Reopening Schools Requires Drastic Investment in School-Based Mental Health Services

March 24, 2021 by Aburiyeba Amaso

by Michael Yu

As the COVID-19 vaccine becomes more widely accessible and available, there is hope that the United States will soon return to a sense of normalcy in the coming months.[1] But this hope, while not unwarranted, may conceal some of the struggles and challenges that lie ahead. Prior to the pandemic, the United States was already facing several interlocking crises—income inequality,[2] educational inequity,[3] and lack of access to affordable mental healthcare.[4] The pandemic has exacerbated all of these crises,[5] and a return to normalcy demands a serious reckoning of the historic neglect of our country’s most vulnerable members.

As vaccines are distributed and people return to work and school, many students and teachers begin the gradual process of returning to the classroom.[6] However, the shift to remote learning over the last year has left many of our nation’s poorest students behind not only academically, but also in terms of their mental health.[7] As students in low-income schools return to the classroom, there must be considerable investment in school-based resources not only to narrow the widened achievement gap, but also resources to address the uniquely severe mental health challenges low-income students have developed and struggled with over the past year. Returning to “business as usual” is not only impossible, but fundamentally unjust.

Prior to the pandemic, public education funding was predictably inequitable. School funding depends largely on the overall wealth of the school’s district, and low-income students attend underfunded schools, both in terms of quality of education as well as facilities.[8] Students in low-income schools have decreased access to quality educational opportunities, such as extra-curricular programs and advanced classes.[9] In terms of spending, high-poverty districts receive an average of $1,200 less per pupil than the wealthiest districts.[10] Due to decades of segregation, students at low-income schools are disproportionately likely to be Black and Hispanic.[11] In 2018, the United States Commission on Civil Rights found that funding inequities in state public education systems “render the education available to millions of American public school students profoundly unequal.”[12] Low-income students, in addition to having less access to equitable education, face higher rates of mental health struggles and have less access to school-based counselors, or any mental health supports at all.[13]

When the pandemic struck, the vast majority of schools shifted to remote learning.[14] Immediately, low-income students faced challenges not experienced by their higher-income peers. They struggled with basic prerequisites of remote learning, such as internet access and devices capable of video-conferencing.[15] Additionally, low-income students were more likely to lack the physical space required to attend online classes, and their parents were more likely to work jobs that required them to work outside the home.[16] Many high-income students have left public education altogether, as wealthy parents moved their children to private schools, pandemic pods, or have elected to begin homeschooling.[17] In April of 2020, a study found that low-income students’ participation in online math homework fell 41% in the spring after the shift to distance learning, but has improved this fall to only a 16% drop in participation compared to participation prior to the pandemic.[18] However, the participation of high-income students has fallen only 2%.[19] A report published by McKinsey & Co. found that students of color, who are also disproportionately from low-income households, lost the equivalent of three to five months of learning in math, compared to one to three months for higher-income white students.[20] In Virginia, Black and Hispanic students living near the poverty line have received six times as many failing grades in math and English than before the pandemic, and youth literacy benchmarks for K-2 students have dropped thirteen percentage points for Hispanic Students and eight points for Black students.[21] At the end of the 2019-2020 school year, a survey of close to 1,600 families found that parents with low incomes were ten times more likely to report that their children were doing little to no remote learning compared to families with incomes upward of $100,000.[22]

While much of the focus has been on the academic achievement gap, low-income students have also faced significant challenges in their mental health as a result of the pandemic. The COVID-19 pandemic has severely limited their ability to seek and receive counseling and behavioral support services.[23] Nationally, a federal hotline for people suffering emotional distress registered a 1000% increase in calls in April of 2020, but the CARES act allocated very little funding for mental health.[24] This crisis was exacerbated by the challenges therapists faced in moving their practices online and the growing insolvency of community-based mental health centers.[25]

Students in particular are especially vulnerable to this crisis. With the shift to remote learning, many students were cut off from the supportive relationships they had built with school counselors, social workers, and psychiatrists.[26] Low-income students with unreliable internet access and technological limitations may not have been able to access telehealth services,[27] if they were even still offered. Students with Individualized Educational Plans—such as those with behavioral challenges or learning disabilities—may not have been receiving the support they are entitled to by law and need during the pandemic.[28] These students are acutely vulnerable in the return to in-person learning.[29]

Further, students that were otherwise not receiving services during the pandemic may have developed mental health concerns as a result of the pandemic and the shift to remote learning.[30] Students struggling with anxiety and depression—as well as the household stress of a parent being laid off, or the bereavement of a family member who has died of COVID-19—are largely invisible[31] and may not be receiving the support they need to function academically.[32] For many low-income students, school clinicians are their primary source of mental health support,[33] and in-person education acts as a screening tool to identify and treat mental health and behavioral issues.[34] Teachers interacting with students in-person can identify students who may be in need of mental health support, and in-person drop-ins or periodic check-ins with counselors, psychologists, and social workers are powerful tools for managing emotional distress that may be largely absent from remote learning.[35]

