September 2026

Overview

A growing number of children in Rhode Island are struggling with mental health conditions. Schools serve as a vital access point to provide mental health services, especially for children from low-income families and living in under-resourced communities. However, school-based mental health professionals’ capacity is limited. Increasing the number of social workers in schools is one way we can make mental health supports more accessible to children.

Children’s Mental Health

Mental health in childhood and adolescence is defined as the achievement of expected developmental, cognitive, social, and emotional milestones and the ability to use effective coping skills.¹ Like physical health, “mental health is a continuum from positive mental wellbeing to mental illness.”² Mental health influences children’s health and behavior at home, in school, and in the community.³ Mental health conditions can impair daily functioning, prevent or affect academic achievement, increase involvement with the justice and child welfare systems, result in high treatment costs, and increase the risk for suicide.⁴

Prevalence of Children with Mental Health Conditions in Rhode Island

In 2025, more than one in five (22%) children under age six who were enrolled in Rhode Island’s Medicaid program were recognized to have a Serious Emotional Disturbance that limited their ability to function at home, school, or in the community, up from 10% in 2017. This increase is likely due to a combination of increased family and community stress and an increase in awareness about the mental health challenges of infants and young children.⁶

Growing Number of Children in Rhode Island are Experiencing Mental Health Conditions

In 2001, 26% of Rhode Island high school students indicated they had feelings of sadness and hopelessness on the Youth Risk Behavior Survey (YRBS) and in 2023, that percentage rose to 36%.⁷ The percentage of students expressing having feelings of sadness and hopelessness varies greatly when disaggregated by student characteristics. For example, in 2023 47% of female students compared to 23% of male students; 56% of Multiracial students compared to 31% of white students; and 74% of transgender students compared to 34% of students who are not transgender; expressed feelings of sadness and hopelessness.

In 2025, more than half (56%) of students in grades 6-12 in Rhode Island indicated that stress hindered their ability to participate in school. More female than male students indicated negative impacts of stress and these percentages also vary by race and ethnicity.⁹

Children in Rhode Island Struggle to Get Support for Their Mental Health Conditions

School based mental health services are provided by many types of professionals that all have unique training and roles, but share the common goal of supporting student well-being by providing crucial socio-emotional, mental health, and academic support to help students overcome barriers to learning.^{13 14} School social workers, school counselors, school psychologists and additional school staff are all essential to meet students needs as “they hold different credentials, experience different training, and perform different roles… They may complement each other, and collaboration among these professionals may improve student outcomes.”¹⁵

Web of Mental Health Supports in Schools

Summary of Roles and Responsibilities of School Counselors, School Social Workers, School Psychologists and Other School Staff

School Counselors	School Social Workers	School Psychologists	Additional School Staff: Teachers, Administrators, Paraprofessionals etc.
School counselors employ various counseling techniques with a focus on supporting students with academic, personal, and career development and planning.16	School social workers utilize various approaches to coordinate support and liaise between the school, the family, and the community to “remove barriers to learning, such as attendance, mental health, and ability to meet basic needs.”17	School psychologist’s duties may include data collection and analysis counseling, consultation, crisis preparation and development of academic behavioral and socio-emotional interventions. However, much of their time is spent conducting evaluations for students with disabilities.18	Despite not always having the necessary training and credentials to support children’s mental health, teachers, administrators, paraprofessionals and other school staff are often the “first line of defense.”19

NOTE: This table reflects a high-level summary of some tasks and duties people serving in these roles may do, but it is not exhaustive.

Rhode Island Needs More School Social Workers

Increasing the number of social workers in schools is one strategy to making school-based mental health supports more accessible to children.

Some school social workers are assigned to serve more than one school which means on some school days, there are no social workers available to help students.

“Los recursos de salud mental en la escuela de mi hijo prácticamente no existen. No hay apoyo para todos los niños.”

Mental health resources at my child’s school practically do not exist. There is no support for all children.”

Linda* – Rhode Island public school parent

While having mental health supports integrated in schools increases accessibility to these services, not all children in need are able to access them. The majority (61%) of public schools nationally indicated they did not have adequate staffing coverage to address their student’s mental health case load.²⁰

In addition to often being split between more than one school, Rhode Island public schools’ estimated school worker-to-student ratio exceeds the national recommendation of 1 social worker for every 250 students. As of January 2nd, 2026, the estimated school social worker-to-student ratio was 371 students to 1 social worker.

Rhode Island’s Student-to-School Social Worker Ratio exceeds the recommendation of 250:1

The Cranston, Foster, Little Compton, and Westerly public school districts as well as state-operated schools and collaboratives, are the only districts/schools in Rhode Island with student-t0-school social worker ratios below the national recommendation of 250:1.

Recommendations

Increasing the number of school social workers in Rhode Island public schools is one strategy for addressing the growing need for student mental health support. Rhode Island schools should increase the number of school social workers to meet the School Social Work Association of America’s recommended ratio of one school social worker for every 250 students. 

