Good mental health is critical for our young people to grow, learn, and thrive in their communities. While youth mental health has been a bipartisan issue with our legislature, a priority for our Governor, and the focus of many young community members’ advocacy – investments in holistic mental health services for our young people continue to fall short. 

The continuum of mental health care in Virginia was not created with young people in mind, therefore, it does not adequately meet the unique needs of our young people. In 2022, 20.2% of youth (ages 12-17) in Virginia, reported suffering from at least one major depressive episode (MDE) as defined and diagnosed in the past year. Of that, 54.5% (75,000) of these youth did not receive any mental health treatment. Young people continue to express feeling unwell, anxious, and depressed – highlighted by data from the 2023 Virginia Youth Survey which found that 33% of high school students reported experiencing persistent sadness and 17% of high school and middle school students seriously considered suicide.  

Countless stories are shared with us about the pressures of growing up, challenges navigating the current social climate, lack of knowledge about who or where to turn to, and the continued combatting of stigma around mental health. These issues compound and often become the emergencies and crises we see in overabundance. It is preventative strategies that support our young people never experiencing a mental health crisis to begin with.  

Building out comprehensive school-based mental health (SBMH) services and programming is one preventative strategy that can ensure we mitigate crises before they occur. SBMH works when we expand access to a variety of strategies such as:  

• Ensuring school-based mental health integration and partnership between schools and community-based providers 
• Implementation of school-based telehealth 
• Building robust in-school infrastructure to bill for Medicaid  
• Offering culturally responsive and language-appropriate mental health supports in schools.  

While we are seeing a verbal commitment by legislators to build out a strong SBMH system – dedicated funding to integrate mental health services in schools no longer exists in the state budget. In June of 2023, the School-Based Mental Health Integration Pilot was established as a Governor’s priority budget item with an appropriation of $2.5 million in FY2023 and $7.5 million in FY2024; this item was further expanded in December of 2023 to $15 million each year forward.  
However, during the 2024 Legislative Session, this money was co-opted to support the development of School-Based Health Clinics (SBHC). These clinics, while able to provide physical health services and some mental health support to students, are not properly equipped to provide comprehensive mental health services, as was the initial purpose of the Integration Pilot. See this SBMH Timeline for more information on how this $30 million has shifted and changed over the last year. 

Now, with the support of the Behavioral Health Commission, we have been working to rededicate $7.5 million to re-establish the School-Based Mental Health Integration Pilot with the requirement that the Department of Behavioral Health and Developmental Services (DBHDS) also develop performance measures for the participating schools.  

However, the budget amendment, Item 295 #5h (Del. McClure), which would re-dedicate $7.5 million and re-establish the School-Based Mental Health Integration Pilot, was not included in either the House or Senate Budget. 

Instead, the following language only amendments were included in the budget item, 295 FF from the House and Senate Budgets.  

• House: Item 295 #5h – Which would allow school districts to use the grant money to contract with a mental telehealth provider.  
• Senate: Item 296 #1s – Which would expand school-based health clinics to utilize mobile clinics to provide school-based care.  

While we are supportive of the expansion of telehealth services for students, we are committed to seeing dedicated funding to mental health services, specifically. This budget item has become so expansive that we have lost the original intention of the funding which was to integrate community-based mental health providers into schools to meet the needs of students unable to be reached by the school-based mental health professionals.  
Integrating community-based mental health providers into schools is a vital step in expanding access to care, strengthening community connections, and alleviating the burden on school professionals overwhelmed by the youth mental health crisis. We will continue to push for dedicated school-based mental health funding as the two budgets go into conference.  
Centering youth in mental health means considering the unique systems they learn and play within, the unique developmental needs they have, and the social climate in which they grow- and investing in the programs that meet them where they are.  

Other budget Items that are relevant investments in or language changes to the overall continuum of care that either directly or indirectly may improve service delivery and access to young people: 

Expand Marcus Alert and Co-Responder Programs 

• House: Item 297 #2h – Provides $3.6 million in FY26 to support six additional Marcus Alert sites to develop co-response programs between law enforcement officers and mental health clinicians. 
• Senate: Item 297 #1s – Provides $7.8 million in FY26 to support the development and establishment of co-response programs in localities that have not yet received funding. 

Expand Boost! Program to increase the number of licensed therapists and social workers 

• House: Item 295 #1h  and Senate: Item 295 #2s  
  • Provides $1.1 million in FY26 for DBHDS to contract with the Virginia Health Care Foundation (VHCF) to expand payments to support individuals working to obtain their licenses for social work or counseling with supervisory hours and licensure exam preparation. This funding will add 60 more slots. 

Increased Funding for Prevention Services at Community Services Boards (CBS) 

• House: Item 297 #3h – Provides $8 million in FY26 to CSBs to continue to provide a variety of prevention services for community members.  

Fund additional support coordinators at CSBs 

• House: Item 297 #1h – Provides $8.7 million in FY26 for CSBs to hire additional support coordinators to help with waiver services. This funding would support 96 additional support coordinators. 

DBHDS and the Department of Planning and Budget (DPB) can direct a portion of funding to the Mental Health Virginia (MHVA) peer support Warmline 

• House: Item 295 #4h – Language only change that allows DBHDS and DPB to direct a portion of funding up to $75,000 in the Crisis Call Center Fund to MHVA Warmline, a peer support line that reduces 988 crisis call center volume.  

Revise the Regulations for Multi-Systemic Family Services  

• Senate: Item 288 #3s – Provides $257,910 GF, $312,564 NGF in FY26 to the Department of Medical Assistance Services to revise regulations on Multi-Systemic Family Therapy (MST), recharacterizing it as “collaborative behavioral health services” and allow Qualified Mental Health Professionals (QMHPs) to deliver the service under the supervision of a licensed person. This will help address the shortage of practitioners and increase access for those youth and families who might otherwise face family disruption and benefit from these services.  

Workgroup on Behavioral Health Medication Management for Youth 

• House: Item 285 #2h – Language only change that directs the Board of Medicine and Board of Nursing to convene a workgroup to study best practices regarding child and adolescent behavioral health medication management, provider availability for child and adolescent medication management, and provider-patient communication regarding medication management.  

Improve Data-Sharing on Licensed Mental Health Professionals in the State 

• Senate: Item 285 #2s – Language only change that directs the Department of Health Professions to provide the VHCF an electronic file with record-level, de-identified data collected from the most recent license renewal period for every licensed mental and behavioral health professional in the state – including demographics, payment form, hours/week worked in-person and virtually, and more.  

Next Steps? 

The House and Senate budgets differ in many ways for prioritizing youth mental health. As a statement of values, it is important that we as advocates continue to push our lawmakers to ensure the needs of our young people are valued through investments, not just empty promises.  
Over the next couple of weeks, budget conferees will still hear from community members, advocates, and experts to help them determine the strongest conference budget. This is our time to take action and make a statement that we must prioritize our young folk’s mental health and well-being where they learn, play and grow.  
By taking a holistic approach to meet the mental health needs of young people, we can prioritize both crisis and prevention; while we address mental health challenges through improving access to services and expanding the crisis continuum, we must also support young people where they learn and play through preventative strategies that build resilience, destigmatizes mental health, and teach social-emotional skills. 

Take Action: Ensure the School-Based Mental Health Integration Pilot is in the Final Budget. 

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