Summary
The 2024 Boston Health Report provided extensive evidence demonstrating the significant increase among persistent sadness in Boston high school students from 2015 to 2021. Evidence showed an increase in mental health issues from 26.7% in 2015 to 43.9% in 2021, which led to Mayor Wu to set an initiative to combat the negative results through implementing millions of federal funds to provide training and mental health professionals in Boston’s high schools.
By: Thomas Haynes, JHBL Staffer
Introduction:
High school students across the United States currently require assistance with their mental health.[1] In the United States, 39.7% of high school students report feeling persistent sadness, that being a report of feeling sad or hopeless almost every day for two weeks or more in a row.[2] In contrast, 43.7% of Boston high school students report that they feel persistently sad.[3] The COVID-19 pandemic contributed to the significant increase in persistent sadness reported by students.[4] Legislators in Boston must address this growing and troubling trend by ensuring that schools provide students with adequate resources and support.[5]
Identifying and fixing one’s source of sadness proves difficult and is sometimes impossible; however, schools must provide resources to provide outlets for students struggling with their mental health.[6] Not all students have outlets such as friends or family members whom they can comfortably confide and seek help with their mental health needs.[7] Students who feel persistent sadness are in dire need of help that they likely will not receive if their school does not provide a social worker or behavioral specialist.[8]
Background:
To address the need for mental health resources in schools, in March 2024, Boston’s Mayor Michelle Wu, the Boston Public Health Commission (hereinafter BPHC), and Boston Public Schools (hereinafter BPS) introduced a $21 million fund aimed at providing mental health resources for high school students.[9] Out of the $21 million, $5.8 million is dedicated to “Project PROVIDE”, which will prepare 200 UMass students planning to become school counselors, school psychologists and social workers to provide mental health assistance to BPS students over the next five years.[10] The majority of the remaining funds will go toward placing more mental health professionals in BPS and training those already working in the school.[11] By implementing the initiatives, BPS will employ more diverse, highly qualified mental health staff while developing the skills of the current mental health professionals.[12] Additionally, to create more positive environments for BPS students, BPHC and BPS will engage in a pilot program, examining the manner in which policies address issues with trauma, disciplinary issues, racism, and other relevant factors.[13]
The 2024 Boston Health Report on mental health provided clear data on the need for assistance in BPS.[14] Since 2015, the percentage of students reporting persistent sadness has consistently increased.[15] Persistent sadness differs based on demographics, with the highest rates reported by LGBTQ+ individuals (66.6%) and females (47.3%).[16] Suicide related indicators from 2015 to 2021 demonstrate an increase in reports of feeling sad or hopeless for longer than two weeks, purposely hurting one self, considering suicide and planning suicide.[17] In 2023 BPS let go of seven psychologists, leaving twenty-five public schools with only part time mental health specialists.[18] The budget cuts that BPS made to staffing and other resources likely contributed to the increase in reported persistent sadness among students.[19]
Massachusetts law requires the presence of a children’s behavioral health research center within the Department of Mental Health, which is tasked with ensuring that providers of mental health services are highly skilled and trained.[20] Additionally, there is a requirement for health insurance benefits for mental health and substance disorders for individuals under the age of nineteen, ensuring youth get assistance despite any lack of healthcare.[21] In 2021, Massachusetts passed the Mental Health ABC Act 2.0: Addressing Barriers to Care, which requires the allocation of funding to create a tele-health behavioral pilot program within BPS, providing mental health resources when students cannot speak with a professional in person.[22]
Analysis:
States that implemented initiatives similar to those pursued by Mayor Wu are seeing extensive benefits.[23] For example, in Maryland in 2021, 36% of students reported persistent sadness.[24] Experts praise Maryland for the state’s discipline initiatives and annual reporting on discipline data.[25] Most notably, a majority of students in Maryland high schools reported the ability to speak to someone when needed.[26]
