School Counselors and Children's Mental Health

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Project Summary A national child and adolescent mental health emergency was declared in fall 2021 amid rising mental health challenges. Approximately one in six children have a professionally diagnosed mental health disorder, which can lead to increased risk of suicide, worse health outcomes later in adulthood, and worse performance in school. However, approximately half of children with mental health disorders do not receive treatment, and Black, Hispanic, and low-income children, are less likely to receive mental health care than their peers. Schools are one of the main places children readily access health services, including mental health care, and school mental health services are often provided by licensed school counselors. Recently, there has been a push to increase mental health services in schools and access to school counselors in particular. The proposed study will examine one of the largest policies to increase funding for and access to school counselors in middle and high schools. Specifically, we will study how California’s 2006 Supplemental School Counseling Program (SSCP) impacted children’s access to school counselors, self-reported mental health outcomes, and related health and well-being outcomes. The SSCP provided middle and high schools with funds to hire more certified counselors, with funding levels that varied based on school sizes. We are not aware of any study that has examined the causal impacts of this large-scale policy on the mental health and related health outcomes of California students, or any related research examining the causal effects of a counseling policy of this scope on children’s health. We will leverage variation in funding levels over time and across schools in a simulated instruments and event study model to estimate the causal impacts of additional counselors hired through the SSCP on health outcomes. Using administrative education data on schools, students, and personnel from the California Department of Education, and self-reported measures of mental health, healthy behaviors, and health outcomes from the California Healthy Kids Survey, we will 1) document how expanded funding for school counselors impacted students’ access to counseling, including the number of counselors hired and their education, experience, and demographics, 2) estimate the causal impact of expanded access to school counselors on students’ health, including mental health, healthy behaviors, and well-being, and 3) examine how access to school counselors and their impacts on children’s health vary by urbanicity, family income, student race/ethnicity, and age. This research will provide evidence on how expanding access to school counselors may improve children’s mental health and how to effectively design related policies so that they impact the children most in need of these services. This is particularly important right now as places consider whether and how to use COVID relief funding to hire more counselors, and people seek ways to address the current national child and adolescent mental health emergency.