Child Health Report Card focuses on youth mental health needs
The biannual Child Health Report Card from NC Child and the North Carolina Institute of Medicine (NCIOM) is now available. In addition to evaluating 14 key indicators of children’s health, the 2025 report includes a special section highlighting school-based mental health resources.
According to a press release, the decision to focus on youth mental health was driven by worsening trends and the need for greater support services.
“We know that schools play a vital role in the lives of children,” said NCIOM President and CEO Michelle Ries. “Schools are where children learn and where they build connections. What happens in school matters for their development and for their health.”
The role of schools
This edition’s special section covers access to student mental health support staff, mental health referral services, the connection between physical activity and mental health, and social media and mental health.
“Today’s youth are dealing with rising rates of anxiety, depression, and suicidal ideation — and what happens at school can contribute to those issues through peer pressure and bullying,” said NC Child Executive Director Erica Palmer Smith. “However, what happens at school can also help alleviate the challenges young people face. We need to look at the factors contributing to the youth mental health crisis and how to best address them.”
According to the press release, there were 1,928 students for each school psychologist in 2024. That’s nearly four times the 500:1 ratio recommended by the National Association of School Psychologists.
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“School psychologists, counselors, and social workers provide vital support for students with developmental, learning-based, and social-emotional needs,” said Ries. “They are often on the frontlines when it comes to prevention, intervention, supporting students in the foster care or juvenile justice system, or helping children who are at-risk”.
“North Carolina faces a youth mental health crisis, and our school systems should be part of the solution to help address students’ needs,” said Dr. Ellen Essick, section chief at NC Healthy Schools within the North Carolina Department of Public Instruction. “The solutions are less about fixing students, teachers, or our schools, and more about fixing a system that’s not supporting our students, teachers, and schools satisfactorily.”
Grade summary
The report card evaluates North Carolina on 14 indicators of child health and well-being. Those indicators fall into four broad categories: secure homes and neighborhoods, access to care, healthy births, and health risk factors.
Below is a summary of the grades for each indicator, organized by category.
Secure homes and neighborhoods
F – Housing and economic security
F – Child abuse and neglect
Access to care
D – Oral health
F – School health
C – Health services utilization and immunizations
A – Insurance coverage
Healthy births
B – Breastfeeding
B – Preconception and maternal health and support
F – Birth outcomes
C – Teen births
Health risk factors
D – healthy eating and active living
D – Tobacco, alcohol, substance use
F – Mental health
D – Education
More details about these grades and indicators can be found in the full report.
According to the press release, NC Child and NCIOM hope that the key findings in the latest report card can guide parents, decision makers, school personnel, and other child health practitioners across the state.
“What we know is that these grades — and their impact on our state’s children — can change for the better,” said Smith. “The Child Health Report Card tells us what’s working and where we need to improve so that every child in North Carolina can reach their full potential.”