Here's what a return to school means for student mental health and what to do to help

With South Jersey students back in school — some for the first appreciable time in 18 months due to the pandemic — educators are once again seeing the effects of a different public health emergency: the ongoing mental health crisis.

Before the COVID-19 pandemic, rates of mental health issues — such as anxiety, depression, suicidality and substance use — had already been getting worse.

Between 2009 and 2019, overdose deaths increased from about 38,000 to more than 70,000, according to the Centers for Disease Control and Prevention. Over the same period, the number of high school students experiencing persistent feelings of sadness or hopelessness rose by 40%, per the CDC. Serious consideration of attempting suicide increased by 36% and attempts increased by 44% for the same age group during the same time.

Suicide has been the second leading cause of death for ages 10 to 24 since 2010, according to the CDC. It's been in the top 10 leading causes of death for all age groups since 2008.

In New Jersey, about one in ten teens suffered a major depressive episode and about one in six adults experienced a mental illness between 2017 and 2018, according to Mental Health America.

But those numbers have likely gotten worse since the start of the pandemic, experts suggest. Nearly a third of parents said their children’s emotional wellbeing was worse than before the pandemic, according to an October 2020 study by the Jed Foundation and Fluent Research. As of January 2021, 40% of adults reported symptoms of anxiety and depression, according to the U.S. Census Bureau.

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Across the board, these rates were even higher for historically marginalized groups, such as people of color, LGBTQ+ people, disabled people and low-income communities.

The Burlington County Times, Courier-Post and The Daily Journal spoke with children’s mental health and trauma experts to find out how parents, families and community members can help kids — and themselves.

What have kids lost, and what have they gained?

From socialization and identity development to a baseline sense of safety and certainty, children and teens have lost a lot since the start of the pandemic, according to experts. They have also gained traumas those same experts say could affect them for years to come.

“We, as a society, have really experienced this collective trauma,” said Robin Cogan, a nurse in the Camden City School District. “For years moving forward, we are going to look at this time of COVID as probably an ACE (Adverse Childhood Experience), because it has impacted all members of society in many different ways.”

Adverse Childhood Experiences are “stressful or traumatic events that occur before the age of 18” and can have a lifelong negative impact on health and well-being, according to the New Jersey ACEs Collaborative. ACEs can include such events as parental separation, experiencing violence, abuse, or neglect, or having a loved one attempt or die by suicide. They can also include challenges such as poverty, discrimination and poor housing quality.

Two out of three children have had at least one ACE, according to the Substance Abuse and Mental Health Services Administration. Children with three or more are 53% less likely to graduate high school, and children with four or more are four times more likely to become juvenile offenders, according to research published in Children and Youth Services and Youth Violence and Juvenile Justice, respectively.

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“What I’m seeing in school now — from students, from staff, from just the community in general — people are exhausted,” said Cogan. “Tempers are short, and stress is high.”

Kara Ieva, a professor in the Counseling in Education Settings program at Rowan University, spoke to the alleged uptick in incidents of violence in and around schools. The "devious lick" challenge — a mid-September TikTok trend of stealing increasingly absurd items from schools, from soap dispensers to bathroom stall doors — could have stemmed from anger and a need to feel seen, she said.

"Kids are bored and reaching out that they need something more," she said. "And the thrill of that and to feel like they're included to a national group of people — even though this is the thing — speaks volumes."

Throughout October, incidents of violence have occurred near or at South Jersey high school football games. During halftime of a Cherry Hill West-Bridgeton game, there was a shooting outside the stadium, a Camden-Pennsauken game was called off midway through due to fan fighting on the Pennsauken side and there was an off-field disturbance during a Lenape-Rancocas Valley game. An on-field altercation involving both sides of a Camden-Pleasantville game resulted in the New Jersey State Interscholastic Athletic Association disqualifying Camden High School from play-off contention.

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Following the NJSIAA's Oct. 20 decision, Camden superintendent Katrina McCombs linked student behavior to the impact of COVID lockdowns.

“While sports can bring fans together in celebration and camaraderie," she said in a statement. "We also understand that the community is still acclimating to being in large crowds and small settings after more than a year of near isolation."

Several athletic directors pointed to the increase of elementary and middle school students attending games.

"Our student body has been great," said Kevin Murphy, Washington Township athletic director. "It's where you have the younger students, the K-8 population not showing up to watch the game."

Washington Township fans cheer on their team during the football game between Washington Township and Williamstown played at Washington Township High School, on Friday, October 8, 2021.  Washington Township defeated Williamstown, 42-7.
Washington Township fans cheer on their team during the football game between Washington Township and Williamstown played at Washington Township High School, on Friday, October 8, 2021. Washington Township defeated Williamstown, 42-7.

"It's the young kids coming to a social event that are struggling," he said. "And most districts in South Jersey are in that same situation."

In response, Washington Township banned younger students from attending games without a parent or guardian.

“It’s a middle school mentality at a high school event," said Billy Snyder, Pennsauken athletic director. "They’re not there to watch the game, they’re there because of the crowds. They create their own TikTok and Instagram videos.

"They dance and do silliness, but they run 30, 40 kids at a time and they just create chaos," he said. "They create this unrest that we’re just not used to. The kids are not acclimated yet to social norms and a high school experience.”

More: Police investigate gunfire near Cherry Hill West football game

More: Camden-Pennsauken football game called off at halftime amid fan fights

“The impact of the persistent presence of uncertainty is rearing its ugly head,” said Cogan.

