Failing Grades for Children’s Mental Health in North Carolina

News | March 31, 2023


Biannual Child Health Report Card reviews 15 key indicators of children’s health 

RALEIGH -- On April 4th, NC Child and the NC Institute of Medicine released the 2023 Child Health Report Card. Since 1997, this biannual report has presented 15 key indicators of child health.  

In 2023, North Carolina earned failing grades in several key areas, including Mental Health, School Health, Housing & Economic Security, and Birth Outcomes. However, the state is making progress in other areas, including preconception health & maternal health support, and substance use. 

Media Preview 

The 2023 Child Health Report card will be released to the public on Tuesday, April 4th. Preview the report card at this link:

Release Webinar 

The authors of the Child Health Report Card will present findings to the media at a brief webinar on Tuesday April 4th at 1 PM. Register here

“Our state is falling woefully short of our goals for children’s mental health and well-being,” said Kathleen Colville, President and CEO of the North Carolina Institute of Medicine. “As we continue our pandemic recovery, this report should be a call to action for consensus-building around policies and programs that promote the health and safety of all North Carolina kids.” 

Summary of Grades 

Below is a summary of grades in this year’s report: 

A - Insurance Coverage 

B - Environmental Health; Health Services Utilization & Immunization; Preconception and Maternal Health & Support; 

C - Teen Births; Breastfeeding; Oral Health;  

D - Education; Healthy Eating and Active Living; School Health; Child Abuse & Neglect; Tobacco, Alcohol, and Substance Use;  

F – Birth Outcomes; Mental Health; School Health; Housing and Economic Security 

Most of the data reported in the Child Health Report Card represent conditions facing children and families in 2021. The report card provides a vivid illustration of how the pandemic exacerbated several troubling trends facing our children, particularly in the areas of mental health, education outcomes, and school-based health.   

Opportunities to Support Children’s Mental Health 

“All of our children deserve the chance to thrive, regardless of whether they live in a rural or urban area, their race, gender, or how much money their parents make,” said Erica Palmer Smith, executive director of NC Child. “The data on children’s mental health is especially concerning.  We are grateful for the parents, elected leaders and clinicians who are coming together to reverse this crisis and help bring our children back to health.”


The authors made several recommendations focused on children’s mental health, including:  

  • Removing barriers to mental health care; 
  • Enhancing the availability of mental health care and crisis intervention in public schools, particularly in rural areas where specialty care is less available; and 
  • Making it harder for children and youth to get access to lethal means of self-harm (e.g., safe storage of firearms and prescription drugs). 


On April 4th, the 2023 Child Health Report Card, as well as data sources and infographics, will be available to the public at


About the North Carolina Institute of Medicine 

The North Carolina Institute of Medicine (NCIOM) is an independent nonprofit organization committed to better health for all North Carolinians. Chartered by the North Carolina General Assembly in 1983, the NCIOM provides nonpartisan information and opportunities for consensus-building on issues of relevance to the health of North Carolina’s population. Visit for more information. 

About NC Child 

NC Child builds a strong North Carolina by advancing public policies to ensure all children – regardless of race, ethnicity, or place of birth – have the opportunity to achieve their full potential. Visit for more information.