Nearly 80% of the Los Angeles Unified School District's half a million students are considered "economically disadvantaged," the type of student for whom school can be quite literally a lifeline. But the coronavirus pandemic has upended the LAUSD community, changing the ways that teachers stay connected with their students — and notably, how tens of thousands of young people receive mental heath care. Schools are the primary sites of mental health care and support for children and young people, and now that a pandemic has disrupted education for months, it's worth examining how coronavirus has changed students' mental health needs come fall.
The Kaiser Family Foundation estimates that "among all adolescents who used any mental health services in the year, 57% received some school-based mental health services." Behavior disorders are most common in children aged 6-11, but anxiety and depression are most common in teens aged 12-17. Both are likely to be exacerbated by the coronavirus pandemic, experts say.
The 30 million children currently out of a traditional educational environment will hopefully return to classrooms in the fall. So the question lingers: Are schools ready for the mental health issues that may accompany them? There are two main challenges for practitioners: how they can address students' needs now, and how they can prepare for new mental health concerns come September.
"School-based mental health professionals are going to have to give a lot of grace."
Thousands of mental health care professionals based in schools are scrambling to shift their work online, speaking with students (and occasionally parents) by phone and video call, to varying degrees of success. Tony Aguilar, LAUSD's chief of special education, equity, and access, runs the district's mental health hotline, but he tells Mic that phone check-ins with professionals can be difficult because they don't allow the person to read a student's body language or facial expressions.
That's why, for students who feel safe in their homes and have a private place to speak, video calls for mental health check-ins are generally preferable, says Katherine Cowan, the director of communications at the National Association of School Psychologists. There are students for whom home is fraught or sometimes violent, however, and Cowan tells Mic that those are the kids who are likely be experiencing more stress while simultaneously having less access to support. "Everybody knows that there's some kids out there they're not reaching," Cowan says.
Cowan says that's why teachers and mental health professionals have to have increased awareness and be attuned to warning signs when kids come back to the classroom, especially as coronavirus may have exacerbated any existing anxieties. Counselors have to be particularly ready to lend additional support to lower-income students, she says, who would have had fewer resources to weather the pandemic and whose home lives may have been more disrupted than more wealthy peers'.
When students return to school, daily life and classes will be far from normal, says George DuPaul, a professor of school psychology at Lehigh University. Some students will return with new traumas, brought on by the mental and emotional stress of social isolation. There's also the fear of not knowing what will happen in the future, and the toll of economic stress on parents that inevitably got passed down to their children, DuPaul tells Mic. Social isolation has long been thought of as a contributor to depressive feelings, and even the Centers for Disease Control have warned that as "student engagement with schools and peers diminishes, [this] could increase anxiety and other mental health and emotional problems."
Much in the way that moving to an online model was a transition for students, so too will be adjusting back to being in a classroom. Many kids have been out of their traditional school environment for months already, and that's before the usual three-month summer break. As Jennifer Rothman, the senior manager of youth and young adult programs at the National Alliance on Mental Illness, tells Mic, "School-based mental health professionals are going to have to give a lot of grace" to students as they reorient themselves to social life, early mornings, and focusing their attention for long periods of time.
Teachers are also responsible for addressing mental health. They often have the most face-time with students, which means that they can most directly impact students' mental, emotional, and intellectual readiness. "I do think it would be smart and very proactive [for teachers] to look at their curriculums to see if they can allow for more time to move around," Rothman says, rather than to thrust students right back into learning as if nothing has changed.
That transition process needs to start before the school year resumes, warns DuPaul. He suggests that teachers start before young people enter the classroom, by screening each student with a routine diagnostic that asks about behavioral and emotional issues. That way, he says, teachers will have an understanding of baseline student needs and could take the kids' emotional "temperature." With that information, instructors could then triage based on immediacy or severity of need, DuPaul says.
Most students' mental health needs will be manageable through typical psychological and intervention services, Rothman says. "Treatment is available and recovery is possible," he explains, but things get tricky when there are more institutional inequalities layered on top of each other. For instance, reaching rural students with reduced access to internet-based services is a challenge, and low-income students who return to school may carry specific traumas, like having endured food insecurity or had a parent lose their job due to coronavirus.
In the same way that sources of stress during the pandemic are interwoven, so too are mental health issues. The CDC explains that about one-third of young people with anxiety also suffer from depression or have behavior problems, while and one-fifth of young people with behavior problems also have depression. Poor children are more likely to suffer from mental health issues, DuPaul says, with 1 in 5 diagnosed with a behavior disorder. They're also more likely to receive mental health care at school than their wealthy peers are. Because low-income schools will have fewer resources to tap into, it's important school personnel at those institutions in particular are prepared for the challenge ahead.
We ask a lot of our teachers and guidance counselors already — likely too much. And when the calendar turns to fall and kids are strapping on their backpacks again, coronavirus will have added one more line to their job description.