Middletown Area High School, which enrolls 650 students in a rural part of Dauphin County, was designed with security in mind.

The school is surveilled with more than 115 security cameras, according to its principal Michael Carnes. And while natural light floods the hallways, most of it comes from glass walls enclosing a courtyard at the center of the building — for security reasons, there aren’t many windows on the exterior, Carnes said.

But Carnes knows that top-of-the-line safety features can only go so far in protecting students.

“We’re never going to be 100 percent [safe],” Carnes said Monday, when his school hosted a threat response training for educators delivered by the U.S. Secret Service. “There’s no Fort Knox for a school, and we don’t want a prison. So how do you make it nice, but safe?”

The answer, Carnes said, is to hire the right people.

In the past decade, the Middletown campus has bolstered its ranks of mental health professionals, hiring its first social workers, doubling the number of school psychologists, and contracting with a private company to provide in-school counseling services, Carnes said.

While demand for mental health services outstrips access in Pennsylvania, state lawmakers in recent years haven’t increased spending, WITF-FM in Harrisburg reported in December.

According to a new poll by Franklin & Marshall College in Lancaster, that lack of funding has been felt by many Pennsylvanians: Nearly two-thirds of registered voters (65 percent) said the state spends too little on mental health services.

At the same time, administrators like Carnes say that mental health services are key to preventing school shootings like the one that killed 17 students and staff in Parkland, Florida in 2017.

In the aftermath of that attack, Pennsylvania’s Legislature took steps to improve school safety.

A new grant program doled out more than $40 million, which schools used to upgrade security equipment and, in some cases, create new mental health programs.

According to WHYY-FM in Philadelphia, 90 applicants for that new funding “mentioned mental health, student trauma, or behavioral supports” in summaries of their grant spending.

The Legislature at the same time created the Safe2Say program, an anonymous system for reporting threats to schools and students.

The hotline has fielded more than 23,000 tips related to school safety since it went live this January, according to a report issued Monday by the Office of the Attorney General, which administers the program. That doesn’t include 1,300 calls that were deemed pranks.

While the tip line may have been set up to prevent school shootings, it’s instead become a catalog of mental health concerns.

More than 10,000 tips statewide related to student bullying and cyber-bullying, suicide, depression, anxiety, and self-harm, the data show. Just 607 tips — three percent of the total — were threats of violence against schools.

“The numbers in this report show the reality of what our children are facing in school as they struggle with bullying, anxiety, and thoughts of self-harm,” the report reads. “The Attorney General urges Pennsylvania’s Legislature to read this report, study the data, and act to address the need for increased mental health resources for students across our commonwealth.”

The findings from the OAG report weren’t a surprise to Carnes, who said the variety of tips was “pretty much on par” with ones his high school has fielded this year.

Mental health advocates, meanwhile, say that the numbers highlight the need for frank, candid discussion of mental health in schools.

Ryan Klingensmith is a Pittsburgh area-based counselor who works with children and teens, and who runs an organization, Shape the Sky, that helps parents and educators teach kids about internet use.

Klingensmith said it’s more important now than ever for schools to teach students about mental health, so that educators can counter the misinformation that kids may encounter online.

“I tell parents, ‘You can’t parent your kids like you were parented. That world doesn’t exist,’” Klingensmith said. “And we have to look at mental health differently. [Kids] can get as much info as they want, and it might not be accurate or helpful.”

But right now, Klingensmith said, most schools need more money and staff to provide adequate mental health care to students and educators.

A February report by the American Civil Liberties Union found that the student to counselor ratio at the average Pennsylvania school falls short of industry-recommended standards. And while Pennsylvania law requires schools to provide staff with four hours of suicide prevention training over the course of five years, Klingensmith said that’s not nearly enough.

Govan Martin, who heads the nonprofit advocacy group Prevent Suicide PA, agrees.

He said that some schools may hesitate to discuss suicide with their students, fearing they’ll lead impressionable youth to take their own lives. But that kind of thinking is “fully false,” he said.

Improving student mental health and preventing suicide, Martin said, is often as simple as having open discussions with individual students or in peer groups.

“Most kids are open to talking about it,” Martin said. “We just have to be OK with talking back.”

If you need help, contact The National Suicide Prevention Lifeline at 1-800-273-TALK (8255).