Op-ed: NYC schools expand mental health support for students as pandemic leaves kids in crisis

Dr. Dave A. Chokshi is New York City's Health Commissioner, Meisha Porter is the New York City Schools Chancellor and Chirlane McCray is the first lady of New York City.

Covid-19 was tearing through New York City during the outbreak's peak last winter, and the staff at a youth center in the South Bronx was especially concerned about a mother and her four children riding it out in a homeless shelter.

The mother frantically searched for a job and worried about her children. The children — ages 5, 6, 9 and 11 — were constantly marked late for school because of spotty Wi-Fi for remote learning. The 11-year-old became acutely anxious as she watched her family struggle and the youngest was sad and uncomfortable when he transitioned into the classroom, saying he missed his mother.     

The pain these children felt exemplifies what too many underserved families endured during the pandemic. But studies indicate that children from all kinds of families also suffered, if only from losing their routines and missing their friends. Others watched family members die or fall ill or suffered the fallout from their caregivers' lost or down-sized jobs.

We must support them all. Amid this unprecedented crisis, we have a once in a lifetime opportunity to create a national roadmap for mental health support for our young people. Because most lifetime mental health conditions begin before age 24 and half before age 14, the earlier we can spot depression, anxiety or other issues, the earlier we can provide appropriate care.

Schools are a good place to start: educating the whole child is not just about reading, writing and arithmetic. We know that good social-emotional skills and good mental health are essential for a productive and healthy life. We need to think about mental health as part of returning to school in 2021, beyond the focus on physical health and Covid safety. 

As students across the country return to socially distanced and disinfected classrooms carrying their backpacks and books, some will bounce with joy to see friends and teachers and some will be somber or even traumatized by their experiences during the pandemic.

A Centers for Disease Control and Prevention study found that between April and October 2020 there was a 24% uptick in the proportion of mental health emergency visits for children ages 5 to 11, compared with the same time in 2019. The Colorado Children's Hospital in May declared a mental health emergency. 

And in a 2021 national poll, 46% of parents said their teen had shown signs of a new or worsening mental health condition since the pandemic.

We are seeing a similar trend in New York City. A new citywide Health Department survey found that 1 in 5 parents or guardians reported the emotional or behavioral health of a child in their home had been negatively affected by the pandemic, and for one-third of respondents, the emotional and social well-being of a child had been a source of stress. 

Here in the nation's largest school district, our education leaders are responding proactively to this mental health crisis by offering a historic expansion of services for young people and families.

Starting this fall, we will be providing universal, school-based screening from kindergarten through 12^th grade to identify students who are distressed, have experienced trauma or have other mental health needs. The new program is entirely voluntary and confidential. We are hiring hundreds of social workers, psychologists, and family support workers — every single school in New York City will have at least one full-time social worker or school-based mental health clinic.  

For schools in the neighborhoods hardest-hit by Covid, there are expedited referrals to public clinics for students who need ongoing treatment. And we are providing training for educators to engage and respond to students' needs in a trauma-informed way as well as expanding mental health resources and training for parents.  

These services will only work, though, when we have enough culturally competent health care providers and a way to access and pay for treatment. We urgently need more mental health providers from Black, Indigenous and other people of color communities. We also require support for community-based organizations that provide mental health care as part of a broader health program. 

 A roadmap for a robust mental health recovery plan should also equip schools with a curriculum for social-emotional learning. SEL is a proven educational approach used in schools nationwide. Students learn to identify their emotions and resolve tough feelings, build relationships, and resolve conflicts. Schools can also offer Youth and Teen Mental Health First Aid, which teaches the signs and symptoms of mental illness and substance use problems and how to respond appropriately.

Because we value our children and our futures, we must also seize this moment to push for national investment. We are pleased that the House recently passed the Mental Health Services for Students Act. That act provides $130 million in competitive grants of up to $2 million each to expand the Project Advancing Wellness and Resilience Education program. The program provides on-site licensed mental health professionals in schools nationwide. We must push legislators to support passage of the act in the Senate.

Future generations will judge us on the choices we make today. Our goal cannot be to get back to normal. Normal means too many students in this country who lack access to proper health care, including mental health care. Mental health must be front and center for a full pandemic recovery, especially for our children.

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