Additionally, Kansas State board of Education received recognition for the formation of the Kansas School Mental Health Advisory Council.[27] The council advises the Kansas State Board of Education on the mental health needs of students that remain unmet, coordinating with the legislature to effectively address issues to meet the needs of students.[28] New York and Virginia also received praise for requiring that all schools’ health education programs include lessons on mental health, providing mental health information and assistance to students who do not intentionally seek out assistance.[29]
Employing mental health specialists in high schools is a necessary step toward providing needed resources for adolescents.[30] Implementing mental health initiatives in schools is incredibly important due to the ability of these programs to reach a considerable number of youths, and improve health, education, and well-being.[31] In schools that provide mental health resources, there are improvements in classroom behavior, peer relationships and classroom engagement, all factors directly correlated with academic success in high school students.[32] Investing in hiring more mental health professionals, and providing more extensive training for current professionals displays immense benefits for students.[33]
The initiatives set forth by Mayor Wu to enact policies similar to those in Maryland place Boston on the right track to see positive results in mental health statistics.[34] To address the mental health struggles in the LGBTQ+ community, Wu’s policies direct $1 million toward training Behavioral Health Champions, who specifically serve youth of color and LGBTQ+ individuals.[35] Increasing funding for the training and hiring of mental health professionals is a positive start, but Boston should implement a council, similar to that in Kansas in order to ensure the initiatives put in place are having a positive impact.[36] In providing more mental health professionals to students, BPS will steer the younger generation onto the right path and encourage healthier ways of coping with mental health issues.[37] Schools are meant to be safe and supportive environments where students can develop key skills and connections.[38] With the assistance of Massachusetts regulations and funding initiatives such as those created by Mayor Wu, Boston is setting high school students up for success and well-being.[39]
Disclaimer: The views expressed in this blog are the views of the author alone and do not represent the views of JHBL or Suffolk University Law School.
Thomas Haynes is a second-year law student at Suffolk University Law School, with a general interest in transactional and business law. He earned a B.A. in Economics from the University of Rhode Island in 2023.
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[1] See Mental Health in Schools, Nat’l Alliance on Mental Illness, https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Mental-Health-in-Schools/ [https://perma.cc/C4N6-ZWTF] (last visited Oct. 16, 2024) (discussing importance of mental health initiatives in schools).
[2] See Jorge V. Verlenden et al., Mental Health and Suicide Risk Among High School Students and Protective Factors – Youth Risk Survey, United States, 2023, 73 Ctr. for Disease Control and Prevention 80 (Oct. 10, 2024) (displaying research based on high school mental health statistics in the United States). The question for determining persistent sadness was as follows: “During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?”. Id.
[3] See Bisola Ojikutu, Health of Boston 2024 Mental Health Report, Bos. Pub. Health Comm’n (2024), https://www.boston.gov/sites/default/files/file/2024/03/HOB_MentalHealth_2024.pdf [https://perma.cc/T2FK-SFG6].
[4] See Deidre McPhillips, ‘Youth in Crisis’: Mental Health of US High School Students Worsened During the Covid-19 Pandemic, CDC Survey Finds, CNN (Mar. 31, 2022), https://www.cnn.com/2022/03/31/health/mental-health-teens-worse-pandemic-wellness/index.html [https://perma.cc/ZU5Z-A5ZU].
[5] See $21 Million to Support Behavioral Health Services, Programming for Youth and Families, Bos. Pub. Health Comm’n (Mar. 20, 2024), https://www.boston.gov/news/21-million-support-behavioral-health-services-programming-youth-and-families [https://perma.cc/5UUX-EP26].
[6] See Raise the Bar: Mental Health and Wellbeing, U.S. Dep’t of Educ. (Sept. 19, 2024), https://www.ed.gov/about/ed-initiatives/raise-bar/raise-the-bar-mental-health-and-wellbeing [https://perma.cc/C4SF-JETB] (presenting importance of resources in high schools and positive results).
