School-based mental health services have become a critical component of the U.S. mental health care system, particularly for youth populations. According to the latest data, nearly one in five students in public schools utilize mental health services, highlighting the importance of schools as an accessible point for care. These services are especially crucial given that approximately 1 in 5 teens experience symptoms of anxiety or depression, and many students face challenges such as bullying and exposure to violence, which can negatively impact their mental health. While these services offer significant benefits, including early identification of mental health issues and reduced barriers to care, several challenges persist, including funding limitations, provider shortages, and recent policy changes that may disrupt service delivery.
The structure and delivery of mental health services in schools vary widely. Ninety-seven percent of schools provide at least one mental health service, with a growing number of schools offering group-based and family interventions. Telehealth has become an increasingly important mode of service delivery, particularly since the pandemic, though some schools were already utilizing it prior to this period. In the 2024–2025 academic year, 76% of public schools that offer mental health services had two or more types of mental health providers, while 24% had only one type of provider. This shift toward multi-provider models may indicate a broader recognition of the complexity of mental health care in educational settings.
Despite these developments, many schools face significant barriers to providing consistent and comprehensive mental health care. Funding constraints and a shortage of licensed mental health professionals are two of the most pressing challenges. For example, 13% of schools did not have mental health services available for staff in the 2024–2025 school year. Additionally, many schools do not offer universal behavioral health screenings, which are considered a best practice for identifying students with mental health needs. These screenings are often hindered by a lack of resources, difficulty accessing providers, and administrative challenges in data collection and maintenance.
Federal support for school-based mental health services has played a crucial role in expanding access to care. The Bipartisan Safer Communities Act (BSCA) of 2022 included provisions to support and expand these services, including $1 billion to increase the number of mental health providers in schools and provide training. However, in April 2025, under the Trump Administration, the Department of Education announced the cancellation of these funds, which may have significant implications for the sustainability of school-based mental health programs. Additionally, the Trump Administration announced an executive order to dismantle the Department of Education, an agency that has historically played a key role in developing guidance for school-based health services and providing resources through partnerships with Medicaid.
Medicaid also plays a vital role in supporting school-based mental health services. Schools can receive reimbursement for medically necessary services included in a student’s Individualized Education Plan (IEP) and for some administrative services. In 2022 and 2023, the Centers for Medicare & Medicaid Services (CMS) issued guidance to increase the accessibility of these services by eliminating practical barriers. However, significant changes to Medicaid, including budget cuts in the reconciliation bill passed in July 2025, may impact how Medicaid supports school services in the future. In 2023, nearly four in ten children in the U.S. had Medicaid coverage, making it an essential resource for schools serving low-income communities.
The impact of school-based mental health services extends beyond students to include staff as well. Teachers and other school personnel play a critical role in monitoring students’ mental health and providing support. However, burnout among teachers, driven by anxiety, depression, and low job satisfaction, is a growing concern. In the 2024–2025 academic year, 36% of staff reported an increase in concerns about colleagues showing signs of depression, anxiety, emotional dysregulation, or trauma. While many schools offer mental health services for staff, 13% of schools do not, which can further exacerbate the challenges faced by school personnel.
The integration of mental health services into school settings can also help address disparities in access to care. For instance, a 2024 KFF survey found differences in the receipt of mental health care services by race and ethnicity, with a larger share of White parents compared to Black, Hispanic, and Asian parents reporting that their children received these services in the past three years. School-based services can reduce these disparities by providing care to underserved populations, including children from low-income households and children of color.
Despite these benefits, the recent disruptions in federal funding and policy may threaten the long-term viability of school-based mental health services. The cancellation of the $1 billion in funding and the dismantling of the Department of Education are particularly concerning, as they may lead to a reduction in the number of mental health providers in schools and limit the availability of training and resources. These changes come at a time when the need for mental health services is growing, particularly in light of the ongoing impacts of the pandemic on student well-being.
For Federally Qualified Health Centers (FQHCs), the implications of these developments are significant. FQHCs often serve as a primary source of mental health care for underserved populations and may need to adapt to changes in school-based mental health services. If school-based services are reduced or disrupted, FQHCs may face increased demand for mental health care services, particularly for students and families who rely on these services for support. Additionally, FQHCs may need to explore new partnerships with schools to ensure continuity of care, especially for students who require ongoing mental health support.
In the context of trauma-informed care, school-based mental health services can play a crucial role in addressing the long-term effects of trauma on students. Trauma-informed care involves recognizing the impact of trauma on mental health and tailoring interventions to meet the specific needs of individuals who have experienced trauma. Given that many students have been exposed to violence, bullying, or other traumatic experiences, trauma-informed approaches can be particularly beneficial in school settings. These approaches may include strategies such as creating safe and supportive environments, fostering positive relationships between students and staff, and providing access to specialized mental health services for students with trauma-related concerns.
Hypnotherapy interventions may also have a role in supporting mental health in school settings. Hypnotherapy is a therapeutic technique that uses guided relaxation and focused attention to help individuals achieve a heightened state of awareness, often referred to as a trance. This state can be used to address a range of mental health concerns, including anxiety, stress, and emotional regulation. While the use of hypnotherapy in schools is relatively uncommon, it may be considered as part of a broader approach to mental health care, particularly for students who benefit from non-traditional or complementary therapies.
Psychological well-being strategies, such as cognitive-behavioral techniques, mindfulness practices, and emotion regulation skills, can also be integrated into school-based mental health services. These strategies are evidence-based and have been shown to be effective in reducing symptoms of anxiety, depression, and other mental health concerns. By incorporating these strategies into school curricula and mental health programs, schools can help students develop long-term coping skills that promote emotional resilience and well-being.
In terms of subconscious reprogramming techniques, the use of guided visualization, affirmations, and narrative therapy may be explored as part of school-based mental health interventions. These techniques can help students reframe negative thought patterns, develop a more positive self-image, and build confidence in their ability to manage challenges. While the use of these techniques in schools is still emerging, they may offer promising avenues for supporting mental health and emotional development in students.
Ultimately, the success of school-based mental health services depends on a combination of factors, including adequate funding, trained mental health professionals, and supportive policies. While recent disruptions in federal funding and policy may pose challenges, there is also an opportunity to re-evaluate and strengthen the delivery of mental health services in schools. By prioritizing evidence-based practices, fostering collaboration between schools and mental health providers, and ensuring equitable access to care, schools can continue to play a vital role in supporting the mental health of students and staff.
Conclusion
School-based mental health services are a critical component of the U.S. mental health care system, particularly for youth and underserved populations. These services offer numerous benefits, including early identification of mental health concerns, reduced barriers to care, and the integration of evidence-based psychological strategies such as trauma-informed care and emotional regulation techniques. However, challenges such as funding limitations, provider shortages, and recent policy changes may impact the sustainability and effectiveness of these services. For Federally Qualified Health Centers, the implications of these developments highlight the need to adapt to changing circumstances and explore new partnerships to ensure continuity of care. As schools continue to evolve in their approach to mental health, it is essential to prioritize evidence-based interventions, support staff well-being, and address disparities in access to care.