Shalini Mustala, PPIC research associate, testified before the Assembly Select Committee on Youth Mental Health Treatment and Accessibility on June 10, 2026. Here are her prepared remarks.

Good morning. My name is Shalini Mustala, and I am a researcher at the Public Policy Institute of California, an independent, nonpartisan, nonprofit research institute dedicated to informing and improving public policy in California. Thank you for inviting me to testify about how teens are faring in terms of their mental health and investments in school-based mental health services.

Adolescence is a critical developmental period; because roughly half of all lifetime mental health conditions emerge by age 14, early identification and intervention are especially important. Rates of depressive symptoms and suicidality in teens have been rising since 2009 both nationwide and in California, and worsened during the COVID pandemic. Between 2022 and 2024, about three in ten children aged 12 to 17 in California reported experiencing symptoms of serious psychological distress; California also saw increases in teen suicide deaths and hospitalizations for self-harm. While teen suicide deaths returned to pre-pandemic levels in 2024, hospitalizations for self-harm remain elevated, indicating many young people continue to struggle.

PPIC analyzed responses to the California Healthy Kids Survey by students in grades 7, 9, and 11 from 2017–18 to 2023–24. We found that an average of 33% reported chronic sadness or hopelessness and 14.5% reported suicidal thoughts. Encouragingly, recent data shows statistically significant improvement. Between 2021–22 and 2023–24, the share of students reporting chronic sadness declined from about 35% percent to 28%, while the share reporting suicidal thoughts fell from about 15% to 11%. These declines suggest that the pandemic’s effects on youth mental health may be easing. However, these levels indicate an ongoing need for mental health support.

Girls report substantially worse mental health than boys; this gender gap emerges early in middle school and persists throughout high school. Teens of color—especially Native Hawaiian/Pacific Islander and multiracial students—report higher levels of distress than their white peers. When we looked at school characteristics, we found that teens in rural schools reported worse mental health than their non-rural peers, which is consistent with a broader body of research.

According to data from the California Health Interview Survey, more adolescents are receiving mental health services than in the past. Since 2019, about one in five California adolescents have reported receiving counseling or therapy during the previous year. However, many adolescents continue to face barriers to accessing these services, including provider shortages and low insurance reimbursement rates.

Because teens spend so much time at school, schools are an ideal setting for identifying mental health needs and connecting students to services. Our research suggests that teens strongly prefer talking to friends, family members, or other trusted adults (which could be in school settings) over formal counseling. For those who do receive mental health services, however, schools are a critical point of access: among students who reported getting help after experiencing a mental health need, about half got counseling or therapy at school.

In recent years, investments by California’s K–12 school districts in student health have been bolstered by an influx of state and federal pandemic recovery funds. Total district spending on health and mental health services increased by 75% between 2018–19 and 2023–24, supporting growth in staffing and the development of school-based resources.

We find that specific resources—including school-based health centers, wellness centers, and community schools—are associated with lower levels of suicidal thoughts in teens. While health expenditures increased across all school types, spending per student at rural school districts remained lower than suburban and city districts despite higher student need in rural schools.

Despite the expiration of pandemic funding and ongoing state budget constraints, California is continuing to support school-based mental health through initiatives such as community schools, the Multi-Payer Fee Schedule under the Children and Youth Behavioral Health Initiative and the Certified Wellness Coach program.

Ongoing evaluation of these investments will play an important role in refining strategies for effectively addressing student mental health needs. In addition, more comprehensive data on school mental health staffing could help target resources to schools with the greatest needs.