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The calls started at 6 a.m., and Patrick McCauley was ready, having retreated to the privacy of his garage where he sat waiting for Angelenos to share how they’re coping with the stresses of the coronavirus pandemic.

For the last 14 years, McCauley has worked as a mental health counselor and consultant in the Los Angeles Unified School District. In April, he began staffing a new hotline the district created to reach students, parents and teachers in need of mental health supports and other services as the virus forced people into isolation and cost jobs and lives.

One day he heard from a fifth grader who was terrified that her parents would catch the illness. Another day, a mother wanted advice on her once mild-mannered daughter, who had started throwing tantrums and yelling profanities after the quarantine began. Teachers wanted to know how to respond to students who appeared distraught during Zoom lessons, or what to do about the kids who didn’t log on at all.

This spring, Patrick McCauley staffed a hotline the Los Angeles school district set up in April. He heard from students who were scared their parents would get sick, families who were worried about their children, and teachers who wanted advice on students who seemed upset. Credit: Patrick McCauley

McCauley, who has a soothing voice and a surfer’s unruffled mien, listened carefully and reassured the callers that they were experiencing understandable reactions to highly abnormal circumstances. Their testimony amounted to a warning, though, of what schools may face when they restart this fall: kids with a history of mental health problems whose symptoms have worsened, students who maybe experiencing anxiety or anger for the first time, children in households that have become financially precarious and those who are experiencing loss. More and more, schools are recognizing that academic learning may at times have to take a back seat to alleviating those challenges.

“Before we push anything at students academically, let’s ask how they’re doing, with no unrealistic expectations that we can somehow solve all their problems or magically fix everything and make all this go away, but just a lot of acknowledgement, a lot of listening to kids and trying to get them the support they need,” McCauley said.  

Around the country, school leaders are trying to anticipate how these mental health burdens will shape what unfolds in classrooms and via screens during a school year in which the trauma is likely to worsen. Some school districts, such as Los Angeles Unified and Baltimore City, are running hotlines to provide guidance and connect families to services. Other schools are offering grief training to teachers, counseling them on how to recognize signs of distress, and encouraging them to attend to their own emotional wellbeing. Still others are setting up virtual “wellness rooms,” inviting community mental health agencies into schools and unveiling new or expanded “social-emotional curricula” to help students process their feelings.

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“It’s very hard to focus on Algebra if you’re anxious or depressed.”

Marisha Humphries, associate professor at the University of Illinois-Chicago and a licensed clinical psychologist

“What’s happening right now is that all children, regardless of their backgrounds, are experiencing a potential stressor,” said Marisha Humphries, an associate professor at the University of Illinois at Chicago and a licensed clinical psychologist. “Schools appear to be very focused on academics and how do we combat summer slide, but I think the first priority has to be how are we going to support children’s social and emotional development. You cannot do effective instruction if children’s social and emotional needs aren’t met. It’s very hard to focus on algebra if you’re anxious or depressed.”

Research on the emotional toll of the pandemic on kids is relatively scant, given how new the crisis is. But what does exist is worrisome: A study of more than 2,300 kids who endured home confinement during the pandemic in Hubei province, China, found that nearly 23 percent reported symptoms of depression, and nearly 19 percent reported experiencing anxiety. In a review of past studies on loneliness and disease, researchers noted that, even early in the shutdown, more than a third of adolescents reported increased loneliness during the pandemic. Given the “well-established links between loneliness and mental health,” the researchers wrote, children and teens were more likely to experience depression and anxiety, even after quarantine concludes.

Already, in the U.S., up to 1 in 5 children experience a mental health challenge such as anxiety, depression or a behavioral problem in a given year. And yet many children don’t get the help they need. Even before the pandemic, many schools were overwhelmed with helping to fill gaps in health services and helping kids develop emotional coping skills. Now their efforts may be further complicated by the education system’s looming financial crisis, which is expected to bring layoffs for teachers, counselors and other school staff who work closely with students and can provide emotional support. The virus’ resurgence has also made efforts to support students more difficult by prolonging their isolation and ending hopes for an immediate return to face-to-face instruction and counseling in much of the country.

Related: A school district wades through a deluge of social-emotional curricula to find one that works

A Dallas student reads from a book designed to provide social-emotional skills. The Dallas Independent School District invests in social-emotional learning and is hiring more than 50 clinicians to help alleviate long waiting times for students to see a mental health professional. Credit: Dallas Independent School District

The Cleveland Metropolitan School District, where 42 percent of children live below the poverty line, has tried for more than a decade to prioritize its students’ social-emotional needs. Administrators hope that before the district reopens in early September for remote-only learning, teachers and principals will have an opportunity to participate in “restorative learning circles” where they can debrief on how the pandemic has affected them. Then, when virtual learning begins, teachers would model those circles for their students, encouraging them to share their experiences since schools closed in March.

