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School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19 (2021)

Chapter: School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19

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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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EXECUTIVE SUMMARY

COVID-19, along with heightened racial trauma, has caused unprecedented disruption in the lives of youth aged 10–18, leading them experiencing increases in mental health concerns. Addressing these negative impacts requires education leaders, school districts, state and local decision makers, parents, teachers, and youth to work together to ensure that young people have the support and resources needed to address their mental, emotional, and behavioral health needs in the wake of the COVID-19 pandemic.

This rapid expert consultation identifies school-based strategies for addressing the mental health and well-being challenges among youth that arose or were exacerbated during the COVID-19 pandemic. Included are strategies designed to support the holistic needs not only of youth but also of educators and staff. Box 1 summarizes these strategies.

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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INTRODUCTION

COVID-19 has caused unprecedented disruption in the lives of youth aged 10–18 as a result of public health safety measures, including school closures; social isolation; financial hardship; food insecurity; disrupted sleep; and gaps in health care access (Shah et al., 2020; Stern, Wagner, and Thompson, 2020). Co-occurring with the pandemic has been racial trauma, including violence against Black communities; protests against that violence; and the disproportionate impact of COVID-19 on Black, Hispanic, and American Indian/Alaska Native individuals. These combined experiences have led to increases in mental health symptoms among youth, including stress, anxiety, depression, and suicide attempts (Lee, 2020; Golberstein, Wen, and Miller, 2020; Yard et al., 2021).1

While limited data are available, these impacts have likely been felt disproportionately by youth facing economic hardship or from traditionally marginalized communities. Also taking a toll on youth’s mental health have been, for example, increased job losses in families and fear for parents working in jobs where exposure to COVID-19 is high (Lowenhaupt and Hopkins, 2020). Immigrant children who are already at risk for poor health outcomes as a result of lack of insurance, discrimination-related health effects, and fear of separation from parents may have experienced high levels of stress as well (Cholera, Falusi, and Linton, 2020).

The impacts of COVID-19 on mental health among youth have also been felt by parents. Parents have reported significantly higher levels of stress related to COVID-19 compared with nonparents; more than 70 percent of parents have cited distance learning for their children as a source of great stress (Margolius et al., 2020). At the same time, it is important to note that, while unprecedented, the events of the past year have only exacerbated an already existing crisis.2

While evidence about the effects of the pandemic and racially traumatic events is still emerging, the science of adolescent3 development shows that those effects may be either ameliorated or exacerbated by the specific environments, such as school settings, in which young

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1 A survey of young people aged 13–19 conducted in April/May 2020 found that young people felt disconnected from peers and adults, and were more concerned than usual about their family’s physical and emotional health. More than one in four reported an increase in sleep loss due to worry, feeling unhappy or depressed, feeling constantly under strain, and loss of confidence in themselves (Margolius et al., 2020). Mental health–related emergency department visits were found to be up 24 percent for children (ages 5–11) and 31 percent for youth (ages 12–17) (Leeb et al., 2020), and 22 percent of parents reported their child’s mental or emotional health was worse than before the pandemic (Verlenden et al., 2021).

2 A 2019 National Survey on Drug Use and Health found that, although an estimated 13.3 percent of adolescents aged 12–17 experienced at least one episode of major depressive disorder in 2017, about 60 percent of these individuals did not receive treatment for their illness (National Institute of Mental Health, 2019). The Centers for Disease Control and Prevention (CDC) also reported that persistent sadness or hopelessness was experienced by 37 percent of high school students in 2019, up from 26 percent in 2009, while the rate of suicide planning rose from 11 percent to 16 percent in that same period (Hertz and Barrios, 2021).

3 Adolescence is defined as a period bridging childhood and adulthood, beginning around age 10 with the onset of puberty and ending in the mid-20s (NASEM, 2019).

