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NEA News

The Widening Mental Health Treatment Gap in Schools

May is Mental Health Awareness Month. To help the millions of children across the U.S. who have a mental health condition, treatment gaps have to be closed.
Published: 05/02/2019

 As educators, parents and students across the nation continue to advocate for more public school funding, the gaps in resources available to students continue to widen. One major area of concern getting more attention over the past few years is the scarcity of mental health resources in schools.

Without the necessary services, students, especially those undiagnosed or untreated, are falling behind their peers. According to a new study published in The Journal of Pediatrics, millions of children across the U.S. are experiencing depression, anxiety and/or behavioral disorders.

“Mental disorders in childhood can negatively affect...children’s ability to achieve social, emotional, cognitive, and academic milestones,” the report said.

Analyzing data from the 2016 National Survey of Children’s Health, the researchers found that 7.1%  of children aged 3-17 years had anxiety problems, 7.4% had a behavioral conduct problem, and 3.2% had depression.

By breaking down the research into twelve sociodemographic and health-related characteristics, the researchers found a significantly higher prevalence of anxiety and behavioral problems than other studies, affecting approximately 4.4 million and 4.5 million children respectively.

The study also points to a near 20 percent treatment gap between children diagnosed with depression versus those experiencing anxiety. Overall, roughly 78% of children with depression have received treatment, whereas treatment for anxiety and behavioral/conduct problems was 59% and 54%, respectively. Without access to services, students with anxiety are at higher risk of later developing depression.

For students to cope with mental, emotional or behavioral disorders as adults, they need to begin developing those skills and mechanisms in the classroom along with their peers. Due to a scarcity of resources, however, educators are often forced to separate students that require greater attention or cause distractions, furthering gaps in knowledge and socialization.

The study also found that three out of four school-aged children diagnosed with depression simultaneously experience anxiety. This means an estimated 1.42 million students with these overlapping diagnoses are expected to function at the same at the same level and with the same amount of attention as their peers.

When they do not, they are likely to be labeled as “bad students,” compounding disconnected feelings with punitive disciplinary actions. Exclusionary discipline rates are significantly higher for students of color and students in special education classrooms.

78% of children with depression have received treatment, whereas treatment for anxiety and behavioral/conduct problems was 59% and 54%, respectively. Without access to services, students with anxiety are at higher risk of later developing depression.

The study also found disparities based on race, ethnicity, and income level. Children from low income, Hispanic and African American families are less likely to be diagnosed and treated based on limited access to care. Biases related to diagnosis of behavioral conduct problems are most prevalent with African American students.

Closing the treatment gap in schools starts with more funding so that districts can bring more counselors and psychologists onboard -  key forces for school safety before and after traumatic events. For students traumatized by the increasing incidents of gun violence on campuses, (and for whom suicide is a second leading cause of death) mental health services are a high priority - more effective than increasing police presence  or arming teachers.

At Amanda Greene-Chacon's school in Oregon, many students never have the opportunity to meet with these trained professionals.

“There is a mental health crisis in our schools," she told The Register-Guard. "The elementary and middle schools do not have adequate numbers of mental health specialists. At the high school level, we are seeing unprecedented levels of problematic, disrespectful and even threatening behaviors."

Greene-Chacon, a member of the Springfield Education Association, also believes the "the real issue is the way we serve our students — in overcrowded classrooms where the pressures of standardized testing have robbed teachers of their ability to provide age-appropriate educational opportunities.”

Liz Hurt, a school nurse in Oakland, California, says the addition of nurses in schools leads to quantifiably more time for teachers to educate their students in the classroom rather than focus on other needs. In her school district, where there are only 22 school nurses, Hurt and her colleagues are not only responsible for the physical care of their students, but mental health treatment, implementing individualized health plans, developing accommodations for medical 504 plans, and proper nutrition.

Mental health experts strongly believe starting early makes for better outcomes in later years, but  the lack of programs and services available to preschool children is glaring.

“For both anxiety problems and behavioral/conduct problems, treatment receipt was more common among school-aged children compared to those aged three- to five-years," the report said.

National Education Association

Great public schools for every student

The National Education Association (NEA), the nation's largest professional employee organization, is committed to advancing the cause of public education. NEA's 3 million members work at every level of education—from pre-school to university graduate programs. NEA has affiliate organizations in every state and in more than 14,000 communities across the United States.