Jaden Brown remembers how easy it was to make friends before entering high school.
“I really enjoyed socializing and interacting,” recalled the now 22-year-old New York City resident, who attended the United Charter High School for Advanced Math and Science IV in Jamaica, Queens. “I was very open to chatting with people.”
However, the mental health challenges that Brown had suffered from intermittently since early adolescence — a result of both hereditary factors and relationships with classmates, he said, threatened to change all of that.
“I was struggling with depression and anxiety … since I was about eight years old,” he said. “It made it difficult for me to maintain strong interpersonal relationships.”
“[Depression] took away a lot of the things I found enjoyable in life,” he went on, describing how his illness affected him. “I couldn’t really see a future for myself.”
Brown said his depression became so visible that “teachers would come and check up on me because they saw that something was deeply impacting me.”
Brown credits his high school guidance counselor and teachers, and the school’s culture of mental health programming, which included mental health awareness rallies that encouraged students to be open and vulnerable about their feelings, with helping him find a way back to his former self.
“We were very close, so I felt whenever I was going through something, I could go speak to her,” he said of his counselor.
“[The school staff] helped me open up and return to the more social being I was,” said Brown, who graduated from Morehouse College last year and will enroll in a master’s program in clinical mental counseling at St. John’s University this fall.
For students like Brown, school-based mental health resources are an essential source of care — and a path to a brighter future. However, a lack of financial investment by the city and state hinders the delivery of mental health services and programming to all students in need.
Brown said the value of the care he received is immeasurable. “[The school staff] really encouraged me to want to be a better version of myself,” he said.
Mental health issues among youth have short- and long-term impacts
An estimated 20% of adolescents between the ages of 12 and 17 in the United States are reported to have a diagnosed mental or behavioral health condition, according to research published by the Department of Health and Human Services. Anxiety is the most common condition, followed by depression and behavioral conduct issues.
More than one-third of New York City youth between the ages of 14 and 24 report wanting or needing mental health services from a professional, but fewer than half report receiving services, according to a 2021 survey by the Citizens’ Committee for Children of New York.
Among high school students, nearly 40% of youth experienced persistent feelings of sadness or hopelessness in 2023, an increase of over 30% over the last decade, according to the latest data published by the Centers for Disease Control and Prevention. Nearly 10% of all students also reported attempting suicide, the data shows. In addition, Black high school students are 1.25 times more likely than white high school students to attempt suicide, according to data published by the Department of Justice in 2023.
“[There’s been] an uptick in a lot of mental health needs,” said Courteney Johnson, Ph.D., an assistant professor in the Division of Psychological and Educational Services at the Fordham Graduate School of Education.
Why does this matter?
Mental health issues are the leading cause of disability and poor life outcomes among young people, according to the World Health Organization. Poor employment performance and an increased risk of substance abuse are also associated with the development of mental and behavioral issues in youth, research shows.
Mental health challenges among adolescents are also a significant predictor of decreased levels of academic success, including on-time high school graduation rates. According to the latest data issued by the National Center for Education Statistics, 81% of Black public high school students graduate on time, compared to 90% of white public high school students. Mental health disorders in adolescents are also associated with decreased odds of graduating from high school, enrolling in college, and graduating from college, a study by researchers from the Johns Hopkins Bloomberg School of Public Health and Harvard Medical School found.
NYC school-based mental health programming is underfunded
In New York City, a lack of adequate funding also hampers the operations of school-based mental health programming. This includes School-Based Health Centers (SBHCs), which are overseen by the New York State Department of Health (NYS DOH) and New York City Department of Health and Mental Hygiene (NYC DOHMH), and provide a range of comprehensive wellness services to students, including mental health services.
Nearly a quarter of students who visited SBHCs in New York State during the 2024–2025 school year used mental health services, while more than 15% of students used both medical and mental health services, according to a report by the New York School-Based Health Foundation.
Of the city’s 137 SBHCs that serve approximately 150,000 students out of the more than 900,000 public school students in grades K–12 in the five boroughs, only 34 are currently funded by the city, according to government sources. This leaves the more than 100 remaining centers, which are sponsored by community-based health organizations, to rely on federal and state funding, as well as grants and reimbursements from Medicaid and other forms of insurance.
