Advancing behavioral health equity – starts in schools

Many factors impact the behavioral health of our school children. The COVID-19 pandemic is an obvious contributor, but so is the issue of behavioral health equity. Long before the pandemic, children’s mental health was a growing crisis. According to the Surgeon General’s 2021 advisory on youth mental health, up to 1 in 5 children ages 3 to 17 struggled with a reported mental, emotional, developmental, or behavioral disorder. Additionally, approximately half of the 7.7 million children with a treatable mental health disorder did not receive adequate treatment.1

What is behavioral health equity?

Behavioral Health Equity is the right to access quality health care for all populations regardless of the individual’s race, ethnicity, gender, socioeconomic status, sexual orientation, or geographical location. This includes access to prevention, treatment, and recovery services for mental and substance use disorders.

Children, especially vulnerable and underserved populations without access to services in their home or community, benefit from increased mental health services at school. The pandemic highlighted this need as well as the fact that racial and ethnic minority groups, along with low-income and LGTBQ+ youth populations, face extra barriers to mental health services. This puts these students in even greater danger of long-term mental health consequences.

The case for more accessible mental health services in schools, specifically when it comes to underserved communities, is compelling.

  • Children of color (especially Black males) are far more likely to experience discipline and arrest rather than being appropriately screened for a mental health condition.
  • While nearly 1 in 4 white students are back to full-time, in-person classes, that number is closer to 1 in 10 for Black, Latino, and Asian American students who are attending in-person full-time. This, of course, means these students have less access to school-based resources.
  • Students, particularly low-income students, are significantly less likely to report that their school offers mental health programs, like counseling, than their principals. Additionally, these students are more likely to think mental health services will no longer be available after the pandemic.
  • A wide majority of students report more problems now than they did in January 2020, before the pandemic began. However, 77 percent of Black and Latino students report more struggles, at least 9 percentage points higher, than the percentage of white or Asian students who said the same.
  • In the area of behavioral health, research indicates that white youth are more likely than minority youth to receive adequate care following a major depressive episode.

This points to an obvious need for improvement in mental health services offered by our schools. But where to start? The CDC recommends the following to help provide a safer and more supportive school environment:2

  • Linking students to mental health services onsite or in the community.
  • Integrating social emotional learning.
  • Training staff.
  • Supporting the mental health of teachers.
  • Reviewing discipline policies to ensure equity.
  • Building safe and supportive environments.

Frontline workers such as teachers and other school personnel are often the first to see mental health issues in children, but they cannot be expected to bear the responsibility of creating change alone. It will take the combined efforts of the healthcare community, government agencies and school systems to create the innovations and reforms that are needed to make children’s mental health and the plight of the underserved a priority. While the pandemic brings many obvious challenges it also brings opportunity for growth – but only by making these issues a priority. If we do that, then we can improve outcomes for all kids.

1 Centers for Disease Control and Prevention: Adolescent and School Health - Mental Health (accessed January 2022):
2 Substance Abuse and Mental Health Services Administration - SAMHSA: Behavioral Health Equity (accessed January 2022):