Mental Health Access and School Discipline: Evidence from North Carolina

• In Event: Mental Health in Education: Risks, Interventions, and Access to Care

Abstract

Student mental health needs have increased sharply, yet access to treatment remains uneven. Schools often absorb the consequences of unmet mental health needs through disciplinary systems, but there is limited evidence on whether expanding access to mental health services changes student discipline. This paper examines how local availability of licensed mental health facilities shapes disciplinary incidents and school responses using longitudinal administrative data from North Carolina.

I link student-level education records (2009-2017) from the North Carolina Education Research Data Center to geocoded data on mental health facilities. Mental health access is measured as the number of facilities within a fixed radius of a student’s baseline residence, lagged by one year. By fixing residential location and estimating models with student, school, and year fixed effects, the analysis isolates within-student changes in nearby access over time, minimizing bias from residential mobility and unobserved student characteristics.

Greater access to mental health facilities is associated with a reduction in overall disciplinary incidents. However, conditional on an incident occurring, students are more likely to receive out-of-school suspension. Decomposition analyses show that access reduces less severe incidents while increasing the relative incidence of more serious cases. Yet this compositional shift does not fully explain the pattern: incident-level models that compare outcomes within the same offense type show that incidents are more likely to result in harsh, exclusionary consequences when access is higher. In contrast, in-school suspension declines, suggesting a shift toward more severe disciplinary responses among observed cases.

These findings point to a nuanced relationship between mental health access and school discipline. While improved access may reduce lower-level behavioral issues, it does not reduce reliance on exclusionary discipline. Within a broader policy context where schools are central to delivering and coordinating mental health supports, the results suggest that expanding access alone is insufficient without complementary changes in school disciplinary practices and responses to student behavior.

Author

• Harneet Kaur, University of Arkansas
  Presenting Author