Health and Wellness

Children are now allowed to participate in mental health days in more states

With child mental health problems on the rise in the past few years, a growing number of states have adopted laws that let students take an excused absence if they feel anxious, depressed or need a day to “recharge.”

Twelve states have already put in place measures that allow children to leave school for mental and not physical reasons. A handful of others* are considering making similar changes to school absentee rules.

This is an acknowledgment of a worrying trend: U.S. in December 2021. Surgeon General Vivek H. Murthy issued an advisory declaring a mental health crisis for American children, citing “an alarming number” of young people struggling with “feelings of helplessness, depression, and thoughts of suicide.” Between March and October 2020, the height of the pandemic, the percentage of children visiting the emergency room for mental health issues rose 24 percent for children ages 5 to 11 and 31 percent for children ages 12 to 17, according to the Children’s Hospital Association.

Centers for Disease Control and Prevention reported that suicide was the second leading cause for teenager deaths in 2020. This represents a 31% rise over 2019.

Christine M. Nicholson is a Kirkland psychologist who works with children suffering from mental illness. She supports the idea of allowing mental health days. She stated that sometimes children may need to leave school, take a walk, watch a video, or even stay home and make a meal or watch a movie.

“I think mental health has to be appreciated as much as physical health,” she said. “Kids are having a tough time, and they need a break.”

“The pandemic, with its isolation, didn’t help,” said California state Sen. Anthony Portantino, a Democrat who introduced a bill that was signed into law in 2021. The bill doesn’t specify how many days a child can be absent from school each year. Portantino, whose brother Michael took his own life in 2010 at age 52, said he hopes other families can avoid the tragedy his family suffered: “The pandemic exacerbated the need, but if it can hasten the fix, then that is something positive.”

New school mental health days? How parents can make these days work for their children.

These measures are being proposed by proponents because they are timely and can help to de-stigmatize mental illness in the eyes and minds of children and parents. Washington, California (so far), Illinois, Maine, Virginia and Colorado have mental health days.

“If nothing else, it makes a huge statement that mental health matters as much as physical health,” said Mike Winder, a Republican Utah state representative who sponsored a bill that became law in 2021. Winder presented the bill after having conversations with his daughter who has suffered from mental illness. “This policy is communicating from the highest levels that it’s okay to take care of your mental health,” he said of the bill, which does not limit the number of days a child can take.

But how does taking a “mental health day,” which Americans traditionally have construed as a “winkwink, nudge-nudge” excuse for playing hooky, improve mental health?

“When students are feeling physically unwell, there is a universal understanding that they should stay home and they should take time to feel better,” said Barb Solish, director of Youth and Young Adult Initiatives for the National Alliance on Mental Illness (NAMI), which supports the use of mental health days.

“School policies that recognize mental health as an acceptable reason for absence can help students take the time they need to care for themselves and restore their health,” Solish said. “Practically speaking, if you have a fever, you’re not paying attention in class, right? You’re not learning the lesson. If you’re feeling overwhelming anxiety, you’re not learning either.”

They may be adopted in different states, but all require parents to sign an exempt note. Some place limits on the number of days off a child can claim — for instance, in Connecticut, students can have two days per year and they may not be consecutive — while others, such as California, do not.

Like all absences, schoolwork must be made up. But the policies do not dictate how the days off may be used — whether for staying in bed or attending therapy appointments or something else. Some believe that abuse could result. Portantino screams at the thought.

“We don’t question that a parent would like Johnny to stay home because he has a cold. That’s the exact reason we have to have this bill. That’s a stigma we have to correct. We’re not making a distinction between physical and mental health. If your child is sick, your child is sick,” he said.

Many laws that have been passed or introduced require parents to provide the same excuse note as a physical illness.

Some worry that providing mental health days isn’t the right approach to this crisis.

In the National Review, Daniel Buck, editor in chief of Chalkboard Review, a newsletter focusing on education, wrote that school mental health days “could alleviate immediate distress but facilitate habits that only worsen anxiety and depression in the long run.” He suggested that they would teach kids avoidance rather than how to deal with the real issues that plague them, such as too much social media. “By popularizing mental-health days, we are encouraging our students to allow the world to dictate their emotions in place of teaching self-regulation and emotional control,” he writes.

Instead, he suggests, “What if we built resilience back into our schools? What if students were taught the virtues of Aristotle and the stoicism Marcus Aurelius? And these would include habits of emotional awareness such as regular reflection, discussions with loved ones, or planned, appropriately timed days of rest.”

Solish said there is a fine line between taking a day off to feel better or missing school to avoid a test you haven’t studied for. That’s why it’s important for parents to get to the bottom of why a child might ask for time off. She also said that if a child requests or takes too many days off, this can indicate something is wrong and a need to seek professional help.

Solish said, “We’re not going to solve the youth mental health crisis with a few mental health days. But it’s a great starting point.”

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Dave Anderson, a New York-based clinical psychologist who studies mental health services for high-need schools in the country, was also in agreement.

Days off will help, he said, but “there are too few [mental health] providers, too few online resources, too few school counselors trying to serve too many students and far too little information given to educators about how to support kids.” Of the more than 100,000 clinical psychologists working in the United States, only 4,000 are child and adolescent clinicians, according to a 2022 report by the American Psychological Association. “School psychologists are also in short supply, leaving kids without enough support at school,” the report said.

Jack Ramirez, 19 years old, from Spring Township (Pa.), said that he believes mental wellness days could be a lifesaver to many young people.

He had urged Pennsylvania State Sen. Judith Schwank, a Democratic senator to introduce a bill on mental health in 2020. This was when he was a summer intern in her office. He said that he was still in shock from the suicide of a classmate just a few weeks earlier. Ramirez believed that if the student felt he could stay at home to care for his mental health, he might still be alive.

The Pennsylvania state Senate has still to consider the measure that would give two days of mental health leave per semester.

“This is not a bill to skip school,” said Ramirez, now a sophomore at Rutgers University in New Jersey who has dealt with his own feelings of isolation and anxiety. “High school students are feeling isolated, they feel the pressure of grades. They are competing with each other. It’s getting really scary, and we don’t pay enough attention. … If we want to start saving lives and start talking about solutions, pressing pause on a lot of these things we face is so important.”

Make the most of a ‘mental health’ day

Do you encourage your children take a step back from the rat race? Is there a way to make it work?

“There’s no perfect way to take a mental health day,” said Barb Solish, director of Youth and Young Adult Initiatives for the National Alliance on Mental Illness (NAMI). “But it does help to be intentional.”

Here are some of Solish’s tips for reaping the most benefit from a “mental health day”:

Listen to your child. Ask them open-ended questions about their experiences and relationships, and why they think they should take a day out. Next, let them talk.

Make it meaningful Do not catch up on schoolwork, or get lost in social media. “Those are stressors for kids,” Solish said.

Find calming activities to do: Get out and walk, bake, draw, or get lost in nature. “Whatever brings your kid back to center is a good thing to do,” said Solish, adding that you don’t want to overschedule the day, because that will be stressful in its own way. Parents should allow children to use video games, television and other screen time. “Nothing is really off limits,” Solish said. “You just want to make sure you’re being really thoughtful about what is going to help.”

Let the emotions speak for themselves: “You don’t have to push kids to talk about their feelings all day,” Solish said. Talk about how important it can be to take care your mental health.

Find out when you are in need of more assistance According to Dave Anderson, a child psychologist at the Child Mind Institute, New York, if your child has a tendency to become more irritable, sleepless, depressed, or is asking to stay home, then you may need mental health professionals. For a recommendation, contact your doctor, school counselor or pediatrician.

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