In the 2022-2024 Appropriation Act, the General Assembly directed the Behavioral Health Commission to study how to maximize school-based mental health services across the Commonwealth (Appendix A). Specifically, the BHC was asked to:

• evaluate the current reach of school-based mental health services and identify strategies to connect mental health clinical interventions to school settings;

• consider opportunities to align Medicaid-funded behavioral health services and school-initiated services newly eligible under the “free care rule;" and

• make recommendations about strategies to implement and expand school-based mental health services.

To complete this study, BHC staff conducted interviews with state agencies responsible for overseeing various components of school-based mental health services, visited schools across Virginia and interviewed school and division staff, reviewed existing literature on school-based mental health planning and delivery models, surveyed school divisions and parents of children in Virginia public schools, and analyzed survey and other data (Appendix B).