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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people live and interact.4 Offering health services to youth in school settings is critical to meeting young people where they are and removing barriers to access needed care. This rapid expert consultation was produced in recognition of the acute behavioral health needs of young people and the impacts of the COVID-19 pandemic and co-occurring racial trauma on mental health. It also reflects recognition of the opportunities for promoting health and well-being in school-based settings. It identifies strategies for addressing mental health challenges and promoting well-being among youth through school-based interventions and provides guidance for leaders in education working with young people.5

In the implementation of any such strategies, it will be essential to recognize that contexts and environments lacking resources as a result of existing societal inequities are likely to impact negatively some youth more than others (Yoshikawa et al., 2020). While vulnerability to mental health issues generally increases during this developmental stage, inequities related to health care access, along with disparities in income and wealth, can lead to worse mental health outcomes for young people. Similarly, the impacts of social isolation, school closures, housing instability, racial trauma, and loss of employment may be felt most deeply by young people in communities lacking access to adequate social and economic resources that can offset such losses.

Adolescence is a period of great opportunity and resilience; however, that promise may be thwarted without adequate investments in resources and supports to ameliorate exposure to stress (National Academies of Sciences, Engineering, and Medicine [NASEM], 2019). Federal COVID-19 recovery funds provide tremendous opportunities to build and sustain comprehensive school mental health programs and promote well-being for all youth, and to rebuild youths’ relationships with each other and adults at school and improve school climate more generally.

To better understand the experiences of young people, educators, and parents during the COVID-19 pandemic, the Societal Experts Action Network and Forum for Children’s Well-Being of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop on May 20, 25, and 27, 2021.6 This rapid expert consultation draws heavily on the experiences shared in the course of those discussions, as well as on a portfolio of reports produced by the National Academies and the broader literature base. Centering and listening to the perspectives and voices of young people and supporting their individual agency is critical in shaping appropriate policy responses (Jackson, 2020; NASEM, 2019). Box 2 highlights some of

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4 Individual paths of development are shaped by complex interactions between developing adolescents and their environments and experiences in context, and access to resources and supports promotes thriving developmental trajectories. Given the interaction among the brain, body, and environment, adversity or prolonged stress exposure resulting in activation of the body’s stress response system can be physiologically and psychologically taxing and lead to negative outcomes (National Academies of Sciences, Engineering, and Medicine [NASEM], 2019).

5 The full statement of task for this rapid expert consultation is as follows: “The National Academies of Sciences, Engineering, and Medicine will produce a rapid expert consultation on how decision makers can address the needs of youth experiencing mental health challenges during the COVID-19 pandemic. Drawing from a three day workshop with experts on the effects of the COVID-19 pandemic on young people’s mental and emotional wellbeing held by the Forum for Children’s Wellbeing and published literature on social, emotional, and behavioral health, this document will identify strategies to address mental health challenges and provide guidance for leaders in education and other institutions working with youth to use as they address mental health issues arising from COVID-19 and work to improve youth services. The document will be designed to be of practical use to decision makers, but will not recommend specific actions or include other recommendations. It will be reviewed in accordance with institutional guidelines.”

6 See https://www.nationalacademies.org/event/05-20-2021/back-in-school-addressing-the-well-being-of-students-in-the-wake-of-covid-9-a-virtual-workshop.

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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the perspectives young people shared during the May 2021 workshop. Though not representative, they shed light on the experiences of young people during the COVID-19 pandemic.7

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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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STRATEGIES FOR PROMOTING MENTAL HEALTH AND WELL-BEING AMONG YOUTH, AS WELL AS EDUCATORS AND STAFF, IN RESPONSE TO THE COVID-19 PANDEMIC

School settings give decision makers at the state and local levels opportunities to address specific mental health concerns arising from the pandemic, along with inequities exacerbated by the pandemic and racial trauma, and to promote well-being for all youth through broader school- and system-level changes (Lowenhaupt and Hopkins, 2020). Leveraging many of these opportunities will require additional resources, which may be available through the American Rescue Plan’s dedicated funds for schools targeted at meeting the social, emotional, mental health, and academic needs of students (U.S. Department of Education, 2021).8 Yet access to evidence-based behavioral health care services remains limited, and this gap continues to be exacerbated by shortages in the behavioral health care workforce, especially providers with specific developmental training to meet the needs of young people (Golberstein, Wen, and Miller, 2020). Box 3 summarizes some strategies for improving access to mental health services outlined in the National Academies report The Promise of Adolescence: Realizing Opportunity for All Youth (2019).

