Youth depression, anxiety, and suicide have risen steadily over the past decade, yet North Carolina continues to struggle to meet students’ mental health needs amid staffing shortages, funding constraints, and policy uncertainty. With federal mental health funding increasingly volatile and the state still operating without a budget, school districts are doing what they can under increasingly strained conditions.
Access to Student Mental Health Staff in Schools
Students experiencing mental health challenges are less likely to graduate on time, more likely to miss school, and more likely to struggle academically. According to NC Child’s 2025 Child Health Report Card, more than half of children report difficulty accessing mental health care, and nearly one in five adolescents experienced a major depressive episode in the past year. At the same time, North Carolina’s student-to-school psychologist and social worker ratios are nearly four times higher than recommended levels.
As a result, school-based mental health staff are stretched thin and often consumed by compliance-driven responsibilities rather than prevention and relationship building. School psychologists, for example, are the only professionals trained to conduct special education evaluations–which is time-intensive work that limits their availability for early intervention and ongoing student support. To help fill gaps, many districts rely on partnerships with community-based providers, but these arrangements bring their own challenges, including staff turnover, Medicaid billing complexities, insurance barriers, and inconsistent service availability. Even as schools expand these partnerships, many report that student needs are only partially met and gaps in care remain widespread.
Addressing North Carolina’s youth mental health crisis will require sustained investment and policies that strengthen supports where students already are–in schools. Policymakers must prioritize funding for prevention, early identification, and the recruitment and retention of school-based psychologists and social workers trained to meet students’ needs.
Mental Health Crises in Rural Schools
These challenges are especially acute in rural districts, some of which have gone years without a single full-time school psychologist. With a limited workforce, districts are often forced to contract services, leaving students without timely support during moments of crisis. Recruitment remains a persistent hurdle, as rural districts are unable to offer the salary supplements available in wealthier communities.
Senate Bill 259 was introduced this session to help address these shortages, proposing more than $20 million to increase compensation for school psychologists, support recruitment grants, provide stipends for interns, and establish a virtual training program through Appalachian State University. Yet the bill has stalled–unsurprising in a state still without a budget. Meanwhile, student needs continue to grow. The General Assembly has an opportunity to respond meaningfully to these crises; continued inaction risks long-term consequences for students, schools, and communities across North Carolina.
Leave a Reply