What many don’t realize is that, even before the pandemic, rates of anxiety, depression, and suicide were on the rise among adolescents, and schools—which have in many areas become the de facto mental health-care providers for children in their communities—have been struggling to keep ahead of the ever-growing need.
The Multi-Faceted COVID Complication
When looking at similar crises in recent history, we see that children displayed that they were needier. They withdrew from peers and interest in activities. They experienced sleep and appetite disturbances, and they became more rebellious, agitated, or apathetic. All of these are normal stress responses which we can anticipate seeing in our students this fall.
As school closures dragged on in many states in the spring, student morale tanked. Over three-quarters of teachers and district leaders recently surveyed said that student morale was lower than before schools closed. Now that many states are ambivalent about opening, student confusion and anxiety is sure to undermine that morale even further.
Researchers found that children who were quarantined for disease containment scored four times higher on a post-traumatic stress test than those who were not.
Amy Learmonth, Ph.D., is a developmental psychologist who has studied how children as young as eight weeks old think and how their abilities change over time. She runs the Cognition, Memory, and Development Lab at William Paterson University of New Jersey and is also president of the Eastern Psychological Association.
“Social development has important impacts at all ages, but for social distancing, the kids who are likely to suffer the most are in late childhood and adolescence,” Learmonth told Healthline.
She added, “Young children are learning the basics of being social beings, and their parents and siblings can provide most of the input they need, while older children and adolescents are learning to navigate complex social groups of peers.”
“They do this by experimenting,” Learmonth said. “They are in the process of figuring out who they are and what they want from their friends. This is why those friendships in middle school particularly can be fragile, and most kids experience some isolation and heartbreak.” The problem is that such friendships are difficult to develop while maintaining a distance of six feet, or over a computer screen or smartphone.
To be sure, not all children will suffer trauma from the COVID-19 pandemic. Some students have already learned healthy coping skills. But many new factors will likely cause the numbers of traumatized students to grow. Some have experienced the loss of a loved one. And others have witnessed substance abuse, neglect, violence, or physical abuse while secluded at home during the coronavirus outbreak, or as these are commonly known — ACEs (Adverse Childhood Experiences).
Wide-ranging research has shown that children who experience ACEs, such as what this pandemic will cause for some, have a higher risk of worsening chronic diseases, autoimmune diseases, asthma, depression, anxiety, and substance abuse far into adulthood. At higher risk are those children who had experienced untreated trauma before this outbreak.
Sarah Smith is senior director of education at the International Rescue Committee. She says that when social disruption interrupts learning, we should expect effects on brain development, especially for students who already had a risk factor or two in their biology or family life. “Their social and emotional well-being is at risk,” she says. “And they’re more likely to experience, for instance, toxic stress, which is just a disruption in their brain development.” It can have “long-term consequences for their overall well-being, their ability to hold down a job, their ability to learn in school later if they get back into school, and their fiscal health.”
More High School Dropouts
Doug Harris, a professor of economics at Tulane University, says schools and districts should prepare for a spike in the high school drop-out rate. In New Orleans, the displacement students experienced from Hurricane Katrina—especially among kids from low-income families—affected high school graduation and college enrollment.
In part, this had to do with economic factors. “Their parents just lost their jobs, and they’ve got younger siblings to take care of while their parents are out trying to find work and trying to manage things,” says Harris. In our current pandemic, the numbers who have lost their jobs, perhaps permanently, is soaring.
Returning to School Poses Risks as Well
As District Administrators and principals agonize over the question as to whether children will return to the classroom in a matter of weeks, they admit that this return is fraught with potential psychological pitfalls. While avoiding the spread of the virus will be top priority for school districts across the country, there are other challenges.
Dr. Justin Dodson of Youth Villages in Germantown, Tennessee, said that the changes within schools, such as wearing masks and social distancing, could lead to more anxiety and depression among children.
“It may send a message to some kids that, ‘well, if school is back in then things should be back to normal.’ And they’re not back to normal,” he said. “You go into a school and everyone is wearing masks, and things look different. If some kids don’t have the right education about what this is going to look like, you may walk into a school and when everything’s different you may be wondering, what is this all about?'”
He says that students could also become targets for bullying. “If my mask is dirty, or I don’t have the same PPE, or if I don’t know as much about what’s going on, that can make children more susceptible to bullying behaviors,” said Dodson.