Adria Cruz, deputy director of health programs and integration at Children’s Aid, which operates two of the SBHCs that are among the few to receive funding from the city, views support from the city as vital to their ability to deliver comprehensive mental health services at the centers.
“The financial support … allows us to do that without running into a deficit or having to tap into other [programming] funds,” she said.
Between 2020 and 2025, five SBHCs closed due to funding issues, according to the New York City Council.
Children’s Aid is part of a coalition of organizations advocating for the city to provide additional budget support to all established SBHCs, a figure estimated by the New York City Council to be $18 million during the city’s 2026 fiscal year. However, despite calls for more funding, the city continues to fail to provide additional financial investments for SBHCs.
In response to an inquiry about the lack of additional funding support for SBHCs from the city, the NYC DOHMH responded with a written statement:
“The NYC Health Department is proud to support more than 130 school-based health centers serving over 143,000 students in 320 public schools across the five boroughs as part of our commitment to support the health of young New Yorkers. Each center offers accessible care at no cost in the places where students spend their time. This supports young New Yorkers’ health while easing the burden on families navigating the medical system or traveling for care.”
School-Based Mental Health Clinics (SBMHCs) are another form of mental health programming in New York City whose operations are hindered by a lack of funding investment.
SBMHCs function as outpatient child and adolescent mental health clinics, overseen by the New York State Office of Mental Health and operated by licensed community-based organizations or local hospitals. The operating agencies contract with schools to provide mental health services onsite through hiring mental health professionals and support staff.
SBMHCs and other models of school-based mental health programming commonly use a system of evidence-based interventions, known as the Multi-Tiered System of Supports (MTSS), to deliver behavioral health programming whose aim is to reach the entire school student population.
“[This] framework allows us to touch every single child, regardless of if they are outwardly projecting any type of behaviors or needs,” said Alicia Wilson, Ph.D., an assistant professor in the Department of Social Work at the City University of New York.
Irianna Munoz, a senior program director of school-based mental health at the Child Center of New York, which operates SBMHCs at 12 public high schools in Queens, noted how insufficient funding for SBMHCs can lessen the impact of the MTSS model. Because the first and second tiers of the model are essential to building a school environment that fosters openness to caring for one’s mental health and having a school-wide impact, a limited availability of funding for staffing at those levels, such as counselors and parent coordinators, can hinder this process, she explained.
In some sites, “mental health [resources are] available, but it’s in the room deep in the second floor,” said Munoz. “You might see the announcements, but there isn’t that active engagement where … there’s a presence [of resources for mental health] that everybody is aware [of] within the school building,” she said.
SBMHCs are primarily funded via a reimbursement model through which the operating agency receives payments from various forms of insurance, covering students who use the clinics’ services. These payments serve as a significant source of revenue for SBMHCs, covering non-billable program administrative costs, such as staff salaries.
Medicaid is the largest source of insurance coverage for children with behavioral health needs, according to the National Association of Medicaid Directors. Many of the mental health services provided in the top two tiers of the MTSS model, however, cannot be billed to Medicaid. This is primarily because, unlike in tier three services, where a licensed mental health provider can bill students’ insurance for individualized treatment services, universal and selective programming largely includes students who have not received a formal behavioral health diagnosis.
New York State is one of 22 states that have yet to expand their school Medicaid programs outside of an Individualized Education Program (IEP), a formal specialized education plan for students categorized as having learning disabilities. The expansion option has been available to states since 2014, when the Centers for Medicare and Medicaid reversed a prior policy that restricted states’ ability to bill Medicaid for school-based health services.
In response to an inquiry regarding the absence of a school Medicaid program expansion exclusive of an IEP in New York State, the New York State Department of Health responded with a written statement:
“The Department currently has a state plan amendment (SPA) related to the School Supportive Health Services Program pending approval from Centers for Medicare & Medicaid Services (CMS). Subsequently, it is our intention to submit a SPA to allow school districts to bill for mental health services for children without an Individualized Education Program (IEP), in accordance with a prior year budget action.”
