Report Reveals the Widening Gaps in Student Mental Health Support Across the U.S.

A growing number of students across the country are struggling with mental health challenges, but many schools lack the staff and resources to meet their needs, according to the new VocoVision 2025 Youth Mental Health Deserts report.

The report was developed to spotlight the growing gaps in mental healthcare for students—especially those in rural and underserved communities. The results highlighted an urgent national concern that more students than ever are experiencing anxiety, depression and emotional distress, but many schools cannot find enough professionals to help.

Poor mental health has been shown to hurt school attendance and academic performance. © WavebreakMediaMicro - stock.adobe.com

According to the CDC, in 2023, 40% of high school students experienced persistent feelings of sadness or hopelessness, 20% seriously considered suicide and 9% attempted it. These statistics reflect a troubling trend that has only intensified since 2013.

In a 2025 Learning Policy Institute report, students’ mental health issues have become more severe due to social isolation during the COVID-19 pandemic, overexposure to social media and adverse childhood experiences (ACEs) such as abuse or neglect.

Nearly 75% of high school students have experienced at least one ACE, and nearly one in five have faced four or more. Poor mental health has been shown to hurt school attendance and academic performance.

Schools play an essential role in addressing this crisis by providing supportive relationships, teaching social-emotional skills and offering mental health services. However, widespread staffing shortages mean many students are left without any help at all.

The student-to-counselor and student-to-psychologist ratios remain far above recommended levels. Without adequate funding, many students—especially those from low-income communities or students of color—are left without access to needed care.

Investing in school-based mental health supports is critical for student wellness and academic success.

To understand where these gaps are most urgent, VocoVision analyzed data from the U.S. Department of Education, the Health Resources and Services Administration (HRSA), the Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA). Using this data, they built a national index measuring youth mental health needs, access to care, and in-school staffing levels, such as the number of students per school psychologist or counselor.

The analysis revealed that the five states facing the steepest challenges are Alabama, Mississippi, New Mexico, Arizona and West Virginia.

In Alabama, the provider-to-resident ratio is the worst in the country—just one mental health provider per 846 people. The state also reports one of the most overburdened school psychologist workforces, with more than 7,500 students per psychologist. In addition, nearly 40% of the student population attends rural schools, where access to in-person care is especially limited.

Mississippi faces similar problems. It has one of the highest percentages of rural students in the nation, with half of all students attending schools in rural areas. Its student-to-psychologist ratio also exceeds 7,500 to 1, and the state ranks 10th worst for general access to licensed providers.

In New Mexico, the unmet need for youth mental health services is striking. Nearly 70% of young people who experienced a major depressive episode in the past year did not receive any care. In addition, the state is only meeting 57% of its school counselor staffing needs—the second-lowest rate in the country.

Arizona struggles with both provider shortages and parent-reported barriers to care. Only 60% of its school counselor demand is being met, and the state ranks fourth-worst for overall access to mental health professionals. One in three parents in Arizona reported difficulty getting mental health services for their child.

West Virginia rounds out the top five with a mix of staffing shortages and rural access barriers. More than 42% of students attend rural schools, and the state’s student-to-psychologist ratio is among the highest—just one psychologist per 1,791 students.

While these five states represent the most severe “mental health deserts,” others are not far behind. Arkansas, Nevada, Kentucky, South Carolina and Indiana complete the list of the ten states with the greatest youth mental health access challenges. These states all show troubling key reasons, such as a lack of licensed professionals, poor student-to-counselor ratios and high rural enrollment.

For example, Arkansas has one of the lowest numbers of licensed child psychologists per capita, while Nevada continues to experience high rates of youth depression and suicide. In Kentucky and South Carolina, recruiting and retaining school-based providers is difficult due to underfunding and geographic barriers. Indiana ranks near the bottom of the Midwest for student-to-counselor availability.

To close these gaps, the report urged schools and policymakers to consider alternative solutions, such as remote therapy. Teletherapy can connect students with licensed professionals even when there are none available locally.

“To close the youth mental health gap, districts must think beyond traditional staffing models,” the report mentioned.

The authors also recommend broader changes, such as increasing public investment in school-based mental health programs, offering incentives to providers who work in underserved areas and expanding training pipelines for future professionals.

With these changes, the report stated that “every student, regardless of where they live, can access the services they need to thrive.”