Number of mental health counselors in South Carolina schools doubled since 2022 – 74

Number of mental health counselors in South Carolina schools doubled since 2022 – 74


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COLUMBIA — The number of mental health counselors in South Carolina schools has doubled in a year and a half, according to a report released Thursday by the South Carolina Medicaid Agency.

A 2022 statewide survey requested by the governor found a shortage of mental health counselors in the state’s schools, despite children’s growing need for mental health services. The state has an average of only one counselor for every 1,300 students, and nine school districts have no counselors at all, according to the Department of Health and Human Services report.

Part of the improvement is due to the agency nearly doubling the amount it pays licensed therapists who work in schools. Since 2022, the cost of a 30-minute class has jumped from $37 to $71, according to the department.

The department met its goal: The latest report found that schools will have one counselor for every 653 students by September 2023. Overall, the number of mental health counselors working in schools increased from 600 in January 2022 to 1,200 in September 2023.

As of September, every district in the state had at least one counselor, the report said. In some districts, counselors attend designated schools every day, while in other districts counselors rotate through different schools.

That number is still well below the American School Counselor Association’s recommendation of one counselor for every 250 students. Nationwide, the average counselor is responsible for 400 students, according to the U.S. Department of Education.

South Carolina’s long-term goal is to have one therapist for every 325 students. Jeff Leieritz, a spokesman for the state’s Medicaid agency, said the biggest obstacle is that the state doesn’t have enough mental health clinicians to meet the demand.

The agency’s report comes a day after Gov. Henry McMaster touted the development and previewed the findings during his State of the State address.

“Over the past two years, we have made significant progress in providing school mental health services to school-age children,” McMaster said in a statement Thursday. “As the mental health crisis continues, especially in our of young people, it is critical that we continue to build on these efforts and ensure our state’s children have access to mental health resources.”

While children can receive treatment outside of school, they are 21 times more likely to use school-provided mental health services, according to findings from the South Carolina School Behavioral Health Institute. Robby Kerr, the state’s Medicaid director, said that makes it even more important to get counselors into schools.

The demand for mental health services is growing.

According to the Centers for Disease Control and Prevention, the national suicide rate among people ages 10 to 24 increased 62% from 2007 to 2021. In 2021, 2.5 children per 100,000 children died by suicide in South Carolina, according to the State Children’s Commission.

In addition to paying therapists more, changing the way they are paid could also help South Carolina’s numbers.

The state Medicaid agency changed its policy to make it easier for schools to hire private clinicians, but still passed the cost on to the agency, whereas before the need was met by state mental health workers.

That opens the door for school districts to hire their own counselors, which nearly 60% of district leaders said they preferred to do, according to the 2022 report.

As of the 2023 survey, about 600, or about half, of the school-based mental health counselors were employed by their school districts, not state agencies. School districts still have the option of partnering with the state Department of Mental Health or adopting a hybrid model that mixes state staff with private clinicians.

Leritz said counselors hired by the district can spend more time in schools instead of jumping from place to place, and the reduced mobility means students always see the same people.

More counselors also mean more support for students in crisis. Clinicians overwhelmed with daily treatments often don’t have time to help children with mental health emergencies, leaving those situations in the hands of untrained nurses or administrators, the 2022 report said.

The SC Daily Gazette is part of States Newsroom, a nonprofit news network supported by a coalition of grants and donors as a 501c(3) public charity. The SC Daily Gazette maintains editorial independence. If you have questions, please contact editor Seana Adcox: [email protected] SC Daily Gazette on Facebook and Twitter.


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