School Counselors and Children's Mental Health - Project Summary
A national child and adolescent mental health emergency was declared in fall 2021 amid rising mental health
challenges. Approximately one in six children have a professionally diagnosed mental health disorder, which
can lead to increased risk of suicide, worse health outcomes later in adulthood, and worse performance in
school. However, approximately half of children with mental health disorders do not receive treatment, and
Black, Hispanic, and low-income children, are less likely to receive mental health care than their peers. Schools
are one of the main places children readily access health services, including mental health care, and school
mental health services are often provided by licensed school counselors. Recently, there has been a push to
increase mental health services in schools and access to school counselors in particular. The proposed study
will examine one of the largest policies to increase funding for and access to school counselors in middle and
high schools. Specifically, we will study how California’s 2006 Supplemental School Counseling Program
(SSCP) impacted children’s access to school counselors, self-reported mental health outcomes, and related
health and well-being outcomes. The SSCP provided middle and high schools with funds to hire more certified
counselors, with funding levels that varied based on school sizes. We are not aware of any study that has
examined the causal impacts of this large-scale policy on the mental health and related health outcomes of
California students, or any related research examining the causal effects of a counseling policy of this scope on
children’s health. We will leverage variation in funding levels over time and across schools in a simulated
instruments and event study model to estimate the causal impacts of additional counselors hired through the
SSCP on health outcomes. Using administrative education data on schools, students, and personnel from the
California Department of Education, and self-reported measures of mental health, healthy behaviors, and
health outcomes from the California Healthy Kids Survey, we will 1) document how expanded funding for
school counselors impacted students’ access to counseling, including the number of counselors hired and their
education, experience, and demographics, 2) estimate the causal impact of expanded access to school
counselors on students’ health, including mental health, healthy behaviors, and well-being, and 3) examine
how access to school counselors and their impacts on children’s health vary by urbanicity, family income,
student race/ethnicity, and age. This research will provide evidence on how expanding access to school
counselors may improve children’s mental health and how to effectively design related policies so that they
impact the children most in need of these services. This is particularly important right now as places consider
whether and how to use COVID relief funding to hire more counselors, and people seek ways to address the
current national child and adolescent mental health emergency.