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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Strategies for Addressing the Mental Health and Well-Being Needs of Youth That Emerged during the COVID-19 Pandemic

For many youth, school-based services are their primary means of accessing mental health care (Duong et al., 2020). Schools can address mental health and well-being among youth by understanding their holistic needs and creating opportunities for screening, prevention, and treatment of mental health conditions. Schools and after-school programs can also adopt a positive mental health–promoting environment by reducing stigma (Durlak, Weissberg, and Pachan, 2010). Integrating trauma-informed, historically, and culturally responsive policies and practices into comprehensive school mental health policies and curriculum is also critical, particularly considering the racial trauma co-occurring with the pandemic. In implementing such strategies, it is important to be careful not to pathologize diverse youth harmed by injustice; instead, the focus needs to be on promoting mental health and well-being by leveraging culturally based strengths. Needed as well are additional strategies focused on addressing resource inequities suffered by some youth as they reengage with in-person learning full-time.

Consider School-Wide Screenings or Identification Processes to Address the Mental Health Needs of Youth While Ensuring Resources to Meet Those Needs

Schools can implement screenings or identification processes conducted by trained staff to understand young people’s current needs and proactively identify and refer youth for more focused supports. Socioemotional and behavioral health screenings can be used as the first step in a multitiered support system (National Association of School Psychologists [NASP], 2020; Substance Abuse and Mental Health Services Administration [SAMHSA], 2019).9 Various mechanisms for “screening” in schools, beyond just using formal assessments of all students, are available. For example, Tehama County in Sacramento has implemented well-being “check-ins” whereby students report their emotional status on a daily/weekly basis and indicate whether they want additional support (Jones, 2021). Such school-wide screenings and referral systems will need to be sensitive to the needs of youth of color, immigrant youth, and youth with disabilities.

Implementation considerations for school-wide screening include building capacity to meet demand for support and services, as well as efforts to engage families. The National Center for School Mental Health (NCSMH), for example, provides guidance on establishing school-wide screenings, including involving students and families in the planning and implementation process, sharing information about screening in multiple formats prior to implementation, and offering the opportunity to consent or opt out (National Center for School Mental Health [NCSMH], 2020). Schools may also benefit from undergoing guided or facilitated self-assessments to better understand the structural contributions within the schools that may impair student well-being.

Identify and Provide Supports to Youth at Higher Risk for Significant Stress or Trauma Since the Onset of the COVID-19 Pandemic

Schools can conduct psychological screening to determine which youth need intensive support related to the impact of the pandemic and racial trauma. Youth who may need additional

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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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support include those experiencing the death or loss of someone close to them (Kidman et al., 2021); those undergoing significant disruptions to their quality of life, such as food or financial insecurity; those with a history of trauma and chronic stress; those with chronic health or mental health conditions; those with exposure to abuse or neglect; and those from communities with a previous history of educational disruption (e.g., disasters, school-located mass casualty events). High-quality after-school programming can also be helpful in facilitating integration and building resilience for youth, particularly those from immigrant and refugee families (Greenberg, 2014).

Providing additional resources and supports, especially for youth impacted by economic hardship resulting from the pandemic, will also be critical (Yoshikawa et al., 2020). To help achieve mental health equity, schools can assess and address the social determinants of health that impact health and education (Center for Health and Health Care in Schools, School-Based Health Alliance and National Center for School Mental Health, 2021; Woodward and Singh, 2021). Wraparound models, whereby, for example, schools provide free meals, laundry services, or health care, have been shown to be effective (Dobbie and Fryer, 2013). One such model was implemented by Seattle Public Schools, whose “Whole Child, Whole Day” initiative includes a comprehensive care coordination model with community partners (Seattle Public Schools, n.d.).

