As you may know, the American Academy of Pediatrics has declared a national emergency in child and adolescent mental health. Over the past decade, evidence of mental health challenges, including suicide, had steadily risen among 10-24 year-olds. The pandemic accelerated these worrisome trends. Doctors and hospitals report “dramatic increases” in emergency room visits by children and adolescents for mental health reasons, including suicide.  “We are caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, and their communities,” sounds the alarm from the AAP.

It's not hard to understand why the pandemic has had such a profound and terrible impact on young people. Nationally, more than 140,000 children lost a primary and/or secondary caregiver to the virus. Virtually all children experienced social-isolation during lock-downs when schools were closed. The lockdowns may also have cut off access to health care providers. Finally, children in unhappy or unsafe circumstances, such as abusive families, found themselves in even greater danger with no ability to leave their homes.  

Notably, girls have especially suffered during the pandemic. NPR recently reported that between February and March 2021, suspected suicide attempts by 12-17 year-old girls as measured by emergency room visits rose 51% compared to the previous year. Eating disorders have also increased significantly over the course of the pandemic, and adolescent girls, particularly white girls, are more likely to experience eating disorders than any other group. An article in Pediatrics documented a 123% increase in the number of admissions for eating disorders at the University of Michigan’s C.S. Mott Children’s Hospital during the period from April 1, 2020 through March 31, 2021 as compared to the previous three years. Finally, pediatricians point to structural racism as having a significant impact on the mental health of children of color, saying, “The inequities that result from structural racism have contributed to disproportionate impacts on children from communities of color.”

Our community is not immune to this crisis. In fact, students throughout the school are experiencing social and emotional issues and mental health struggles. The counselors and teachers from all three divisions have observed developmental delays -- students acting and even feeling -- younger than they are. Younger students (through middle school) are finding it hard to interact with peers; are having difficulty settling down in class and managing transitions; they are being physical -- touching one another -- and being more rambunctious. Middle Schoolers seem to need to run around in ways we wouldn’t have seen in the past. In Upper School, girls are saying things like “I don’t feel like a 10th grader.” A ninth grade physics teacher expressed concern the other day that her students don’t know how to work together. In all three divisions, teachers are witnessing and, in some cases, students are even recognizing a loss of study skills. If they ever learned how, they have forgotten how to study and how to take tests.  Students are feeling overwhelmed by work. There is more work than last year, but in most cases still less than pre-pandemic levels; students are out of practice doing it, making the burden seem greater. Their skills deficits contribute to a rise in anxiety around tests, and also in other areas. In one typical example, a Middle School student said to the counselor last week, “I am so scared about this test. I’m going to die.” That may sound like normal adolescent hyperbole, but the intensity with which the fear is being expressed is different. Across the board, we are seeing higher levels of anxiety and depression as well as unhealthy eating (including actual eating disorders) and self-injury. All three counselors are referring students for outside evaluation and clinical support much more frequently than pre-pandemic. The Middle School Counselor reports, “I have had more students either hospitalized or sent for psychiatric evaluation already than I typically see in an entire year.” Everyone is seeing more fatigue and more crying amongst students. Upper Schoolers are also worried about academic gaps -- the one thing they don’t need to worry about since everyone around the world experienced academic disruption -- and more specifically about college. Stressing about college, of course, is not new; however, the changing college landscape with its attendant uncertainty is heightening students’ concerns.  

Students’ home life plays a role in their mental health, as well. Of course, adults, especially parents, have also suffered emotionally and mentally during the pandemic. We are hearing from parents overwhelmed by the same behaviors in their children we see at school. We are also hearing from students about parental mental health struggles, substance abuse, and relationship conflict including divorce as well as about siblings with issues that are affecting the family as a whole. As I reported last spring, Dr. Soniya Luthar, who works with high-achieving schools, has been surveying sixth through 12th graders since 2019 and has concluded that parent behavior plays a more significant role in promoting young people’s depression and anxiety than any other factor. 

Obviously, not all students are exhibiting the behaviors we are describing, nor, of course, are all adults and families dealing with the kinds of issues I just described. However, all of these things are happening at higher levels than normal and at sufficient levels to cause institutional concern. Holton is fortunate to have a number of structures in place to help us support our students. First, we have an experienced, full-time counselor in each division. Second, we have programs, such as Responsive Classroom in Lower School, advisory in 6-12th grades, and Seminar in grades 3-11, that already address social and emotional learning. In Middle School, teachers have shifted topics in Seminar so that they are teaching units on mental health earlier. Seminar teachers in Lower and Middle School will more frequently be using Open Session, an instrument that allows participants to raise concerns anonymously (or not) and get the support of the group as well as inform teachers about general issues. Middle Schoolers might also be going outside more during Wellness, which provides the salutary benefits of the outdoors while also giving the opportunity to blow off steam. The Upper School Counselor has been holding regular Thursday lunch meetings called “Stress Happens,” voluntary drop-ins for students to share concerns. All the counselors are partnering with parents and providers to support our students most in need. Counselors are also working with faculty to help support them in their work with students. For example, the three counselors made a presentation to all employees last Wednesday, sharing just this kind of information. In addition, the counselors take part in student support meetings at all levels and work with individual teachers. On Monday, November 15, a speaker from Active Minds shared the story of her sister, a star athlete and student who died by suicide her freshman year at Penn, with students in grades 7-12. With all students, she emphasized the importance of seeking help if you are struggling emotionally as well as destigmatizing mental health issues, while she also focused on social media and destructive perfectionism with older students. It was a powerful talk, especially since her sister was very relatable to our students. (Read more here.)

We continue to live in challenging times. We are here to support our students and to work with parents in that support. We want our students to get the help they need to be healthy, fulfilled functioning people on the road to reaching their potential. If you are worried about your child or if your child is expressing concerns to you, reach out to a health professional. As in any health issue, the sooner we address problems the better. And remember to take care of yourself as well. We can’t be good parents -- or any other role we play -- if we ourselves are unwell.   

Want to learn more about Holton’s student-centered support services? Join Susanna this Friday, November 19 at the next School-wide Parent/Guardian Coffee at 10 a.m. on Zoom. This week’s Coffee features schoolwide updates and highlights from Susanna and includes segments dedicated to mental health lead by our counselors. The recording and slides will be available on the Coffee Archive page and in the Skim this weekend.