The COVID-19 pandemic has brought unprecedented change to schools and has significantly impacted children, their families, and school staff. With the return to school, whether in-person, or a mixture of remote and in-person instruction, what can be expected and planned for to assist schools and staff? Awareness of what students have been exposed to affords schools the ability to be proactive in providing behavioral health services and supports for them in the school environment. The Centers for Disease Control (CDC) National Center for Health Statistics is collecting data that shows one-third of Americans are showing signs of clinical anxiety or clinical depression related to the COVID-19 pandemic.

Children spend most of their waking hours at school. In addition to providing academic education for students, schools also provide mental health supports. The documents in this toolkit address how mental health has been impacted by COVID-19 and mental health considerations for how to best support students, staff, and parents in the transition back to school. The sooner those who are showing signs of difficulties can be identified, the sooner they can be connected to support to help prevent further academic and emotional decline. Students experiencing learning, emotional, behavioral, or coping difficulties require additional student and learning supports, as well as school and community resources. Community supports and resources are needed to help fill in the gaps, as the percentage of people needing mental health services increases after a natural disaster, crisis, or pandemic.

The aftermath of Hurricane Harvey revealed the extent to which natural disasters contribute to problems related to mental health. The initial findings of the Hurricane Harvey Registry indicated that nearly two-thirds of the respondents experienced mental health problems, notably symptoms related to post-traumatic stress. Traumatic events “can put individuals at risk for mental health problems, especially children and those who were previously exposed to traumas” (Kaplow, 2019). In many cases, mental and behavioral health disorders are treatable. When the proper care is promptly provided after the traumatic exposure, mental and behavioral health disorders can be prevented.

How does the COVID-19 pandemic and absence from school impact the mental health of students and staff?

The absence from school affects students in myriad ways. In addition to learning loss, it compounds issues through the loss of many safety nets and coping mechanisms that schools provide, including a sense of stability, support, and routine. For students with behavioral health needs, school closures can mean they no longer have access to the resources that schools provide.

The impact of the pandemic on transportation, finances, and providers can leave families unable to maintain behavioral health appointments or compliance with medications. This places students in a vulnerable state, especially with the added stressors of a new school year, and can lead to an increased risk for behavioral health problems or maladaptive coping behaviors, including substance use.

The pandemic also affects children’s sense of security, which is dependent on the safety of their caregivers. Students may anticipate devastating events happening to them or their loved ones and worry whether their parents or others they know will contract or succumb to the virus. Some may have already experienced loss due to the virus. As COVID-19 research continues and we await the release of a vaccine, concerns about exposure at school and how that impacts daily life persists.

Additional stressors include:

The inability to provide for basic needs due to:

  • Food insecurity. This creates additional stressors for families who cannot buy groceries as they used to before the pandemic.
  • Lack of safety resources (e.g., masks, antibacterial wipes, hand sanitizer, soap).
  • Financial loss or loss of employment.
  • Lack of transportation.
  • Business and store closures.

Isolation:

  • Adversely affects social development in young people.
  • Adversely affects many adults.
  • Especially difficult for those who live alone.

Increased mental health or physical health concerns:

  • Providers closed offices.
  • Some behavioral health and medical offices transitioned to teletherapy and telemedicine. Due to lack of technology or internet access some families are unable to utilize these services.
  • Reluctance of going to the hospital or doctor offices due to fear of contracting the virus including avoidance of well-child visits and routine vaccines.
  • Lack of transportation to fill prescriptions.
  • Lack of financial resources to pay for copays or prescriptions.
  • Stressors and trauma leading to behavioral health concerns.

The absence from school created by the COVID-19 pandemic has impacted the mental health of students and staff and has brought unprecedented change to schools. Schools should focus on re-engaging students, strengthening the relationship between school staff and students, and nurturing the resiliency of students. It is through these trusted relationships that school staff can best support students as they return to school for a new academic year.

These mental health considerations are divided into topics. Each topic has information applicable to a school setting and key takeaways.

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