Rates of teen distress increased over the past decade and peaked during the pandemic, both nationally and in California. While the latest state data shows some signs of improvement, many still face significant gaps between the need for mental health care and receipt of services. At a recent event, PPIC researcher Shalini Mustala presented findings from a new report and led a panel discussion with co-authors Paulette Cha and Shannon McConville.

“Adolescence is a critical developmental period,” Mustala began. “Roughly half of all lifetime mental health conditions emerge by age 14, so early identification and intervention are important.” She shared that during and after the pandemic, California school districts used some temporary federal and state relief funds on student health and mental health, mostly for staffing. Between 2018–19 and 2023–24, total district spending on this rose by 75%—from about $934 million to $1.64 billion.

“Those one-time funds have expired,” Mustala said. “So sustaining these staffing gains may be challenging.” The state recently committed $8 billion in supports that include school-based mental health services. New programs of note are community schools grants and wellness centers, along with more established school-based health centers. Although these are currently a small subset of offerings and available mostly in high-poverty schools, teens in those schools report lower suicidal ideation.

“[Community schools and school wellness centers] are very far from randomly assigned investments,” Cha remarked. She explained that some have clearly been deployed to “places that have greatest need, that have high poverty, that are more urban.” While this is a good start, both Cha and Mustala pointed out that it leaves rural schools—whose teens report more distress than their urban/suburban peers—struggling. Despite higher needs, these districts still spend $150 less per student.

The Children and Youth Behavioral Initiative (CYBHI) has invested in improving school-based services. It also requires insurance companies to reimburse schools for qualified services. Cha reported that “wellness centers are really proliferating, along with wellness rooms and now [certified] wellness coaches.” These coaches can provide insurance-qualified behavioral health services—helping to fill gaps in districts where registered clinicians are scarce. Moreover, McConville stressed how important it is to “create more steady [funding] streams through insurance reimbursement.”

The good news is that the period between 2021–22 and 2023–24 saw declining reports of chronic sadness (35% to 28%) and suicidal thoughts (15% to 11%). Mustala said the decrease could reflect post-pandemic stabilization. Nonetheless, all three authors agreed that the overall level of teen distress in California is still high, and districts need help to sustain and build on their improved supports.

To this end, they recommended identifying stable funding streams to maintain expanded staffing and services, helping schools implement billing systems and insurance reimbursement processes, exploring telehealth for rural districts, building systems with current school-level data to accurately target funding, and evaluating CYBHI investments regularly to refine strategies over time.

As Cha pointed out, “Community schools grants, school-based health clinics, wellness centers, wellness rooms, and wellness coaches can’t help teens unless they are funded.”