Overcoming the Challenges of Funding School Mental Health Programs

One of the largest obstacles to the delivery of expanded school mental health (esmh) services is developing and sustaining funding sources. The school mental health approach to care integrates mental health, education, and in some cases other systems such as health, social services, and juvenile justice. With the involvement of multiple systems and disciplines, the problematic question becomes which agency or organization is responsible for payment. No one payer can realistically take on all of the responsibility, leaving many esmh programs to creatively meet fiscal challenges and repeatedly come up with solutions to the next fiscal crisis

The fiscal solutions that have been developed to support esmh programs are extremely diverse and constantly evolving. Knowing that funding opportunities change quickly over time, it is a challenge to provide useful and current information. Furthermore, fiscal opportunities vary greatly between communities and states, complicating an attempt to provide a useful snapshot of the financial issues that impact expanded school mental health. This chapter consolidates some of the financial aspects behind school mental health programs and provides an overview of the complexity of the issue. The chapter concludes with the stories of three esmh programs that have successfully maintained funding over the years and describes their funding successes and failures

There are two important caveats to this chapter. First, while there are many school mental health programs funded by schools and systems of education, these are not within the purview of the chapter. Instead, this chapter addresses programs that receive grant, contractual, fee-for-service, or other forms of revenue to sustain operations. Second, most of the literature on funding is specific to school-based health centers (SBHCS) and these may or may not include mental health services. In fact, only about 60% of sbhcs have mental health professionals on staff (Center for Health and Health Care in Schools (CHHCS), 2001a). Furthermore, there are many esmh services that are not connected to sbhcs. Therefore, our literature review depends heavily on articles on mental health programs developed within sbhcs, and we acknowledge that this does not capture the full range of issues related to school mental health funding