How to get mental health help in NYC public schools

This is part of an ongoing collaborative series between ChalkbeatTHE CITY, and ProPublica investigating learning differences, special education, and other education challenges in city schools.

As the pandemic upended our understanding of education’s role in society, one point became remarkably clear: schools are the first line of defense for student mental health support.

But what isn’t always apparent is what help is available to the city’s nearly 900,000 public school students  — and how outcomes can vary depending on the resources schools provide.

Chalkbeat and THE CITY, along with ProPublica, have been examining how public schools are a de facto mental health system for many families. To help explain what services are available school-by-school, we tracked dozens of data points related to mental health resources, and talked to families, educators, and experts about navigating the system.

All of New York City’s roughly 1,600 public schools, at a minimum, have access to a social worker or school-based mental health clinic, officials say, and the city will soon offer teletherapy for high school students.

But many families say getting services can be a battle, especially as mental health needs mount. One in five New York City children ages 3 to 13 had one or more mental, emotional, developmental or behavioral problems in 2021, according to unpublished data from a city health department survey.

“It’s a crisis,” said Brittany Kaiser, an art teacher at Manhattan’s Earth School, who says she and her colleagues need more support as they’ve noticed their pre-K through fifth-graders’ behavioral issues worsening.

That picture seems consistent throughout New York City. More than 1 in 200 New York City children lost a caregiver to COVID, an analysis from the COVID Collaborative found. Many young people are still reeling from prolonged isolation and lost schooling. The threat of gun violence, climate change, racism, and poverty weigh heavily on many kids. On top of that, thousands of children from asylum-seeking families are arriving at city schools with significant needs.

These challenges affect what happens in the classroom — and whether kids show up at all. Chronic absenteeism, when students miss at least 10% of school, remains much higher than pre-pandemic levels. Crippling anxiety leading to school refusal — when kids have an extreme aversion to attending class — seems to be on the upswing, parents say.

“We’re really looking for resources and support,” said Rasheedah Brown-Harris, a leader with the Bronx’s New Settlement Apartments Parent Action Committee whose Healing-Centered Schools Working Group is pushing for school-wide trauma-informed approaches. “We’re all trying to figure it out.”

Here’s what to know about getting your child school-based mental health support.

Start with the people who know your child best, whether that’s a classroom teacher or other trusted adult in the school. Parents can also reach out to a counselor or social worker at the school, an assistant principal or principal, or the parent coordinator. Every school has a counseling plan with contact information on its education department homepage under the “reports” tab.

School staff may also flag children with significant emotional needs — just as when children have academic needs — but it can take time. In such cases, a school might deem a child “at risk” andt provide short-term counseling as part of a process called “response to intervention,” or RTI.

Schools, though, don’t get extra funding for at-risk students, and they triage based on need. So getting services can feel like an uphill battle, parents say.

“The process can look very different for different students, and can require significant time, individual attention, and resources, and the fair student funding formula doesn’t take this into account,” said Kaiser.

Often it can come down to whether a counselor or social worker has openings — and many have been working through their lunch periods to meet the increased demand, educators said.

Fourth grade teacher Miriam Sicherman, at the Manhattan’s Children’s Workshop School, was able to get counseling earlier this school year for one of her students who witnessed neighborhood violence. But Sicherman isn’t sure the process would have been as easy a few months later, after her school received nearly 60 children, largely from asylum-seeking families who experienced some form of trauma.

Receiving temporary, at-risk services could be a first step while a family begins the evaluation process for an Individualized Education Program, or IEP, mandating services, such as counseling.

Children with anxiety, depression, or other mental health challenges could be eligible for an IEP under the “emotional disability” classification. The state recently changed the label of that classification from “emotional disturbance” to reduce the stigma of the classification, which overwhelmingly is assigned to boys of color. Three-quarters of those with the label were boys; nearly half (47%) were Black even though Black students make up less than a quarter of students citywide, according to city data from November 2022.

Anxiety or other mental health issues might also qualify a student for a 504 plan, which under the Americans with Disabilities Act provides accommodations for children with disabilities or impairments that substantially limits a major life activity.

For example, a child with major depression who has trouble getting out of bed might not need an IEP for a special education teacher, but could benefit from a 504 plan with accommodations such as counseling, partial credit, reduced workloads, or movement breaks, explained civil rights attorney Miriam Nunberg.

However, schools don’t get extra funding for students with 504 plans, so they might make families jump through hoops to get them. They often put the onus on families to get outside evaluations to qualify rather than do school-based ones, and they often make families renew 504 plans on an annual basis.

“That’s not supposed to happen,” Nunberg said.

Social workers are trained to provide more intensive student support from a clinical perspective in terms of prevention and treatment than counselors. But at some schools, social workers don’t work directly with children, and instead work on initial IEP evaluations by conducting social histories and classroom observations.

