Comprehensive School-Based Mental and Behavioral Health Services and School Psychologists

Mentally healthy children are more successful in school and life. Good mental health is critical to children’s success in school and life. Research demonstrates that students who receive social–emotional and mental and behavioral health support achieve better academically. School climate, classroom behavior, engagement in learning, and students’ sense of connectedness and well-being all improve as well. Mental health is not simply the absence of mental illness but also encompasses wellness promotion; social, emotional, and behavioral health; and the ability to cope with life’s challenges. Left unmet, mental health problems are linked to costly negative outcomes such as academic and behavior problems, dropping out, and delinquency. Mental and behavioral health problems not only affect students’ short-term classroom engagement, but also interfere with long-term development of positive relationships and work-related skills.

There is a growing and unmet need for mental and behavioral health services for children and youth. According to the U.S. Department of Health and Human Services, one in five children and adolescents experience a mental health problem during their school years. Examples include stress, anxiety, bullying, family problems, depression, learning disability, and alcohol and substance abuse. Serious mental health problems, such as self-injurious behaviors and suicide, are on the rise, particularly among youth. Unfortunately, many children and youth do not receive the help they need, and disparities in access to care exist among low-income communities and minoritized youth. Among the 3.8 million adolescents ages 12–17 who reported a major depressive episode in the past year, nearly 60% did not receive any treatment, according to a 2019 report by the Substance Abuse and Mental Health Services Administration. Of the adolescents who do get help, nearly two thirds do so only in school.

Schools are an ideal place to provide mental and behavioral health services to children and youth. Schools provide an ideal context for prevention, intervention, positive development, and regular communication between school and families. Schools also offer caring relationships and regular, consistent connections between students and staff both in person and virtually. School-employed mental health professionals (i.e., school psychologists, school counselors, school social workers, and school nurses) know the students, parents, and other staff, which contributes to accessibility of services. Research shows that students are more likely to seek counseling when services are available in schools. In some cases, such as rural areas, schools provide the only mental health services in the community. Comprehensive, culturally responsive school mental health services can help address inequities in access and help reduce the stigma associated with receiving mental health services by making it part of the fabric of the school system.

Comprehensive school mental and behavioral health services support the mission and purpose of schools: learning. All services provided in schools should be appropriate to the learning environment; those that are not risk being ineffective or even counterproductive. Just as children are not simply small adults, schools are not merely private clinics with white boards. Being trained to work within the school culture is essential to being effective (and cost-effective). School psychologists have specialized training in child development, mental health, learning, diversity, culturally responsive services, and school systems and law. Their unique expertise lies in how these elements interact to shape children’s behavior, learning, and overall adjustment.

Comprehensive school mental health services are essential to creating and sustaining safe schools. Increased access to mental health services in schools is vital to improving the physical and psychological safety of our students and schools, as well as academic performance and problem-solving skills. Culturally responsive school mental health supports that encompass social–emotional learning, mental wellness, behavioral health, resilience, and positive connections between students and adults are essential to creating a school culture in which students feel safe and empowered to report safety concerns, which is proven to be among the most effective school safety strategies. Additionally, in the aftermath of a crisis, school-employed mental health professionals provide supports that facilitate a return to normalcy, are sustainable, and can help to identify and work with students with more intense or ongoing needs.

Providing a continuum of school mental and behavioral health services is critical to effectively addressing the breadth of students’ needs. Comprehensive mental health services are most effective when provided through a multitiered system of supports (MTSS). MTSS encompasses the continuum of need, enabling schools to promote mental wellness for all students, identify and address problems before they escalate or become chronic, and provide increasingly intensive, data-driven services for individual students as needed. Access to adequate staffing of school-employed mental health professionals, like school psychologists, is essential to the quality and effectiveness of these services.

School psychologists provide a continuum of services that connect mental health, behavior and learning, school and home, and school and community services. Meeting the full continuum of student needs requires collaboration and coordination. Typically, community providers offer supplementary or intensive services that go beyond school capacities. An MTSS approach facilitates collaboration while ensuring that services provided in school are appropriate to the learning context and those that are provided after school hours are appropriately linked to and supported in the school setting. Partnerships are most effective when they are coordinated by school-employed mental health professionals, are defined by clear memoranda of understanding, and reinforce an appreciation for the unique contribution each group makes to creating more seamless and comprehensive service delivery. This not only reduces gaps, redundancy, and conflict, it also reduces stress on families and supports their roles as primary caregivers and decision makers regarding their child’s development.

School psychologists are part of a team of school-employed mental health professionals who provide these services. Improving staffing ratios for these professionals is critical to adequately supporting students’ mental and behavioral health. For more information on school-based mental health services and the role of school psychologists, visit

Please cite this document as:

National Association of School Psychologists. (2021). Comprehensive School-Based Mental and Behavioral Health Services and School Psychologists [handout]. Author.

© 2021, National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda, MD 20814, 301-657-0270,

Related Resources

Comprehensive School-Based Mental and Behavioral Health Services and School Psychologists (PDF)
Download a PDF version of this handout to print and share it with stakeholders and members of your school community.

Comprehensive School Mental and Behavioral Health Infographic (Digital)
Download and share this infographic to convey the breadth of your skills at all tiers and the importance of improving staffing ratios.

Comprehensive School Mental and Behavioral Health Infographic (Printable)
Download and share this infographic to convey the breadth of your skills at all tiers and the importance of improving staffing ratios.