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Mental Health Should Be a Top Priority in Schools, New Biden Administration Guidance Says

President Joe Biden’s administration on Tuesday unveiled updated guidance and resources to help school staff support childhood and adolescent mental health, citing the ongoing impact of the COVID-19 pandemic as reason for the change.

Released by the Department of Education, the Supporting Child and Student Social, Emotional, Behavioral and Mental Health handbook highlights seven key challenges to providing mental or social help to students across K-12 schools and in institutions of higher education, as well as associated recommendations on how to improve the problems. 

“Amid the pandemic, we know that our students have experienced so much,” education secretary Miguel Cardona wrote in a statement. “We can’t unlock students’ potential unless we also address the needs they bring with them to the classroom each day. As educators, it’s our responsibility to ensure that we are helping to provide students with a strong social and emotional foundation so that they also can excel academically.”

The first challenge cited in the report is the growing mental health needs — and disparities — among school children and student groups, with officials saying it is imperative that school administrators both support students and ensure that they take care of their own mental health. 

The Department of Education stressed that marginalized students are at increased risk of experiencing mental difficulties without having access to adequate care. 

Compounding barriers to mental health support include a student’s socioeconomic and housing status. Even before the pandemic, youth who experienced homelessness were both more likely to experience mental health issues, but less likely to seek help for those problems. Food insecurity is also closely associated with heightened instances of mental health issues; as access to healthy food became increasingly difficult during the pandemic, experts noted an uptick in adolescent mental health problems. 

Race and ethnicity can also act as barriers to healthcare access, with officials noting: “To be clear, racism, not race, is a critical risk factor for mental health concerns and poorer outcomes.” 

The reasons for the disparities are vast, and range across various demographics: For example, the increased rates of hate crimes against Asian Americans may contribute to increased mental health issues for that demographic; darker-skinned Latino status tend to experience racial discrimination at higher rates than lighter-skinned Latinos, while Non-Hispanic Black, female, and LGBTQI+ students experienced the “highest risk of increases in depression symptoms” since March 2020.  

As a beginning step to addressing these disparities, the Department of Education recommended that state, district, school, and program leaders use region-specific data to determine mental health needs of both students and staff, and use that data to implement wellness programs that vary by location and need.

Some concrete suggestions include eliminating busywork from educators’ schedules; allowing time for rest and relaxation for students and teachers; ensuring teachers wages are competitive; normalizing self-care practices by fostering interpersonal connctions with students and the development of “specific strategies to support children and students from race, ethnicity, socio-economic, and LGBTQI+ groups, who are underserved and disproportionately at higher risk for experiencing harassment, discrimination, mental health challenges, and barriers to effective mental health care.” 

Other challenge areas listed by the department are the real or perceived stigma of mental health as a barrier to care; ineffective implementation of mental health guidance and care; ineffective support delivery systems; gaps between desired policy and needed funding; gaps between professional development and support and an overall lack of usable, region-specific data to guide such decisions. 

The department provided several examples of school districts that have successfully implemented programs to address one or more of these challenges. 

Clifton Public Schools in New Jersey has leveraged school administrators, parents, teachers and even local law enforcement to best reach children of all backgrounds, in part by outlining mental health resources and expectations in languages including English, Spanish, and Arabic.

Oregon’s Central School District has similarly leaned on community partners in order to “identify student needs and support mental health holistically including community resources and partnerships to provide support,” which led the district to increasingly offer students access to basic needs like food and the internet. 

Tuesday’s recommendations build on the department’s previously published Return to School Roadmap, which also stressed the importance of focusing on student and teacher wellness as schools across the country returned to in-person learning this school year. 

Schools can use funds from the American Rescue Plan’s Elementary and Secondary School Emergency Relief program (ESSER), which allocated $122 billion for state and local education leaders to implement mental and social health programs. 

The updated guidance came the same day that a coalition of medical groups declared a “national emergency” in children’s mental health, and called on lawmakers at all levels of government to address the crisis. 

The statement, issued by the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry (AACAP) and the Children’s Hospital Association (CHA), said the pandemic has “taken a serious toll on children’s mental health as young people continue to face physical isolation, ongoing uncertainty, fear and grief.” 

“Young people have endured so much throughout this pandemic and while much of the attention is often placed on its physical health consequences, we cannot overlook the escalating mental health crisis facing our patients,” AAP president Lee Savio Beers wrote in a statement. “Today’s declaration is an urgent call to policymakers at all levels of government – we must treat this mental health crisis like the emergency it is.” 

According to data from the U.S. Centers for Disease Control and Prevention (CDC), pediatric mental health-related emergency room visits increased dramatically starting in April 2020, and remained elevated through at least October of last year. Mental health–related visits for children aged 5–11 increased by 24% compared to 2019, with such visits for 12–17 year olds rising approximately 31% in the same time period.

separate CDC study showed that from Feb. 21 – March 20, 2021, suspected emergency room visits for suicide attempts among girls aged 12-17 increased by over 50% compared to 2019; the same visits for boys aged 12-17 increased by just above 3% in the same time frame. 

The coalition recommended a number of policy changes to address their growing concerns, including increased federal funding to help both students and families access mental health care; addressing workforce shortages among school administrators and staff and better access to telemedicine. 

By Rachel Tillman

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