How two journalists discovered that Texas schools are failing to meet students' mental health needs

Last year, investigative reporter Alex Stuckey told the story of a 5-year old boy who was committed to a psychiatric hospital after his school said he couldn’t return until his ADHD was under control. The child was assaulted in the hospital less than 24 hours after he was committed, court documents alleged. 

It was just one of many stories Alex had come across about kids getting inappropriate and subpar care for their mental health. So Alex and data journalist Stephanie Lamm teamed up to investigate further. 

It became clear during the six-month investigation that public schools were the flash point — a place where kids could, with appropriate resources, be reached before they were in crisis.

We learned that professional organizations recommend specific staffing ratios for counselors, social workers, nurses and psychologists in schools. Our investigation found that most Texas school districts don’t have enough providers in those four key mental health care positions to meet the nationally recommended student-to-staff ratios.

We used data from the Texas Education Agency to calculate the student-to-provider ratios for these four positions in all 1,200 public school districts and open-enrollment charter schools. Since 2013 — the earliest available data — not a single district in Texas met the recommended ratio for all four positions. That means for nearly a decade, more than 5 million kids in Texas schools each year have gone without appropriate access to mental health professionals. 

Here’s a more detailed breakdown of what we found:

• The vast majority of students — 98% — attended districts that did not meet the Texas Education Agency’s recommendation of one counselor per 250 students.

• The Texas Model for Comprehensive Counseling Programs, which schools must use to build their counseling program, sets a lower recommendation — one counselor per 350 students. Less than 3 percent of students attended districts that met even that standard.

• The National Association of School Psychologists recommends one psychologist per 500 students. Just 25 districts met that standard.

• Only four districts met the standard of 250 students per social worker, recommended by the National Association of Social Workers.

• Two-thirds of districts failed to meet the ratio of one nurse per 750 students, as recommended by the National Association of School Nurses.

Our findings shocked lawmakers and policy experts. 

For this three-part series, we spoke to more than 100 people. Students said they wanted more time with counselors. School counselors said they were overworked. Superintendents said hiring more mental health staff would take dedicated state funding. Lawmakers said their efforts to get dedicated funding have failed. 

Since publishing the series, numerous families and mental health care providers have reached out to share their stories. We are working on follow-ups to the three stories published with the help of Center for Health Journalism 2021 Data Fellowship. 

Policy experts have pledged to share the stories at Congressional hearings on the topic and professors have pledged to make it required reading on their syllabi.

Pro-bono therapy was even offered to one of the main characters in the stories.

Some advice for reporters who cover childhood mental health:

• Spend time digging around on your state’s education agency website. There is so much data on K-12 education but it’s sometimes hard to track down. 

• When you have the data, reach out to experts who have worked with it before. That expert might be at the agency holding the data, or you can try to find someone at a non-profit who has worked with the data. They can help you avoid pitfalls and tell you the limitations of the dataset. 

• We worked with a scripted analysis using R. This allowed us to tweak the analysis as we went without starting over. If you’re not using a scripted analysis, take careful notes and save copies of the data at each stage of the analysis. 

• Run your findings by policy experts and get reactions from the people inside the school system. We asked superintendents, advocates, parents and school mental health professionals to gut-check our findings. We also performed more granular spot-checks.  If our analysis showed a district had a ratio of 1 psychologist for every 1,400 students, we went to that district and asked if that was correct. This showed us the limitations of our analysis, such as not accounting for shared providers through co-ops or for part time providers. 

• Find a school that's providing mental health care appropriately. It’s enormously helpful in showing the public that it can be done and that they need to hold their school to a higher standard.

• Facebook is your friend: As terrible and, sometimes, scary as Facebook can be, it is still the place parents gather to discuss their school district. These school Facebook groups are where you are going to find sources that make your stories shine. 

• Familiarize yourself with the National Center for Education Statistics, run by the U.S. Department of Education. It can provide a starting point for determining the level of mental health care providers in schools. 

• Read past legislation on the topic, even if it failed. Track down people who spoke at the bill hearings. They can get you up to speed on the legislative history and tell you about initiatives that may not be publicized yet. 

• For maximum impact, make sure the story gets in front of people who work on this topic. Find advocacy organizations, university programs, lobbyists, lawmakers and other key figures and send them the stories.

We need quality, data-driven reporting on both mental health and education. Fortunately, there’s an abundance of state and federal data on education. 

If you have any questions, feel free to contact us at alex.stuckey@chron.com and stephanie.lamm@chron.com.