Q&A: WSU professor discusses research that shows rural schools have trouble getting kids mental health assessments


Shane Ersland


Fewer rural public schools have the ability to get students diagnosed with mental health issues than their urban counterparts, according to a study led by researchers at Washington State University (WSU).

The study showed that only a little more than half of all public schools (58%) reported providing assessments for mental health disorders. Researchers’ analysis revealed that schools in rural environments (19%), towns (21%), and suburban areas (11%) were significantly less likely to provide assessments than city schools. Treatment was offered in only 38.3% of schools overall, with suburban schools the least likely to provide it.

Dr. Janessa Graves is an Associate Professor at WSU’s College of Nursing, and served as the first author of the study. She discusses its findings and possible solutions to the issue in this Q&A.


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State of Reform: What were some of the factors that motivated researchers to conduct the study?

Janessa Graves: “We were interested in looking at geographic variation in school-based mental health services because we are aware that rural youth face major hurdles in accessing mental health services. Schools could provide a convenient means of providing mental health services to youth where they are, eliminating challenges associated with transportation, finding providers, and scheduling. 

This is important because we have seen a concerning rise in youth deaths by suicide in rural communities, compared to a slower rise in urban areas. By providing mental health services through schools, maybe we can serve more youth and get them the services and care they need.”

SOR: The study showed that schools in rural areas, towns, and suburban areas were significantly less likely to provide assessments for mental health than their urban counterparts. What do researchers believe some of the reasons for that divide are? Is it mainly a matter of a lack of resources? 

JG: “The survey data provided some insights regarding the barriers facing schools in offering mental health services. We know [that with] rural schools, inadequate access to professionals, and inadequate funding were cited as factors that limit efforts to provide school-based mental health services. 

We do not see any statistically significant associations for schools in towns or suburban areas, however. It seems that, for towns at least, the data are trending in the same direction, suggesting that inadequate access to professionals and inadequate funding limit efforts to provide school-based mental health services.”

SOR: What are some things these schools can do to increase student access to mental health assessments or services?

JG: “If schools are facing challenges in accessing mental health professionals locally, which is often an issue in rural communities, tele-mental health services can be offered through schools. Whereby a mental health professional provides counseling, therapy, or other services remotely to a student at the school. 

This model has been employed successfully throughout the last couple of years and holds promise as a stopgap measure to meet schools’ immediate needs. However, in the long run, we should ideally work to recruit and retain health professionals within our rural communities.”

SOR: You have expressed hope that lawmakers might advocate for more funding for rural schools to reduce these disparities. What other health-related needs do these schools have, and would additional funding help address those needs as well?

JG: “There is great need for increased support of school nursing within rural communities, as well as other healthcare providers who might serve youth through schools, [for example] speech-language therapy, occupational therapy, physical therapy, and, of course, behavioral and mental health.”

This Q&A was edited for clarity and length.