As an adolescent and emergency physician I’m plagued by the reality that as we move from the initial phase of the pandemic to reopen schools, we are going to continue to face its long-lasting impacts on children and youth. There will be a tsunami of mental health needs and crises directly related to this period of isolation. Our schools and educators are going to have to quickly and urgently create new, innovative approaches to support our struggling youth.
When classes return, all students will experience a radically different school environment. This might include staggered hours, smaller classes, restricted outdoor activities, and teachers wearing personal protective equipment. Students’ excitement for seeing their friends will co-exist with their intense doubts and uncertainty, and possibly directives to remain distant on the playground or in the hallways. Will I be able to play sports? How will I manage my grades?
But underlying these universal changes lie much larger, more significant and urgent challenges that are becoming increasingly evident and are even apparent now when students are still at home. They go well beyond academics and getting classes back on track. Sadly, many students have experienced a highly traumatic, disruptive, and frightening several months. These are the primary causes of long-term mental health issues.
Domestic violence rates are rising, food banks are seeing increased use, and young peoples’ parents are losing their jobs at unprecedented rates. Calls to Kids Help Phone have increased by 350% and many youths are facing death and grief for the first time, and at a truly bewildering scale. Moreover, a 2013 study of children who had been quarantined for infectious diseases found that 30% of isolated and quarantined children met the criteria for PTSD. “Normal” life will be rocked forever for these kids, and school administrators need to be cognizant of that when schools return.
Mental health and wellbeing experts are rising to the occasion, emphasizing social-emotional learning in curricula and direct mental health supports. Support for families as well as individual students is becoming increasingly recognized as essential. With the need for social distancing, technology such as tele-counselling is playing an enormous role as one solution. However, there are neither the resources nor the direct need to provide ongoing counselling to every student. New mental health apps and virtual outreach services are also growing, but the connection between these services and those that need it the most are not guaranteed.
Each student’s experiences will have been unique, and one-size-fits-all solutions for support will waste precious resources without yielding effective results for each student. Paul Reville, former secretary of education for Massachusetts, stated the following, “Some students will be fine during this crisis because they’ll have high-quality learning opportunities, whether it’s formal schooling or informal homeschooling of some kind coupled with various enrichment opportunities. Conversely, other students won’t have access to anything of quality, and as a result, will be at an enormous disadvantage… the most economically challenged in our society will be the most vulnerable in this crisis, and the most advantaged are most likely to survive it without losing too much ground.”
Clearly, each student’s mental health needs to be triaged so that those who need it most can be connected with the specific support they need.
So how can schools fill this gap? After decades of experience helping administrators answer this very question, I know that strong data is critical to strong solutions. Taking a proactive approach, schools can be in the driving seat, screening families and students to assess their needs to connect them with support. However, traditional screening surveys are limited in user responsiveness and inadvertently introduce bias and stigma that creates serious sensitivity issues. How will families feel safe to disclose those students with hidden significant trauma? How do we reduce the stigma for those afraid to come forward? How do we access those with less health literacy or language barriers?
Beyond being a matter merely of responsiveness, we know that in this tsunami, managing the data and making the connections between needs and services will be another significant workflow barrier. How can one efficiently triage an entire class or school so that scarce resources are managed efficiently and effectively?
Additionally, for school administrators and frontline workers, high-quality data is helpful but not enough. Tools need to fit seamlessly into workflow and reduce case-load and workload. Leveraging data analytics with automatic triaging, alerts for critical responses, and personalized navigation to appropriate services will allow counsellors, schools, and the entire education system to support those most in need while providing families and students with vetted tools and resources, helping them get back on track.
In the current situation, elegant solutions should work for everyone in our diverse communities and those that serve them, solving real-world problems efficiently and effectively. For students and their families, we need solutions that embody empathy, cognition, emotion and compassion while understanding user diversity, like different ages, races, genders, literacy levels, geography, and disabilities. I have seen the power of these “digitally empathic” assessments and surveys in real-world, youth-based programs in ensuring each parent and student can safely and confidently share their true story and build trust with those supporting them.
As we continue to navigate the fallout of COVID-19, we are undertaking COVID responsive projects in partnership with large school districts and individual schools in both Canada and the US. These types of projects are what counsellors, administrators, and organizations will need to effectively navigate the coming tsunami with the limited resources we all have available.
We know this tsunami is coming, so it’s our duty as parents, educators, and health care professionals to be prepared and keep our kids healthy and safe.