A shortage of mental health staff in NYC schools
At M.S. 936 in Sunset Park, Brooklyn, Maya Tsekenis considers her office a protected environment where students can find refuge. Serving as the school’s only dedicated clinical social worker since 2021, Tsekenis provides clinical mental health therapy and counseling to the school’s student population of grades six through eight.
Nearly three-quarters of public schools do not meet the minimum staffing ratio of one social worker for every 250 students set by the National Association of Social Workers, according to a 2025 report published by the New York City comptroller. More than half of schools also lack adequate staffing for guidance counselors, the report found. An annual investment of $402 to $426 million would be required for the NYC DOE to ensure that the city’s public schools meet national staffing standards for clinical social workers and guidance counselors, the report estimated.
“Some students I see once a week … [while] other students I see five times a week because they just need to come in the morning to say hi …,” she said. “They have a safe base, and then from [there], they’re able to go back into their classes.”
Tsekenis, who has worked in New York City’s education system for 18 years, including as a high school-based social worker, views the relationships she builds with students, who may suffer from a range of mental health and behavioral challenges such as anxiety, depression, and eating disorders, as essential to creating positive change in their lives. That is part of why she works so hard to find creative ways to show up for them, she said, such as a student whom she connected and engaged with through volleyball — the student’s favorite sport — when “traditional talk therapy wasn’t really working for her.”
“We establish[ed] a rapport and trust, and three years later, she’s graduating with honors,” Tsekenis said. “This is a kid who was depressed and it was difficult for her to show up. She wanted to do the work, but she just couldn’t show up in that way.”
As the sole social worker in a school of nearly 450 students, as well as recording secretary of the Social Work and Psychologist Chapter of the United Federation of Teachers, Tsekenis is restricted in the amount of time she can spend on providing services to students over the course of the school year, she said. Typically after 10 weeks, she stops counseling sessions with students, after which she may refer them for further counseling to an outside therapist or the local community-based organization that provides a number of social services to the school.
“I have to discharge (them) and then move on, so that I can service as many kids as possible because I’m just one person,” she said.
Tsekenis’s limited ability to support the needs of all her students fully is a reflection of the shortage of clinical social workers and other mental health support staff, such as guidance counselors, employed in New York City public schools.
Tsekenis was one of 500 social workers hired by the New York City Department of Education in 2021 to bolster mental health support in schools in the aftermath of the trauma and social isolation caused by the onset of the COVID-19 pandemic. Although the initiative was implemented to allow that “every school has – at minimum – access to a social worker, guidance counselor or school-based mental health center,” a 2022 audit report by the New York State Comptroller found that the increased staffing levels would still not be sufficient to ensure the presence of a full-time on-site mental health professional in every school.
Despite the comptroller’s recommendation that the NYC DOE determine how to maintain adequate mental health staffing in schools, capacity issues continue to plague the city’s education system.
In response to an inquiry about the report’s finding of a lack of adequate staffing of social workers and guidance counselors in NYC public schools, the NYC DOE responded with a written statement:
“Ensuring that every child has access to a robust slate of mental health resources at New York City Public Schools is a top priority for our system. Across every borough, every student has access to a school counselor or social worker through school-based staff, shared staffing models, school-based mental health clinics, and partnerships with community-based organizations. In addition, students are supported by school psychologists, school nurses, and other trained professionals who work together to provide counseling, crisis intervention, and social-emotional supports.”
For social workers like Tsekenis, however, the addition of more mental health staff for the school would be invaluable, she said, enabling her to develop closer relationships with students throughout their full duration at the school.
“What I would do is the same way that hospitals have social work departments,” she said. “I feel like schools could have little social work departments where there’s a social worker per grade. [Then] I can really go in depth, and get to know the kids and their families, and follow them through the three years [of middle school] … [so] we’re able to cover more ground.”
The value of school-based mental health support
Ranging from school-based health centers and mental health clinics operated by community organizations to referral services for off-site therapy and counseling to provider teams of school social workers and psychologists, school-based mental health programming is shown to have a positive impact on students’ emotional and behavioral health.
Using school-based mental health services is associated with decreased levels of depression and anxiety in students, research shows. A school-based mental health initiative implemented in K–12 public schools in Minneapolis and surrounding communities resulted in a nearly 15% decrease in self-reported suicide attempts, according to a 2023 study led by researchers at the University of Minnesota.
