Do not underestimate school mental health

The Department of Education has announced that it is cleared to hire 10,000 school counselor associates, a government plantilla item newly mandated by Republic Act No. 12080, or the Basic Education Mental Health and Well-Being Promotion Act. This allows non-licensed college graduates with relevant degrees in psychology and guidance to assist licensed guidance counselors in public schools. The intention is to fast-track mental health support in schools, which are increasingly exposed to violence and mental health distress. Some, however, questioned why the agency is prioritizing the hiring of counselor associates over expediting the hiring of licensed school counselors, noting that such positions remain unfilled due to poor compensation and unclear career progression.

When it comes to addressing the gap between mental health needs and services, there is a tendency to adopt what I loosely call the “warm bodies” approach, where any person will do. Are there counselor shortages in public schools? Throw warm bodies in there.

Underlying this kind of thinking is a severe underestimation of mental health in general and of school mental health in particular. There seems to be an assumption that mental health services are simply about offering a listening ear. Because it does not require technical equipment, surgical tools, or prescribed substances, people think that providing a full, nonjudgmental presence in counseling is easy. They also tend to forget that counseling is a highly analytical and technical skill, requiring the ability to make sense of multiple layers of data in order to arrive at the most therapeutic response. There is also the necessity of the quick pivot, the capacity to be highly flexible and change the course of one’s interventions as needed, which can only be forged through experience.

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People might think that inpatient or hospital-based settings are the most challenging population to work with. They underestimate the complexity of schools, thinking that since the majority of the general population statistically do not meet criteria for psychiatric disorders, they must have less serious issues and require less professional help. I am writing to dispel this notion.

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Working in school-based mental health means working with children. Children are not simply little adults. Because of their evolving development, the way they experience and understand the world and the way they express themselves can differ significantly (and change rapidly!). Likewise, mental health professionals must develop the skill to meet child and adolescent clients where they are. This requires having mastery of development, including how individual differences and differential capacities impact not just how a child manages their emotions but also how they learn. For example, one can risk invalidating a child’s experience by unfairly comparing them to adult standards, such as when we overestimate their developmental capacity for inhibitory control (“He should know better than to do that”). Conversely, we can also risk underestimating their capacities, such as when they actually need more challenging and cognitively stimulating tasks to regain motivation, by generalizing issues as simply caused by stress.

Working in school-based mental health means working within a community. Compared to clinics, working in schools gives us access to both their parents and teachers, who greatly influence children’s mental health. We also get to see students in their natural environment, observe how they fare with their peers, and gain a deeper understanding of what they’re going through. We have the added firsthand experience, as employees of the school, of what it’s like to navigate the social and structural systems they face, such as their curriculum, school rules, and social hierarchy.

This, however, is double-edged: in such a setting, standalone interventions usually aren’t enough. As professionals, we cannot just write a written recommendation for their teachers and parents and hope for the best. Because we are part of the school milieu, we have the responsibility of following through. We do not just counsel students; we also negotiate actively and collaborate long-term with the adults in the student’s life. This means having the interpersonal savvy to advocate for the student’s well-being to school administrators. This also requires skills in joining with parents and families, so they can trust us enough to collaborate on changes needed in the home. Such skills tend to be honed with extensive training and experience.

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School mental health services require a deep bench of skills in order to adequately address the complexity of a child’s well-being, influenced greatly by their development and the social systems and structures that they are embedded in. As such, they require more care and expertise, not less.

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