Special Report
Student Well-Being

School Counselors and Psychologists Remain Scarce Even as Needs Rise

By Arianna Prothero & Maya Riser-Kositsky — March 01, 2022 14 min read
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Clarification: The count of states without a single district meeting school psychologist and counselor ratios has been updated to reflect that Illinois and Utah did not report any staff data.

Pine Grove Area High School, located in a small town in eastern Pennsylvania by the same name, closed its school building for the pandemic on Friday the 13th back in March 2020. In the nearly two years since, the social isolation, followed by the carousel of a hybrid schedule and the jolt of returning fully to school in person, has been hard on students’ mental health.

Then came this autumn, when two students died by suicide within three weeks of one another, sending shock waves through the rural community. No one, said Pine Grove’s principal, Michael Janicelli, is left untouched by that kind of tragedy in a small town and school.

“From within the school, obviously their friends, to the homeroom teacher, who takes attendance the day after and there’s a seat—it’s hard,” he said. “It’s hard on everyone.”

Pine Grove High has two full-time school counselors helping the school’s 500 students handle the emotional fallout from all this—or had. Now Janicelli is searching for a replacement for one counselor who is leaving for another job while his students are still coping with so much grief. Janicelli’s school also has access to the district’s two school psychologists who are there to step in at times of crisis, he said, but day-to-day they are mostly focused on special education.

Hiring is tough these days—whether it’s teachers, bus drivers, or counselors—and Janicelli is worried he won’t be able to find another counselor anytime soon.

“You used to get excited to interview someone, but the excitement is gone,” he said. “Now, you cringe when there is an opening at your school.”

The mental health and well-being of children and teenagers have been driven to a breaking point nationwide by the pandemic and the isolation, disruption, fear, and grief it has brought with it. At the same time, many K-12 schools across the country lack enough school psychologists and counselors to respond to the mounting mental health needs of their students.

Nearly 40 percent of all school districts nationally, enrolling 5.4 million students, did not have a school psychologist in the first full year of the pandemic, according to an Education Week analysis of the most recent federal data. Just 8 percent of districts met the National Association of School Psychologists’ recommended ratio of one school psychologist to 500 students.

While most districts did have a school counselor in the 2020-21 school year, only 14 percent met the ratio of one school counselor to 250 students recommended by the American School Counselor Association.

And the whiter the district’s student population, the more likely it is to meet the ideal ratios of school psychologists and counselors.

Oversized caseloads can make it impossible for school psychologists and counselors to adequately meet students’ mental health needs, especially at a time when those needs are rising. Mental health is directly related to learning. Students struggling with anxiety, depression, or the effects of trauma simply don’t have the mental bandwidth to process new information.

How states stack up on school based mental health professionals

Education Week analyzed the most recent federal data to see what percentage of students in each state are attending districts that meet the ideal ratios of school psychologists and counselors to students.

A bad situation made worse

Children and teenagers were suffering before the pandemic even started. Adolescent suicide rates had increased dramatically in the decade before 2017 and a growing number of teens were reporting symptoms of severe depression between 2005 and 2017, according to federal data.

Some of that increase may have been because youth have become more aware of—and open to discussing—mental health problems. But other theories are not so rosy and point to social media, academic pressure, and rising poverty as likely driving the deterioration of children’s and adolescents’ mental health.

Whatever the culprit, the mental health situation for youth was declining before COVID-19 sent it into a free-fall, according to a research analysis in the journal JAMA Pediatrics.

In the early days of the pandemic, children and teens in the United States and around the globe experienced widespread anxiety and depression, driven by an increase in isolation and screen time and a decrease in exercise and adult supervision. (The analysis also found that there was no significant connection between school closures and suicide in the early days of the pandemic.)

Two years in, many kids are still struggling. Children’s hospitals, for example, report that self-injury and suicide cases in children ages 5 to 17 were up 45 percent in the first half of 2021 compared with the same period in 2019.

Children are also affected by the pandemic’s damage to those around them.

“Every year, we have students who lose a loved one,” said Teshia Stovall Dula, a counselor at Hull Middle School in Gwinnett County, Ga. “But over the last two years, we have had more students who have lost loved ones and some kids have lost even more than one family member. We have more grief.”

Dula paused her interview with Education Week to greet a student who came to her door: “How can I help you, sweetheart?” This was just one of the 400 students under her care.

Another issue Dula is seeing at her school is that students’ social skills are worse: “Kids seem even less mature.”

She’s doing more conflict resolutions and peer mediation this year than any she can remember in the past and she’s been a school counselor since 1998.

