James Donaldson on Mental Health – Rising to the challenge: Addressing the youth mental health crisis in our schools

By Erica Palmer Smith

By Michelle Ries

Youth mental health is in a state of crisis. There is no denying that anymore. According to the latest data, nearly one in five adolescents in North Carolina suffered from depression and one in ten of our high school students reported attempting suicide. 

There has been a drastic increase in rates of anxiety, depression, and suicidal ideation amongst our youth in recent years and we know that what happens at school is contributing to those issues through peer pressure and bullying. That’s why schools have to be part of the solution. 

Schools are places of learning and connection. Schools are where young people spend the most important hours of their day and where some of their most formative moments will occur. Schools have a huge impact on their health and wellbeing. And that impact should be positive. 

But today there is a gap between the needs of our young people and the services available. In 2024, there were 1,928 students for each school psychologist in North Carolina — nearly four times the ratio recommended by the National Association of School Psychologists. For school social workers, the ratio was also nearly four times higher than what is recommended. 

That’s a challenge that we should address. We know that school personnel provide much needed support for students with developmental and social-emotional needs. They monitor progress, they develop prevention and intervention plans, and they help students who are in need or who are at risk of dropping out. They’re on the frontlines and they are often the first responders of our youth mental health crisis. And they need our support.

That was a focus of the 2025 North Carolina Child Health Report Card recently released by NC Child and the North Carolina Institute of Medicine. 

The report card included a special section on school-based mental health including access to support staff, referral services, the connection between physical activity and mental health, and the impact of social media on mental health. And we can learn so much from this report. 

We should address the causes of the youth mental health crisis (from new technology to social pressures) and we should also provide support to young people who are dealing with these issues. We are encouraged by efforts to increase pay for providers, develop the mental health workforce, and improve the state’s crisis system. And that more people are paying attention. 

The Whole Child NC Advisory Committee at the North Carolina Department of Public Instruction recommends improving access to school-based health services as a statewide priority. 

East Carolina University has a Healthier Lives at School and Beyond program utilizing telemedicine to reduce barriers to services in rural areas. There’s also the Carolina School-Based Telehealth Learning Collaborative, comprised of health care providers across the state that implement both physical and mental virtual health services in our schools. 

Several of our partners are raising awareness about the importance of school-based mental health services through the EarlyWell Initiative, Essentials for Childhood, and CaroNova’s NC Youth Mental Health Action Plan. And we will continue to as well. We know that what happens at school can affect mental health and we need the resources to make that a positive outcome. 

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson’s latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

About the North Carolina Child Health Report Card: 

At the North Carolina Institute of Medicine and NC Child, we are dedicated to ensuring that communities and policymakers have the best information on the issues facing our children. For nearly three decades we have partnered together to publish a Child Health Report Card. 

The biannual report card provides a snapshot of the health and well-being our state’s children, and sheds light on the successes and challenges facing our youngest generations. 

This year the results were mixed. North Carolina received an “A” for insurance coverage and a “B” for maternal health and support. But we also received poor grades for oral health, healthy eating and active living, and education outcomes, and a failing grade for youth mental health. 

That’s why we are speaking out about the severity of the youth mental health crisis and the opportunity we have to make a difference. Our hope is that the report card will inform leaders and policymakers across the state. The report card tells us what’s working and where we need to improve so that every child can reach their full potential. And that’s our goal.