Two members of President Donald Trump’s Cabinet recently called for improving students’ mental health through a focus on “strong families, nutrition and fitness, and hope for the future,” as they took aim at mental health screenings schools use to identify students in need of support.
But their characterization of screenings as “medicalizing” young children’s behavior and treating students “like patients” misrepresents a tool used in a growing number of schools, school psychologists said.
U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. and Secretary of Education Linda McMahon—who shared their views in a Sept. 10 opinion essay in The Washington Post—also contradicted recommendations from a National School Safety Commission assembled by Trump in his first term and the positions of such national organizations as the National Center for School Mental Health.
Use of the screenings comes at the risk of over-diagnosing mental health conditions and unnecessarily pathologizing students, the secretaries argued, singling out a bill signed by Illinois Gov. J.B. Pritzker—a Democrat and frequent Trump target—that will require all schools to conduct evidence-based mental health screenings of students in grades 3-12 by the 2027-28 school year.
“Medicalizing the unique and sometimes unpredictable behavior of young children can create new stigmas that students might carry with them for life,” the secretaries wrote. “We must make American children healthy again without treating them all like patients.”
Schools should instead focus on factors like nutrition, exercise, and cellphone use to improve student well-being, they wrote, echoing recommendations in the Make Our Children Healthy Again strategy released Sept. 9 by the Trump administration.
The high-profile criticism of mental health screenings and other school-based mental health interventions comes as educators continue to voice urgent concerns about students’ mental health, emotional-regulation skills, and classroom behavior. Organizations including the American Academy of Pediatrics have declared an emergency in child and adolescent mental health.
School-based mental health screenings are a growing strategy
In a nationally representative survey of 1,019 K-12 public school principals conducted by the RAND Corp. in October 2024, 30.5% of respondents said their school required mental health screenings for students. The practice has previously been endorsed by the U.S. Centers for Disease Control and Prevention in recommendations for schools that are still posted on the agency’s website.
Kennedy and McMahon inaccurately portrayed school mental health screenings, said Kelly Vaillancourt Strobach, the director of policy and advocacy for the National Association of School Psychologists. The screenings are not used to give students formal diagnoses, and schools don’t provide clinical counseling or medication as a result, she said.
“These are not tools used to label kids,” said Strobach, a former school psychologist.
Schools that offer the screenings require parental consent for students to complete a self-report survey. The results help educators intervene earlier when students report problems they may have not shared with adults, like difficulty making friends or anxiety about coming to school.
Those interventions could be as simple as teaching students strategies to talk through conflicts or process grief after a family member’s death, Strobach said.
If screenings flag more serious concerns that are backed up by other data, such as poor attendance, schools would share those results with parents and refer them to community organizations, like therapy providers, she said, but results from one survey are not used to support a clinical mental health diagnosis.
“These are not invasive, they don’t take that long, and they help identify kids who may need a little extra support,” Strobach said.
Patterns in the resulting data may also help schools identify whether schoolwide strategies, such as peer mentoring, are effective, supporters say.
Schools that use screenings should ensure they’re developmentally appropriate, give parents and caregivers a chance to participate in the process, and ensure they have proper follow-up protocols in place when students show signs of distress, said Dr. Laura Erickson-Schroth, the chief medical officer for The Jed Foundation (JED), a nonprofit organization that promotes mental health and suicide prevention for teens and young adults.
These are not invasive, they don’t take that long, and they help identify kids who may need a little extra support.
Kelly Vaillancourt Strobach, director of policy and advocacy, National Association of School Psychologists
Half of young people ages 12 to 17 who receive mental health services get at least some of their care in educational settings, Erickson-Schroth wrote in an email. And mental health interventions support other school priorities, such as cutting chronic absenteeism and improving academic performance.
“In order to effectively reach young people and prevent suicide, we have to meet young people where they are—and that includes schools,” she wrote. “For many students, especially those in rural or under-resourced communities, school is the only door in.”
Illinois will be the first state to require school mental health screenings
Kennedy and McMahon’s criticism of Illinois’ policy comes as Trump spars with Pritzker over unrelated matters, like a surge of federal immigration enforcement in Chicago.
Illinois will become the first state to require universal school mental health screenings as the result of a multiyear strategy Pritzker launched in 2022 to improve the state’s behavioral-health system for children. The state will require schools to secure parental consent—either by requiring them to sign permission forms or allowing them to opt their children out.
Iowa, New Jersey, and Utah also encourage screenings or support them through grants.
