At present, one in five children in Minnesota have a diagnosed mental or behavioral health condition, and close to half of them receive little or no care; most of them are from underserved communities with limited access to mental health services. The state’s long-standing mental health professional shortage doesn’t help, with 74 out of 87 counties in Minnesota regarded as mental health shortage areas by the federal government. As a result, school-aged children in need of mental services have to endure prolonged wait times to see a community mental health provider.
As an aspiring child and adolescent neuropsychiatrist and someone who lost a close friend to suicide as a consequence of an unresponsive student counseling service, I see a school-based mental health service model (SBMH) as the best solution to address this problem. An SBMH program will bring mental health services to students where they are, eliminating significant barriers to access.
A recent study led by professor Ezra Golberstein of the School of Public Health at the University of Minnesota shows that SBMH programs, when implemented, improve access to mental health services to students by 8% and reduces the attempted suicide rate by 15%. Not to mention, SBMH serves as a primary source of mental health services for children from underserved communities. Approximately 50% of children receiving school-based mental health services have never accessed mental health services in the past, with 45% of them having a significant mental health concern. Thus, given how effective an SBMH model is in improving students’ access to mental health, why isn’t it implemented in all schools in Minnesota?
The SBMH program receives significant funding from the federal and state governments. Yet many schools report significant challenges adopting it, pointing to provider shortage as a major obstacle. Some schools even report having unfilled vacancies for mental health providers. Minnesota ranks 10th in states with the most considerable shortage of mental health professionals.
The state currently has only 250 child and adolescent psychiatrists, which results in an approximate ratio of one psychiatrist to 1,000 youths with significant mental health concerns. The workforce shortage is even more pronounced in rural Minnesota, which has 27 child and adolescent psychiatrists — making access to comprehensive mental health services in rural Minnesota unattainable for most. But how can Minnesota address the long-standing mental health provider shortage?
The healthcare system historically responds well to financial incentives. Therefore, an upfront tuition scholarship program for aspiring mental health professionals would be very effective in developing a robust mental health workforce in Minnesota. Some states have even developed initiatives that offer full-ride scholarships to students accepted into a masters-level program for mental health professionals. Washington State’s Behavioral Health Workforce Development Initiative, which grants up to $51,000 scholarships to students accepted into a Master of Social Work program, has been pivotal in addressing the state’s long-standing mental health workforce shortage.
Minnesota has made laudable efforts to make education affordable for its residents; the recently passed North Star Scholarship Program makes college free for young adults from low-income families.
The government can look back on the success of previous higher education investments and confidently commit to funding a government-sponsored education program to train students who have demonstrated a strong commitment to becoming mental health professionals. By eliminating the financial barrier of an expensive clinical training program, qualified students from all walks of life can enroll in a mental health graduate program, thereby strengthening the number and diversity of providers in the state, which will facilitate tailored mental health services that meet the needs of each patient.
Key stakeholders have questioned the practicality of the SBMH model. Parents will argue that schools should be schools, school administrators will say that they lack the capacity and time to provide such services to their students, and community providers can make a case for the potential duplication of services.
All of these are rational arguments, but there is compelling evidence that an SBMH program, even when partially implemented, significantly improves students’ access to mental health services. Therefore, an SBMH model fortified with a solid mental health service workforce will help all scholars across the state build the mental resilience and well-being they need to excel academically and navigate the challenges of growing up.
Praise Emukah-Brown is a physician and a graduate student at the University of Minnesota School of Public Health.