Establish School-Based Health Centers or Community Partnerships with Health and Mental Health Providers

As noted above, offering health services to youth in the school setting is critical to removing barriers to accessing care. One study found that youth in schools with mental health services, such as dedicated mental health staff, including counselors, social workers, resource officers, or psychologists, had a significantly lower likelihood of suicidal ideation and suicide attempts compared with youth at other public schools (Paschall and Bersamin, 2018).

Districts across the nation have established formal partnerships with community behavioral health providers (e.g., hospitals, outpatient mental health centers) to offer mental health services directly in schools or via referrals to off-campus providers. Some services are offered in the context of school-based health centers, which offer both primary care and mental health care, and sometimes additional health services, such as vision and dental care (Keeton, Soleimanpour, and Brindis, 2012; NCSMH, 2020). School districts can undertake a community inventory to understand available services in their area. For example, school districts in Long Island, New York, have partnered with a local children’s medical center for direct, easily accessible services to meet young people’s mental health needs (Chatterjee and Herman, 2021), while the Kentucky Valley Educational Cooperative established Ripple Effects, an online program to provide behavioral health access for youth in rural settings.10

Families that confront multiple psychosocial problems can be served by family empowerment programs11 and connected to community clinics by school counselors or school-based mental health experts (Cleek et al., 2012). Schools can also invest in culturally responsive mental health interventions that leverage community assets, recognizing and addressing the impact of social injustices on the well-being of youth, families, and their communities.

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10 See https://rippleeffects.com.

11 A family empowerment program is a multisystemic family therapy program that partners multistressed families with an interdisciplinary resource team while remaining attached to a “traditional” mental health clinic (Cleek et al., 2012).

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Create Healthy, Safe, and Supportive School Climates

Specific means for creating healthy, safe, and supportive school climates include instituting culturally responsive and trauma-responsive policies and practices, supporting staff well-being, building mental health literacy for school staff and youth, supporting social and emotional learning, and addressing crisis preparedness. Safe and supportive schools promote an inclusive and respectful classroom environment in which the assets of all youth are valued, and equitable treatment by all educators and staff in addressing young people’s concerns is standard. Such schools may also offer formal coaching and professional development related to diversity, equity, and inclusion for school leaders and teachers to help ensure that they value the contributions and assets of all youth. Assessing and improving school climate is also an important mechanism for fostering peer and student–teacher relationships in schools.12

Incorporate Social and Emotional Learning into the Core Curriculum

Social and emotional learning has been shown to be effective for improving mental health and well-being in schools (Durlak et al., 2011; Osher et al., 2016; Taylor et al., 2017), and can be incorporated by, for example, being embedded in curricula of core academic subjects.13 Social and emotional learning emphasizes competencies in self-awareness, self-management, social awareness, relationship skills, and responsible decision making, as well as mental health literacy (Collaborative for Academic, Social, and Emotional Learning, 2019). To incorporate social and emotional learning into their core curriculum, schools need to rebuild classroom environments to consistently include practices that address youth wellness and establish an intentional focus on social and emotional skill development. Social and emotional learning programs integrate these skills into the overall curriculum using teachers and other school staff to provide lessons on self-management, setting positive goals, expressing empathy, and establishing positive peer relationships (Durlak et al., 2011; Taylor et al., 2017).

Promote Parental Engagement, and Support Parents and Families

Promoting parental engagement in schools may have protective effects (Hill and Tyson, 2009). Frameworks for engaging families can include opportunities for two-way communication, welcoming environments, shared power and responsibility, and respectful interactions. Such strategies need to recognize that “family” is defined and conceptualized differently in different communities and cultures; family engagement considerations need to be culturally attuned and inclusive. Schools can provide resources, such as newsletters, virtual workshops, or in-person meetings that inform parents and families about mental health and well-being. Parents can be invited to school town halls to encourage healthy, open discussion of mental health issues and remove stigma, improve awareness, and promote self-care for both parents and their children (Lindsey et al., 2014).

