Reopening Schools: Mental health vs Health & Safety?
by Marnie Dobson Zimmerman, Ph.D., & Pouran Faghri, M.D.
During the past few weeks in the U.S., the debate over school reopenings in the Fall, in light of COVID-19 surges, has been fever pitched. The negative mental health and academic impacts of social distancing and online learning on children are given as reasons to reopen schools despite being in the midst of an out-of-control pandemic. But while these are real, legitimate concerns, do they outweigh the risks to the health and safety of children, families, and teachers returning to classrooms amid a surge?
There is growing evidence that the mental health of Americans has been suffering during the coronavirus pandemic as much of the country shut down in March 2020, including schools, workplaces, sports, amusement parks, restaurants, and shops. Life including work, as we knew it, changed rapidly as we stayed at home to “flatten the curve” of the pandemic. Social distancing and loneliness, grief over losing loved ones, anxiety about losing jobs, fear of catching the disease, difficulty in family dynamics while staying at home, decisions about children’s education, and finally, uncertainty about the future, are all contributing to a potential mental health crisis.
In a report released in May by the American Psychological Association (APA) Stress in the Time of COVID-19, a representative survey of 3,000+ U.S. adults reported significantly higher levels of general stress as a consequence of the epidemic. People of color, women, people with preexisting conditions, and adults under age 34 reported higher levels of fear and anxiety. Unemployment, a well-known contributor to mental illness, hit levels not seen since The Great Depression — in April, about 36 million people in the U.S. filed for unemployment insurance. Unemployment still remains high. There have been ongoing concerns, and other reports, like the APA survey, showing evidence that the pandemic is increasing stress, anxiety levels, and depressive symptoms. It may also be fueling the opioid epidemic (opioid deaths have increased in 2020) and could possibly increase the “deaths of despair” including suicide.
In May, to address the possibility of economic and other distress due to “stay at home” orders, the White House and some Governors urged states to “reopen” their economies, despite evidence that COVID-19 cases, hospitalizations, and deaths were not yet in decline in most states. And now there is a push to reopen the schools in the Fall due to an apparent concern for the education and mental health of children. While we have some evidence of the mounting mental health effects on children and adults as a result of the pandemic, we have to also anticipate further negative mental health effects from reopening schools too soon in the midst of rising coronavirus cases and surges in deaths. These mental health effects – on parents, children, and teachers – have been ignored in the school reopening debate.
Working Parents and Work-Family Conflict
There have been concerns about the mental health of working parents with school-aged children at home due to school closures. 70% of them report high levels of stress from managing their own work and their children’s online distance learning. We have previously discussed the stress associated with teleworking (working from home) causing blurred boundaries between work and home, as well as the stress of essential workers (many of whom are low wage, Black or Latinx) who cannot work from home and must risk exposure to the virus as part of their job. The dilemma for working parents is: how can they return to work (if required to be in a physical workplace) or continue working effectively at home if their children are not at school? As one mom in a recent NYTimes article suggested, working women are particularly impacted by this pandemic because you can’t have a full-time job and care for a kid.
However, if schools were to reopen for in-person classes – an issue about which many parents are divided and which is causing anxiety – many parents will worry about school outbreaks that may result in their children getting infected or (less likely) sick and bringing home the virus to vulnerable family members. While many parents are desperate for their kids to return to school full-time, many more are not willing to risk the consequences of school outbreaks.
Children’s mental health and the pandemic
We have limited data on the effect of this pandemic on the mental health of children as yet, though its presumed effects are being used as a reason to reopen schools. There are concerns about the impact of school closures and the isolation caused by the pandemic on the social and emotional health of children, especially with those children with special needs or existing mental illness. The lack of in-person schooling and reliance on technology for learning is thought to be causing learning deficits — especially in poor and non-white communities where access to sufficient computer technology and reliable internet is a problem. There have also been reports of increased child abuse during the pandemic, especially when there are no teachers around to identify and report the abuse. Some parents report that children are having trouble sleeping, are sleeping more, or have been displaying depressive symptoms. The lack of social interaction with friends, time to play, and exercise made available at school could also be contributing to mental health challenges. However, we must remember that most plans for physically reopening schools (with safety precautions in place) do not provide much interaction with friends, nor time to play, anyway.
