Students’ mental health challenges multiplying  

The COVID-19 pandemic is most defined as a physical health issue, with its wealth of serious symptoms and potentially life-threatening outcomes. Yet a wealth of studies indicates the ongoing crisis is manifesting itself in other ways, most significantly in terms of mental health issues and potentially self-destructive behaviors, especially among adolescents, teens, college students and other young adults. They’re presenting an entirely new realm of challenges for the medical community – in many ways, the pandemic behind the pandemic. “Since the pandemic began, children and adolescents have higher rates of anxiety, depression and stress, and even more specific issues such as addictive internet behaviors,” Education Week reported in a story published in March. In a separate study, the U.S. Centers for Disease Control and Prevention reported from April-October 2020, the proportion of children between the ages of 5 and 11 visiting an emergency department because of a mental health crisis had increased by 24% compared to the same period in 2019. Among 12- to 17-year-olds, the proportion increased by 31%. Counseling services are reporting a lack of capacity to adequately deal with the growing caseload. Utilization of mental health services has declined since the pandemic began, with preliminary data for Medicaid/CHIP beneficiaries suggesting there were approximately 34% fewer mental health services delivered during the pandemic months of March-October 2020, as compared to the same months in 2019, though the issues themselves were still present. The issue even surfaced during the State Health Facilities Council’s meeting earlier this month to consider the University of Iowa’s certificate of need application for a new $230 million hospital proposal in North Liberty, with council chair HW Miller asking how the new facility could help provide more mental health treatment services. Yet experts say the pandemic is far from the sole cause of increasing mental issues among today’s students. Stressors that have existed for generations – bullying, economic stratification, behavior challenges and racial divides, to name just a few – have been joined in more recent years by new challenges, from social media to ever-present electronics, the “Me Too” movement and sexual identity challenges. “Students certainly seem to be exhibiting more distress in the last 10-15 years,” said Dr. Barry Schreier, a licensed psychologist and the director of the University Counseling Service at the University of Iowa. “Our students are much more mentally ill than they’ve ever been – higher levels of depression (and) anxiety. And while there has been somewhat of an uptick across the last generation, what we’re seeing is simply higher levels of distress.” However, at least for college students, the pandemic itself hasn’t sparked a significant increase in mental health issues. Dr. Schreier cited a recent report from the Center for Collegiate Mental Health at Penn State University, based on data submitted by several hundred universities – including the University of Iowa – showing that students seeking counseling hadn’t indicated a significant increase in mental health concerns. “Distress remained unchanged,” he said, “but overall, students maintained themselves pretty well over the last few months. In fact, suicide rates fell for those students.” John Speer, chief administrator of the Grant Wood Area Education Agency (AEA), which provides services to 32 public school districts and numerous non-public schools in Benton, Cedar, Iowa, Johnson, Jones, Linn and Washington counties, said he feels the issues facing teens and adolescents aren’t dramatically different from those faced by society. “If you look at overall trends, both with adults and students, we do see higher incidences of mental health needs across the spectrum,” Mr. Speer said. “And I think that’s because there are more demands on our children, and our lives are busier than they were 30 or 35 years ago. All of that helps contribute to the fact that we’ve got students who are growing up with more frequent deeds for mental health assistance. I think you would see that same trend with adults, honestly.” Rather than simply looking at the numbers, Dr. Schreier said he feels it’s more important to look at the factors driving students’ mental health issues – and why the volume of cases remains high. “We live in distressing times,” he noted. “The world is unsafe. We are living through a pandemic without precedent in anyone’s lifetime. We are in a time of high cultural charge with the Black Lives Matter movement and the murder of George Floyd. What we find is that students are simply reacting to the world outside of them, and it’s distressing. “As soon as we start framing this as ‘our students are stressed, our students are having anxiety,’ we transfer the problem to the student, (asserting that) the student is the one that has the problem,” he continued. “What we find … is they’re simply responding to distressing things. The pathologies may be actually outside, and the students are simply responding to it, rather than the pathologies being within our students.” As schools continue to cope with pandemic-related factors – including the possibility that a dramatic spike in cases could cause school districts to return to remote learning models – Mr. Speer said such a move would create difficult challenges for both students and educators. “We know that for the overwhelming majority of students, an in-person learning setting is more aligned with how they learn,” he said. “Having to balance that with … is it safe for students to be in school with a pandemic going on? That’s a very difficult scale to balance. We all fear that if we don’t end up trying to accelerate learning coming out of this pandemic, there could be a generation of students who are really significantly impacted by up to two-and-a-half years of interrupted learning. Balancing those two ideals – that most students learn best in person and the safety of students in a pandemic – is a very difficult challenge.” Dr. Schreier said his department offers a few basic tips to students seeking guidance – don’t be afraid to reach out to support networks; acknowledge that some situations are beyond their control; and practice good self-care, including regular sleep, nutrition and physical activity. In many ways, he noted, today’s students are remarkably hardy, considering all the challenges they face from the world around them. “As I see students in the classroom this year, I always say to them, you are to be congratulated,” he said. “You showed grit and resilience and fortitude, and you persisted and got yourself here. Almost the entire world is conspiring against you to not allow that to happen, and you still did it. So while our students do struggle, they are also a really resilient generation. Unfortunately, that doesn’t get as much attention, but it’s an equally important thing about this generation of students – their struggles as well as their strength.”