Dodson urges parents to take time to explain to kids what to expect if they return to school. “Get the right information from the school so you can communicate that to your kid,” he said. “Do some role playing of what that may look like at school. But patience is going to be the biggest key because now you get to see what education looks like in a time like this, and that’s not always easy.”
Comprehending The New Reality
As states deliberate whether or not to reopen schools, some online school psychologists are expressing yet another worry — that schools don’t even fully grasp the extent of their students’ emotional trauma with which they will be confronted.
In their rush to get kids into classrooms, school officials overlook what could be a mental health crisis in their students, says Maryam Jernigan-Noesi, a psychology professor at Agnes Scott College in Decatur, Georgia. Going back to school won’t immediately solve students’ mental health challenges brought on by the pandemic. Many of them face uncertainty about whether or not they will have to leave school again.
“They are coming back to school feeling very unstable,” she says. “This place that was once a place of stability, they’ve been detached from that, which has affected their own attachment to both their educators and the school environment.” To help ease this transition, teachers, district administrators, principals, and staff can look at the principles of trauma-informed schools, says Jernigan-Noesi. These schools train their staff to recognize and respond to students experiencing trauma and other stressors.
“Trauma can lead to experiences of disorganization, something we refer to as our executive functioning in our brains, which allows us to focus and to organize things that children need for learning,” she says. “It’s about creating or facilitating a way for children to be able to calm themselves.”
Mindfulness exercises are used in trauma-informed schools to teach children to recognize what they feel in their bodies, which grows their emotional intelligence, Jernigan-Noesi says. This can be as simple as starting off the school day with a deep breathing exercise.
Many educators have expressed concerns that remote learning has caused many students to fall behind. Jernigan-Noesi says she is concerned that, without mental stability, students will struggle to stay focused.
“I’ve been really concerned about commentary that says children have missed so much. We’ve got to get back to the business of learning,” she says. “The tools children need to learn may be disrupted at this time.”
“Instead of rushing right back into learning, teachers and parents need to be patient in allowing kids to express themselves during this time,” she says. While teachers shouldn’t expect every student to speak up, it’s important to offer a safe space for them to express their feelings — especially since they may be lacking that at home,” Jernigan-Noesi says.
Unable to Meet the Swelling Demand for Mental Health Care
So it will come as no surprise that experts say, when kids return to campuses, the demand for mental health care and online school psychologists will certainly far exceed the available services. “We’re only going through the first wave of the disaster,” said Dr. Curley Bonds, chief medical officer for the L.A. County Department of Mental Health. “This is the equivalent of people waiting on rooftops to be saved after Hurricane Katrina.”
According to a recent Education Week Research Center Survey, fewer than a quarter of school leaders say they’ve been able to meet students’ mental health needs at the same level as before the coronavirus pandemic. And the situation is particularly grim for urban schools, where only 5 percent of school leaders say they have been able to maintain the same level of mental health care.
While this isn’t the time to despair, to deliver the services that students deserve and expect, we must face this problematic reality head-on. Just as triage is a critical component of an effective emergency room in a hospital, triage will be vital to solving this unprecedented mental health crisis that district administrators are about to confront.
COVID-19 is “this great unknown,” says Robin Gurwitch, Ph.D., professor of psychology at Duke University Medical Center. “We don’t know how long this is going to last.” And that can heighten anxiety in children, as it can for adults. “Children certainly are being impacted by this because it’s changed their worlds,” says Dr. Gurwitch.
When district administrators and principals consider the mental health needs of the students under their watch, they have a plethora of considerations. What may be helpful is to take heed of acute concerns initially. Without addressing these immediately, the entire process may become more complicated.
The following are immediate priorities:
Raising Student Morale
Treating those who have suffered Event-Based Trauma such as losing a loved one, or those have witnessed substance abuse, neglect, violence, or physical abuse and have suffered ACEs from this pandemic
Engaging those who have been negatively impacted by Social Isolation
Prioritizing those students more susceptible to dropping out of school
Being sensitive and aware of students who will experience trauma in returning to school
Providing the necessary psychological resources such as online school psychologists, social workers, and counselors for the many students and their pressing mental health needs promises to be a complex challenge for district administrators and principals. They will need our constant support as they devote themselves to helping our children cope and heal from this unprecedented disruption in their tender young lives.