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12 The National Center for Safe Supportive Learning Environment has a wealth of resources for assessing and improving the school climate; see https://safesupportivelearning.ed.gov/school-climate-improvement.

13 The Collaborative for Academic, Social, and Emotional Learning (CASEL) provides best practices for socioemotional learning; see https://casel.org.

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Rebuild Relationships with Peers and Teachers, and School Connectedness

As more youth return to in-person learning full-time, it is important to remember that learning is most successful when students feel safe and supported. Building school connectedness is an important protective factor for youth. Giving young people the time and space to build relationships with their teachers and peers and establish consistent routines will help ready them for learning.

Schools will also need to recognize the unique challenges of youth entering a new school (e.g., new to middle school or high school). Schools can provide additional opportunities to get youth acquainted with peers and staff, such as open houses and virtual tours, and to build peer supports, such as matching new students with peer buddies. Teachers will need time to gain awareness and understanding of young people’s experiences during the pandemic so they can better tailor educational supports to meet students’ needs. Schools can institute strategies designed to ensure that every student has at least one adult in the school building who knows them by name and can support them.

Youth highly value peer connection and approval and may need additional supports and time to rebuild peer relationships. With the onset of the pandemic, young people who had been gaining independence from their families and developing their own identities and relationships may have lost opportunities for healthy social development. Although technology has enabled continuity of relationships for some youth, the lack of social opportunity during the pandemic may have had negative impacts on young people’s social skills and relationships (Scott et al., 2021). As schools consider their fall schedules, they will need to create time, space, and opportunities for youth to rebuild lost relationships and address their social needs.

Balance Academic Learning Opportunities with Social, Emotional, and Behavioral Support

Given the challenges presented over the last school year, overemphasizing loss of learning and the need to close gaps, or “catch up,” could further increase stress and anxiety among students. Instead, it is important to offer differentiated and responsive learning opportunities adapted to variations in young people’s academic levels and emotional well-being through, for example, fall learning camps. Schools can perform educational assessments to determine effective, individualized educational planning.

Provide Resources for Mental Health, Including Stress and Anxiety Management

The quality and characteristics of the school environment can exacerbate or diminish stress for youth (Eitland et al., 2017). Schools can create spaces for youth that prioritize wellbeing, such as by developing curated virtual resources or library collections with social and emotional learning tools, designating recharge rooms or calming spaces, and providing access to outdoor spaces. Establishing peer-led support groups can also support well-being. For example, high schools in Westerville, Ohio are implementing “Hope Squads”—a peer-to-peer suicide prevention and mental health education program (Westerville City School District, 2020).

School-employed and community mental health professionals can also facilitate evidence-based classroom lessons focused on mindset and behavioral standards (e.g., learning strategies, self-management skills, and social skills). These lessons could follow such models as restorative/community circles, advisory periods, and social and emotional learning.

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Other approaches include ensuring that youth have the phone number or other contact information for mental health hotlines (e.g., suicide prevention) and know how to offer peer support in times of crisis. Normalizing the stressful effects of the pandemic on mental health and the decision to seek care will be important to combat stigma for help seeking and fear of disclosing the need for support and mental health treatment. Schools can prioritize emotional support by setting aside time to discuss impacts of COVID-19, creating resilience narratives of young people’s experience during the pandemic, and building “brain breaks” or opportunities for mindfulness and stress relief into the school day.

Promote and Build Resilience

Resilience is the process of adapting well in the face of adversity, trauma, or significant sources of stress. A focus on resilience in youth recognizes the protective factors that predict successful, adaptive coping despite adversity (Masten and Narayan, 2012). Resilience programs can help youth build relationships, encourage them to create healthy self-perceptions, provide opportunities for efficacy and self-control, develop a sense of belonging and responsibility for others, and foster understanding of the importance of cultural and historical roots (Ungar, 2018).