We’re in a situation where in many cases school psychologists are providing services to 1,500 [or] 3,000 students ... You ask what gets lost? That’s what gets lost: school psychologists’ focus on creating a school environment for all students where they feel safe and connected.

Now that students are mostly back to learning full time in person, some of the stressors driving anxiety and depression among children and teens have eased. But new issues are arising, tied to the ongoing effects of the pandemic: Nearly half of school and district leaders said in a December survey by the EdWeek Research Center that their school or district is getting more threats of violence by students than in fall of 2019. Two out of 3 teachers, principals, and district leaders say students are misbehaving more now than they did before the pandemic.

Educators in urban and suburban districts were more likely to report an increase in student threats and misbehavior.

Students see the toll firsthand

The early days of the pandemic were lonely and scary for Katie Herring, an 11th grader at Pine Grove High School. She missed her social life and worried about getting sick or her loved ones falling ill.

“You can feel really alone. You can start to lose sight of how loved you are,” she said.

But being back in the school building with her friends daily doesn’t mean the worrying has stopped—especially after losing two schoolmates this past fall to suicide.

“I was actually walking into a cheer practice, and one of my friends told me, and it was the same reaction as hearing about the first suicide: It is just shock. … You want to believe that it’s a rumor,” she said. “All of us cheerleaders, we just hugged each other, a few of us were crying because we knew the person. It makes you even more worried about your friends. … Even if they say they’re OK, you have that thought in your head, ‘Are they really? Are they hiding it from you?’”

That’s why she got involved with her school’s newly-formed Aevidum chapter, which helps students raise awareness of suicide and reduce the stigma around mental health in their school. That might mean running campaigns to educate students and staff on the warning signs of depression and suicide, informing students of resources available to them such as the National Suicide Prevention Lifeline, and designating and staffing a table in the cafeteria set aside for any student who needs someone to sit with.

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or contact the Crisis Text Line by texting TALK to 741741.

The school’s counselor, Alison Gimbi, is encouraged by the results so far. A lot of students and teachers are trying to open up more about mental health, and it’s changing the stigma around the issue.

“Students are coming into the counselor’s office more because they are more comfortable talking about it,” Gambi said. “We don’t just get the kids after something is already a problem. It’s helped us do prevention, not just reaction work.”

Nationally, student demand for school-based mental health services is up. Nearly 9 in 10 teachers and school and district leaders surveyed by the EdWeek Research Center in February said that the percentage of students seeking school-based mental health services has increased since the fall of 2019.

Nearly half said they do not have the staff needed to meet students’ mental health needs.

And neither do their surrounding communities, which are also stretched thin by a metastasizing mental health crisis.

That’s the case in Pine Grove, said Janicelli, the principal.

“I think if you called right now and said, ‘I need to see someone,’ it might be a six-month wait,” said Janicelli.

School counselors and psychologists are referring students to specialists outside their schools, which is standard practice, only to have parents come back to them and say they can’t get their child in anywhere.

“I am seeing more kids experiencing crisis symptoms and anxiety and self-reported and diagnosed PTSD,” said Amy Cannava, a school psychologist at Wakefield High School in Arlington, Va. “I think it’s overwhelming our mental health practices in the area, but I want to scream back, I am overwhelmed, too. You have the ability to turn people away. I don’t, nor should I.”

In a typical week, Cannava will schedule 10 to 12 students for one-on-one counseling, but she usually sees an additional 10 students for unplanned sessions as issues come up. That’s on top of testing students for mental illness and learning disabilities, and meetings with staff, parents, and other community providers to coordinate on working with shared clients.

Cannava currently serves around 2,500 students with the help of another full-time psychologist and a part-time psychologist as well as school counselors and social workers.

“I have some of the best ratios I have ever had,” she said, “and I can’t even begin to describe how busy we are.”

What staff shortages mean in practice

Education Week’s analysis found that 15 states don’t have a single district meeting the ideal ratio of 1 psychologist to 500 students, affecting almost 12 million kids. (That count includes Hawaii, which is a single, statewide school district.) Hawaii, Florida, and the District of Columbia don’t have a single district meeting the recommended ratio of 1 counselor to 250 students. Illinois and Utah did not report any staff data.

Among districts where less than a quarter of students are white, 11 percent meet the ideal ratio of school counselors, compared to 18 percent of districts where more than three quarters of students are white.

Only 6.5 percent of districts where less than a quarter of students are white meet the ideal ratio for school psychologists, while around 8.5 percent of districts that are more than three-quarters white meet the recommended ratio.

There is a lot that gets lost when school counselors and psychologists have too high of a caseload.

It can be bigger things such as less time improving disciplinary practices, supporting teacher well-being, or implementing schoolwide programming on bullying, mental health awareness, or social-emotional learning.

