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Do school counselors help with mental health

The School Counselor and Student Mental Health


(Adopted 2009, Revised 2015, 2020)

ASCA Position

School counselors recognize and respond to the need for mental health services that promote social/emotional wellness and development for all students. School counselors advocate for the mental health needs of all students by offering instruction that enhances awareness of mental health, appraisal and advisement addressing academic, career and social/emotional development; short-term counseling interventions; and referrals to community resources for long-term support.

The Rationale

Students’ unmet mental health needs can be a significant obstacle to student academic, career and social/emotional development and even compromise school safety. Even so, most students in need do not receive adequate mental health supports (Centers for Disease Control and Prevention [CDC], 2013). Research indicates 20% of students are in need of mental health services, yet only one out of five of these students receive the necessary services (Erford, 2019). Furthermore, students of color and those from families with low income are at greater risk for mental health needs but are even less likely to receive the appropriate services (Panigua, 2013) despite increased national attention to these inequities (Marrast, Himmelsteim & Woolhandler, 2016).

Of school-age children who receive any behavioral and/or mental health services, 70%–80% receive them at school (Atkins et al., 2010). Preventive school-based mental health and behavioral services are essential. Without planned intervention for students exhibiting early-warning signs, setbacks in academic, career and social/emotional development can result during later school years and even adulthood.

The ASCA Student Standards: Mindsets & Behaviors for Student Success (ASCA, 2021) identify and prioritize the specific attitudes, knowledge and skills students should be able to demonstrate as a result of a school counseling program. School counselors use the standards to assess student growth and development, guide the development of strategies and activities and create a program that helps students achieve to their highest potential. This includes offering instruction that enhances awareness of mental health and short-term counseling interventions designed to promote positive mental health and to remove barriers to success.

The School Counselor’s Role

School counselors focus their efforts on designing and implementing school counseling programs that promote academic, career and social/emotional success for all students. School counselors acknowledge they may be the only counseling professional available to students and their families. Thus, school counselors:

  • Deliver instruction that proactively enhances awareness of mental health; promotes positive, healthy behaviors; and seeks to remove the stigma associated with mental health issues
  • Provide students with appraisal and advisement addressing their academic, career and social/emotional needs
  • Recognize mental health warning signs including
    • changes in school performance and attendance
    • mood changes
    • complaints of illness before school
    • increased disciplinary problems at school
    • problems at home or with the family situation (e.g., stress, trauma, divorce, substance abuse, exposure to poverty conditions, domestic violence) 
    • communication from teachers about problems at school
    • dealing with existing mental health concerns
  • Provide short-term counseling and crisis intervention focused on mental health or situational concerns such as grief or difficult transitions
  • Provide referrals to school and community resources that treat mental health issues (suicidal ideation, violence, abuse and depression) with the intent of removing barriers to learning and helping the student return to the classroom
  • Educate teachers, administrators, families and community stakeholders about the mental health concerns of students, including recognition of the role environmental factors have in causing or exacerbating mental health issues, and provide resources and information
  • Advocate, collaborate and coordinate with school and community stakeholders to meet the needs of the whole child and to ensure students and their families have access to mental health services
  • Recognize and address barriers to accessing mental health services and the associated stigma, including cultural beliefs and linguistic impediments
  • Adhere to appropriate guidelines regarding confidentiality, the distinction between public and private information and consultation
  • Help identify and address students’ mental health issues while working within the:
    • ASCA Ethical Standards for School Counselors
    • ASCA Professional Standards & Competencies for School Counselors
    • National, state and local legislation, which guides school counselors’ informed decision-making and standardizes professional practice to protect both the student and school counselor
  • Seek to continually update their professional knowledge regarding the students’ social/emotional needs, including best practices in universal screening for mental health risk
  • Advocate for ethical use of valid and reliable universal screening instruments with concerns for cultural sensitivity and bias if state legislation or school board policy requires universal screening programs for mental health risk factors (ASCA, 2022)
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School counselors focus their efforts on designing and implementing school counseling programs that promote academic, career and social/emotional success for all students. School counselors acknowledge they may be the only counseling professional available to students and their families. Thus, school counselors:


Students’ unmet mental health needs pose barriers to learning and development. Because of school counselors’ training and position, they are uniquely qualified to provide instruction, appraisal and advisement and short-term counseling to students and referral services to students and their families. Although school counselors do not provide long-term mental health therapy in schools, they provide a school counseling program designed to meet the developmental needs of all students. As a component of this program, school counselors collaborate with other educators and community service providers to meet the needs of the whole child.


Adelman, H. S., & Taylor, L. (2015). Mental health in schools: Engaging learners, preventing problems, and improving schools. United States: Skyhorse Publishing

American School Counselor Association. (2022). ASCA Ethical standards for school counselors. Alexandria, VA: Author.

American School Counselor Association. (2021). ASCA Mindsets & behaviors for student success: K–12 college-, career- and life-readiness standards for every student. Alexandria, VA: Author.

American School Counselor Association. (2019). ASCA National Model: A framework for school counseling programs (4th ed.). Alexandria, VA: Author.