Consider the Importance of Sleep in Future Planning

Schools also need to consider the benefits of sleep as they plan the school day and design homework and assignments to support management of stress and anxiety (NASEM, 2019). Existing research has shown that sleep problems are not uncommon among youth, with many young people reporting that they have trouble falling asleep, restless sleep, and variability in sleep patterns (Telzer et al., 2015), which have in some cases been exacerbated by changes in routines and increased stress and anxiety during the pandemic (Stern et al., 2020). School-based sleep interventions with promising results include those that use motivational interviewing (Bonnar et al., 2015), changes to the start times for schools (Meltzer et al., 2021), and mindfulness approaches (Bei et al., 2013).

Strategies for Supporting Educators and Staff

Provide Professional Learning Opportunities Related to Mental, Emotional, and Behavioral Health

Schools can provide high-quality training and resources for educators and staff related to mental health promotion, life skills training, coordination with parents, and referral to mental health care professionals, as well as train educators and mental health providers in cultural inclusiveness and equity. Establishing cohorts of educators and professional learning communities for real-time problem solving has also been found effective (Brown, Horn, and King, 2018; Snow-Gerono, 2005). Schools can help teachers and staff convey hopeful messages that counteract the negative messages and uncertainty brought about by the pandemic.14

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14 The Mental Health Technology Transfer Center (MHTTC) Network provides additional resources; see https://www.classroomwise.org.

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Provide Direct Support for the Mental Health Needs of Educators and Staff

Better teacher well-being is associated with improved well-being and fewer psychological difficulties among students (Harding et al., 2019). The pandemic year presented educators and staff with unprecedented challenges and necessitated near-constant retooling to meet ever-changing conditions. Many educators and school staff are experiencing increased burnout, stress, anxiety, and fear related to returning to school (Pressley, 2021), which may have been exacerbated by the pandemic, and additional supports and resources will be needed to address their needs.15 Beyond encouraging educators to undertake health-promoting behaviors, schools can structure collaboration to improve working conditions and the school environment. For example, schools can schedule increased collaboration and planning time to enable teachers to develop self-care curriculum and share strategies for assisting youth.

CONCLUSION

Current federal COVID-19 recovery funding provides tremendous opportunities to build and sustain comprehensive school mental health programs and promote well-being for all youth. Such resources will also be needed to monitor and track the long-term effects of the COVID-19 pandemic and co-occurring racially traumatic events on youth and align current practices with evolving psychosocial and mental health needs. Moreover, policy makers will need to take the steps necessary to ensure sustainable funding for and a long-term commitment to addressing deeply rooted inequities in access to opportunities, resources, and supports among young people, given that the pandemic and racial trauma of the last year have likely only exacerbated longstanding disparities in behavioral health outcomes by race and ethnicity and socioeconomic status.

SEAN is interested in your feedback. Was this rapid expert consultation useful? Send comments to sean@nas.edu or (202) 334-3440.

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15 See, for example, Roman (2020).

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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ACKNOWLEDGMENTS

We thank the sponsors of SEAN—the National Science Foundation and the Alfred P. Sloan Foundation. The associated workshop series that informed the development of this rapid expert consultation was hosted by the National Academies’ Forum for Children’s Well-Being, which is supported by the American Academy of Pediatrics, the American Board of Pediatrics, the Centers for Disease Control and Prevention, the Children’s Hospital Association, Family Voices, the Global Alliance for Behavioral Health and Social Justice, the Health Resources and Services Administration, the Society for Child and Family Policy and Practice, the Society of Clinical Child and Adolescent Psychology, Well Being Trust, and ZERO TO THREE.

