Indicator: Access to health, mental health, and social supports
Definition
Individuals have access to health, mental health, and social services provided by educational institutions and employers.
RECOMMENDED METRIC(S)
Pre-K: Percentage of programs offering health, mental health, and social services, or staff or consultants providing infant and early childhood mental health consultation (IECMHC) services
K–12: Ratio of number of students to number of health, mental health, and social services full-time equivalent (FTE) staff (for example, school nurses, psychologists, and social workers)
Postsecondary: Ratio of number of students to number of health, mental health, and social services FTE staff (for example, school nurses, psychologists, and social workers)
Type(s) of Data Needed
Administrative data; survey dataWhy it matters
Schools can be a critical source of support for students’ physical, mental, and social-emotional health. For example, three out of four students who ever access mental health services do so through their school. Schools that provide access to nurses, school psychologists, and social workers tend to see improved learning outcomes, school climate, and student well-being. For example, schools with higher nurse-to-student ratios appear to improve attendance by preventing unnecessary release from school. Yet health programs and services are distributed inequitably—that is, schools that serve higher shares of students from low-income households and students of color tend to have fewer and lower-quality resources available. Following the COVID-19 pandemic, the need for mental health and social supports has grown. For example, in recent national surveys, 14 percent of teens and 40 percent of college students reported feeling depression. Data from several employer surveys also show that behavioral health is increasingly important to workers in the wake of the pandemic.
What to know about measurement
Standardized measurement of this indicator is likely to vary across sectors. In the K–12 and postsecondary sectors, the number of FTE staff in various student support roles can be measured consistently using administrative data. For example, the U.S. Department of Education’s National Teacher and Principal Survey collects data on the number of FTE nurses, psychologists, and social workers among a sample of schools. In pre-K, metrics to measure access to services are still evolving, and access to on-site staff may vary according to program size. Some early childhood education programs have early childhood mental health specialists who work with children and teachers; to measure this feature, we propose assessing the availability of early childhood mental health consultation (ECMHC) services. In workplace settings, we recommend that employers report information on their benefits programs—for example, through the Kaiser Family Foundation Employer Health Benefits Survey, which asks about mental and behavioral health benefits and wellness programs.
E-W Case Studies
Source frameworks
Nine source frameworks reviewed for this report emphasized the need for access to health and mental health services throughout the E-W continuum. Our metric for pre-K draws from the National for Children in Poverty’s State Indicators for Early Childhood. The recommendation to measure the ratio of students to health professionals in K–12 and postsecondary aligns with work by StriveTogether and the National Education Association. We expanded the definition and measures to include employer health and mental health services to align with current workplace best practices.
References
The framework's recommendations are based on syntheses of existing research. Please see the framework report for a list of works cited.