Some guidance counselors support at-risk and students with IEPs in one-on-one or small groups, but they also focus on students’ academic progress, including helping on applications for middle school, high school and college.

“Their objective, fairly universally, is to see that a child progresses through the school,” said Kevin Dahill-Fuchel, executive director of Counseling in Schools, which provides counseling services at roughly 70 schools across the city.

National guidance recommends one counselor and one social worker for every 250 students in a school. When students have more intensive needs, the preferred ratio is 1 to 50.

Systemwide, there are roughly 5,000 social workers and guidance counselors, an increase of 1,000 since 2014, education department officials said. Still, the citywide average is 277 students to one counselor and 456 students to one social worker, according to an analysis of public data.

The role of counselors and social workers can look different school to school, and some of these staffers are part-time, traveling to different schools. That means they might not be around on the day a child has a crisis.

Some social workers say their schools pull them away from counseling.

“I am ordered to fill in the gaps, from wake-up calls to data entry to disciplining students for dress code violations,” one social worker wrote in a Chalkbeat essay. “I’ve had to cancel counseling sessions to stand by metal detectors that children are required to go through, to monitor the hallways, or to ‘watch’ a group of suspended students.”

Nearly 390 schools have on-site health clinics that often include mental health services that are more robust than schools typically provide.

Another 330 schools have on-site mental health clinics, and the city is developing a $9 million telehealth program for high school students, a model becoming more common across the nation. (The school-based mental health clinics charge fees, but they take health insurance, Medicaid or offer a sliding scale for billing.)

There are also 421 “community schools” that partner with community-based organizations that often offer free counseling or connect students to services. (These counselors don’t factor into the student-to-counselor ratios.)

Very few schools, however,  are able to provide long-term therapy, said Dr. Kelly Fradin, a pediatrician who worked in school health in the South Bronx and author of “Advanced Parenting: Advice for Helping Kids Through Diagnoses, Differences, and Mental Health Challenges.”

“What the schools are able to, or what I’d like them to be able to reliably provide, is to triage and bridge children to support…. To help families as partners, and say to the parents, ‘Is your child struggling with their mental health? Would they benefit from more resources?’”

School counselors play crucial roles responding to children in crisis, but also connect them to the right people outside of school, especially if a child is feeling suicidal, having restricted eating or possible anorexia, or experienced a trauma such as the loss of a parent.

But quickly getting outside services is not always feasible, as parents report long waitlists for therapists.

Other data points that could indicate how supportive a school environment might include “child in crisis” incidents (when schools call on police officers and EMTs to respond to students in emotional distress), as well as suspensions, which can be found in annual education department reports. In both of these cases, Black students and children with disabilities are disproportionately affected.

Changes to the discipline code during the de Blasio administration have curtailed the use of suspensions. But some educators say they need more training in alternative approaches, like restorative justice, which gives students space to talk through conflicts instead of more punitive discipline.

Some schools have restorative justice coordinators to help shift their culture toward this model. More recently, the city has looked to partnering schools with violence interrupters and mentors through its “project pivot” initiative.

Other factors can affect kids’ emotional wellbeing, like class size, school start times, access to outdoor space and gym, and whether a child is in an appropriate classroom setting, experts say.

“We know that when a child is not in the right learning environment, whether they’re too gifted for the class or struggling to keep up, they have more problems with self regulation and emotional regulation,” said Fradin.

If a school is refusing to give services mandated on an IEP or making it difficult to get or implement a 504 plan, parents can file a complaint with the U.S. Department of Education’s Office of Civil Rights, Nunberg said. Though, she acknowledged that can be a slow process.

Parents can call their district superintendent’s office for help and speak with a student services manager, advised Jenn Choi, who channeled her parent advocacy into Special Support Services, a consulting firm for families of students with disabilities. These staffers student registration and transfers as well as act as liaisons between schools and students in hospital, homeschool, or other special situations, among other duties.

Some families have transferred out of schools to find more supportive environments, but the Office of Enrollment does not necessarily make it easy to do that, Choi said.

The education department lists something called a “guidance transfer” for families with concerns that their children are not “progressing or achieving academically or socially.” Parents have to contact the Family Welcome Center for such requests.

Families can also apply to new schools during the regular application season. For example, there might be openings for rising 10th graders at certain high schools as enrollment is often in flux. Additionally, the city runs nearly 60 alternative high schools, known as transfer schools, which focus on students who struggled to succeed at traditional high schools and are at risk of dropping out. They often offer individual support, small classes, and wraparound services to push students to graduation.

Amy Zimmer is the bureau chief for Chalkbeat New York. Contact Amy at azimmer@chalkbeat.org.

Chalkbeat is a nonprofit news site covering educational change in public schools.