Evaluating School-Based Mental Health Counseling for K–12 Students In New Jersey: Changes In Internalizing and Overall Psychosocial Symptoms

Background and Purpose.
Schools have become a central access point for youth mental health services, particularly as students face increasing psychosocial stressors and barriers to community-based care. School-based mental health counseling offers a promising strategy for delivering timely, accessible support within students’ everyday environments. Despite widespread implementation, there remains a need for empirical evidence evaluating whether these services are associated with measurable improvements in student mental health outcomes in real-world school settings. This study evaluates the effectiveness of school-based mental health counseling in reducing internalizing symptoms and overall psychosocial distress among K–12 students in New Jersey.

Methods.
Data were drawn from 262 K–12 students who participated in school-based mental health counseling during the 2023–2024 academic year across 49 school districts in New Jersey. The sample included 146 female, 111 male, 3 gender-neutral, and 2 transgender students. Racial and ethnic composition was as follows: 100 White, 87 Hispanic, 45 Black/African American, 14 Bi-Racial, 14 Asian, and 2 multiracial/other. Mental health outcomes were assessed using the Pediatric Symptom Checklist, a widely used screening tool for psychosocial functioning. Students completed assessments at program entry and approximately nine months later. Paired-samples t-tests were used to examine changes in internalizing symptoms and overall symptomatology over time. Additionally, regression models using difference scores were estimated to assess whether changes in outcomes varied by race and gender.

Results.
Findings indicate statistically significant improvements in both internalizing symptoms and overall psychosocial functioning from baseline to follow-up. Mean internalizing symptom scores decreased from 4.14 at baseline to 3.26 at follow-up, t(261) = 7.24, p < .001. Mean overall symptom scores decreased from 24.46 to 20.57, t(261) = 7.36, p < .001. Regression analyses revealed no statistically significant differences in symptom change by race or gender, suggesting that observed improvements were consistent across demographic subgroups within this sample.

Conclusions and Implications.

These findings suggest that school-based mental health counseling may be a promising approach for reducing psychosocial distress among K–12 students in routine practice settings. By embedding services within schools, counseling programs may help mitigate structural barriers to care, including transportation, cost, and stigma. The absence of differential effects by race or gender further suggests the potential for these services to reach diverse student populations. For school social work, these findings underscore the importance of sustained investment in school-based mental health infrastructure and interdisciplinary collaboration among social workers, educators, and mental health professionals. At the policy level, results support continued expansion and evaluation of school-based mental health services as part of a comprehensive approach to promoting student well-being. Future research should build on this work by incorporating comparison groups, examining service dosage, and exploring longer-term outcomes to strengthen causal inference and better understand mechanisms of change.