As we enter the third anniversary of COVID-19, the pandemic experience continues to leave its mark on all of us. While collectively, as a nation, we appear to be moving on from the daily disruption and devastation of COVID-19 (New York State recently dropped their face mask requirements for hospitals and health care facilities), we will never forget the lines around the block to get tested, the grocery store wastelands, the long days with restless kids at home and interminable office zoom calls. And, of course, the unfathomable number of deaths.
The psychological effects will persist for years. But none is suffering more socially and emotionally from three years of uncertainty and isolation than our country’s youth. The decline in students’ mental health makes them one of the true casualties of the pandemic.
Adverse Effects on Student Mental Health During the Pandemic
Data shows that most adolescents experienced negative events during the COVID-19 pandemic — and those experiences were linked to a higher prevalence of poor mental health and suicide attempts.
A recent CDC analysis shines additional light on the mental health of U.S. high school students during the COVID-19 pandemic, including a disproportionate level of threats that some students experienced.
According to the new data, in 2021, more than a third (37%) of high school students reported they experienced poor mental health during the COVID-19 pandemic, and 44% said they persistently felt sad or hopeless during the past year. The new analyses also describe some of the severe challenges youth encountered during the pandemic:
- More than half (55%) reported they experienced emotional abuse by a parent or other adult in the home, including swearing at, insulting, or putting down the student.
- 11% experienced physical abuse by a parent or other adult in the home, including hitting, beating, kicking, or physically hurting the student.
- More than a quarter (29%) reported a parent or other adult in their home lost a job.
While this influx of evidence points to the diminishing of our youth’s mental health since the pandemic started, the question is – did the pandemic actually cause a decline in the well-being of our children, or did it merely shine a light on an already growing, 15-years-in-the-making student mental health epidemic? Early maturation, the damaging effects of social media, and consistent exposure to traumatic events such as school shootings, political polarization, and climate change all affected our youth’s mental health long before COVID-19.
Data from 2009 — 2019 reveals that mental wellness amongst high schoolers was already in sharp decline. The study showed that persistent feelings of sadness or hopelessness increased by 40% between 2009-2019 for U.S. high school students; students seriously considering suicide grew from 13.8% to 18.8%, and suicide attempts increased from 6.3% to 8.9%.
In September 2022, the Clarify Health Institute, the research arm of Clarify Health, initiated an ongoing investigation of trends in pediatric mental and behavioral health and reported their findings in the brief, The Kids are Not Alright: Pediatric Mental Health Care Utilization from 2016 – 2021. Leveraging a national observational sample of health insurance claims from more than 20 million children aged 1–19 years old annually, they observed several important trends in the mental health care of America’s youth from 2016–2021. Their findings included:
- A 61% increase in mental health inpatient (IP) hospital admissions from 2016–2021
- A 20% increase in mental health emergency department (ED) visits from 2016–2021
- Significantly higher rates of mental health IP admissions and ED visits among teenagers compared to younger children
Our recent nationwide poll in collaboration with John Zogby Strategies of over 1,000 administrators and parents found that while schools have made progress in tackling the youth mental health crisis and 80% of parents believe that schools should play a role in the delivery of mental health, educators say that districts continue to face significant hurdles when it comes to early identification of students with mental health challenges (52%), staffing (50%), and funding (47%).
Psychologist Kimberly Hoagwood, Ph.D., a child and adolescent psychiatry professor at New York University’s Grossman School of Medicine, states, “We’re seeing really high rates of suicide and depression, and this has been going on for a while. It certainly got worse during the pandemic.” If these earlier findings indicate a generation of youth crying out for help, the pandemic turned that cry into a full-blown youth mental health crisis.
Meeting An Intensified Mental Health Need
The good news is that most well-meaning educators are reacting to this crisis by either fortifying existing resources or sourcing external programs to treat the worsening mental health of their students. But that’s what’s troublesome — are they quickly reaching for a lifeline, cobbling together a piecemeal program that’s neither comprehensive nor coherent to try and meet the overwhelming need? Surgeon General Vivek Murphy stated in his 2021 Advisory: Protecting Youth Mental Health, “To be sure, this isn’t an issue we can fix overnight or with a single prescription.”
Hiring additional clinicians might seem like the obvious solution. But without highly structured clinical protocols, ad hoc solutions such as hiring clinical interns, re-assigning social workers, and other “random acts of therapy” don’t provide optimal outcomes for students requiring mental health interventions.
What is needed are thoughtful, data-driven, evidence-based solutions proven effective in the long term, not just when overwhelmed or during a crisis. Mental health is a long game; as those who enjoy sports know, a great offense always outplays a great defense. Amid what many consider “the defining education and public health issue of our time“, schools have an opportunity and an obligation to proactively make a difference by delivering effective, clinically supported, high-quality mental health services to every student in their care.
To that end, Effective School Solutions has published Will to Wellness: Six Steps to Reinventing Mental Health in Schools, a best practice guide to serving the mental health needs of K — 12 students. While most districts have the will to support the mental health of their students, it is the execution — the processes, policies, and systems – needed to deliver high-quality services that remain a work in progress for many districts. This six-point framework represents the key areas that districts should focus on in the next five years when reinventing mental health care in schools.
State and federal policymakers also have an opportunity and an obligation to ensure the efficacy of school-based mental health. The six steps include recommendations and suggestions for state and federal policymakers on how best to support and incentivize school districts’ efforts to implement mental health programs in schools to ensure every student has access to high-quality mental health care.
By implementing these six steps and following the guidelines outlined in this framework, proven to improve care, strengthen academics, address trauma, and maintain student wellness, schools can ensure they are utilizing best practices for implementing, overseeing, and measuring the efficacy of their in-school mental health services and behavioral support programs.