The Six Mental Health Challenges Districts Will Face in the Fall (Part I)

By Duncan Young, CEO, Effective School Solutions

I am fortunate to work with over 200 of the finest school-based mental health professionals in the country. These individuals provide intensive, school-based programs for students with emotional and behavioral challenges, and in the last two months have been interacting virtually each day with students and families. Because of this, they’re in a unique position to weigh in on the types of mental health challenges that students, and the school districts that serve them, will face in the fall.

As we have received more and more questions from school districts about how they can plan for the mental health challenges their students will undoubtedly face with a possible return to school in the fall, we thought it would be especially helpful to harness the voice of these individuals and ask them to respond to two simple questions:

· What are the major challenges that you see emerging in the fall with respect to student mental health?

· What do you believe is the single most important thing that you think school districts should be doing in the fall with respect to supporting the mental health of all students?

This article will serve as Part I and will address the first question above, while a second Part II article will address the second question next week.

With respect to major challenges emerging in the fall, here are some of the challenges that we heard.

Challenge 1: The Uncertainty of the Fall is Making Planning Difficult

None us know exactly what schooling is going to look like in the fall. With each passing week, it seems increasingly unlikely that it will be “business as usual” with schools, with more probable outcomes ranging from staggered schedules and enforced social distancing, to a continuation of virtual learning and/or a delayed start to physical schooling. We recommend that districts plan for two distinct scenarios:

1. School in session in a modified manner (e.g. A/B days with 50% of students in school each day)

2. Full- on virtual learning

Our clinicians report that the nature of challenges that districts will be faced with will differ depending on which of these scenarios is in place. In the first scenario of a return to school, social anxiety and re-adjustment challenges will be significant. Should remote learning continue, depression and isolation become bigger challenges.

“I believe that major challenges for students that will emerge in the fall will develop into two categories. The first is if we return to on site programming, social anxiety and peer acceptance will be two major factors followed by academic performance and sport/club inclusion. If we continue with remote programming anxiety, depression and isolation will be high risk factors for our students.”- ESS Clinician

Challenge 2: Anxiety & Depression Will Increase

A significant number of individuals surveyed believe that anxiety and depression are likely to increase in all school opening scenarios in the fall. The major driver? Trauma. In many ways the current pandemic serves as a sort of “ambient trauma” for students that is likely to affect their anxiety levels, whether they realize it or not.

“With elementary students, the major challenges that I envision emerging are increases in anxiety and school refusal. The lack of structure, predictability, and routine creates anxiety in many students. Furthermore, this virus is scary. So many people are feeling worried, anxious, scared with job losses, health issues, etc. This anxiety trickles down and affects our students.” — ESS Clinician

“I think there will be an increase in trauma-related symptoms and behaviors in students as a result of this quarantine. I think returning to school in general will trigger increased anxiety, even in students who were previously comfortable in school.” -ESS Clinician

Challenge 3: The Return to Routine

Most clinicians report that a key challenge that has occurred during this time of school closure has been a lack of routine. The degree of structure in online learning has been widely variable across regions, with a high degree of structure and required check-ins in some states, and very few instances of structured or “synchronous” interactions in other areas. As one clinician reports, it will be a challenge to “change back to a structured school schedule with authority figures and increased workload.”

“A big challenge is going to be our students getting acclimated back into a routine and schedule. There is little to no structure/accountability for many students, especially those with parents who are essential workers.”- ESS Clinician

“The major challenges I see with younger students are going to be the transition issues. My students benefit strongly from a routine, structure and knowing ‘what comes next.’ We spent the first few months of the school year working to help these students actually come to school and enjoy school. The pandemic took this away from them and I truly believe that ESS will be crucial in getting these children back into a routine.” -ESS Clinician

Challenge 4: Go to Sleep!

A huge part of getting back into a routine and establishing a strong foundation for mental health is the establishment of healthy sleep patterns. Clinicians report that for many students, sleep patterns have been significantly disrupted during this period of school closure, particularly in areas where virtual learning has been less structured and lacking in defined check-in times. Reports of students staying up until 4 am and waking up at 10 or 11 am are not uncommon. Young people generally struggle with executive functioning (the ability to set goals, plan towards goals, and generally self-regulate) and the lack of defined structure has led to many of them keeping late hours.

“One major challenge I feel significantly concerned for in the fall is the difficulty our students will have with adjusting to their old school routine (i.e. waking up very early in the morning, having to sit through 48-minute classes, being surrounded by large groups of peers, etc.). For many of our students that experience anxiety and difficulties with adjustment, I am concerned that it may become extremely overwhelming to be thrown right back into their old routine; after months of being isolated at home away from others. For those students with ADHD, it may be extremely difficult to sit through a class; after months of being able to get up and walk away from their “class”/computer whenever they felt frustrated or became distracted.” -ESS Clinician

Challenge 5: Social Recalibration is Going to Be Tough

Re-acclimating to the social structure and norms of school will be a challenge for many students, clinicians predicted in the survey. Some students have seen school closures as a reprieve from social stressors that may have caused them anxiety or led to depression. Other clinicians predict an increase in negative, attention seeking behavior as students adjust to the norms of school.

“Self-esteem and social skills will also be challenging due to a lack of in person socialization.” — ESS Clinician

“Students have had a reprieve from the social stressors school presents, acclimating to being in person and facing being judged and/or teased by peers.” -ESS Clinician

Challenge 6: Expect an Uptick in School Avoidance/School Refusal

Perhaps the most common prediction from clinicians surveyed was an increase in school avoidance behaviors. There are multiple drivers of this, including an uptick in social anxiety upon return to school, fear of the virus and fear of getting sick. Many students who were previously school avoidant have actually enjoyed the relatively stress-free environment of virtual learning and may loath to return to an environment that reminds them of past stress or trauma. It’s also highly likely that districts will see previously non avoidant students demonstrate school refusal behaviors as well.

“The major challenge I see for my students returning in the fall will be heightened/increased school avoidance and/or issues related to social anxiety.” -ESS Clinician

“Some kids I work with who have social anxiety have been LOVING this quarantine because it’s allowed for them to avoid many of their most distressing triggers. Some of them have reported feeling lighter, happier, less anxious overall. Quarantine has enabled their avoidance! I anticipate it being very hard for them to go back to school. With some kids we are already coming up with scenarios and planning for those triggers that they’ve been able to avoid for the last few months.” -ESS Clinician

“The longer that our students with anxiety and history of school avoidance are out of school, the more comfortable they can become at home. I have had lots of conversations with students about being worried about the progress they have made with improving attendance and how being out of school for months and then the entire summer could lead to significant anxiety to leave the house and return to school.” -ESS Clinician

“One of the major challenges that I see emerging in the fall, is the apprehension from parents to send their child to school. I also feel that the anxiety of the parent will cascade to their child, further instilling the student’s anxiety on returning to school.” -ESS Clinician

In short, all the mental health professionals surveyed predicted a significant uptick in mental health challenges in the fall as schools begin to re-open. Districts should be aware of these challenges and be proactive in terms of putting plans in place to support a broader cross-section of students with a mental health safety net. In Part II of this article, we’ll share clinicians’ top recommendations about what school districts can do to prepare. Stay tuned!