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There's a surge of mental health issues for kids back for in-school learning


For kids around the country, this school year was supposed to bring a return to normalcy, ending the isolation and stress of remote or hybrid learning. But halfway through the year, schools and health care providers say they're seeing a massive rise in students struggling with mental and behavioral health problems. NPR's Rhitu Chatterjee has the story.

RHITU CHATTERJEE, BYLINE: When Millis Public Schools opened its doors this fall, teachers and staff were happy to have everyone back in classrooms. Bob Mullaney is superintendent for the school district located just southwest of Boston.

BOB MULLANEY: You know, we were so excited that everyone was coming back to begin the school year.

CHATTERJEE: But, he says, it's been stressful.

MULLANEY: From the beginning, we've seen elevated levels of stress, anxiety, different behavioral issues in students.

CHATTERJEE: More students acting out, being aggressive - not just at his school district, but across the state.

MULLANEY: We've had, in Massachusetts, a principal who was assaulted by a student. We've had staff members assaulted by students. We've had students assaulting other students.

CHATTERJEE: And students hurting themselves.

MULLANEY: We've seen an increase in students with self-harm issues, suicidal ideation, more suicide attempts, things that the school itself is really not equipped to handle.

CHATTERJEE: Mullaney says the school district has referred more kids for mental health treatment than ever before, and health care providers nationwide are seeing more referrals coming in.

VERA FEUER: Definitely we're seeing the schools referring kids with more behavioral issues and aggression.

CHATTERJEE: Dr. Vera Feuer is associate vice president of school mental health at Cohen Children's Medical Center in Long Island, which runs a couple of behavioral health centers serving 14 school districts. She says she and her colleagues are seeing kids with a range of mental health issues.

FEUER: A lot of them still come in for suicide risk assessment or depressive symptoms or school refusal.

CHATTERJEE: And many kids are ending up in hospital emergency rooms because they're in crisis and have nowhere else to seek help.

Earlier this fall, the American Academy of Pediatrics, the Children's Hospital Association and the American Academy of Child and Adolescent Psychiatry called the situation a national emergency. The U.S. surgeon general called attention to the issue this month in an advisory on youth mental health. Heidi Baskfield is vice president of population health and advocacy at Children's Hospital Colorado.


HEIDI BASKFIELD: Our emergency department admissions with respect to mental health visits increased by 75%. On any given day in our emergency departments, there are between 15 and 40 children with mental health needs seeking care.

CHATTERJEE: Speaking at a virtual congressional briefing last week, Baskfield said the situation is untenable.


BASKFIELD: We are consistently full with all of our mental health units. Our outpatient visits went from a three-week wait to sometimes upwards of nine months. And if you can imagine being a parent with a child who has mental health needs calling for support and basically being told, call us back in a year.

CHATTERJEE: Now, the rise in kids' mental health symptoms didn't start with the school year. In fact, recent studies show that the pandemic exacerbated an already growing crisis in youth mental health. But the situation has only worsened in recent months.

TAMI BENTON: And much of that has to do with the stress of returning to school for many kids.

CHATTERJEE: Dr. Tami Benton is psychiatrist-in-chief at Children's Hospital of Philadelphia. She says kids have lost friendships during the pandemic and have lost out on a year of social development.

BENTON: The year that they were out of school was a year that they didn't have the opportunities for developing the social skills that normally happen. And you're sort of catching up on all of that under extraordinary circumstances.

CHATTERJEE: But, Benton says, catching up has been harder for some kids than others - children who relied on in-person support at school, which went away with virtual learning, and they fell far behind their peers, also kids who had a mental health diagnosis before the pandemic.

BENTON: Many people have delayed services. So by the time they did seek mental health treatment, they were actually doing worse. For some of those kids who had actually pretty strong peer support groups prior to the pandemic, had to reestablish those when they returned to school.

CHATTERJEE: Then there are children grieving the loss of loved ones to COVID-19. An estimated more than 175,000 lost a parent or a caregiver. And kids of color, who are already disadvantaged, have been disproportionately affected by these losses, says Dr. Nicole Christian-Brathwaite.

NICOLE CHRISTIAN-BRATHWAITE: And that trauma alone is very significant, particularly when there are some children who have lost generations of family members.

CHATTERJEE: Christian-Brathwaite is a child and adolescent psychiatrist and chief medical officer at Array Behavioral Health (ph), a telepsychiatry company. She says these kids are often trying to cope without adequate support.

CHRISTIAN-BRATHWAITE: Going into school and having to manage that stress without necessarily having a therapist available or a school counselor or a nurse - in many underserved communities, some schools have no mental health supports. And some schools have one counselor spread across an entire district.

CHATTERJEE: That's why schools across the country have reached out to mental health care workers and advocates for support. In many places, schools and providers are collaborating to more quickly connect kids to care before things escalate. And there's been some federal funding that's helping schools add more resources to address the increased demand, including Millis Public Schools in Massachusetts. Again, Superintendent Bob Mullaney.

MULLANEY: The CARES Act and the American Rescue Act has provided us with some funds to hire our own counselors and social workers.

CHATTERJEE: But he's already worrying, what happens if the funding goes away next year?

MULLANEY: You know, we need to find a way to continue these services because it's not going to be done in a year.

CHATTERJEE: The mental health toll of the pandemic on the country's youth will likely persist for a long time.

Rhitu Chatterjee, NPR News.

SHAPIRO: If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-8255, or text HOME to Crisis Text Line at the number 741741. Transcript provided by NPR, Copyright NPR.

Rhitu Chatterjee is a health correspondent with NPR, with a focus on mental health. In addition to writing about the latest developments in psychology and psychiatry, she reports on the prevalence of different mental illnesses and new developments in treatments.
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