In June, guidelines released by the American Academy of Pediatrics (AAP) discussed these concerns and made a strong recommendation that all school reopening plans for the Fall should begin with the premise that all students should be physically present at school. Revised CDC guidelines in July also begin with a political sounding opening recommending schools fully reopen. These recommendations are echoing calls from some working parents desperate for a reprieve from having to juggle work and online learning — an obviously unsustainable, stressful work-life conflict, falling for the most part on the shoulders of working mothers. While the arguments for returning kids to the classroom are not insignificant, and those of us who have children or are teachers are no doubt concerned about the social-emotional well-being of students and the drawbacks of distance learning, the current surge of coronavirus cases throughout the country makes it seem like a bad experiment to open schools in just a few weeks.
The CDC and AAP recommendations and recent threats by Donald Trump and the White House – to withhold funding to schools that don’t physically reopen – are dangerous and shortsighted given the current trajectory of the U.S. COVID-19 pandemic. At this time, there are 4 million confirmed cases and almost 70,000 new cases per day, while hospitalizations and deaths (>1000 reported 7/21/20) are on the rise in many states. Additionally, the CDC and AAP recommendations fail to address or completely overlook a number of important health and safety issues, not just for children, but for families, teachers, and communities.
But do children’s mental health issues outweigh the health and safety issues of returning to a COVID classroom?
The challenge of getting millions of children back into classrooms in the Fall presents both a logistic nightmare of monumental proportions coupled with an inexcusable public health risk. Current evidence, supported by 239 scientists in a recent letter to WHO is that SARS-COV 2 is airborne; meanwhile, the AAP strangely suggests 3 feet of social distance between desks should be enough if children wear masks. Whether 3 feet or 6 feet, if all children are to return physically to school, even 3 feet in currently cramped classrooms would be impossible on most school campuses. We must also assume that children of any age will not obediently wear a mask for a whole day of school, nor will they all remain in their seats (3 feet from peers) patiently listening to their teacher lecture (because small group work will be impossible). They will no doubt get too close to each other and could increase the risk that they may become infected from schoolmates and, in turn, will pass the virus on to other children, adults in the school including teachers, staff and then eventually to their siblings, friends, parents, and relatives. Without effective testing in schools, this will be a disaster waiting to happen.
It is also unlikely that this kind of school environment will be “normal” — sitting masked at a desk, facing forward, and unable to connect with peers or eating lunch indoors. All these necessary precautions may not be particularly socially or emotionally healthy for children either. Many children may also be worried about catching the disease or transferring it to others. Sending them to school with no mental health preparedness could increase their level of fear and anxiety and decrease academic performance.
What about Teachers?
Teaching is already a challenging, underpaid profession with high levels of burnout. The AAP report did not mention the health and safety of the millions of teachers returning to classrooms. While teachers would much prefer teaching in person, many are voicing their concerns about the safety of returning physically to the classroom in the middle of an uncontrolled pandemic. Policing children by making them stay in their seats and wear their masks, ensuring effective hand washing is occurring, is not a teacher’s job. Nor is evaluating possible illness among students. Maintaining a clean physical environment is also a necessity to prevent transmission, but teachers are not hired to clean. And budget cuts to many public schools mean there may not be enough money to hire needed custodial staff. Not to mention the health and safety of these custodial staff who will need training to learn new disinfecting techniques which will take many hours of additional work.
By sending children back to school, we will be exposing teachers to COVID-19 at an unprecedented rate. Yes, many need their jobs to survive and will have no choice other than to come to school and risk exposure. Yet teachers — many of whom have small children and who themselves are at risk — should not have to choose between their jobs and the safety of their children and risk to their life. For those who can afford to, they may not choose to come back to work or may take early retirement rather than risk their own health or family members’ lives; so it’s possible we may end up with a teacher shortage.
There are no plans in place to protect the mental health of teachers as they experience the stress of exposure to infection, the stress of juggling the safety of children, and potentially work overload from implementing hybrid teaching models and distance learning simultaneously. Guilting teachers because of their commitment to teaching, into returning to unsafe classrooms is unfair, and will undoubtedly heighten the stress of an already stressful job.
The Economy versus Health and Safety?
So what is driving this fervor to return children to schools “as normal” in the Fall, despite the pandemic raging out of control? One word — the economy.
The drive to get “the economy re-started” has not only fueled the new spikes in COVID-19 cases, especially in the U.S. South and West, but it highlights the dilemma — that if we require working parents to be physically at the workplace without being able to “store” children in schools, parents wouldn’t be able to go back to work (or at least one of the two would not). There are no easy answers to this predicament.