[7] See Verlenden et al., supra note 2, at 84 (analyzing connection between mental health and parental relationship). Findings from the report show that there are differences in household experiences, with an adult who monitors a child reporting lower persistent sadness. Id.
[8] See id. (discussing importance of mental health resources where students lack outlets in household and community).
[9] See $21 Million to Support Behavioral Health Services, Programming for Youth and Families, supra note 5.
[10] See Mayor Wu Announces $21 Million for Behavioral Health Services for Youth and Families, City of Bos. (Mar. 2024), https://www.bostonpublicschools.org/site/default.aspx? [https://perma.cc/HT33-9XYV] (describing allocation of funding for mental health resources).
[11] See id. (providing detailed description of funding allocation).
[12] See id. (illustrating benefits of funding for mental health resources in BPS).
[13] See id. (describing programs, initiatives, and benefits of funding for BPS students).
[14] See Ojikutu, supra note 3, at 4 (stating findings from Boston mental health study).
[15] See id. In 2017, the persistent sadness rate was 33.4%; in 2018, the rate was 35%; and in 2021, there was a significant increase to 43.9%. Id.at 16.
[16] See id. at 17. In comparison, males had a reported rate of 27% feeling persistent sadness. Id.
[17] See id. at 19 (providing statistics for each suicide related indicator each year from 2015 to 2021).
[18] See Kathy Wang, Mental Health Support for BPS Students has Shrunk Even as Need Remains High, GBH (Oct. 2, 2024), https://www.wgbh.org/news/education-news/2024-10-02/mental-health-support-for-bps-students-has-shrunk-even-as-need-remains-high [https://perma.cc/MMY7-TZ7Q].
[19] See id. (discussing effects of budget cuts in BPS). The budget cuts in BPS left many schools without resources for students, leaving many with no outlets to discuss their mental health issues. Id.
[20] See Mass. Gen. Laws ch. 19, § 23 (2008). The center shall conduct activities as the mental health commissioner directs to pursue the center’s primary goals. Id. Those activities could include collecting quarterly data from state agencies, researching best practices for identifying and treating mental health needs, evaluating the demand and cost of providing resources within Massachusetts and publishing annual progress reports. Id.
[21] See Mass. Gen. Laws ch.118E, § 81 (2022). Individuals under the age of nineteen shall be provided mental health and substance use disorder benefits for the diagnosis and necessary medical treatment of any behavioral health disorder. Id. The coverage and benefits are provided to individuals under nineteen on a non-discriminatory basis for the diagnosis and treatment of mental health disorders. Id. The benefits are to be provided for those in instances where the disorder substantially limits the functioning and social interactions of the adolescent. Id.
[22] See S. 2572, 192d Gen. Ct., 1st Sess. (Mass. 2021). Federal funding to support the reforming of mental health care is provided in Massachusetts to ensure that individuals are given the support they need. Id. The tele-health pilot provides mental health resources in instances where the students are not physically in school and can speak with the school’s mental health professional. Id.
[23] See Amy Shields, New Report Scores School Mental Health by State and Provides a Roadmap for a Hopeful Future, Well Being Trust (Feb. 16, 2022), https://wellbeingtrust.org/press-releases/new-report-scores-school-mental-health-by-state-and-provides-a-roadmap-for-a-hopeful-future/ [https://perma.cc/TCK9-37TB] (praising standout states taking positive steps in providing mental health resources). The report analyzed all fifty states in their review of policies to support school mental health resources. Id. The report reviews the steps taken by each state along with their policies surrounding mental health in high schools. Id. Findings of mental health issues within the United States caused the study to be conducted to ensure that all states are taking steps toward providing positive mental health resources. Id.
