Policy without Progress: Mapping Federal School Mental Health Legislation, 2020–2026

Background: Student mental health in PreK–12 public schools has emerged as a critical public health concern, particularly following the COVID-19 pandemic, which intensified existing gaps in school-based mental health (SBMH) services. Despite widespread recognition of this need, little is known about the federal legislative landscape shaping SBMH policy, including the extent to which proposed legislation addresses workforce provisions specific to school social workers (SSWs). Policy surveillance offers a systematic method for tracking and analyzing legislative activity over time. This study aimed to map and characterize federal legislation related to SBMH introduced in the U.S. Congress from 2020 to March 2025, with a focus on school-based mental health workforce provisions and funding mechanisms.

Methods: A policy surveillance methodology was employed to identify and analyze federal legislation using Congress.gov. Search terms included "school" and "mental health," limited to legislation (bills only, excluding amendments) introduced during the 116th–119th Congressional sessions (2020–March 2026). Inclusion criteria were restricted to bills addressing PreK–12 public school mental health. An initial screening pool was identified across Health and Education subject-policy areas. Two independent reviewers screened all results, with discrepancies resolved by consensus. Included bills (N = 46) were then coded in a structured extraction tool capturing: bill number, congressional session, final legislative action, school-based funding provisions, graduate education funding, SSW-to-student ratio requirements, school employee training provisions, and targeted school populations.

Results: A total of 46 bills meeting inclusion criteria were identified across the 116th–119th Congresses. The majority of bills remained at the "Introduced" stage, with only one bill passing the House (H.R. 7780, Mental Health Matters Act, 117th Congress). No bills were enacted into law across the full study period. A recurring SSW-to-student ratio of 1:250 students appeared across nearly all included legislation. Most bills proposed funding for school-based mental health services, with many also including graduate education funding provisions. Several bills specifically targeted high-need populations, including low-income schools, minority-serving institutions, and schools responding to traumatic events. Notable bills introduced included the Increasing Access to Mental Health in Schools Act (reintroduced across multiple sessions through the 119th Congress), the School Social Workers Improving Student Success Act, and the CARE for Student Mental Health Act.

Conclusions and Implications: Despite sustained and growing federal legislative interest in SBMH across six years and four congressional sessions, including the height of the post-pandemic youth mental health crisis, not a single bill was enacted into law through March 2026. The reintroduction of the same bills across successive sessions, with no advancement beyond committee referral, points to deep and persistent structural barriers to federal SBMH policymaking. The consistent appearance of a 1:250 SSW-to-student ratio across sessions suggests an emerging policy consensus around workforce standards, even as legislative progress remains stalled. These findings carry important implications for social work advocates, who must look beyond federal bill introduction as a marker of policy progress, and for researchers seeking to understand the gap between legislative intent and enacted policy. Policy surveillance offers a replicable framework for monitoring these trends over time.