Atkins, M., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010). Toward the integration of education and mental health in schools. Administration and Policy in Mental Health, 37, 40–47.

Centers for Disease Control and Prevention (2013). Mental health surveillance among children – United States, 2005-2011. Retrieved from

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Counts, N., & Gionfriddo, P. (2016). Education, health and behavioral health: New policy priorities for their integration emerge for 2017, Health Affairs Blog, December 23, 2016. doi: 10.1377/hblog20161223.058080

Erford, B. T. (2019). Helping students with mental and emotional disorders. In B. T. Erford (ed.) Transforming the school counseling profession (5th ed.) (pp. 382-405). Upper Saddle River, NJ: Pearson.

Erickson, A., & Abel, N. R. (2013). A high school counselor’s leadership in providing school-wide screenings for depression and enhancing suicide awareness. Professional School Counseling, 16(5), 283-289. doi: 10.5330/psc.n.2013-16.283

Marrast, L., Himmelstein, D. U., & Woolhandler, S. (2016). Racial and ethnic disparities in mental health care for children and young adults: A national study. International Journal of Health Services, 46(4), 810-24. doi: 10.1177/0020731416662736

Panigua, F. A. (2013). Assessing and treating culturally diverse clients: A practical guide (3rd ed.). Thousand Oaks, CA: Sage.

The prevalence of mental illness in children has reached an all time high, and it’s a public health issue that up until recently has been widely ignored. According to the Centers for Disease Control and Prevention, ¹ an estimated 1 in 5 children are diagnosed with “mental disorders such as ADHD, Tourette syndrome, behavioral issues, mood and anxiety disorders, autism spectrum disorders, or substance abuse disorders.”

Left undiagnosed or untreated, children’s mental disorders can cause a number of problems both at home and in the classroom, affecting the way children learn, behave, and handle their emotions. Despite this, nearly 80 percent of adolescents who would benefit from mental health treatment do not receive it, and this disproportionately affects children of color and the uninsured.²

This gap in treatment for students can be explained by a number of factors. Counselors, parents, and teachers are constantly battling with challenges that include mental health stigma, budget constraints, inadequate insurance coverage, and availability of mental health services in the community.³

For students who do receive a diagnosis, schools are often the first providers of mental health resources. 4

The Role of the School Counselor

Throughout the week, many students spend more time in the classroom than they spend with their parents. As such, teachers, counselors, and other school staff are among the first to notice concerning changes in behavior that could signal a mental or behavioral health issue.
While teachers arguably spend the most time with their students, a study by the research journal School Psychology Quarterly found that a mere 34 percent of teachers surveyed felt that they had the skills needed to identify mental health issues in students and find resources for students with mental health conditions. 5

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As such, school counselors become a crucial part of the education team, collaborating with teachers, administrators, parents, and social workers to ensure that each student receives the care and resources necessary to succeed in their academic and personal lives. 6
School counselors allocate much of their focus to designing and implementing programs which promote the academic and personal success for all of their students. These responsibilities include:

  • Enhancing the awareness of mental health in their schools, and aiming to remove shame and stigma
  • Provide external referrals, which may include short-term counseling or crisis intervention
  • Recognize and respond to warning signs, such as sudden changes in grades or attendance, disciplinary problems, or visible problems at home
  • Provide individual focus to students about issues surrounding their mental health, academic well being, and social and emotional needs
  • Provide resources and support for teachers, administrators, and parents 7


Barriers to Mental Health Treatment

Counselors are a vital part of the educational team, and in an ideal world, children would have adequate access to school counselors. But when districts are confronted with budget cuts, counselors are often among the first to be laid off.

As it stands, the national student-to-counselor ratio is much higher than the average 250-1 ratio recommended by the American School Counselors Association. 8 At some schools, the student-to-counselor ratio is as high as 781:1. 9

Additionally, counselors must also operate based on the mental health services readily available in their communities, and not all communities are equally prepared to handle mental health concerns.

When left unmet, students mental health needs can pose serious barriers to social and educational development. Counselors are a necessary part of an educational staff, as they have the unique qualifications required to provide education, intervention, and referral services to children, parents, and teachers. Although school counselors typically do not act as long-term therapists, they help foster an environment where mental health stigma is erased, help bridge the gap between student and community resources, and make sure the developmental needs of all students are met.

Students who obtain their Master’s Degree in Counseling from Wake Forest University Online enter the field prepared to help students, parents, and teachers manage student mental health.



Centers for Disease Control and Prevention, Children’s Mental Health

National Library of Medicine, Unmet Need for Mental Health Care Among U.S. Children: Variation by Ethnicity and Insurance Status

Education Week, Including Teachers in the Student Mental-Health Continuum

Digital Commons, How Schools Can Support Students with Mental Illness 

Ed Source, New Push for Mental Health Training for Teachers and Principals

MN 2020, Don’t Forget School Counselors in Mental Health Debate

School Counselor,The School Counselor and Student Mental Health 

American Counseling Association, United States Student-to-Counselor Ratios for Elementary and Secondary Schools