School districts were able to avoid some of the drastic cuts that many expected at the beginning of the pandemic. A combination of federal assistance through the CARES Act and states tapping into reserve accounts and delaying spending on other activities has prevented the worst-case scenario.[36] But, many of these accounts are depleted[37] and the amount of Federal aid is, as of writing, uncertain.[38]

Going forward, school districts will undoubtedly have to grapple with the gaps in academic achievement for their lowest income students. However, school districts also have an opportunity, if not a moral mandate, to invest in mental health support services for students as well. School districts should invest more in training for teachers to screen for mental health issues. Moreover, they should hire more counselors, psychologists, and social workers, not only to address the existing gap in mental health access for low-income students, but to repair the damage that has been done to students’ emotional and behavioral wellbeing by the pandemic. Recovery from the pandemic does not end when the last person is vaccinated. Addressing the educational and social-emotional impact of the pandemic for students will be an ongoing process that demands radical investment in an educational system that has been neglected for decades. School districts, with the aid of the Federal Government, have an opportunity to address some of the largest and most severe issues facing students, and this presents the chance to return not only to “normalcy,” but something more just and equitable for our country’s most vulnerable children.

[1] See Carl Zimmer et al., Coronavirus Vaccine Tracker, N.Y. Times,  https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html (Mar. 4, 2021).

[2] Juliana Menasce Horowitz et al., Trends in Income and Wealth Inequality, Pew Research Center (Jan. 9, 2020), https://www.pewresearch.org/social-trends/2020/01/09/trends-in-income-and-wealth-inequality/.

[3] Jill Barshay, A Decade of Research on the Rich-Poor Divide in Education, Hechinger Report (Jun. 29, 2020), https://hechingerreport.org/a-decade-of-research-on-the-rich-poor-divide-in-education/.

[4] Nat’l Alliance on Mental Illness, The Doctor is Out: Continuing Disparities in Access to Mental and Physical Healthcare, 10 (2017), https://www.nami.org/Support-Education/Publications-Reports/Public-Policy-Reports/The-Doctor-is-Out/DoctorIsOut.

[5] Brea L. Perry et al., Pandemic Precarity: COVID-19 is Exposing and Exacerbating Inequalities in the American Heartland, 118 Proc. Nat’l Acad. Sci. 1, 1 (Dec. 28, 2020) https://www.pnas.org/content/118/8/e2020685118.

[6] Operational Strategy for K-12 Schools Through Phased Mitigation, Ctrs. for Disease Control and Prevention, https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/operation-strategy.html (Feb. 26, 2021).

[7] Heather Stringer, Zoom School’s Mental Health Toll on Kids, Am. Psych. Ass’n (Oct. 13, 2020), https://www.apa.org/news/apa/2020/10/online-learning-mental-health (“Children with attention-deficit/hyperactivity disorder (ADHD) or other behavioral disorders are also likely to suffer academically and psychologically during distance learning . . . . ”).

[8] See U.S. Comm’n on C.R., Public Education Funding Inequity in an Era of Increasing Concentration of Poverty and Resegregation, 44-47 (2018), https://www.usccr.gov/pubs/2018/2018-01-10-Education-Inequity.pdf.

[9] Id. at 62-63.

[10] Id. at 6-7.

[11] Id. at 13 (“Public schools today remain racially and economically segregated . . . [p]overty is strongly linked with racial and ethnic minority enrollment in schools, and the higher the minority enrollment, the higher the enrollment of students coming from high-poverty households.”).

[12] Id. at 9.

[13] See Manny John Gonzalez, Access to Mental Health Services: The Struggle of Poverty Affected Urban Children of Color, 22 Child and Adolescent Soc. Work J. 245, 245-48 (2005).

[14] See Mark Lieberman, Why Students Still Can’t Access Remote Learning: How Schools can Help, Educ. Wk. (Sept. 15, 2020), https://www.edweek.org/technology/why-students-still-cant-access-remote-learning-how-schools-can-help/2020/09 (“As of Sept. 2, 73 percent of the 100 largest U.S. school districts had chosen remote learning only as their back-to-school instructional model . . . .”)

[15] See Emma Dorn et al., COVID-19 and Learning Loss—Disparities Grow and Students Need Help, McKinsey & Co. (Dec. 8, 2020), https://www.mckinsey.com/industries/public-and-social-sector/our-insights/covid-19-and-learning-loss-disparities-grow-and-students-need-help.

[16] Id.

[17] Id.

