By Clayton Henkel, NC Policy Watch
As the North Carolina General Assembly returns to Raleigh this week for the 2023 session, state educators and healthcare providers are issuing an urgent call for improved student access to mental health services.
The North Carolina Department of Public Instruction (NCDPI) was recently awarded $17 million in grant funding from the U.S. Department of Education to help student mental health needs in 15 school districts. But during last week’s State Board of Education meeting, board members discussed the need for more recurring state dollars to sharply increase the number of school psychologists and school social workers.
In areas where those professionals are scarce, the NC Department of Health and Human Services is advocating for a $4.2 million pilot telehealth program that would help connect students with child and adolescent psychiatrists.
“[In] over half of our counties we don’t have a child health psychiatrist or we don’t have enough behavioral health workforce to work with children,” explained Dr. Charlene Wong, NCDHHS Assistant Secretary for Children and Families. “So this type of telehealth arrangement and delivering that in schools where children are is really a great way to increase access to these clinical evidence-based supports for kids.”
Another strategy would provide mental first aid trainings for students and staff to help better identify and respond to signs of distress or a crisis in their friends and peers.
The commitment to improving school health services comes in the wake of a disturbing trend of unhappy, anxious youth.
During the years of 2019 to 2021, the number of North Carolina youth experiencing one or more major depressive episodes increased by 46%.
One-third of the state’s high schoolers said they felt alone.
Less than half (49%) of North Carolina high school students said they feel good about themselves. Back in 2011, that figure was 80%.
In a December tweet, state Health and Human Services Secretary Kody Kinsley called the data ‘heartbreaking.’
NCDHHS and NCDPI officials want those numbers to improve for the better.
“By doing this work in schools we can really promote equity and access to supports and build resilience in our children,” said Dr. Wong.
This week, we take a closer look at how children are faring based on the latest Youth Risk Behavior Survey and some of the budget requests the state Department of Public Instruction will prioritize in this legislative session.
25 – Percentage of North Carolina youth (1 in 4) who have experienced a behavioral health need while in grade school
33 – Percentage of NC high school students who agree or strongly agree that they feel alone in their life — in 2011, that number was 19 percent (Source: NC DHHS/NC Healthy Schools)
22 – Percentage of NC high school students who said they seriously considered attempting suicide during the past 12 months (Source: 2021 NC Youth Risk Behavior Survey)
48 – Percentage of gay, lesbian, or bisexual NC high school students who said they seriously considered attempting suicide during the past 12 months (Ibid)
46 – During 2019-21 the number of North Carolina youth experiencing one or more major depressive episodes increased by 46%
30 – Percentage of high school students who reported it would take them less than an hour to get and be ready to fire a loaded gun without a parent or other adult’s permission (Source: 2021 NC Youth Risk Behavior Survey)
11 – Percentage of North Carolina children (ages 3 to 17) who have ever been diagnosed with or reported to have anxiety or depression by a doctor or health care provider (Source: 2022 KIDS COUNT Data Book)
1:750 – The national recommended ratio of one school nurse for every 750 students
1:890 – Average North Carolina school nurse-to-student ratio, 2020-21 (Source: NC DHHS/NC Healthy Schools)
1:1,001 – 2,000 – The school nurse-to-student ratio in Wake and Durham counties (Source: NC Annual Survey of School Health Services 2019-2020)
52 – Percentage of North Carolina school nurses who serve one school
36 – Percentage of North Carolina school nurses who routinely serve two schools
10 – Percentage of North Carolina school nurses who routinely serve three schools
Nearly 1 in 5 – Beyond mental health needs, an average 17%-19% of North Carolina students receive services in school each year due to chronic health conditions
The Leandro Plan addresses many of these issues by funding support staff at national guidelines. The Leandro plan calls for:
Nurses: 1 per school Counselors: 1:250 students
Psychologists: 1:700 students
Social Workers: 1:400 students
$100 million – The cost to fund a dedicated school nurse or social worker in North Carolina’s economically disadvantage Tier 1 and Tier 2 counties
$4.2 million – The funding needed to establish a school-based telehealth pilot program for behavioral health that would allow children to see a child psychiatrist from a room within their school
10,000 – An estimate of the number of students who would benefit from the telehealth pilot program once it’s up and running
10 – The percentage of schools that will have telehealth services by 2023 (those with this service mostly focus on physical health, not behavioral health)
3 – The number of counties that have a “mostly sufficient supply” of child and adolescent psychiatrists. (Source: American Academy of Child and Adolescent Psychiatry)
$10 million – Additional recurring funding the State Board of Education/NCDPI will be seeking in the 2023 long-session for school social worker pay increases (master’s level pay)
$5 million – Additional recurring funding sought for a School Psychologist Internship program that would expand the pipeline of future school psychologists (the program was not funded in the last legislative session)
$1.7 million – Estimated annual budget cost of establishing a statewide school electronic health record documentation system that would allow all North Carolina schools to document student health records and for records to follow a student if they change schools (many schools now rely on paper records)
$5 million – Recurring funding the State Board of Education/NCDPI will be seeking in the 2023 long-session budget to eliminate the student co-pay for reduced price meals
Why this matters:
20 – Percentage of North Carolina children living in poverty
36 – Percentage of North Carolina children in single-parent families
The state will finalize its Unified School Behavioral Health Action Plan this Spring.