Maryland is now the ninth state to join the Interstate Compact for School Psychologists with the hopes of shrinking its behavioral health professional shortage.
During the 2024-2025 school year, Maryland was averaging one school psychologist per 1,037 students, which doubles the recommended ratio set by the National Association of School Psychologists.
Alexis Nadau is a school psychologist in Anne Arundel County, and she says she’s feeling that shortage in real time.
“We try our best to make sure that all of the needs are met. However, our caseloads, they really are variable,” she said. “What I’m looking at for my caseloads is about triple of what it is supposed to be.”
Nadau says it’s common for elementary school psychologists to be split between two or three different school buildings, meaning their reach within the student population is often limited.
“Our bandwidth, it’s so stretched thin, where I feel as if I can really concretely say I’m addressing 15 percent of the concern. However, I’m looking at the bigger picture of, I’m missing a whole chunk of students that really go unsupported, and so there are students that do fall within the cracks.”
To help address this workforce shortage, the Maryland General Assembly passed a new law this year that enters Maryland into an interstate licensure compact to make it easier for school psychologists to work across state lines.
Member states have set up an information exchange system for licensure documentation, allowing receiving states to grant school psychologists from other states an equivalent license to practice.
Colorado, Nebraska, Kansas, Mississippi, Georgia, Virginia, Delaware and West Virginia have all joined the compact, and Pennsylvania and Ohio have legislation pending in their state legislatures.
Ann Geddes, the Mental Health Association of Maryland’s (MHAM) Director of Youth and Older Adult Policy, says a move like this is key amid what is considered the largest youth mental health crisis ever recorded.
According to data from the the Centers for Disease Control and Prevention’s 2023 Youth Risk Behavior Survey, almost 30 percent of high school students are experiencing poor mental health and two in 10 students seriously considered attempting suicide.
“There’s every reason to throw as many resources at youth mental health services as we can, and we know that schools are a prime place for youth to be able to access those services,” Geddes said.
She says when students are referred to mental health services outside of schools, it can be difficult for families to get weekend or evening appointments, provide transportation for those appointments and cover additional costs.
In addition to supporting the licensure compact, Geddes says MHAM is focused on ensuring funding is maintained for the Maryland Consortium on Coordinated Community Supports.
The consortium was created under the ambitious statewide education overhaul passed by the General Assembly in 2021 known as the Blueprint for Maryland’s Future.
It provides $96 million in grant funding for organizational programs, all of which are targeted toward expanding access to comprehensive behavioral health services for Maryland students, pre-K through grade 12.
Maryland is not just short on school psychologists – it’s facing challenges within recruiting and retaining behavioral health providers as a whole.
According to a 2024 report commissioned by the Maryland Health Care Commission, the state is nearly 50% short of the workers needed to meet the behavioral health needs of Marylanders.
The state needs to almost double its workforce to meet projected care needs by 2028.
Geddes says providing better pay for behavioral health professionals would be a good place to start.
MHAM advocated for a 3% increase in Medicaid reimbursement for behavioral health services, but that measure did not pass likely due to a precarious budget year for the state.
“Without increased salaries, Medicaid reimbursement for these providers, the workforce is just going to continue to shrink. So that’s a real concern,” Geddes said.
But advocates remain hopeful around what the Interstate Compact for School Psychologists will do for the state.
Nadau says having more staff could not only open the door to helping more students, but it could help expand the types of care offered.
“For example, running some counseling groups, anger management classes, or executive functioning groups, in which a lot of students struggle with some of those planning, initiation, motivation and organizational skills that really produce productive citizens in our state,” she said.
The compact goes into effect on Oct. 1 of this year.