Special thanks go to the members of the SEAN executive committee, who dedicated time and thought to this project: Mary T. Bassett (co-chair), Harvard University; Robert M. Groves (co-chair), Georgetown University; Dominique Brossard, University of Wisconsin–Madison; Janet Currie, Princeton University; Michael Hout, New York University; Arati Prabhakar, Actuate; Adrian Raftery, University of Washington; and Jennifer Richeson, Yale University. We thank as well the Forum for Children’s Well-Being, particularly workshop planning committee members David Willis, Cheryl Polk, Mary Ann McCabe, Rebecca Baum, and Sandra Barrueco.

We extend gratitude to the staff of the National Academies, in particular to Emily P. Backes, Malvern T. Chiweshe, and Chelsea Fowler, who contributed research, editing, and writing assistance. We thank Dara Shefska, who led the communication and dissemination of the project, as well as Monica Feit, who provided helpful guidance and insights. Thanks are also due to Erin Kellogg and Adam Jones, who organized and planned the virtual workshop. We also thank Rona Briere for her skillful editing.

To supplement their own expertise, the authors received input from several external sources, whose willingness to share their perspectives and expertise in the course of the virtual workshop was essential to this work. We thank Sharon A. Hoover (National Center for School Mental Health); Abby Frank (student, Ann Arbor, Michigan); Lukas Tucker (student, Knightdale, North Carolina); Brianna Attey (student, Endicott, New York); Chioma Oruh, Chi Bornfree; Lisa Math (Family Network on Disabilities); Kerri Eaker (Family Support Network of Western North Carolina); Jenna White (Northern Virginia PTA); Vanessa Rodriguez (Family Voices National); Amity Noltemeyer (Miami University); Kristy Brann (Miami University); Ka-Shara Jordon (Niagara Falls High School); Tami Santa (Westerville City Schools); Concepcion Pedroza (Seattle Public Schools); Noel Candelaria (National Education Association); Dana Godek (Collaborative for Academic, Social, and Emotional Learning); Kate King (National Association of School Nurses); Paul Imhoff (American Association of School Administrators); Celeste Malone (National Association of School Psychologists); Aaliya Samuel (U.S. Department of Education); Chelsea Prax (American Federation of Teachers); Allen Pratt (National Rural Education Association); Susan Borja (National Institute of Mental Health); and Sarah Sliwa (Centers for Disease Control and Prevention).

We also thank the following individuals for their review of this rapid expert consultation: Robert W. Blum, Bloomberg School of Public Health, Johns Hopkins University; Catherine Pilcher Bradshaw, School of Education and Human Development, University of Virginia; Jeanne Brooks-Gunn, Teachers College and College of Physicians and Surgeons, Columbia University; Sharon A. Hoover, National Center for School Mental Health and Center for Safe Supportive Schools, University of Maryland School of Medicine; Allen Pratt, National Rural Education Association, Chattanooga, TN; and David W. Willis, Center for the Study of Social Policy, Washington DC.

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions of this document, nor did they see the final draft before its release. The review of this document was overseen by Alicia L. Carriquiry, Department of Statistics, Iowa State University and Robert A. Moffitt, Department of Economics, The Johns Hopkins University. They

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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were responsible for making certain that an independent examination of this rapid expert consultation was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authors, and the document has been reviewed and approved for release by the National Academies.

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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SOCIETAL EXPERTS ACTION NETWORK (SEAN)

EXECUTIVE COMMITTEE

MARY T. BASSETT (Co-chair), Harvard University

ROBERT M. GROVES (Co-chair), Georgetown University

DOMINIQUE BROSSARD, University of Wisconsin–Madison

JANET CURRIE, Princeton University

MICHAEL HOUT, New York University

ARATI PRABHAKAR, Actuate

ADRIAN E. RAFTERY, University of Washington

JENNIFER RICHESON, Yale University

Staff:

MONICA N. FEIT, Deputy Executive Director, Division of Behavioral Social Sciences and Education

EMILY P. BACKES, Senior Program Officer

MALVERN T. CHIWESHE, Program Officer

CHELSEA FOWLER, Associate Program Officer

DARA SHEFSKA, Communications Specialist

PAMELLA ATAYI, Program Coordinator

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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FORUM FOR CHILDREN’S WELL-BEING: PROMOTING COGNITIVE, AFFECTIVE, AND BEHAVIORAL HEALTH OF CHILDREN AND YOUTH