However the priority should be to reduce the spread of COVID-19, and until we do that, it is not safe to “return to everything as normal.” Whatever form of schooling occurs in the Fall, the decision must be based on public health interest — not the economy at this time! Florida teachers’ unions are suing the Governor over his decision to open schools fully in the Fall despite the worst outbreak in the U.S. Recently the Los Angeles Unified and San Diego school districts announced they will go online-only in the Fall, as are many public and private universities. Many other large school districts will probably follow suit. It appears to be the safest, albeit not ideal, option open to us.
We must protect our schools and communities from COVID-19 exposure while at the same time continue to address mental health. Both are crucial.
While we put our efforts towards flattening the curve of COVID-19, we simultaneously need to consider pathways to flatten the curve of a growing mental health crisis. The United Nations issued a policy briefing on COVID-19 and mental health, documenting increases across the spectrum of mental health — from increased psychological distress in multiple countries to rising depressive and anxiety symptoms, as well as actions that must be taken.
The workplace costs of employee mental health issues were already high prior to the pandemic. Even if schools were to resume in the Fall with the physical presence of all children and staff (as some politicians in Florida, Ohio and Texas are urging), the concern that many parents will feel about the health and safety of their children, the likelihood of outbreaks at school, and the likelihood that children may bring home the disease to vulnerable family members, will affect the mental health of children as well as parents and teachers.
Public health officials, local and state government, along with the White House, must focus their efforts on containing the spread of COVID-19 at this crucial time. Many European countries have already “flattened the curve” and are slowly opening their economies and schools. Since, the coronavirus “curve” in the U.S. has gone in the opposite direction, distance learning may be the best option for most school districts in the U.S. at this time given the surge in cases.
However, to reduce the mental health burden, workplaces should implement flexible work hours policies and alleviate some of the burden put upon working parents who are homeschooling their children. Working with parents to create more realistic workloads, reduce redundant meetings, institute job sharing, and allow for paid family leave and job security so that those parents who opt to leave to care for their children, can come back to their jobs when all this is over, are just some possibilities.
Moving forward, there is also a need for developing and enforcing policies and practices at the local and federal levels to prevent worsening mental health, as well as providing resources to address mental health now and for many years following this pandemic. The Families First Coronavirus Act was passed in March to secure paid sick leave for workers infected with COVID-19, or who need to care for someone with the disease, and for parents who must be at home to take care of children because schools were closed. This support is generally inadequate, restricted to employers less than 500 people, and only allows two weeks of paid sick leave (when some COVID patients are often sick for many months). Ten weeks of paid family leave for parents to take care of children who are not in school, will not cover even half of the Fall term, and so should be extended substantially and apply through the end of the year — at least.
Mental health is a multifaceted public health concern. Preventing mental health problems from arising by addressing the stressors associated with changes in working life as a result of this pandemic, is an important part of promoting healthy work and healthy people.
Learn more
- If you want to learn more about the challenges of finding work-life balance right now, check out our May 2020 article, “Blurred Boundaries: Work-Life Balance in the Time of COVID19.”
- If you want to know about the impact of precarious work in a pandemic, check out our June 2020 article, “Freelance and Gig Work during COVID-19.”
*This article was commissioned as part of the Healthy Work Campaign. To learn more and obtain free resources, visit https://healthywork.org.
Dr. Marnie Dobson is the Co-Director of the Healthy Work Campaign, as well as the Associate Director of the Center for Social Epidemiology. She is also an Assistant Adjunct Professor at the University of California, Irvine Center for Occupational and Environmental Health (COEH) where, for the last 12 years, she has been involved in work stress research, including qualitative, participatory methods, enhancing epidemiological studies and intervention development with several blue-collar working populations including firefighters and urban transit operators. She continues to teach in occupational health classes at UCI and UCLA, as well as publish academic articles and book chapters and present at scientific conferences. (LinkedIn, Twitter)
Dr. Pouran Faghri is the Principal Investigator for the HWC Dissemination and Implementation Project and a Research Associate with the Center for Social Epidemiology. She is an Emeritus Professor at the University of CT and was the Director of the Center for Environmental Health and Health Promotion at the University of Connecticut. Following her recent Visiting Professorship appointment at the University of California, Los Angeles, Professor Faghri is continuing her collaboration with UCLA Department of Environmental Health Sciences as Full Professor (adjunct) starting July 2020 and presently is collaborating with researchers at the NIOSH Southern California Education and Research Center at UCLA, as well as the UC Irvine Center for Occupational and Environmental Health. (LinkedIn)
Acknowledgments
We would like to acknowledge the contributions made to this article by our colleagues:
- For science writing support: Peter Schnall & Paul Landsbergis
- For editorial support: Maria Doctor
