It will come as no surprise to parents that the COVID-19 pandemic has had a devastating effect on young people’s mental health. The Centers for Disease Control and Prevention found that almost half of high schoolers surveyed last year reported experiencing persistent feelings of sadness or hopelessness. One in five said they had seriously considered suicide.
Even before the pandemic, rates of depression and suicide had been climbing among teens, and that mental health crisis continues, even as life returns in many ways to a new normal.
What some parents might not know is that their child’s school could be the best place to look for help.
“There’s no institution better positioned to engage with students on mental health issues than schools,” says John Crocker, director of school mental health for Methuen Public Schools, north of Boston. “We can look for emerging concerns and provide social and emotional learning about managing stress and strong emotions.”
School-Based Mental Health Providers
While staffing varies — and many districts remain understaffed — school-based mental health providers usually include counselors, psychologists and social workers.
— School counselors have broad responsibility for helping students succeed in school and plan for college and careers. That can include helping students with social and emotional issues.
— School psychologists have master’s or doctoral level training. Their primary role is to assess children for learning and behavioral problems and work with teachers, administrators and parents to develop plans of support. They can also provide individual and group counseling, and refer students to outside practitioners if needed.
— School social workers have master’s or doctoral level training. Social workers provide therapy and work with other school staff to develop support plans for students. Social workers also work with families and do case management, identifying and coordinating other services that students might need.
Working as part of school staff, school psychologists, social workers and counselors have access to a child’s history at school, including friendships and discipline. This information is important when assessing a child, since many kids aren’t good at putting their feelings into words. As any parent knows, even a child who is behaving as if they’re struggling is unlikely to come right out and say, “I’m sad.”
How to Reach Out for Support for Your Child
The first clue that a child may be struggling is a change in their behavior, says Candace Weidensee, director of student services for the Oregon School District in Wisconsin.
For instance, when children who are usually energetic start sleeping more and complaining of tiredness, they might be feeling sad or anxious. But as with many signs of stress, there may be a developmental or medical cause as well, so it’s worth contacting your child’s pediatrician to rule those out. Weidensee notes that anxiety and distress can manifest in different ways in children than adults, such as:
— Not engaging in classes when they normally participate
— Unusual trouble managing their emotions
— Lack of interest in things they used to enjoy
— Trouble paying attention
Other children might have changes in appetite, complain of tiredness or display more extreme introversion or extroversion when they are struggling, says Faith Cole, director of student services at Oak Park and River Forest High School outside of Chicago.
If you’re concerned about your child’s mental health, start by reaching out to a trusted teacher or coach. Teachers and other staff spend hours with children every day and, after parents and guardians, may be the most likely to notice troubling behavioral changes.
The school psychologist or social worker will generally want to meet with children privately to assess how they are doing and to determine whether they need ongoing therapy or some other type of support, says Frederick Heid, superintendent of Polk County Schools in central Florida. The psychologist or social worker may recommend additional counseling sessions, or they may also refer your child for therapy outside the school, if the issues fall outside of their expertise. These steps usually require parental consent. If this happens, the school provider will maintain communication with you and the outside therapist.
“What you don’t want is us not understanding what’s going on with a child and doing things differently,” says Heid. “It’s not a hand-off, but an ongoing partnership.”
Once this process is underway, it is important for parents to remain involved and be persistent. Many parents wonder if they will have access to what their children talk about in therapy. The answer is, it depends. Some districts are required to get parental consent before a child can receive support services. Others are allowed to offer a limited number of therapeutic visits without notifying parents.
State laws about parental access to the content of therapy sessions also vary. Some states require that school therapists provide parents with a summary after meeting with a child. Others follow confidentiality protocols that require therapists to disclose only if a child is threatening harm to themselves or others.
School mental health providers stress the importance of also contacting your child’s doctor. “Oftentimes, if pediatricians have to be looped in because medication is needed, it’s better if they’re aware of what’s going on from the beginning,” says Cole. In addition to being able to run tests to rule out medical issues, your child’s doctor may be able to provide insight into possible developmental changes.
Expanding Mental Health Supports
Nationally, there is a critical shortage of school psychologists. While the National Association for School Psychologists recommends one psychologist for every 500 students, the organization says the average is closer to one for 1,200 and reaches 5,000 in some states. The shortage extends to school counselors as well. Nearly one in five students don’t have access to a counselor at their school, according to a 2019 report from the Education Trust.
Some states and districts, largely in response to school shootings, began investing in mental health support programs before the pandemic, and advocates hope that federal COVID-19 funding directed at child mental health will further improve schools’ staffing and services.
In addition, districts are increasingly using technology to keep track of how students are feeling. In Polk County Schools, for example, a new telehealth program provides an online interface for parents to connect with health providers. Students can immediately speak with a licensed medical or mental health clinician from home. Nearly half of contacts made to the system are for mental health support, Heid says, and many consultations with medical practitioners lead to a mental health referral.
“We’ve been surprised,” Heid says, “but we’re thrilled that we have the supports in place.”
Many districts also use app-based mental health screenings to survey selected parts of the student population with questions about mental well-being. These self-reporting surveys have been surprisingly effective at finding kids who need support, but who might otherwise have slipped under the radar.
After sending out the first surveys, the Methuen public schools saw a 63% increase in the number of students eligible for mental health services. Once students have reported that they are struggling, district staff follow up with them for an assessment.
“The goal is to provide a formal opportunity for a kid who is interested in sharing,” Crocker says, “and then have a conversation that offers potential help.”
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