CHERYL POLK (Co-chair), Safe & Sound

DAVID W. WILLIS (Co-chair), Center for the Study of Social Policy

SANDRA BARRUECO, Catholic University of America

WILLIAM R. BEARDSLEE, Baer Prevention Initiatives and Department of Psychiatry, Boston Children’s Hospital; Department of Psychiatry, Harvard Medical School

HAROLYN M. E. BELCHER, Johns Hopkins University School of Medicine; Center for Diversity in Public Health Leadership Training, Kennedy Krieger Institute

RAHIL D. BRIGGS, ZERO TO THREE, Washington, DC; Department of Pediatrics, Montefiore Medical Group

C. HENDRICKS BROWN, Departments of Psychiatry, Behavioral Sciences, and Preventive Medicine, Feinberg School of Medicine, Northwestern University

TINA CHENG, Department of Pediatrics, Johns Hopkins University School of Medicine

NATHANIEL Z. COUNTS, Mental Health America

ROBERT H. DUGGER, Hanover Provident Capital, LLC, and ReadyNation

BETH DWORETZKY, Family Voices

MARY A. FRISTAD, Society for Clinical Child and Adolescent Psychology, Nationwide Children’s Hospital

KIMBERLY EATON HOAGWOOD, Department of Child and Adolescent Psychiatry, School of Medicine, New York University

STEPHANIE M. JONES, Harvard Graduate School of Education

JENNIFER W. KAMINSKI, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention

AMY WIMPEY KNIGHT, Children’s Hospital Association, Washington, DC

LAUREL K. LESLIE, American Board of Pediatrics; Departments of Medicine and Pediatrics, Tufts University School of Medicine

MARY ANN MCCABE, Society for Child and Family Policy and Practice; Society of Pediatric Psychology; Department of Pediatrics, George Washington University School of Medicine; Department of Applied Psychology, George Mason University

TYLER NORRIS, Well Being Trust, Oakland, CA

CARLOS E. SANTOS, Luskin School of Public Affairs, University of California, Los Angeles

VERA FRANCES “FAN” TAIT, American Academy of Pediatrics

DEBORAH KLEIN WALKER, Global Alliance for Behavioral Health and Social Justice and Boston University School of Public Health

LESLIE R. WALKER-HARDING, Department of Pediatrics, Seattle Children’s Hospital

Forum Staff:

ERIN KELLOGG, Director

ADAM JONES, Senior Program Assistant

Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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Suggested Citation:"School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19." National Academies of Sciences, Engineering, and Medicine. 2021. School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26262.
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School-Based Strategies for Addressing the Mental Health and Well-Being of Youth in the Wake of COVID-19 Get This Book
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COVID-19, along with heightened racial trauma, has caused unprecedented disruption in the lives of youth aged 10-18, leading them to experience increases in mental health concerns. Addressing these negative impacts requires that education leaders, school districts, state and local decision makers, parents, teachers, and youth work together to ensure that young people have the support and resources needed to address their mental, emotional, and behavioral health needs in the wake of the COVID-19 pandemic. This rapid expert consultation identifies school-based strategies for addressing the mental health and well-being challenges among youth that arose or were exacerbated during the COVID-19 pandemic. Included are strategies designed to support the holistic needs not only of youth but also of educators and staff.

This rapid expert consultation was produced through the Societal Experts Action Network (SEAN), an activity of the National Academies of Sciences, Engineering, and Medicine that is sponsored by the National Science Foundation and the Alfred P. Sloan Foundation. SEAN links researchers in the social, behavioral, and economic sciences with decision makers to respond to policy questions arising from the COVID-19 pandemic. The associated workshop series that informed the development of this rapid expert consultation was hosted by the National Academies' Forum for Children's Well-Being.

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