Adapting to Youth Mental Health Needs in Rural Schools: Lessons from NYKids’ Latest Study

Youth mental health is a top concern for educators and policymakers as the last two decades have seen a rise in youths’ mental health struggles. Scholars have identified youth social media engagement, social isolation during the COVID-19 pandemic, and the concerning number of young people growing up in poverty as factors which have negatively affected youth wellbeing. Beyond the multitude of negative impacts mental health challenges can create or exacerbate, youth mental health struggles are also associated with declines in academic performance. 

In this blog, we focus on the challenges rural schools face in addressing students’ mental health needs. We draw on data from mental health professionals working in 6 rural schools that participated in our latest study of Emergent and Persistent Positive Outliers to share challenges and adaptations educators in these schools have used to meet youth mental health needs.  

Rural Schools and Mental Health 

Although schools are looked to as viable centers for delivering critical mental health support services to youth and their families, not all schools and their systems of support offer sufficient capacities to meet the mental health needs of those they serve.  

As research has shown, youth in rural regions are less likely to receive the mental health care they need in comparison to their urban peers. While rural schools are diverse in size, configuration, and local ecology, high rates of poverty and widely dispersed populations pose unique challenges to delivering mental health services.  

Other major hinderances for youth accessing mental health care in rural regions may include negative beliefs associated with mental health and care providers; disparities in access due to limited transportation; and limited understanding or awareness in identifying mental health issues among family members.  

As the research is bearing out, in rural schools, a lack of student support services personnel (i.e., mental health care professionals) and professional training among other staff who interact with youth regularly (e.g., classroom teachers, food service and transportation staff) can prevent adequate identification for and application of counseling services. 

Lastly, at the regional level, scarce mental health resources may impede school mental health professionals’ abilities to connect youth with appropriate and needed out-of-district programs. 

Lessons from NYKids’ Research on Addressing Rural Youth Mental Health Needs 

Our findings come from NYKids’ latest study of Emergent and Persistent Positive Outlier schools. These schools were included in this study because they are either a persistent positive outlier (demonstrated above-predicted graduation rates consistently since the last time NYKids studied them) or an emergent positive outlier (have risen to positive outlier status since our last study when they were identified as “typically-performing” in terms of graduation rates).  

This blog focuses on the experiences of 16 staff members who provide mental/behavioral health counseling services to students (e.g., psychologists, social workers, counselors, school nurses) in 6 of the positive outlier schools in the study that are located in rural contexts.

“A Giant Influx”: Challenges Faced by Mental Health Professionals  

• Growing Needs: Mental health professionals noted the growing needs of students in their schools especially in the context of the COVID-19 pandemic and the widening gap between these needs and the capacity to meet them given the resources at their disposal. As a school psychologist put it, “I would say, during and after COVID, there was a giant influx of those students that were just walking in and needing the support on a daily basis.” A social worker reiterated a similar sentiment, noting “[T]here’s an increase of students in crisis… we’re trying to balance everything and do our best to get everybody’s needs met.”  

• Paucity of Resources: Several mental health professionals noted the paucity of resources available to them in the school as well as the wider community. A school psychologist described a lack of “manpower” of mental health supports for students in the surrounding area. “Now, counseling is everything… but we are the ones providing that service. There is certainly a lack of available resources,” one staff member explained. A school psychologist described the challenges to referring students to outside services, “[The] waitlists are astronomical right now.” 

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  Take-aways on Challenges: A convergence of raised demand and lowered capacity was a prevalent theme across the schools in this study. Like other rural school districts across the country have experienced staff shortages, mental health professionals experience the difficulties of not having enough staff to meet students’ needs. As one counselor in this study put it, “We had lost a school psychologist, and so we had all these students coming back from COVID… We were really struggling to support all of our students.” 

“Wearing Many Hats” and Marshalling Resources: Adaptations to these challenges  

• Expanding Roles: Mental health professionals in these rural contexts utilized several adaptations to meet the needs of their students even amid the challenging contexts described above. First, these staff recognized the need to expand their roles given the growing needs of their students and the lack of additional resources available to them. For instance, several staff members described “wearing many hats” as they performed duties outside their defined role such as developing and delivering social-emotional learning (SEL) curricula in an effort to provide preventative services to all students. As one psychologist said, “[T]here’s a lot more focus on mental health and socio-emotional learning and trying to sort of teach the whole child and knowing that… it can impact how are kids doing.”  

• Marshalling Outside Resources: Despite the challenge of marshalling countywide resources, several mental health professionals explained how their schools utilized grant funds which allowed them to provide additional mental health staff for students as frequently as possible. In some cases, schools were able to bring in an additional counselor from county organizations using COVID relief money to bolster their network of support. 

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  Take-aways on Adaptations: The participants in this study described collaborating with colleagues to facilitate changes in the school culture which emphasized the need for all adults to address students’ mental health. Many felt that the pandemic refocused educators’ attention on students’ mental health needs which existed prior to the pandemic but had become a higher priority. As a counselor explained, “I think student needs are being put on the forefront. I think that there’s been a shift in the culture of school that allows for student needs to be a priority instead of just focusing on academics.” 

How Do We Better Address Rural Youth Mental Health Needs? 

The answer to this question is, at least, two-fold: First, there is a need to recognize the problems and what their root causes are. While NYKids study findings are limited to a small number of schools, patterns nonetheless did emerge regarding root causes to some of the major problems regarding mental health services. On this point, in every rural school in our study, educators spoke to the challenges of a mismatch. This mismatch is between 1) growing mental health needs, in both number and severity, in part related to rising mental health challenges among parents and caregivers as well as youth due to pandemic-related social isolation or rising poverty;  and 2) educators’ internal/school-level capacity to meet the needs in part due to declining enrollments and/or staffing cuts.  

The second part of the answer to the above question is about solutions: Our research shows that mental health professionals in rural communities utilized various adaptations including expanding their roles as whole-school advocates and guides in supporting youth well-being and marshalling resources from outside of the school. Marshalling resources, importantly, is not just up to mental health professionals. Instead in the schools in this study a host of stakeholders including school and district leaders, community-based mental health service providers, BOCES leaders, and others work hand in hand to innovate around ways to address needs as they come.  

Our study illustrates the need for additional resources in rural schools and points to several implications for policy. These include: 1) providing more support on a regional level to connect community-based organizations and mental health providers to schools and 2) enhance incentives to recruit and retain experienced mental health professionals in rural communities. These efforts hold promise for advancing the mental health support system such that every child and youth has timely access to appropriate mental health services.  

As always, thank you for your interest in NYKids’ research. Full case studies from our latest study are available on our website and stay tuned for more to come in the next few weeks! Reach out to us at nykids@albany.edu or follow us on X, Instagram, Facebook, and LinkedIn!