Then came COVID-19. Americans of all ages say the pandemic has taken a toll on their mental health, but the trend has been especially pronounced among young people.
The rate of children ages 11 through 17 who were screened last year for anxiety and depression was 9% higher than it was in 2019, according to a Mental Health America report. Centers for Disease Control and Prevention data shows the number of children sent to emergency rooms for mental health conditions skyrocketed from April to October last year.
Although federal statistics for last year aren’t yet available, anecdotal evidence suggests a surge in teenagers being treated for suicidal ideation and attempts in hospitals – a phenomenon corroborated by various surveys.
“I’m incredibly distressed but not surprised,” said Jen Vorse Wilka, executive director of YouthTruth, a nonprofit group that polls the country’s young people in an effort to help schools better respond to their needs.
For high schoolers, the biggest stressors have been the sense of disconnect from friends and loved ones and difficulties focusing on school or work, according to survey data by YouthTruth.
But the mental health challenges won't magically disappear once students trickle back into school buildings. In some cases, the challenges will be compounded by new ones – the pressure to achieve after a year of widely reported learning losses, the anxiety of returning to structured days and settings and the fear of being in close proximity with others.
“Feeling depressed, stressed or anxious is now the No. 1 obstacle to students' learning,” Wilka said.
Schools are starting to recognize this, and many districts ramped up funding for mental health services and offer professional development for educators wondering how to best respond to the crisis.
‘The effects won’t go away’
“You cannot ignore that this past year happened," said Benjamin Heim, a student in Lenox, Massachusetts. "The effects that COVID had on students won't go away."
A few months into the pandemic, Heim said, isolation drove him into a paralyzing anxiety. "I felt like I was in the bottom of a pit that I could not get out no matter what I did," he said.
He couldn't find joy in the activities that used to pick up his spirits – funny YouTube videos or short nature walks. As much as he wanted to talk things out, he struggled to muster up the courage – "to have the initiative" – to reach out to friends.
Despite advocating for his peers' mental health, he didn't know how to advocate for himself.
He finally talked to his parents about seeing a therapist. Since then, he's learned it's OK to be vulnerable. He schedules regular check-ins with friends and said it's made a world of difference.
But the stressors – including the heightened focus on academic achievement when so many students have fallen behind – remain.
What Laura Horne, chief program officer at Active Minds, found most striking about the organization’s survey data last year was the extent to which the pressure to achieve undermined students’ emotional well-being. “A major driver is uncertainty about ‘Do my teachers understand I'm not going to do my best work right now?’” she said.
Anushka Gupta, a high school senior in Long Island, New York, said her worries about getting into college exacerbated her anxiety during the pandemic. Will I be able to prove myself? Will I be prepared for college after spending my last years of high school online?
Experts said it's important for educators to first be mindful of basic student needs, including mental health, before stressing learning loss.
“If you can’t meet those basic student needs, the learning can’t continue,” said Sheryl Place, an educator in Florida’s Miami-Dade County Public Schools who helps campuses adopt technology.
Children navigate all kinds of real-world stressors, after all.
More Americans of Asian or Pacific Islander descent sought out mental health supports in 2020 than ever before, according to research by Mental Health America. (One factor could be the wave of hate crimes and harassment targeting Asian Americans.)
In-person learning is a stressor
In a poll conducted among parents by NPR and Ipsos, nearly a third of the respondents said they may stick with remote learning. The findings are a testament in part to the reality that conventional schooling can compound the stressors faced by many students, experts suggested.
When Madeline Glasser was in first grade, she was bullied by her peers for walking on her tiptoes. "We tried every pair of shoes, but nothing worked, and then it ended up so bad that my teacher was actually bullying me, too," said Madeline, 9. The situation escalated to the point that other parents began to intervene.
Madeline home-schooled for a few months to let the situation die down. That was before COVID-19. Madeline returned to the classroom once her third grade school year kicked off, but when the pandemic hit, she decided home-schooling was a better option in the long run. Not only would it free her of the name-calling she'd endured pre-pandemic, she could work at her own pace. She's learning at a fourth grade level through Florida's public virtual school.
Many students contend with personal responsibilities, burdens magnified by the pandemic.
Briseyda Velásquez Sanchez, a recent immigrant to the USA, struggles to keep up with her studies while caring for her young son. The teenager moved to California from Mexico upon realizing she was pregnant and deciding she wanted to give her child a more prosperous upbringing than the one she had. She enrolled in a high school with a flexible schedule, hoping it would help to advance her post-secondary goals while allowing her time to be a mother.
The juggling act has been tough, as has the constant reminder that she can't interact with her neighbors or with other families at the park.
"The lack of intimacy is really hard," she said in Spanish – including her inability to engage in the simple joys outside her home. "There are a lot more of those moments – of realizing, 'OK, I can't leave, I can't take my son to the park.' Instead of being in an open environment, it's very ‘to yourself.’”
Some districts build upon pre-pandemic social-emotional learning initiatives with hefty investments in programs aimed at helping students cope with the trauma of the pandemic. Others, including Las Vegas' Clark County School District, equipped their school-issued devices with software designed to detect when a student is suicidal through internet searches and the like. (The New York Times reported that district suffered from 18 student suicides by last December.)
The interventions will go only so far, absent an emphasis on school culture – a point emphasized in a report published by the Fordham Institute, an education think tank.
In interviews with USA TODAY, high schoolers across the country said schools ought first and foremost to ensure students feel comfortable talking about their challenges.
“It's OK to not always be OK,” said Gupta, the Long Island high schooler. “Even if everything’s not fine, we know it will get better.” As part of their school’s Active Minds chapter, Gupta and her classmates are launching a website where, among other things, students can post anonymously about their mental health struggles.
Three years ago, the state of Florida infused school districts with funding to help enhance their mental health supports.
The state – the entire country – was still reeling from the massacre at Parkland’s Marjorie Stoneman Douglas High School, where 17 people were killed.
About 40 miles southeast, Miami-Dade County Public Schools used that funding in part to develop a Department of Mental Health Services. The district – the country’s fourth-largest – hired dozens of coordinators it tasked with connecting with families and raising awareness among educators.
Once the pandemic hit, Miami-Dade realized it would need to rethink how it delivered mental health supports, said Sally Alayón, the district’s assistant superintendent of educational services and school operations.
Last May, the district started using a program called Kognito in an effort to better address students’ distress.
Kognito is an evidence-based virtual platform in which teachers use role play to practice talking with students about their mental health status and needs. Users learn how to build trust with students through open-ended, affirming conversations and to serve as a bridge between their classrooms and mental health professionals. The simulations feature animated, ethnically ambiguous characters.
“We think about educators as the eyes and ears of mental health – they’re not mental health practitioners,” said Jennifer Spiegler, vice president of strategic partnerships at Kognito. “One thing we’ve learned during this pandemic is that what teachers don’t need is a new job.”
The idea behind Kognito is that it enables teachers to be better listeners – not problem solvers.
Teachers don’t need more stress, either. As Place, the technology facilitator in Miami-Dade, put it, “we cannot be everything to everyone if we don’t take care of ourselves.”
Crisis Text Line provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.