The Solutions.

The Hopeful Futures Campaign school mental health report cards provide an easy-to-understand snapshot of school mental health policy in each state. To create these report cards, we held focus groups with students, parents, and general voters, as well as consulted with subject matter experts, to establish eight policy areas that contribute to a comprehensive school mental health system.
School Mental Health Professionals

A state’s ratios of students to school mental health professionals is an important signal of the availability of mental health support in schools. We urge states to meet nationally recommended ratios for school psychologists, counselors, and social workers, and to ensure that these providers reflect the diversity of the students they serve.


Policy Goals:
Policies that require comprehensive annual well-being checks and/or screenings for all individuals on campus.

  • Invest in significantly improving the ratios of school psychologists, school social workers, and counselors in K-12, including through telehealth partnerships and workforce programs that incentivize careers in mental health.
    • Ratio of students to school psychologists (1:500) 
    • Ratio of students to social workers (1:250)
    • Ratio of students to counselors (1:250) 

School-Family-Community Partnerships

Partnering with and effectively engaging families, youth, and community stakeholders, including community-based mental health providers, is vital to successfully implementing and sustaining a comprehensive school mental health system.


Policy Goals:

  • Require school districts to adopt family engagement plans.
  • Require partnerships between school districts and community mental health providers that ensure access to services for students with ongoing needs.

Teacher and Staff Training

Regular training in mental health, substance use, and suicide prevention can help school staff feel better equipped to identify warning signs of mental health problems, to respond appropriately, and to have knowledge of available resources and effective interventions.


Policy Goals:

  • Require regular training to ensure K-12 teachers and staff receive regular training on mental health conditions, substance use conditions, and suicide awareness and prevention, including effective interventions and supports and available school and community-based services and resources.

Funding Supports

Medicaid can play an important role in helping fund school mental health services by bringing federal matching funds that help state dollars go further. Many state Medicaid programs cover school mental health services, including via telehealth, for all Medicaid-enrolled students, but many others limit coverage to students on an Individualized Education Plan (IEP). 


Policy Goals:

  • Expand Medicaid billing to include school-based mental health services, including via telehealth, for all Medicaid eligible students (beyond students with an IEP).
  • Ensure the state Medicaid program covers services delivered by school psychologists, social workers, and school counselors.

Well-Being Checks

Regular checks of mental wellness can help identify students and staff who may need support. With high rates of mental health and substance use problems, it’s important to be able to intervene early to help students and staff thrive.


Policy Goals:

  • Require annual well-being checks for all students and staff in K-12.

Healthy School Climate

Policies that foster safe, supportive schools help create a positive learning environment and foster mental wellness for all students. There are many policies that contribute to a healthy school climate, and for the purposes of this report, we focused on the policies noted below.


Policy Goals:

  • Enact legislation to address healthy school climate policies, including statewide school climate surveys, adopting anti-bullying policies, promoting an inclusive environment through anti-discrimination policies, permitting excused absences for mental health concerns, requiring alternatives to exclusionary discipline, and implementing suicide prevention programs.

Skills for Life Success

Relationship skills, self-management, responsible decision-making, self-awareness, and social awareness are all life skills that help children and youth in school and beyond. While many states have adopted these skills for pre-kindergarten, our focus is on K-12.


Policy Goals:

  • Require adoption of evidence-based life skills education for K-12, including making training in the curriculum available to parents and caregivers.

Mental Health Education

Mental health education can increase awareness and understanding and promote help-seeking behavior. While many states mention mental health concepts in health education, states are increasingly passing legislation to support comprehensive mental health education in K-12.


Policy Goals:

  • Require K-12 health education to explicitly include education on mental health.

State by State Ratios of School Mental Health Professionals

Download America’s School Mental Health Report Card