Mental Health and School Re-Entry
What does the evidence show?
It is an unfortunate and sometimes downright upsetting phenomenon to see mental health used as a scapegoat to divert attention from other topics. Many will likely be able to report seeing this happen in the wake of mass shootings. In those instances, some people who wish to divert the conversation away from a focus on gun control may say something like “this isn’t about gun control, this is about mental health.” They tend to claim that untreated mental illness is the real culprit behind the tragedy and often propose solutions such as registries of people with mental health diagnoses that can be used in gun purchases. While mental health can and certainly often is a factor here—and we personally are always in favor of conversations that might shine a light on the often-overlooked problem of untreated mental illness in this country—the motivation behind this attention is likely simply to turn attention away from another urgently important but less politically desirable topic.
This kind of diversion tactic unfolded again last spring and summer with calls for schools to reopen amid the COVID-19 pandemic. Then-President Donald Trump, many of his supporters, and others claimed that keeping schools closed was very threatening to mental health and that the mental health-related risks of not reopening posed a greater threat than the COVID-related risks of reopening.
It goes without saying that school and socialization are positive drivers of youth mental health. But is it really fair to say that keeping schools closed poses a dire threat to mental health? More dire than the threat of serious outbreaks of a highly contagious and potentially deadly disease? It is here that we must better understand what the evidence we have actually says.
In general, and perhaps not surprisingly, school attendance is associated with better mental health and emotional well-being. Being in school can lead to a greater sense of connectedness, social support, and, more practically, better access to services. The benefit is often more pronounced for students with special needs and those who have behavioral or emotional issues and thus for whom extensive use of technology as part of virtual schooling might be difficult.
Indeed, any population that is already vulnerable will struggle more with school closure. For all students, schools are central to general development (especially for young children), building social and emotional skills, food security (which has an impact on mental health), and addressing social and racial inequity (which also has an impact on mental health).
Given the mental health benefits of being in school, does it necessarily follow that we need to rush our children back into these potentially unsafe conditions in the midst of a pandemic that threatens all of us? Ultimately the question comes down to one of weighing risks. And to be able to weigh risks, we have to have a clear understanding of what has happened to mental health (and what is likely to happen to mental health) as a result of the pandemic and associated school closures and general lockdowns.
There is some reason to believe that the pandemic is already taking a toll on mental health, especially among teens. One study out of Italy and Spain found that 85 percent of parents perceived changes in their children’s emotional state during quarantine. High school and college students are clued into the possibility of the pandemic’s negative effects on their mental health, with more than half in a recent survey expressing concern about their own mental health as a result of the COVID pandemic. Professionals in California have also reported an uptick in depression and anxiety in the teen population since COVID began.
Despite these reports, it is difficult to know the ultimate impact of COVID-19 and associated quarantine on mental health. It may take years before we understand the relationship and even then, it will be hard to isolate COVID-19 as the cause, especially since mental health issues are already on the rise among teens and young adults.
In cases such as these, we would normally advocate carefully and scientifically weighing the risks against one another to reach a decision about when to keep schools open and when to shut them down. But there is simply too much uncertainty here to be able to do that. We don’t fully understand how contagious the virus is specifically among young people, we don’t know what the role of school opening is in the perpetuation of large outbreaks, and we also don’t know how long the pandemic will even last.
In our view, it is not acceptable at this stage to keep schools open or reopen schools on account of mental health when COVID cases are extremely high. It is likely that many factors are involved in whether or not opening schools in specific communities is a major driver of increased viral transmission. We simply don’t know enough about the relationship between quarantine and mental health to be able to say that the risks of keeping children out of school outweigh the risks of COVID-19 spreading widely in a community. In the end, we need to do everything we can to protect both the physical and mental health of as many people as possible.