Challenges in school-based mental health service utilization: a qualitative study with school social workers

Rates of depression and anxiety among adolescents are particularly of growing concern, as they have been increasing over the last decade. The COVID-19 pandemic has led to a surge in mental health needs among adolescents, with leading pediatric health teams declaring a national emergency in adolescent mental health. Schools have become a primary access point for mental health services to cover the gap between need and service utilization that has long existed, particularly among vulnerable populations. This study aimed to explore student utilization of school-based mental health services from the perspective of school social workers. Primary data collected from focus groups with school social workers conducted in October 2022. The sample included school social workers in Virginia working in middle and/or high schools (N = 16). Braun and Clarke’s six steps were used to conduct thematic analysis. The primary themes were: a) awareness/understanding of the role of school social workers among school staff and administration, as well as students and families, b) mental health stigma, c) challenges in coordination of services, and c) perceived mental health needs among adolescent students. The current study reveals important information regarding barriers to school-based mental health service utilization from the perspective of school social workers. This study can support future efforts and interventions by schools and school-based mental health professionals to better collaborate and work together to ensure effective, sustainable, and culturally responsive services for their students.