And it can be the smaller, unofficial tasks that school counselors and psychologists take on.

Alma Lopez is a counselor at the middle school for the Livingston Unified School District and the National School Counselor of the Year. She oversees a caseload of about 400 students in the rural district east of San Jose, Calif. At the beginning of the pandemic, Lopez started a list of every student who lost a family member and the date they died so that she could check in on her students on the anniversary of the death. But that quickly fell by the wayside as she became overwhelmed by students’ more immediate needs.

Lopez said she also has become less visible during the pandemic. She is meeting a lot more with students individually in her office because many need the more intensive, one-on-one counseling. But that means she isn’t in the hallways, classrooms, or cafeteria as much.

“I love to greet my students in the morning,” she said. “I’m out there, I take some silly pompoms—I think I must have wanted to be a cheerleader. But if there is a student, or a parent, or a staff member with a significant need, then cheerleading is on hold.”

That visibility is crucial to developing relationships in which students feel comfortable approaching counselors with their problems.

For Joanna Aragon, a school counselor at Hillview Junior High in Pittsburg, Calif., a high caseload of about 450 students and increased demand for her time means that her connection to families suffers. She’s not able to do the outreach she needs to build relationships with parents, which means they are less likely to seek her help when their kids are struggling.

On top of everything else Aragon has been juggling—mediating fights, holding friendship groups for students who moved to the school when all classes were remote—she’s also been teaching classes when the school is short on teachers. One day she taught four out of six class periods, she said.

“I was teaching band and choir,” she said. “I did appreciate the extra contact with the kids. That was the positive. But I wasn’t able to do my job.”

High caseloads mean school psychologists’ days are consumed by testing for special education and making sure schools are in compliance with special education laws. That is important work, said Eric Rossen the director of professional development and standards at the National Association of School Psychologists, but it can be limiting professionally and lead to burnout.

In this situation, school-based mental health professionals are constantly reacting to crisis, unable to get out in front of problems.

“We’re in a situation where in many cases school psychologists are providing services to 1,500 [or] 3,000 students,” he said. “You ask what gets lost? That’s what gets lost: school psychologists’ focus on creating a school environment for all students where they feel safe and connected.”

School psychologists and counselors are not the sole sources of mental health support in school buildings. Teachers, principals, and even other students can help. There are also social workers and school nurses. But schools are facing shortages of people in those professions as well.

While the National Association of School Nurses no longer makes an official recommendation of the ideal ratio of school nurses to students, its president-elect, Kate King, said most schools do not have enough nurses.

“We know about 25 percent of schools have a full-time nurse and 25 percent have no nurse whatsoever,” said King. “About 50 percent have a part-time nurse. So, no, we don’t have enough school nurses. And every child deserves access to a school nurse all day every day.”

Nurses, she said, may be the first to realize a student is struggling. Mental health problems often present as physical ailments such as tummy aches, sleepiness, and panic attacks.

Money alone won’t fix the problem

The shortage of mental health staff in schools is getting a lot more attention—and money—from the federal government.

Schools can use money from federal COVID-19 relief aid to hire more school counselors and psychologists and other staff. And many have: Forty-two percent of schools said in a federal survey last September that they have hired new staff to help support students’ social, emotional, and mental well-being.

But the availability of extra federal money to hire more mental health support staff doesn’t always mean schools can.

The pipeline of school psychologists, for example, was struggling to keep up with demand even before the pandemic, said Rossen with NASP.

“The data show that while we are seeing increases in the number of applicants to school psych programs and graduates from programs, those increases are small and are largely outpaced by both demand and even in increasing enrollment in P-K-12 public schools,” he said.

The federal money is also temporary and may not be as much use to low-income districts that don’t have permanent funds to support mental health providers after it runs out.

In the meantime, just like they are for teachers and principals, the pandemic and the crush of students’ needs are taking a toll on school counselors and psychologists’ mental health, too.

Cannava, the school psychologist from Virginia, recalled a moment earlier this year: It was the very end of the school day when she heard a student’s voice at her door say, “Ms. Cannava?” She replied with a curt, “What?”

Cannava immediately felt awful. She composed herself, apologized to the student, and invited them into her office.

“But I realized this is too much,” said Cannava. “Twenty months into the pandemic I am tired. It’s not just me. School mental health staff in particular, when you’re dealing with emotional crisis frequently, it’s draining, and there is little time for self-care.”

Coverage of whole-child approaches to learning is supported in part by a grant from the Chan Zuckerberg Initiative, at www.chanzuckerberg.com. Education Week retains sole editorial control over the content of this coverage.

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