How Schools Can Adapt Pandemic Protocols to Support Students’ Mental Health

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Two years ago, I had the distinct honor of facilitating a conversation with Lorena Sanabria, a student who was present during the 2017 Marjory Stoneman Douglas high school shooting in Parkland, Fla., at a national education conference. As we sat together on stage, Lorena, who was 17 years old at the time but wise far beyond her years, shared that one of the hardest things after the tragedy was the pressure to go “back to normal.” Within weeks of a shooting that killed 17 people, well-meaning teachers and parents were encouraging Lorena and her peers to reclaim their old lives. But, as she shared, “We were trying to tell them that normal will never be ‘normal’ again.”

Lorena’s words struck a chord with me that day, and her story has stayed with me since. I’ve recalled it again and again in recent weeks as governors, mayors and superintendents discuss plans to reopen schools and get “back to normal” in the fall.

While their optimism is warranted after a banner month for COVID-19 recovery milestones, an even cursory glance at children’s mental health data makes clear that truly going “back to normal” is an impossibility this fall.

Children’s hospitalizations for mental health-related issues rose by more than a quarter in 2020, and more than half of 11- to 17-year-olds reported having regular thoughts of suicide or self-harm. The demand for children’s mental health services has become so great that it is pushing many providers to a breaking point, even prompting Children’s Hospital Colorado to declare a pediatric mental health state of emergency last month.

For schools, seeking a return to normalcy is only natural, but it may actually be counterproductive. Students coming back through our doors in the fall will be carrying the stress, anxiety and trauma of the past year. As Lorena shared in 2019, and as I have seen over the past decade consulting with schools on health and safety-related issues, reinforcing the idea of normalcy dismisses how abnormal things may feel for them.

So, what’s the alternative to getting back to normal? Ultimately, it’s being comfortable with another abnormal school year—even if that’s the last thing students, educators and parents want. And it’s building systems that ensure no students fall through the cracks and escalate to violence or self-harm.

With so many competing priorities this fall, this will be no easy feat. But the good news is that most schools have already built a solid foundation for this work through their COVID-19 response protocols.

All of the hard work schools have done since March 2020 to build out health and safety measures and mechanisms does not have to go to waste just because the likelihood of severe illness and death from the virus has been diminished. Schools can translate those protocols to address mental health.

1. Destigmatize mental health challenges by integrating questions about mental health into daily COVID-19 health screenings.

Two years ago, the idea of having to undergo daily temperature checks and health screenings as an entry ticket to a school building would have seemed ludicrous. But it has become so commonplace now that people have adapted their morning routines to it. It’s almost an afterthought.

Schools can work toward a similar comfort level with mental health conversations. One strategy for this includes asking every student how they are feeling every day. This can be as simple as adding a question to the morning health check, such as, “How are you doing today emotionally?” or “Is there anything specific on your mind today?”

The specific content of the question matters less than the fact that the question is being asked. The goal is to maintain a high volume of visible, accessible adults outside in the morning to notice when something is off or different about a student. Building this kind of compassionate check-in into the daily routine can help destigmatize conversations about mental health challenges and ensure staff have a way to identify and address emotional distress early.

2. Build a strong threat assessment system that mimics COVID-19 response protocols to address concerns before they become greater issues.

At this point, most schools have strong and robust COVID-19 response protocols in place to mitigate and minimize risk, such as mask-wearing, social distancing, contact tracing and quarantining. A similar process can be used to detect potential threats to campus safety.

A threat assessment is a process for determining a student’s risk for violence or self-harm by gathering data. In this case, “data” does not necessarily mean numeric data, but any relevant information about that student’s communication and behavior, about any stressful or negative events they have experienced, and about the resources the student has at their disposal to address these difficulties.

All of this information, together, can help school staff identify students who may be a threat to themselves or others, and evaluate concerns through a threat assessment system. To build a successful threat assessment system, schools must first establish clear procedures, then—and this is the all-too-frequently forgotten step—let the community know where and how to report concerns. They must also provide key staff, such as principals, nurses and counselors, with training so they understand how to conduct a threat assessment of their students.

3. Utilize resources that have been dedicated to contact tracing to strengthen connections with families.

Research has shown that having stronger connections between school and home improves a child’s chances of success. Knowing the challenges children have navigated over the past 15 months, and how embedded they have been with their families during remote learning, we should be prioritizing this home-school connection now more than ever.

As more vaccinations are made available to young children in the coming months, the prevalence and spread of COVID-19 cases within schools will inevitably decline. But that doesn’t mean the resources devoted to contact tracing have to go to waste. Schools that have invested the time and effort to ramp up contact tracing can repurpose those resources to make calls home to families to strengthen these connections and gain a better understanding of what families are facing from week to week. This can provide valuable insight into students’ mental health and also create stronger relationships between families and school staff, which would be a helpful foundation to lean on should any issues arise.

As we enter this next stage of our pandemic response and work to address the spike in children’s mental health challenges, schools will play a pivotal role. But they don’t have to start from scratch. Many of the systems and routines that have been established during this global health crisis can easily be converted into solutions to address the mental health crisis that awaits us.

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