a barrier to students accessing mental health services in schools.
- Barriers include high deductibles, prior authorization requirements, and restricted networks that fail to include sufficient mental health providers.
- Narrow networks occur in both the public and private insurance, however Medicaid does a better job of reimbursing for in-training therapists.
- Insurance networks that don’t recognize therapists in-training keep students from accessing services offered at their school location.
- School mental health works best when a student who has been referred for individual therapy is able to access it quickly and conveniently at school.
Properly recognizing and reimbursing therapists in-training supports students and supports new therapists entering the field.