by the Healthy Schools Campaign, Mental Health America and Attendance Works.
Students who experience well-being and feel engaged are much more likely to attend school and achieve academically. Recently reported declines in student mental health are raising concern among educators, families, and pediatricians and may be contributing to the dramatic increase in chronic absenteeism seen in most schools today.
Chronic absenteeism (missing 10% or more of school for any reason) is one of the biggest challenges facing K-12 public schools. When children are not in school, they may be below grade level for reading and arithmetic in the early grades, achieving in high schooland graduating from high school. They are also at greater risk of falling behind in socio-emotional development and executive functioning. Chronic absence almost doubled since the COVID-19 pandemic, from 16% to nearly 30% of students in the 2021-22 school year. It is disproportionately affecting black and brown children and those living in poverty. state data for the 2022-23 school year shows only modest decreases in most states and even slight increases in some.
Studies show that physical health problems, such as asthma or unmet oral health needs, have been the leading causes of health-related school absenteeism. When analyzing data from school health centers, The Los Angeles Fund for Children’s Health found that anxiety, depression and mental health are currently the leading drivers of health-related absenteeism in those schools. A recent Youth confidence survey of 500,000 students found that almost half (48%) reported that depression, anxiety and stress make it difficult for them to do well in school, a substantial increase from 39% in 2020.
As schools, districts, states, and communities seek to address the attendance crisis, they must consider the positive impact of school-based mental health services on student attendance. Since children spend half of their waking hours at school, schools are the ideal place to receive such services, especially in low-resource areas where students may have difficulty receiving them. Accessing mental health services at school can also reduce stigma and address transportation and scheduling barriers.
Mental health care can be integrated into school and district investments to ensure multi-level approach to reduce chronic absence that begins with prevention and an investment in underlying needs positive conditions for learning that motivate all students to come to school while promoting academic success.
The following models of service delivery and integrated care in schools have shown positive impacts on students’ school functioning, with significant improvements in attendance.
School-Wide Social and Emotional Supports
The foundations of a successful multi-tiered strategy are aimed at supporting all students: universal, prevention-oriented approaches that reinforce positive social and behavioral skills. Investigation shows that students who participated in these programs experienced significantly improved skills, behaviors, sense of security, peer relationships, and academic achievement. A assessment Positive Action, a social-emotional character development program, shows a reduction in chronic student absenteeism as one of the results. Other research shows that implementing school climate initiatives like PBIS can improve attendance. The Centers for Disease Control and Prevention has created a action guide promote and support mental health and wellbeing using a multi-tiered approach.
School health centers
School health centers provide comprehensive health services in a clinic located in or near a school. A recent study Analysis of data from a large urban school district revealed that students who received care from an SBHC for any reason showed better attendance trajectories after their first visit to the SBHC, and outcomes were nearly five times better for students who visited the SBHC. SBHC specifically for a mental health issue. .
School-Community Partnerships
School-community partnerships are formal agreements between schools and community mental health providers to allow those providers to provide services to students in the school setting, which can reduce stigma and address transportation and programming barriers . For example, the Mental Health Integration Team program in Kansas began as a pilot project in nine school districts across the state. state data estimates that student attendance rates after participation in the MHIT program improved absenteeism by more than 33%. Positive results from the pilot led Kansas lawmakers to expand the program from the original nine districts in the 2018-2019 school year to 90 districts in 2023-2024.
Integrated Care Models
Integrated behavioral health services in primary care models provide team-based care by behavioral health staff who work with pediatricians and other team members to assess and provide services to youth. Although not specifically provided in schools, recent research on integrated care models, such as Transforming and Expanding Access to Mental Health Care in Urban Pediatrics (TEAM UP), revealed that participation in integrated care at a federally qualified health center is associated with better care. Children missing school due to mental health issues decreased from an average of one day per two-month period to an average of one day of school missed per 10-month period. The study also showed that students were late less often.
School health providers
School mental health providers are employees of the school district and include school nurses, social workers, and school psychologists. They play an important role in recognizing early signs of absenteeism and preventing chronic absenteeism in the first place. A review of research published between 2002 and 2018 shows that the presence of a school nurse is associated with fewer days missed from school. More recently, research published in 2023 finds that students with a high number of part-time absences are likely to visit their school nurse for support.
School teletherapy
Teletherapy is another important approach to providing mental health services in schools and https://www.attendanceworks.org/ It can also help students attend school regularly. TO 2023 study of three rural school districts in North Carolina found that access to a school-based telemedicine clinic, which provided physical and mental health services, reduced the likelihood of chronic absenteeism by 29%.
Going forward
Today, schools are grappling with dwindling health care resources and difficult decisions, especially now that the federal COVID Elementary and Secondary School Emergency Relief (ESSER) and other unique funding sources end this year. However, the mental and behavioral health challenges students face do not go away just because this funding ends.
Sustained federal and state investments are needed to achieve the full impact that school mental health services can have on student attendance and well-being. These should include increasing state and school district supports that were enacted as part of the bipartisan federal Safer Communities Act, including funding to support the mental health workforce in schools. Additionally, increased funding can be provided for federally qualified health centers and school-based health centers, especially those that integrate behavioral health into primary care settings.
As states and schools face the ESSER fiscal cliff, it is urgent that they maximize other available funding sources and streams. School Medicaid is a key source to help sustain ESSER’s mental health investments, even 25 states have not taken any steps to allow for greater reimbursement of services in schools by the federal government.
Recent research and data on the impact of school-based mental health services on chronic absenteeism provide an exciting start, but gaps in our knowledge remain. For example, new research can help us better understand the impacts of school climate and culture on absenteeism and how school mental health services support teachers and staff, as well as families and caregivers.
Investments in mental health services and school attendance are urgently needed. Moving forward, comprehensive mental health services must be an integral part of efforts to reduce chronic absences and promote student success and well-being.
This blog post is written by Healthy Schools Campaign, Mental Health Americaand Assistance jobs.