[24] See Mohammed Choudhury, Mental Health in Schools, Md. State Bd. of Educ. (Feb. 22, 2022), https://www.marylandpublicschools.org/stateboard/Documents/2022/0222/MentalHealthinSchoolsFebruary2022V2.pdf [https://perma.cc/8T9C-G72X] (reporting mental health statistics in Maryland public high schools). In 2022, a study was conducted in Maryland public schools to address the impact of the COVID-19 pandemic on high school students’ mental health. Id. The report also presented the programs that provide students with mental health resources in schools. Id.
[25] See Shields, supra note 23 (listing states that provide adequate mental health resources in schools); see also Md. Code Ann., Educ. § 7-306 (West 2021) (describing discipline and annual reporting initiatives required in Maryland). The statute requires the Maryland State Department of Education to submit a report detailing student discipline data, which includes a description of the restorative approaches the schools are taking and a review of the practices and policies in place within the state. Id.
[26] See Choudhury, supra note 24 (analyzing mental health statistics from Maryland public school students). Maryland students reported being able to seek help from those around them: 82% feel they can talk to a peer about their life, 73% feel they can share their feelings with an adult at home, and 77% were able to socialize virtually during the pandemic. Id.
[27] See Shields, supra note 23 (recognizing states that stood out in analyzing mental health resources). The report highlighted those states that were among those that stood out as models for positive change. Id.
[28] See Kansas School Mental Health Advisory Council, Kan. State Dep’t of Educ. (July 2017), https://www.ksde.org/Agency/Division-of-Learning-Services/Special-Education-and-Title-Services/Kansas-School-Mental-Health-Advisory-Council [https://perma.cc/J4ZA-8D8B].
[29] See Shields, supra note 23 (pointing out states that stand out with specific mental health programs implemented); see also N.Y. Educ. Law § 804 (Consol. 2019) (detailing health related lessons schools must provide to students). Schools must include the dimensions of mental health to enhance student understanding, attitudes, and behaviors that promote health, well-being, and human dignity. Id.
[30] See Ctr. for Disease Control and Prevention, U.S. Dep’t of Health & Human Servs., Promoting Mental Health and Well-Being in Sch.: An Action Guide for Sch. and Dist. Leaders 8 (2023).
[31] See id. (describing benefits of schools promoting mental health and well-being in students).
[32] See id. (analyzing importance of mental health in connection to academic success). Findings support that poor mental health hurts student’s academic success. Id. When properly addressed, the factors listed improve academic success by improving student’s mental health. Id.
[33] See id. at 18 (discussing benefits of implementation of positive mental health resources). Administrators must implement the programs and create guidelines for staff to follow to support mental health training. Id. In schools where the staff provides mindfulness education, the students see decreased anxiety and depressive symptoms and increased positive coping behaviors. Id.
[34] See Choudhury, supra note 24 (presenting mental health statistics and resources for Maryland public school students).
[35] See ARPA Workforce, Bos. Pub. Health Comm’n (Sept. 2024), https://www.boston.gov/sites/default/files/file/2024/09/ARPA%20Workforce%209.2024_1.pdf [https://perma.cc/B8CA-93VZ].
[36] See Shields, supra note 23 (providing praise to states that stand out in mental health initiatives). Similar to the council set up in Kansas, it would be beneficial for Boston to have a council tasked explicitly with presenting the unmet needs to the State Board. Id.
[37] See Ctr. for Disease Control and Prevention, Promoting Mental Health and Well-Being in Sch.: An Action Guide for Sch. and Dist. Leaders 8 (2023) (highlighting benefits of mental health resources for student’s futures).
[38] See id. at 9. Schools providing mental health resources benefit students by creating connections with caring adults and encouraging positive peer relationships. Id.
[39] See Shields, supra note 23 (discussing need for mental health resources in schools). Despite the significant number of students who experiencemental health issues, fewer than half of adolescents with a major depressive episode receive treatment. Id. One of the most effective ways to aid those students is by providing mental health resources within schools. Id. States can do this by creating programs and policies that provide adequate mental health resources within schools. Id.