Policy Watch: Alabama Lawmakers Propose Mandated Mental Health Professionals in K-12 Schools

By Kimberly Tsoukalas | Lister Hill Center Program Coordinator 

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In 2009, the Institute of Medicine compiled a report that recommended local and state governments develop a system to increase access to resources for students for the prevention and treatment of mental, emotional, and behavioral disorders. A year later, the state of Alabama created the School-Based Mental Health Coalition, a subsidiary of the Alabama Department of Mental Health. The agency’s goal was to bridge the various government offices such as the Department of Education and Department of Public Health to ensure that students enrolled in public K-12 schooling had adequate access to adequate mental health intervention, treatment, and prevention services. 

Currently, there are 80 school systems statewide collaborating with just over a dozen mental health agencies to refer students for professional services. The program was expected to increase attendance, reduce the frequency of administrative corrections like suspensions, and integrate mental health practitioners into students’ lives. 

However, the program is not currently statewide, only accounting for 57% of school districts. While the state does offer some funding available for schools to partake in the program, often, the local districts are responsible for a portion of the cost, limiting the ability for poorer districts to join. 

Proposed Legislation 

Senate Bill 306, proposed by Sen. Rodger Smitherman (D-Birmingham), works to establish a minimum set of requirements for a certified mental health services coordinator and mandate that at least one position be required in all school districts within the state. The bill would go into effect with the 2023-2024 academic year. 

The coordinator must have one or more of the following qualifications: 

(1) Have a bachelor’s degree in social work. 

(2) Satisfy State Department of Education qualifications for a school counselor. 

(3) Satisfy State Department of Education qualifications for a school nurse. 

(4) Have professional mental health experience, or have been licensed in a mental health occupation including, but not limited to, licensure as a licensed professional counselor or marriage and family therapist.

(5) Other qualifications as determined by the Alabama Department of Mental Health and the State Department of Education.

Additionally, employees have one year after being hired to complete a certification program developed and implemented by the Alabama Department of Mental Health. 

The legislation also outlines an implementation plan to enact the bill, requiring each local board of education to complete a needs assessment report and a resource map for all public schools in their jurisdiction. These documents are intended to document the status of mental health for the entire school system and create a baseline on which to improve once the program is implemented. 

While the bill does not specify that school districts must join the School-Based Mental Health Coalition, there is substantial overlap between the legislation and the purpose of the SBMHC. 


According to the World Health Organization, mental-health-related disabilities are a leading cause of mental health issues worldwide, with over ⅔ of patients receiving no or inadequate treatment for those conditions. Rates of depression have risen almost 50% in the last ten years, but access to mental health services has remained stagnant. Weare and Nind (2011) state that “childhood and adolescence provide key opportunities to develop the foundations for mental health and prevent mental health problems, and the school is a unique resource to help achieve this.” School-based services such as counselors and caseworkers have been shown to positively impact mental health prognosis in children and teens.

Multi-tiered systems of support (MTSS) are integral to providing proper support to students utilizing a school counselor, social worker, or psychologist. MTTS methods often utilize universal intervention as the primary mechanism for identifying at-risk students, primarily through widespread behavioral testing across the student body. A second tier, narrowed intervention, focuses on a select, smaller unit of students who may be at risk or suspected of behavioral disorders and includes increased monitoring and small-group counseling sessions. Lastly, the final stage of MTSS is an individualized plan of action which may consist of

“(a) conducting a functional behavior assessment and developing an individualized behavior plan; (b) direct student-level mental health services provided by a counselor, school psychologist, or school social worker; (c) additional coordinated mental health services with community agencies; or (d) possible identification for special education.” 

However, there can be a substantial delay in getting students access to necessary psychiatric and behavioral resources, negatively impacting mental health outcomes. A study completed by Guerra et al. (2019) found that the presence of a mental health services coordinator was vital to creating an environment that supports mental student health and learning. While there is no accessible data in the state of Alabama correlating improved health outcomes with mental health service coordinators, broad-scale investigations have shown a substantial impact on overall mental health outcomes across districts. The legislation would ensure that coordinators employed in every school district help streamline the processes to get students the help they need. 

Next Steps 

The Alabama Legislative Session is currently underway and will continue for several months. SB306 is presently being discussed in committee and has not yet gone to a vote. If you want to make your voice heard on this or future legislation, click here to identify your elected officials

Don’t know what to say? Check out this guide from the American Civil Liberties Union on drafting a letter to your government officials. 

Stay Informed 

Want to learn more? Several state agencies are dedicated to mental health resources in the state, such as the Alabama Department of Mental Health and its subsidiaries, the National Alliance on Mental Health, and the Youth Services Institute

Additionally, check out these previous publications that the Lister Hill Center has released about mental health services in Alabama: 

Policy Review: Analyzing Alabama’s Efforts to Improve Mental Health

Policy Review: Medicaid Expansion’s Impact on Mental Health

Policy Review: Student Mental Health at UAB