Objectives

To determine what steps the State Education Department (Department) is taking to ensure that school districts have the necessary mental health education in place as required by law. We also sought to determine what mental health services are available at the school districts. Our audit covered the period July 2018 through August 2021.

About the Program

As the steward of New York State’s education program, the Department is charged with the general management and supervision of the State’s school districts and the education of approximately 2.6 million students statewide.

The coronavirus disease 2019 (COVID-19) pandemic has presented many challenges to students, educators, and parents. Children already coping with mental health conditions have been especially vulnerable to the changes, and now we are learning about the broad impacts on students as a result of schools being closed, physical distancing guidelines and isolation, and other unexpected changes to their lives. In mid-March 2020, schools across the United States, including New York State, went into lockdown and needed to rapidly adopt remote learning. Among other consequences of these challenges, teachers, students, and their families have experienced increased stress and anxiety, which has led to a decline in mental health. The American Psychological Association reports that nearly 81% of teenagers experience more intense school-related stress due to COVID-19. In October 2021, a coalition of the nation’s leading experts in pediatric health (American Academy of Pediatrics, Children’s Hospital Association, and American Academy of Child and Adolescent Psychiatry) issued an urgent warning that the mental health crisis among children is so dire that it has become a national emergency.

To help confront the mental health crisis among youth in New York State, the Mental Health Association in New York State, Inc., a non-profit organization, led a call to action for a State law that would require mental health instruction in the kindergarten–Grade12 health curriculum. With the passage of the legislation, which amended Section 804 of the Education Law (Law) effective July 1, 2018, New York became the first state to require that health education in schools must include instruction in mental health. The Law mandates all school districts to ensure that their health education programs recognize the multiple dimensions of health by including mental health and the relation of physical and mental health to enhance student understanding, attitudes, and behaviors that promote health, well-being, and human dignity.

In addition to education, mental health services are an important component of a mental health program; however, the Law stops short of requiring that all students have access to in-school mental health services. Although school districts are not required to provide mental health services to students unless specified in an individualized education program (IEP), schools are often considered the natural and best setting for comprehensive prevention and early intervention services for all students, including those without identified education disabilities. The need for mental health services will likely increase as COVID-19–related and other life stresses continue to plague students.

Key Findings

The Department has taken steps to aid school districts in implementing mental health education into their health education curriculum, namely in the form of issued guidance and resources made available on its website. For example, the Department’s 2018 “Mental Health Education Literacy in Schools: Linking to a Continuum of Well-Being” guide provides evidence-based and best practice instructional resources and materials to assist school districts in developing classroom instruction that complies with the Law. Additionally, during the COVID-19 pandemic, it issued guidance to schools with recommendations on how to help students and what resources were available.

While not assigned specific oversight responsibilities under the amended Law, the Department is charged with the general management of public schools and the educational work of the State. Given the magnitude of the escalating mental health crisis among students, the Department should have a means to assure itself that school districts statewide have established a mental health curriculum and that schools are implementing it. However, the Department does not require school districts to submit any documentation or other information to verify their compliance with the Law, and thus has no assurance that all school districts have developed and implemented the required mental health education curriculum.

For a sample of 22 school districts we surveyed, all were able to describe the mental health curriculum they implemented; however, only 19 actually provided supporting documentation to show they implemented some sort of mental health education and met the minimum requirements of the Law. Furthermore, we found that the mental health curricula varied among these 19 school districts. Without some level of oversight, the Department cannot be assured that students are receiving mental health education or that the instruction achieves the intent of the Law: to enhance student understanding, attitudes, and behaviors that promote health, well-being, and human dignity.

While the State’s commitment to mental health through education is critical, the fight against the mental health crisis is waged not only through education but also the provision of services. When students, in all school districts statewide, are educated about mental health as an important aspect of overall health and well-being, they will be better equipped to effectively recognize signs and symptoms related to mental health issues in themselves and others and will know where to turn for help. In turn, the stigma that surrounds mental health issues will decrease. Although schools are often considered the natural and best setting for comprehensive prevention and early intervention services for all students, we determined that, for many school districts, their mental health teams (i.e., school-employed psychologists, counselors, and social workers) are understaffed, based on staff-to-student ratios recommended by the National Center for School Mental Health and the National Association of School Psychologists.

Key Recommendations

• Develop a mechanism to determine if school districts are providing mental health education as required by Law.
• Explore partnering with State and local entities to determine whether school districts should maintain certain staffing levels for mental health professionals.