“It’s very difficult for parents who are working and need childcare,” she said. “There’s stops and starts in terms of kids being able to attend school and then having a period of quarantine.”

When thinking about mental health, it is important to also keep in mind two other concurrent issues — climate change and racial injustice — said Dave Ellis, Executive Director of the Office of Resilience in the NJ Department of Children and Families.

All of these issues compound, like piling on “weighted blankets,” said Ieva.

Rates of domestic violence and substance abuse have increased during the pandemic, she said.

Cogan also noted that anywhere between 120,000 and 150,000 children have lost a primary caregiver because of the pandemic.

“I think what happened when we started this school year is that people really believed that schools would be able to maintain some sort of what they think is normalcy,” said Ieva. “But kids lost two years of socializing, they lost two years of identity development. There is a lot of loss.”

Some students Ieva had recently spoken with said they “didn’t know how to socialize.” For others, engaging with fellow students was “so awkward” that they solely focused on academics. Many, she said, are terrified of contracting COVID.

“If you think about this, a sixth grader right now would have been in fourth grade (in March 2020),” said Ieva. “Now they’re walking into a new school.”

But she also acknowledged that some students benefited from online learning.

"Virtual school takes a lot of pressure off a kid," she said. "No social anxiety, and the ability to talk in the chat or not have a camera on (so) all you have to do is focus on class."

Students at higher risk for bullying, such as LGBTQ+ students, are once more vulnerable to in-person harassment, and many disabled students, for whom online learning made some classes more accessible, are again facing accessibility hurdles, said Ieva.

How to spot a kid who is struggling

Establishing the normal range of behaviors for a child is a first step toward recognizing when they might be struggling, said Ellis.

Then ask yourself if the child is behaving very differently from what you expect.

“It may be that you've got a kid who's very outgoing and all of a sudden they want to stay at home, close to mom and dad,” said Ellis. “Or you've got a kid who is very quiet, who all of a sudden wants to be the center of attention. You may have a kid who resorts to bullying because they want attention, and that's not normal behavior.”

For young children, anxiety can manifest as new and seemingly irrational fears, according to Alisha De Lorenzo, a mental health and education consultant with a practice in Red Bank. Fears of going outside, getting separated from parents, even clouds and changes in the weather, are all examples of how young children externalize anxiety, said De Lorenzo, who is also a community advisory board member of the NJ ACEs Collaborative.

Other behaviors to look for include negative self-talk and self-esteem and disengagement from friends and family, said Ieva.

How to help a kid who is struggling

“The data will tell you that two of out three kids have at least one ACE in their background,” said Ellis. “But what we know for sure, is that three out of three adults can help.”

Ellis gave three pieces of advice for helping a child struggling with their mental health: form a connection, share a conversation and, most importantly, slow down.

“Take a deep breath,” he said. “I’ve learned that controlling my breathing, and teaching kids how to control their breathing is just a simple thing you can do.”

He gave the example of a jar filled with water and glitter; a craft he shares with the kids he works with. When someone is angry or riled up, their brain is like a shaken-up glitter jar, he said. They can’t see clearly until the glitter — or their emotions — settle down.

De Lorenzo said part of slowing down is shifting away from asking “what’s wrong with this kid?” Instead, parents, families and community members should ask, “what’s good about this kid? What are their strengths? What are their core gifts?”

Sharing conversations with kids is another way to help, according to Ellis.

“I like to just listen,” he said. “I want them to share stories.”

“I can tell them about who I am, what it was like growing up — the invitation then is for them to do the same, and that’s exceptionally helpful,” he said.

He also stressed the importance of having these conversations when everyone involved is in the right headspace to do so. Like a traffic light at an intersection, safe interactions can only happen when everyone understands where others are coming from.

“When we’re in the green zone, we can have a conversation right now about whatever it is,” said Ellis. “When we’re in the yellow, we may have to wait a while for people to diffuse.

“In the red zone, we may have to wait all day, we may have to wait till next week,” he said.

The last way parents, families and community members can help — sharing a connection — is often the easiest. Sometimes a high-five is all a kid needs, said Ellis.

“These are things that are not rocket science,” he said. “It doesn’t have to be a therapy session.”

How can I help myself?

“Children do not exist outside of the context of family,” said Ellis. “So everything we talk about is not just impacting that young person, it's also impacting family.”

“And since the family doesn't exist outside of the context of community, it gets impacted too,” he said.

The best way for adults to help the young people in their lives is to work on themselves first, said De Lorenzo.

“Our responsibility as adults is to be competent in our own regulation of our emotions, in managing our emotions and addressing our traumas, and showing up for young people with some space to hold their big emotions,” said De Lorenzo. “If we’re unable to do that as adults, number one, we’re not modeling for them how to do it.”

Just as the ACEs of the pandemic will likely impact young people for the rest of their lives, so too will the way parents, families and community members react to it.

“Young people are watching how we’re responding to this crisis,” said De Lorenzo. “And they’re learning how to deal with crisis in their own lives.”

Aedy Miller covers education and the economy for the Burlington County Times, Courier-Post, and The Daily Journal. They are a multimedia journalist from Central Jersey and a recent graduate of the George Washington University.

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This article originally appeared on Cherry Hill Courier-Post: Student mental health at all-time low. Here's how you can help.