At the top of each school day, teachers would also do a “temperature check” of students, asking them how they’re doing, while mindfulness exercises would be sprinkled throughout the day, said William Stencil, who leads the district’s social-emotional work.

A study of kids who endured home confinement during the pandemic in Hubei Province, China, found that nearly 23 percent reported symptoms of depression, and nearly 19 percent reported experiencing anxiety.

In recent decades, lessons like these have become popular in schools nationwide, amid a growing body of evidence suggesting that children’s capacity to regulate their emotions affects their ability to learn. But the lessons can be a burden for teachers, who have to squeeze them in between the avalanche of academic content they must cover. The pandemic, though, has left adults with little choice about prioritizing these needs.  

“We’re going to have to offer an astounding amount of support,” said James Wagner, a fifth-grade teacher at Cleveland’s Benjamin Franklin PK-8 school. “We’re going to have to embed social-emotional learning within every single subject we teach, every minute that we’re with the students.” Wagner, who has taught in the district for 33 years, said he worries about many of his students, few of whom showed up for Zoom lessons in the spring.

It’s not just the virus that is leaving students feeling overwhelmed and anxious. Next door, in the East Cleveland school district, Jerome West said he wants to make space this year for conversations around racial injustice, which some psychologists refer to as “the second pandemic.” This spring, when George Floyd was killed by a Minneapolis police officer, “kids were upset, they were angry, they were enraged, they thought how is this still happening, this is 2020,” said West, executive director of the East Cleveland Neighborhood Center. The nonprofit center provides social-emotional support to the school district, where 99 percent of students are Black.

When schools shut, the group held “wellness calls” with parents, and ran virtual programs for small groups of students, including a You Matter Academy designed to help kids cope with stress. Kids reported feeling lonely, frustrated and concerned that teachers were piling on worksheets and other assignments to compensate for the lack of in-person classes. Parents reported feeling anxious about taking on the role of teacher, but they also appreciated having more time with their kids, West said.   

The killing of George Floyd was a blow for some kids in East Cleveland, where 99 percent of students are Black. Students were “upset, they were angry, they were enraged, they thought how is this still happening, this is 2020,” said Jerome West, who leads the East Cleveland Neighborhood Center. His group tried to stay connected with students during the shutdowns. Credit: East Cleveland Neighborhood Center

The Philadelphia school district, which will open remotely on September 2, plans to train principals, teachers and other staff on trauma and coping with stress, with a particular focus on racial injustice and social isolation. While the district has done social-emotional work in a piecemeal way in the past, all schools will now ask students to spend 30 minutes greeting each other and talking through their feelings each day, said Abigail Gray, deputy chief of school climate and culture. The district also intends to contract with additional counselors and social workers from local mental health agencies to work directly with students who need additional support.

At some KIPP charter schools in New Jersey, teachers will receive training in suicide prevention, grief counseling and how to spot signs of distress in an online environment. This fall, teachers will also trade “calming corners” in classrooms for an online wellness space where kids can listen to music, fill online coloring books or practice yoga on the school’s virtual learning platform. If students seem upset, a teacher might ping them through the virtual learning platform and encourage them to visit the web tool, said Sheyla Riaz, director of social work for KIPP New Jersey.  

Related: Counseling kids during coronavirus: A tough job made even tougher

As crises go, the pandemic is unusual in that it combines a public health emergency and an economic downturn while isolating kids from school, friends, activities and other support. Each of these emergencies has the potential to create adverse child experiences, known as ACES, that can have long-term consequences on children’s health and wellbeing. Archana Basu, a clinical psychologist and instructor at Massachusetts General Hospital and Harvard Medical School and a researcher at the Harvard T.H. Chan School of Public Health, noted that studies after the 2008 recession showed increases in partner violence and child maltreatment, which are among the experiences that can make a child more vulnerable to later health problems.   

“Teachers are going to have to be very understanding and considerate of the frustrations that kids have experienced.”

Michael Lindsey, New York University’s McSilver Institute for Poverty Policy and Research

Basu also expects to see an increase in social anxiety and in students refusing to attend school. And Michael Lindsey, who directs New York University’s McSilver Institute for Poverty Policy and Research, noted that following the death of Floyd, anxiety and depression among Black Americans shot up. Violence, overpolicing and hate “all play a role in the psyche and mental health of Black youth that may make them reflect on whether their lives really matter, it might make them feel hopeless about their futures and if things might change,” he said. “Teachers are going to have to be very understanding and considerate of the frustrations that kids have experienced.”