Improvements in school behavior, including lower disciplinary rates and improved attendance, are also seen among students served by school-based mental health programs.
“We know that [school-based mental health programming] does have an impact,” said David Cipriano, Ph.D., associate professor of psychiatry at the Medical College of Wisconsin and lead author of a 2024 study that found higher testing scores among students who had access to school-based mental health programs. “If kids aren’t feeling good, they can’t show up and be fully present for learning. They can’t benefit fully from instruction.”
School-based mental health programs are also critical in reducing barriers to care, such as the need for parents or caregivers to transport children to medical settings.
“[We] are where the young people are,” said Sharon Hoover, Ph.D., a former school-based mental health clinician and now a professor emeritus in the Department of Psychiatry at the University of Maryland School of Medicine and former co-director of the National Center for School Mental Health. “[We’re] there in their daily environment … showing up to their basketball games and fashion shows and all the things that go along with a school environment.”
Today, nearly 97% of public schools nationwide provide at least one form of mental health services to students, according to a 2025 report published by KFF based on survey data from the United States Census Bureau and the United States Department of Education. This can include individual-based interventions such as counseling or therapy, group-based or family-based interventions, referrals to outside care, and universal mental health screenings for all students.
Despite the seeming prevalence of services, one-third of public schools indicate they are unable to effectively provide mental health services to all students in need, the report found. Inadequate funding and a shortage of mental health providers are cited as the most frequently reported barriers to the provision of services by public school administrators. The percentage of schools citing inadequate funding increased from 47% in 2021 to 56% in 2025, the report noted.
The system … “is crumbling from [the federal funding piece that doesn’t exist anymore], and we’re trying to plug in the holes,” said Prerna Arora, Ph.D., associate professor of psychology and education at Teachers College, Columbia University, of the funding structure of school-based mental health resources. “One piece gets removed, and it heightens how many [funding] issues there are.”
A better path to care
Child and adolescent health advocates admit that the many challenges standing in the way of building a robust, comprehensive school-based system of mental health care in New York City can often feel overwhelming.
Rohini Singh, director of the School Justice Project at Advocates for Children of New York, believes, though, that critical to the process is first evaluating the landscape of existing need among students and existing mental health resources among schools.
“The first step should really be a mapping and an understanding of what is and isn’t in place and where the gaps are and trying to address them,” she said, adding that development of a centralized system would also help track program outcomes and guide pathways for investments.
The absence of a centralized infrastructure system to document and assess mental health services and needs remains a critical weakness in the city’s school-based mental health system, according to the 2025 New York City Office of the Comptroller Report. This is despite similar critiques by the New York State Comptroller, as well as a commitment by the NYC DOE to adopt a digitized tracking platform by the 2025–2026 school year.
In response to an inquiry regarding a timeline for implementing the system, the NYC DOE responded with a written statement:
“NYCPS [New York City Public Schools] monitors student behavior in schools, including mental health needs. The Office of Safety and Prevention Partnerships collaborates with a range of partners, including the Office of School Mental Health, to ensure our students are receiving comprehensive supports.
“The Office of School Health is committed to serving the school community, and continues to explore ways to improve and innovate. We look forward to sharing updates when they are available.”
Scott Bloom, inaugural director of school mental health services at the NYC DOE from 2005 to 2021, agrees that the “fragmentation of systems” remains a significant obstacle in developing comprehensive school-based mental health programming, but he remains confident about the city’s ability to build better systems of care for its youth.
“I am hopeful that they do the right thing, and they listen,” he said. “They listen to the [kids and the parents]. They listen to the schools [and] what their struggles are, and they listen to the providers … I am hopeful, definitely hopeful.”
Jaden Brown, whose academic career was almost derailed by undiagnosed depression and anxiety, continued to find mental health help at Morehouse and through the Jed Foundation, and now is planning to pursue his Ph.D. so he can “open up safe spaces for youth and adolescents to be able to speak freely about [their] challenges whether it be depression, anxiety, bipolar disorders, PTSD, anything like that … [so they can] reshape their mindset and let them know ‘Hey, you can talk about this.’”
This story was produced with support from Type Investigations’ Springboard Project.
