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As school resumes this fall, educators are surveying every child, teaching more coping skills, and enlisting an army of counselors to address their students’ mental health. And yet, many already know all this will probably not be enough.
Many students may be traumatized by the disruptions and losses of the past year and a half, battling anxiety after being out of school for so long, worried about COVID-19 and the risk of exposure. A record number of youths suffered crises during the pandemic, with Boston Children’s Hospital seeing more children with depression, anxiety, and eating disorders — and a 40 percent increase last summer in admissions for suicidal thoughts and attempts.
Yet even before the pandemic, the educational system was not prepared for the mental health needs of young students. One analysis from 2020 showed Massachusetts schools had only half the number of social workers that they needed, with psychologists and counselors also in short supply.
“The needs are higher than they’ve ever been and we didn’t have enough before,” said Ashley Niggl-Aguiar, president of the Massachusetts School Psychologists Association. “Mental health is a prerequisite for learning.”
After schools shuttered in March 2020, students of all backgrounds struggled with isolation during the pandemic. But specialists say the most affected were youths who relied on school as an escape from difficult homes, and those most affected by the health and economic crises, including low-income students, students with disabilities, and students of color. Researchers estimate nearly 104,900 children in the United States lost a parent to COVID. Nearly one in three Black or Latino families nationwide faced multiple compounding hardships such as housing insecurity, hunger, and unemployment, twice the rate of white and Asian-American families.
In Boston, hundreds of teenagers reached out in desperation to Bridge Over Troubled Waters, an agency that provides housing, food, and support for people age 14 to 24. Since the pandemic, 1,500 young people contacted the organization, a roughly 30 percent increase, said Elisabeth Jackson, the nonprofit’s chief executive.
School closures “disconnected their social network, it disconnected them from food and their free T pass, it disconnected them from that one teacher or that one social worker that they felt connected to,” Jackson said. “When we talk about mental health, that was shut down.”
School-based intervention can make a difference in identifying and reaching out to students. But a student’s access to emotional-health resources can vary widely based on where they attend school. Finding treatment outside school can be difficult, as pediatric therapists often have months-long waiting lists for appointments.
This year, more school districts are surveying students about their mental health to tailor resources to needs, said Niggl-Aguiar. In her district, Narragansett Regional, she said, surveying kids has helped save the lives of suicidal students who otherwise wouldn’t have asked for help.
She worries that some school districts won’t implement universal screening out of fear they may not have enough staff to respond to the need.
“Many people feel like, ‘If you know about it, you have to do something about it,’” said Niggl-Aguiar. “But we’re talking about kids’ lives; we’re not talking about being behind in math or reading. We’re talking about a suicide.”
In the Boston Public Schools, officials screen most students twice a year. But even that doesn’t always identify every youth in crisis.
Last year, Serennity Figueroa, a Charlestown High School student, struggled with depression but felt too shy to tell her teachers. Instead, she withdrew and chain-smoked marijuana to cope with stress in her home, which she recalls feeling “like a prison” because she and her family couldn’t attend work or school.
Figueroa felt increasingly hopeless and alone. Last summer, she turned to self-harming behavior, and then landed in an acute care unit at Boston Children’s Hospital.
There, therapists and doctors taught her coping skills and encouraged her to reach out for support. She started spending more time with Turn It Around, a youth enrichment program that’s part of Massachusetts General Hospital’s Charlestown Coalition, which emphasized healthy habits such as mindful breathing, exercising, and spending time with friends and outdoors; she even took her first-ever mountain hikes.
“Now I feel I could call somebody if I was going to self-harm,” said Figueroa, 17. “I have to look at the long run; I want to have a good future for myself. I want to be successful.”
She hopes teachers this year ask students more about their emotional well-being and not only focus on academics.
Boston Superintendent Brenda Cassellius says mental health is a top priority. This year, for the first time, every Boston school will have its own social worker and a family liaison. Before last fall, each social worker covered 13 schools, with bilingual ones juggling 25.
“Our goal is to meet families where they’ll be in September,” said Melissa Rodrigues, a BPS social worker. “Our capacity to do that will be increased beyond what any of us imagined would happen so quickly; it’s amazing.”
BPS will now meet the nationally recommended ratio of one social worker per 250 students. Still, that doesn’t mean the district will have enough staffers to handle all the daunting challenges facing families, from emotional crises to homelessness and food insecurity, said social worker Lucinda Mills.
“We know in high-needs urban districts, you need more than the recommended ratios,” Mills said.
Boston offers a range of services, from classroom social-emotional lessons to individual counseling and group therapy. Some schools also have outside partners that offer therapy.
That disparity can be seen across the state. Many districts have few counselors, while others contract with outside therapists to treat the neediest students during the school day.
This school year, one provider, Gosnold, Inc. will provide one-on-one therapy to more than 800 students in 75 schools in districts such as Stoughton, Braintree, Falmouth, and Plymouth. Gosnold bills the family’s health insurer and charges each school around $2,000 for the year for a therapist to come in one day weekly.
During the pandemic last year, Gosnold treated a boy from Barnstable, now 9, who was suffering from anxiety and sensory disorders. He was becoming angry, tried to eat metal and glass, and threatened to hurt himself and his family. His mother said the Gosnold therapist calmed him and helped him cope.
“My husband and I would not have survived this past school year without her help,” said the mother, Emily, who asked that only her first name be used to protect her son’s privacy.
Gosnold therapists have helped high-needs students attend school and lead better lives, said Melissa Maguire, director of student services in Monomoy Regional School District. But many districts are still hesitant to contract with providers, she said, fearing they’d become responsible for addressing broader mental-health needs rather than narrower, learning-related ones.
“We’re not funded to be medical providers,” Maguire said. “We have gone beyond our roots of reading, writing, math, and science and become something more to our students and families, but those are not the resources we have.”
Schools are exploring other efforts at balance.
A group of Boston Latin Academy students last year persuaded school leaders to add time in the schedule aimed at supporting emotional needs. Now, twice a week, students will receive a free “wellness” hour to attend workshops or clubs, meet with counselors, or visit the gym or library.
“In schools like BLA, students always feel pressure to be the best and you lose a part of yourself,” said senior Josiah Bufford-Paul, 17. “We’re trying to teach the people behind us how not to have that experience because it was really taxing.”
Naomi Martin can be reached at firstname.lastname@example.org.