Study: Use of school mental health services rose just before the pandemic

Months after the American Academy of Pediatrics (AAP) declared a national emergency in child and mental health, Emory University researchers have found that use of school of mental health services went up among key adolescent groups in the year before COVID-19 struck compared to previous years in the U.S. The study offers critical insights about the importance of school mental health services in alleviating the growing youth mental health crisis.

In a study published in JAMA Pediatrics, the research team – a collaboration between Emory and Harvard University – saw the use of school mental health services jump by almost 14 percent among students in 2019, the year after the 2018 school shooting in Parkland, Florida. The upswing in usage was most pronounced among non-Hispanic Black adolescents and adolescents from low-income families.

Using a national database to examine mental health trends over a decade (2009-2019), the researchers sampled more than 170,000 adolescents (12 to 17 years) who participated in the national survey and found a distinct uptick in the use of school mental health services in 2019.

Janet Cummings, the study’s senior author and associate professor of Health Policy and Management at Emory’s Rollins School of Public Health, says the odds of receiving any school mental health service were greater in 2019 than at any other point during the study period. She also notes that the findings underscore the need for such services, especially now.

“Given that less than half of youth with a mental health disorder receive any services, an increase in the use of school mental health services likely means that more kids who need help are getting connected to care,” says Cummings.

The researchers found that this increase was concentrated in school mental health service use versus mental health services in other settings. No corresponding increase was found year over year (2018 to 2019) in the use of mental health services in non-school settings.

Lead author Adam Wilk, Cummings’s colleague at Rollins, observed that these increases may have been fostered by school mental health programs that were created or expanded in the 18 months following the school shooting tragedy in Parkland, Florida.  “Those improvements came at a time when there was heightened national discourse and focus on school mental health,” says Wilk. “As a next step, it will be important to understand how mental health programs and services implemented during the COVID-19 era and beyond have affected access to needed mental health care and mental health outcomes.”

Cummings and Wilk also authored a commentary in the same journal a month ago encouraging state legislators and educators to consider incentivizing or requiring schools to offer proven models of mental health services on a sustained basis. In this commentary, the researchers outlined five action items for policymakers, educators, health care providers, and families to support children’s mental health.

The recommendations include creating mental health plans at the school district level, training educators on mental health literacy, and implementing a social and emotional curriculum which has been shown to improve emotional skills, behavior, and academic outcomes.

In October 2021, the AAP joined two other health care professional organizations to declare a national emergency in child and adolescent mental health, saying the pandemic was worsening an already-existing crisis.

The Centers for Disease Control and Prevention found that emergency department visits for mental health emergencies rose by 31 percent for children ages 12-17 years between March and October 2020. In addition, emergency department visits for suspected suicide attempts increased nearly 51 percent among girls ages 12-17 years in early 2021 compared to the same period in 2019.