School-Based Mental Health Initiatives
School-based mental health initiatives have expanded over the past half-century. In recent years, troubling increases in the prevalence of school violence and youth emotional distress have prompted a sense of urgency among policymakers, leading to the bipartisan action of committing billions of dollars annually in federal funding to bolster these programs.
But school-based mental health initiatives face fundamental challenges that warrant more thoughtful attention: mental health interventions for youth are not a panacea and warrant judicious utilization; the goals of the education and mental health systems are often in conflict; and vague policy, guidance, and expected outcomes undermine accountability and confuse responsibilities within and across systems.
Policymakers and education authorities should be clear-eyed about these challenges and the unintended consequences of administering mental health services through the education system. A decades-long track record of inconsistent marginal benefit, poor implementation, and some evidence of harm tempers confidence that effective, comprehensive school-based mental health services are attainable or desirable.
