Because roughly half of all lifetime mental health conditions emerge by age 14, early identification and intervention are essential. Currently about three in ten California children ages 12 to 17 report symptoms that meet the criteria for serious psychological distress over the past year. This report provides an up-to-date picture of teen distress, looks at school-based services, and reviews how districts are spending their money on student mental health. 

Findings: 

• One-third of students in our study report chronic sadness, and 14.5% report suicidal thoughts. Teens of color — especially Native Hawaiian/Pacific Islander and multiracial students — report higher levels of distress than their white peers. 
• Girls report substantially worse mental health than boys. This gap emerges early and persists throughout high school. 
• Teens in rural schools have worse mental health. Authors find a gradient effect, with students in the most urban schools having better mental health than their counterparts in suburban, town-based, and rural schools.
• Teens in the poorest schools are about 8 percentage points more likely to report chronic sadness/hopelessness compared to those in the richest schools. 
• Half of teens reporting a need for help from a counselor or therapist and who get help do so at school. However, teens have a strong preference to talk to someone they know rather than go to counseling.
• Bolstered by the influx of federal and state pandemic recovery funds, school district per student health spending has nearly doubled in recent years. Between 2018–19 and 2023–24, total school district spending on health and mental health services in California rose from $934 million to $1.64 billion. Funds are mostly allocated to personnel costs. However, as the pandemic-related, one- time funds have expired and the state faces growing budget constraints, maintaining these expanded resources will be challenging. 
• District spending on mental health is similar for low- and high-poverty schools. And although school districts across geography — city, suburb, town, and rural — have increased spending, rural districts still lag behind their more urbanized counterparts.