How school counselors can address the youth mental health crisis

America is experiencing a mental health crisis, and mental health struggles amongst the nation's youth are intensifying. Student mental health is in a precarious place, with children and teens exposed to more information, more social contact, and more discord than ever before. The student mental health crisis is pervasive.

The good news is that Americans are more aware of the importance of mental health now more than ever. Age-old taboos are finally lifting. Even the federal government is throwing its support behind mental health initiatives: in 2023, the Department of Health and Human Services (HHS) and the Health Resources Services Administration (HRSA) made available $25 million to expand primary care, including mental health services, in schools. Although it's not a complete solution, it is a start. To end the student mental health crisis, more funding, training, attention, and collaboration is needed. 

School counselors are on the front lines of the student mental health crisis. Their involvement is critical in making schools the uplifting, inclusive, and safe places they need to be. Counseling Schools looks into how school counselors are boosting student mental health, and what more can be done to support them in their mission.

Understanding the Student Mental Health Crisis

"The mental health crisis has escalated to an alarming degree," says Allison Paolini, school counseling program director and assistant professor of school counseling at Arkansas State University. "According to the CDC, in 2021, it was reported that more than 42 percent of students experienced ongoing sadness or loss of hope."

The ingredients of the student mental health crisis were present before the Covid-19 pandemic: according to a study in JAMA Pediatrics, anxiety increased by 29 percent and depression increased by 27 percent in children and youth between 2016 and 2020. 

But the effects of the enforced isolation and persistent uncertainty brought on by the pandemic have carried over after it's receded, and going back to the classroom doesn't mean going back to the way things were previously. Students still experience all the mental health stressors of adults, plus some darkly unique ones.

"Gun violence is very problematic universally and has a detrimental impact on student mental health," Paolini says. "Students who experience or witness violence are more likely to experience depression and anxiety, have lower test scores, decreased enrollment in school, may experience survivor's guilt and post-traumatic stress disorder (PTSD), are more likely to experience truancy, may have difficulty concentrating, and may struggle to build peer relationships. This has a monumentally negative impact on one's overall health and wellbeing."

The student mental health crisis reaches into every demographic, but some groups are more affected than others. According to the CDC, LGBTQIA+ students, female students, and students across racial and ethnic groups are more likely to experience negative feelings. Black students more likely to attempt suicide than students of other races and ethnicities. Nearly half (45 percent) of all LGBTQIA+ students in 2021 seriously considered attempting suicide. 

Diverse students have diverse problems, and that requires a multi-tooled response. As the acuity of issues that students face is increasing, it is paramount for school counselors to be trained to conduct assessments, understand protocols, as well as provide resources and referrals to students experiencing suicidality or self-harm.

"It is essential for school counselors to individualize their approach," Paolini says. "There is not a universal one-size-fits-all approach to counseling. School counselors must be eclectic and use various skills, modalities, techniques, and best practices that are most impactful for each student they work with."

How School Counselors Address the Student Mental Health Crisis

School counselors sit at a critical juncture and are often a student's first encounter with a mental health professional who has specialized training in social and emotional wellbeing. School counselors can use techniques such as cognitive behavioral therapy (CBT) and solution-focused brief therapy (SFBT) to modify unhealthy thoughts, reframe personal problems, and take a proactive approach in finding solutions. 

Although school counselors play an integral role in fostering student wellness and providing support, there are still limits to what school counselors can do on their own. It is critical that school counselors practice within their scope of competency and provide referrals to those who need additional support.

"School counselors cannot diagnose and are not licensed to provide more intensive counseling that is sometimes required, specifically if a student is struggling with an underlying mental health disorder," Paolini says. "It is crucial for school counselors to collaborate with mental health counselors so that students have the services that they need to flourish."

Connecting students with mental health services—and with mental telehealth services in rural and underserved areas—is vital. Virtual wellness centers, resource-laden personal websites including Google Sites, and even well-designed Google Forms can all help enhance the connection between school setting and mental health services. 

School counselors themselves can also contribute to a positive learning environment by incorporating Kindness Week, starting an anti-bullying program, promoting diversity, safety, and inclusion, and advocating for the integration of social-emotional learning (SEL) in the school's curriculum. SEL teaches students imperative skills such as time and stress management, leadership, accountability, empathy, communication, coping, conflict resolution, optimism, motivation, and resilience.

"These are life skills that help students to be prepared for their post-secondary endeavors," Paolini says. 

The student mental health crisis has multiple fronts, and the digital arena—particularly social media—should not be neglected. Paolini notes that most students who end up carrying out acts of violence post about it on social media before doing so. And bullying, which is pervasive nationwide and a major stressor on students and a detriment to their mental health, is even more damaging when taken onto the internet virtually: social media allows cyberbullying to have a larger audience and platform. 

"School counselors must encourage families to monitor their child's social media accounts, as doing so is crucial for reducing cyberbullying," Paolini says.

Addressing the student mental health crisis is a Herculean task: school counselors can't do it on their own; it truly is a collaborative effort. Students, teachers, administrators, parents, policymakers, and other mental health professionals must all contribute and work together to facilitate positive change. 

"The most important part of the counseling relationship is having a strong therapeutic alliance, as this helps to build trust and amplify self-disclosure," Paolini says. "It is necessary for school counselors to work diligently to build strong therapeutic alliances with students and other critical stakeholders. More than years of experience or modality used, one's ability to create a solid therapeutic alliance has the greatest impact on stakeholder growth."

The Future of Student Mental Health

There are ample reasons to look at the future through a positive lens. Children and teens are highly resilient. Minorities are more visible. And while the Covid-19 pandemic worsened the student mental health crisis, it also helped raise more awareness to the importance of mental health and wellness on a broader scale.

"Students will continue to struggle with mental health, but I am an eternal optimist," Paolini says. "More and more school counselors are recognizing the need to be knowledgeable about mental health disorders so that they can best support students who are struggling. And more school counselors are implementing prevention programs and facilitating workshops to address the importance of mental health and wellness."

School counselors play an instrumental role in addressing the student mental health crisis. But they need reinforcements. Research has shown that the ideal ratio of students to school counselors at any given school is approximately 250-to-1; the national average is over 400-to-1. 

"In regard to government policies, there needs to be more focus on mental health, and additional money needs to be allocated to the field to ensure there are enough school counselors and helping professionals at each school," Paolini says. "As of now, the demand outweighs the supply."

Outside of the school counselor role, more bridges are needed between the mental health and educational communities. Additional funding, awareness, and collaboration can help create uplifting learning environments that are more inclusive, protective, secure, engaging, and empowering. Student mental health needs to be met with a team effort between school counselors, teachers, families, mental health professionals, and the community at large.

"Children and teens are our future," Paolini says. "We must work diligently and intentionally to make sure that they have the help, guidance, and mentorship that they need to identify and build upon their intrinsic strengths, believe in their innate abilities, reach their fullest potential, and be their best selves."