• Pass Legislation to Increase School Social Workers: In 2026, legislation was introduced in the Rhode Island House (House Bill 7456) and Rhode Island Senate (Senate Bill 2245) which would require each K-12 public school to have at least one full-time social worker for every 250 students by 2030 and allocate $2 million dollars in state funds to support this effort. An iteration of this bill has been introduced in Rhode Island in 2023, 2024, 2025 and 2026 but has not passed.
• School Districts can Maximize Available Funding to Hire More School Social Workers: Many school districts cite financial constraints as limiting their ability to effectively provide mental health supports to students.²¹ School districts can capitalize on the opportunities presented by recent legislation that permits Medicaid reimbursement for mental health services provided in schools.²²

* Pseudonym

References:

1. Centers for Disease Control and Prevention. (2021). What is children’s mental health. https://www.cdc.gov/children-mental-health/about/index.html ↩︎
2. Rhode Island Department of Education. (n.d.). School mental health. https://ride.ri.gov/students-families/health-safety/school-mental-health ↩︎
3. Bitsko, R.H, Claussen, A.H., Lichstein, J., Black, L.I., Jones, S.E.,…Ghandour, R.M. (2022). Mental health surveillance among children – United States, 2013- 2019. MMWR. Morbidity and Mortality Weekly Report, 71(Supp.2), 1–36. ↩︎
4. Murphey, D., Barry, M., & Vaughn, B. (2013). Adolescent health highlight: Mental health disorders. Child Trends. ↩︎
5. Data Resource Center for Child & Adolescent Health. (2026). 2023-2024 National Survey of Children’s Health: Mental, emotional, developmental, or behavioral problem, age 3-17 years. https://www.childhealthdata.org/browse/survey/results?q=11087&r=1&r2=41 ↩︎
6. Rhode Island Executive Office of Health and Human Services. (n.d.). MMIS Database, 2017-2025. ↩︎
7. Rhode Island Chapter of the American Academy of Pediatrics, Rhode Island Council for Child and Adolescent Psychiatry, Hasbro Children’s Hospital & Bradley Hospital. (2022). Declaration of a Rhode Island State of Emergency in Child and Adolescent Mental Health. https://riccap.net/wp-content/uploads/2022/04/child-adolescent-mental-health-emergency-declaration.pdf ↩︎
8. Centers for Disease Control and Prevention (CDC). 1991-2023 High School Youth Risk Behavior Survey Data. http://yrbs-explorer.services.cdc.gov/. Accessed on June 17, 2026. ↩︎
9. Rhode Island Department of Education. (2025). SurveyWorks. https://ride.ri.gov/information-accountability/ri-education-data/surveyworks ↩︎
10. Hoover, S., & Bostic, J. (2021). Schools as a vital component of the child and adolescent mental health system. Psychiatric Services, 72(1), 37–48. ↩︎
11. Meng, J.F. & Wiznitzer, E. (2024). Factors associated with not receiving mental health services among children with a mental disorder in early childhood in the United States, 2021–2022. Center for Disease Control. https://www.cdc.gov/pcd/issues/2024/24_0126.htm ↩︎
12. Children’s Hospital Association. (2025). Four years on: Children’s mental health remains a national emergency. https://www.childrenshospitals.org/news/newsroom/2025/10/childrens-mental-health-remains-a-national-emergency ↩︎
13. Frank, D. (2026). School Counselor vs psychologist vs social worker: Key differences. University of Olivet. https://www.uolivet.edu/school-counselor-vs-school-psychologist/ ↩︎
14. Public Schools First NC. (2025). Facts on helping professionals (School Social Works, Psychologists, Nurses, & Counselors). https://publicschoolsfirstnc.org/resources/fact-sheets/facts-on-helping-professionals-school-social-works-psychologists-nurses-counselors/ ↩︎
15. Zink, H., & Anderson, K. (2025). Mental health and student support service providers in the schools: Understanding access and equity across the United States. School Psychology Review, 54(1), 1–16. ↩︎
16. American School Counselor Association. (2025). The role of the school counselor. https://www.schoolcounselor.org/getmedia/ee8b2e1b-d021-4575-982c-c84402cb2cd2/Role-Statement.pdf ↩︎
17. Murphy, J., Borge, K. A., Harrell, D. R., Javna, A., & Craft, K. (2025). “We want to be there to support … do we have the capacity to do that?” Current priorities and challenges in school social work. The Journal of School Health, 95(3), 219–226. ↩︎
18. Pulse, M., & Sims, W. (2023). School psychologists: Working at the intersection of psychology and education. American Psychological Association. https://www.apa.org/ed/precollege/psn/2023/09/school-psychologists ↩︎
19. Korbey, H. (2022). What’s the role of teachers in supporting student mental health? https://www.edutopia.org/article/the-doctor-is-in-your-classroom/ ↩︎
20. Pierrottet, C. (2023). States face challenges building a school mental health workforce. National Association of State Boards of Education. https://nasbe.nyc3.digitaloceanspaces.com/2023/08/Pierrottet_School-Based-Mental-Health-final.pdf ↩︎
21. Kelly, C.H. (2024). School social work and mental health funding. National Association of Social Workers. ↩︎
22. Rhode Island KIDS COUNT. (2023). School-based mental health services: Perspectives from Newport youth, parents, and the community. https://rikidscount.org/wp-content/uploads/2024/05/school-based-mental-helath-services-perspectives-from-newport-youth-parents-and-the-community-november-2023.pdf ↩︎