The 119th Congress can make a difference in our nation’s youth mental health crisis by passing two previously introduced bills that would make an immediate and future impact on teen mental health using America’s network of school systems. In 2021, citing teen’s mental health challenges, the U.S. Surgeon General called on the federal government to fund more school-based behavioral health programs. Since then, members of Congress introduced related legislation, including the Mental Health in Schools Act of 2024 (which would mandate that schools teach students warning signs of common psychiatric conditions and how to get help through their school) and The One School One Nurse Act of 2025 (which would provide a full-time RN for the one-third of public schools that don’t employ one).
The combined passing of these bills would assist with the prevention and intervention of youth psychiatric illness and help the nearly one-third of teenagers currently struggling with poor mental health. In 2023, 9% of our nations’ high schoolers attempted suicide in and more than 20% seriously considered it. Unfortunately, these bills were sent to committees where—according to GovTrack.us—they have no chance of being passed. School communities, their students, and the families they serve crave solutions from our government. Why can’t these bills make it through Congress when suicide is now a leading cause of death for young Americans?
A registered nurse for more than 30 years, I worked at a school from 2005 to 2021 as both a nurse and a high school health teacher. This provided me with a front row seat to escalating teen mental health concerns—now a top worry for both parents and teens—where youth depression has practically doubled over the last decade. As an RN who taught mental health literacy, I’ve seen firsthand the benefits of these classes combined with access to help at school. Comfortable classroom conversations about depression and suicide prevention help to reduce stigma and students become more comfortable talking with nurses and other school-based professionals about psychiatric concerns for both themselves and for friends; this is critical since early interventions are associated with better outcomes. Our kids need mental health awareness education and clear pathways to get help when needed.
Access to a school nurse is important, as school-based RNs are often the initial point of care for both physical and psychological complaints. “These trusted professionals make schools safer for everyone, both because they can address medical emergencies on site, and they play a role in the triage and early intervention of mental health concerns,” said the Dean of Yale School of Nursing Azita Emami, PhD, RN, an expert on equity of healthcare access. This aligns with what I experienced as a school nurse. An RN in every school would address access to care inequities, especially in rural communities, which are known to have more barriers to mental health treatment, and where the rate of suicide among 15- to 19-year-olds has increased by 74% over the last decade and is 54% higher than that of their urban peers. Currently, only 56.2% of rural schools employ a full-time RN compared to 70.3% of their urban counterparts. Additionally, as pointed by Dr. Emami, “meaningful interactions [with school nurses] help inspire the next generation of nurses,” a critical need, especially in rural areas.
With Congress gridlocked, schools have been left to solve these problems themselves. Given wide disparities in state and local education budgets, some schools have devised strong mental health programs, while others haven’t been able to address the issue at all. Why do states and local governments have to struggle so hard with a national problem? All our young people need to learn how to take charge of their mental health, and they could get invaluable help at school if districts were given the budget to assist with curriculums and needed staff. Without evidence-based education where students can be directed to school-based health professionals for help, children are seeking answers to mental health questions on social media platforms with disastrous consequences, including suicide. With little best practice guidance publicly available, many private companies are trying to fill the mental health curriculum void. They now sell programs to affluent schools, providing such offerings as Prepare U, 7 Mindsets, and Positive Action. But what about schools that lack funds?
Frameworks to enhance school-based student mental health support are starting to emerge. The Jed Foundation, a nonprofit involved in teen mental health—funded by philanthropists and grants from Wellness Classroom and Gotham Gives—recently collaborated with the New York City Public Schools (NYCPS) to train about 1,500 school nurses in suicide prevention. NYC’s public schools now have a strong safety net, with a robust K-12 mental health literacy curriculum, a school nurse with extra training in every school, as well as other student mental health support programs and personnel. These New York schools can serve as a model for other school districts—with the caveat that this model requires financial support.
Providing federal funds and guidelines to help schools create needed mental health literacy curricula and mandating a school nurse in every school would serve as an ideal approach to increasing equity and access to mental health prevention and early intervention for our youth. The 119th Congress has an opportunity to improve the current and future mental health of our nation by moving the aforementioned bills through the legislative process to become laws. It’s unethical to leave the solution up to underfunded school systems that want to help, but simply can’t.
Sherrie Page Guyer, MSN, RN, is a DNP Candidate (May 2025) at the University of Virginia in Charlottesville, VA