[18] Id.

[19] Id.

[20] Id.

[21] Hannah Natanson, Virginia Schools Plan Gradual Reopening as Evidence of Online Learning Gap Piles Up, Wash. Post (Dec. 3, 2020 10:11 PM), https://www.washingtonpost.com/local/education/virginia-schools-plan-gradual-reopening-as-evidence-of-online-learning-gap-piles-up/2020/12/03/a4f5d742-35a6-11eb-8d38-6aea1adb3839_story.html.

[22] Ginia Bellafante, Are We Losing a Generation of Children to Remote Learning?, N.Y. Times, https://www.nytimes.com/2020/11/06/nyregion/nyc-remote-learning.html (Nov. 9, 2020).

[23] See Dan Levin, In a World ‘So Upside Down,’ the Virus is Taking a Toll on Young People’s Mental Health, N. Y. Times (May 20, 2020), https://www.nytimes.com/2020/05/20/us/coronavirus-young-people-emotional-toll.html.

[24] See William Wan, The Coronavirus Pandemic is Pushing America into a Mental Health Crisis, Wash. Post (May 4, 2020 12:57 PM), https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus.

[25] Id.

[26] See Levin, supra note 23.

[27] Brooke Auxier & Monica Anderson, As Schools Close Due to the Coronavirus, Some U.S. Students Face a Digital Homework Gap, Pew Res. (Mar. 16, 2020), https://www.pewresearch.org/fact-tank/2020/03/16/as-schools-close-due-to-the-coronavirus-some-u-s-students-face-a-digital-homework-gap/ (“Roughly one-third (35%) of households with children ages 6-17 and an annual income below $30,000 a year do not have a high-speed internet connection at home . . . These broadband gaps are particularly pronounced in black and Hispanic households. . . .”).

[28] See, Cf., Greta Anderson, Accessibility Suffers During Pandemic, Inside Higher Ed (Apr. 6, 2020), https://www.insidehighered.com/news/2020/04/06/remote-learning-shift-leaves-students-disabilities-behind (discussing the lack of accessibility for students with mental and physical disabilities in the shift to remote learning).

[29] Levin, supra note 23.

[30] See Archana Basu & Karen Felscher, Kids May Face Mental Health Issues as School Begins Amid Pandemic, Harvard T. H. Chan Sch. of Pub. Health (Sept. 11, 2020), https://www.hsph.harvard.edu/news/features/kids-may-face-mental-health-issues-as-school-begins-amid-pandemic/.

[31] Student Mental Health During and After COVID-19: How can Schools Identify Youth Who Need Support?, Am. Psych. Ass’n (Sept. 22, 2020), https://www.apa.org/topics/covid-19/student-mental-health (“Some of the typical indicators teachers may use to identify students experiencing mental health difficulties may not be available.”)

[32] See Donna St. George & Valerie Strauss, Partly Hidden by Isolation, Many of the Nation’s Schoolchildren Struggle with Mental Health, Wash. Post (Jan. 21, 2021 6:20 PM), https://www.washingtonpost.com/local/education/student-mental-health-pandemic/2021/01/21/3d377bea-3f30-11eb-8db8-395dedaaa036_story.html. (“[S]chool districts and states have tried to beef up resources . . . though nowhere do officials say what they are doing is enough.”)

[33] See Mir M. Ali et al., Utilization of Mental Health Services in Educational Setting by Adolescents in the United States, 89 J. Sch. Health 393, 400 (May 2019) (“Study results indicated that minority students, those with public insurance, and students living in households with low income were more likely to utilize services in educational settings only. This finding suggests that school-based services are the primary source of treatment for some students of color . . . .”).

[34] See Student Mental Health During and After COVID-19: How Can Schools Identify Youth Who Need Support?,  Am. Psych. Ass’n (Sept. 22, 2020), https://www.apa.org/topics/covid-19/student-mental-health.

[35] Id.

[36] See Valerie Strauss, How COVID-19 Has Affected School Budgets So Far—and What Lies Ahead Without More Federal Aid, Wash. Post (Oct. 7, 2020), https://www.washingtonpost.com/education/2020/10/07/how-covid-19-has-affected-school-budgets-so-far-what-lies-ahead-without-more-federal-aid/.

[37] Id. (“Cares Act funding for education has been exhausted.”)

[38] With the passage of the American Rescue Plan, H.R. 1319, 117th Cong. (2021), almost $130 billion will go towards assistance for K-12 schools. See Rachel Siegel, What’s in Congress’s $1.9 trillion Civid Bill: Checks, Unemployment Insurance, and More, Wash. Post (Mar. 10, 2021 5:37 PM), https://www.washingtonpost.com/business/2021/03/10/what-is-in-the-stimulus/.