Many Illinois districts already use screening tools, and their input helped the state design its policy, said Dana Weiner, the director of the Illinois Children’s Behavioral Health Transformation Initiative.
The Mount Olive school system, for example, uses the BASC-3 Behavioral and Emotional Screening System, a 25- to 30-question survey developed by Pearson that takes five to 10 minutes to complete, a state report said. The survey asks students to rate their level of agreement with statements like “I have trouble sitting still,” “I am lonely,” and “I feel safe at school.”
Contrary to the secretaries’ assertions, schools that use the screeners do not risk unnecessarily funneling healthy children into therapy, Weiner said.
“Screening tools are a public health tool used to detect problems that could potentially be life-threatening if they aren’t treated,” she said. “We don’t have the desire or the resources to treat kids who don’t need mental health treatment. This is a response to an outcry.”
School psychologists stress the need for parental consent
To be sure, student mental health efforts in some states have faced opposition from an active conservative parents’ rights movement that has led to more skepticism about the data schools collect on students and how they use it.
In 2022, Florida took the unusual step of opting out of the Youth Risk Behavior Survey, an anonymous, voluntary, biennial survey administered by the CDC that asks high school students questions about such issues as bullying, suicidal thoughts, drug use, sexual behavior, exposure to violence, and risk-taking activities, like texting while driving. The result of that survey is not reports on individual students but year-over-year, state-by-state data that allow researchers, policymakers, and others to monitor trends and identify solutions.
Colorado passed a law in 2023 that provided grants for mental health screenings for students in grades 6-12, but lawmakers repealed it earlier this year, citing concerns that the law infringed on parents’ rights by requiring those who didn’t want to participate to opt their children out, rather than requiring all parents to give affirmative permission through a universal form.
“Quite frankly, it’s not the school’s role to subordinate the parent when it comes to their children,” John Graham, then-president of the school board for District 49 in Peyton, Colo., told Education Week in 2023. The board was part of a group of school boards that adopted resolutions opposing the state’s 2023 bill.
Some school leaders have also said they have inadequate resources—not enough school counselors and psychologists, for example—to respond when mental health concerns are identified. Others say the screenings help them use those resources more effectively.
Criticisms contradict recommendations from the first Trump administration
The Education Department and the Department of Health and Human Services did not respond to requests for comment.
Kennedy and McMahon’s opposition follows a pattern of the current Trump administration contradicting recommendations made by a handpicked federal school safety commission, chaired by former Education Secretary Betsy DeVos, that held hearings around the country in Trump’s first term. That report recommended strategies like social-emotional learning, which the current Education Department has criticized as a possible “veil for discrimination,” and identifying students in need of early mental health interventions.
“Schools are a viable setting for screening, which could be incorporated just like visual and hearing screening,” the commission wrote in the December 2018 report that was part of a federal response to school shootings in Parkland, Fla., and Santa Fe, Texas.
After years of efforts to strengthen school mental health efforts, educators have voiced concerns that the current Trump administration is taking steps backward. In April, the Education Department pulled roughly $1 billion in grants that were meant to boost the ranks and training of mental health professionals who work in schools, saying the grant awards made under the Biden administration now conflict with Trump administration priorities.
Kennedy has a history of disagreeing with the broader scientific consensus on issues like the safety and efficacy of vaccines. The MAHA children’s health report outlines broad priorities like shifting children’s diets away from processed foods, reducing exposure to “synthetic chemicals,” and encouraging exercise. The report also criticizes “overmedicalization” and prescription of medications like those used to treat ADHD and a popular form of anti-depressants.
In the Washington Post essay, Kennedy and McMahon praised school cellphone restrictions and called for educators to pay more attention to health factors like sleep and diet.
“Though we should not discount the necessary contributions of mental health professionals, we also can’t forget the harms therapy can do when aggrandized into a ‘system’ that processes normal schoolchildren like patients in a sanatorium,” they wrote.
But it’s a false choice to say schools must either stress mental health interventions or healthy physical habits, like sleep and exercise, because those factors go hand in hand, mental health experts said. In fact, mental health screenings may help schools identify students who need help building healthy sleep habits or forming stronger relationships.
“Physical exercise and nutrition are essential to young people’s emotional health, but mental health and suicide are complex and multifactoral and therefore, our approach has to be comprehensive and holistic,” said Erickson-Schroth of JED. “It’s not an either-or: Accessible mental health-care and life-skills education can—and should—co-exist with ensuring young people exercise and eat well.”