“It is important to emphasize that this is not just remote or homeschooling,” Basu wrote in an email. “This is really very different. It is crisis schooling.”

This doesn’t mean that every kid will experience trauma from the events of this year; most won’t. Sadness and anxiety are perfectly natural responses to the pandemic and typically don’t become clinical concerns, said Karestan Koenen, a professor of psychiatric epidemiology at the Harvard school of public health. On the whole, kids tend to be more resilient than adults, she said.

“What’s hard in a lot of these situations, after any disaster, is that a lot of people have symptoms of anxiety, depression, even PTSD,” said Koenen. “Some of that is going to be normal reactions to difficult circumstances, and in many people and kids they will resolve over time … But in some people they won’t, and we can’t always predict well where the problem is.” That reinforces the need for universal interventions such as the social-emotional work that some school districts are trying, experts say.  

Related: School counselors keep kids on track. Why are they first to be cut?

Kids in the East Cleveland school district participated in a You Matter Academy this spring to help them cope with the stress during the shutdowns. Credit: East Cleveland Neighborhood Center

But efforts to intervene and help kids can be expensive. Social-emotional lessons sometimes require curricula schools must purchase and professional development for teachers. Counseling and other one-on-one supports for kids who need greater attention is costly and counselors are already stretched thin: Nationally, counselors serve an average of more than 430 students. Many schools lack social workers, psychologists and other mental-health staff. It’s unclear whether schools will have the money to help kids who need it at a time when falling tax revenues will soon force deep cuts in U.S. public education.

Historically, districts have been relatively quick to shed school counseling jobs. The Philadelphia school system, for example, eliminated hundreds of school counselors and nurses during a 2013 budget crisis. But Jayme Banks, director of trauma-informed school practices, said the district recognized the toll that spreading counseling staff thin had on students, and would prioritize mental health through this crisis. “Lessons were learned,” she said.

“What’s hard in a lot of these situations, after any disaster, is that a lot of people have symptoms of anxiety, depression, even PTSD. Some of that is going to be normal reactions to difficult circumstances, and in many people and kids they will resolve over time … But in some people they won’t, and we can’t always predict well where the problem is.”

Karestan Koenen, Harvard T.H. Chan School of Public Health

In Tennessee, the governor had pledged in February to put $250 million in a trust fund for mental health in schools. But in June, amid predictions of a $1 billion shortfall, that money was cut from a revised budget. Teachers, counselors and parents say they worry how schools will grapple with the increased needs this fall, in a state where youth suicide rates have been steadily climbing.  

“It’s the opposite of robust,” said Rachel Bauer, a parent in Memphis, of the support available at the PK-8 school her daughter, Noel, attends. “It’s minimal, basic.”  

Four years ago, after her son died of misdiagnosed strep throat, Bauer sought school counseling for Noel, who is now 11. For a while Noel benefited from seeing the counselor once a month, but “there are just too many students who need her as well,” said Bauer. When the year ended, they turned to private counseling, an option unavailable to many families.   

Bauer worries that the pandemic will exacerbate feelings of grief and anxiety in kids like Noel who’ve experienced past trauma. This spring, said Bauer, “I saw her spirits dim.”

Still, there are a few places that have made investments in counseling and support. In June, the Dallas Independent School District announced that it would hire 53 new clinicians and reorganize its work helping children with emotional and behavioral needs under a new Mental Health Services Department.

That expansion was prompted by the fact that students were waiting an average of three months to see a clinician, said Leslie Stephens, assistant superintendent of school leadership. “Three months is a long time to say, ‘Deal with it the best you can,’ ” she said.

For now, Dallas schools are planning to open in early September under a hybrid model, with a mix of virtual and in-person classes. Paula Agulefo, a clinician who has worked in the district for 10 years, said she was able to stay in touch with students this spring via video calls

She spoke with kids who couldn’t sleep, kids who’d started wetting the bed again, and children who’d been chatterboxes but had gone quiet. It was harder to connect with kids virtually but not impossible, she said.

“If they’re watching a Disney movie, I’m watching the Disney movie too. If they’re playing a hand game, they’re telling me about it. I know more about Fortnite than I have ever known,” she said. “Children are very good at allowing you into their world when they trust you.”

Agulefo said she’s optimistic teachers and administrators will find a way to meet kids’ emotional and academic needs when schools reopen. “There’s no blueprint or examples of how this can be done, but we know it has to be done,” she said. “We have to get it done because kids, they have to learn.”  

This story on mental health in schools was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for Hechinger’s newsletter. 

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Caroline Preston is a senior editor. She previously worked as a features editor with Al Jazeera America's digital team and a senior reporter with The Chronicle of Philanthropy. Her freelance writing has...

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