Apr 14, 2022 - Health

Kids' mental health at risk of becoming America's next culture war

Illustration of a pair of scissors cutting a swing where a child is sitting.

Illustration: Aïda Amer/Axios

As more states and school districts move to address children's mental health, some parents and activists are making school-based support programs a political flashpoint, saying they put school officials in inappropriate roles and could indoctrinate students in progressive thinking.

Why it matters: The pandemic has created a greater sense of urgency around children's mental health, but statistics have been trending in the wrong direction for years, with sometimes tragic consequences for families and communities.

State of play: School-based efforts that have been shown to support kids' mental, social and emotional health are getting pulled into a broader debate about what happens in public school classrooms and guidance counselors' offices.

  • High-profile state legislation, like Texas' law equating transgender care with child abuse and Florida's law prohibiting "classroom discussions about sexual orientation or gender identity" before fourth grade have sparked outrage among mental health professionals concerned about their impact on children and families.
  • The reach of such legislation — as well as grassroots campaigns and local school district disputes — goes beyond issues of sexuality and gender identity.
  • Florida's law, for example, requires schools to give parents an opt out from available mental and physical health services and to notify parents if there's a change in services or monitoring surrounding a student's health and well-being, per the NYT.

Zoom in: A recent CDC survey found U.S. teenagers are reporting high levels of mental distress, risky health behaviors, economic instability and abuse. More than half reported emotional abuse by a parent or another adult in their home.

  • The U.S. Preventive Services Task Force recommended earlier this week that all children 8 and older should be screened for anxiety, a response to its prevalence.
  • Groups representing pediatricians and other providers declared children's mental health an emergency last fall, citing rising emergency department visits for mental health emergencies and a spike in hospitalizations among children for self-injury and suicide.

Between the lines: Researchers caution against jumping to broad conclusions about the pandemic's effect on kids' mental health, especially since emotional well-being is measured in all kinds of ways and there's a broad spectrum of mental health conditions.

  • School itself can put a lot of stress on children, says Tyler Black, a children and adolescent psychiatrist in Vancouver.
  • While it offers a place of comfort, safety and growth for some kids, it is also a venue for bullying — and the pressure of academics can itself be a source of immense distress. School issues are a major factor in pediatric suicide, he says — a grim reminder that "milder" mental health concerns can lead to much more severe ones.
  • But school can also be a place to devise solutions, Black says. "[Social-emotional learning] and mental health development programs are as important as anything else schools offer."
  • Social-emotional learning is a process increasingly used to help students develop skills like self-awareness, self-control and interpersonal skills.

The intrigue: Some conservative activists have begun protesting social-emotional learning, saying it is a front for race-related classroom discussions labeled as teaching "critical race theory" or for schools to control children's emotional health.

  • Even though many states have passed legislation supporting or requiring social-emotional learning, a handful are now considering bills that would restrict the program, the Washington Post recently reported.
  • "It's a lack of trust about the schools indoctrinating people," David Law, superintendent of the Anoka-Hennepin School District outside Minneapolis, told the Post. "If you tell people we're teaching interpersonal skills and we're teaching resiliency, they say, 'Absolutely.' If we say we're teaching SEL they think, 'What are you doing to our students?'"

Yes, but: Most states are moving in the opposite direction, shoring up school- and community-based mental health care.

  • As of March, at least 22 states had enacted laws that support children's mental health, including a mix of red and blue states, according to the National Academy for State Health Policy. Even more legislation has been introduced.
  • Since the beginning of the pandemic, more than two-thirds of states have collectively enacted nearly 100 laws that support schools in providing behavioral health care, according to NASHP.
  • School districts around the country are using sizable portions of federal coronavirus relief funding on social-emotional learning, hiring mental health professionals and other mental health-related efforts, according to Georgetown University's FutureEd.

The bottom line: The pandemic's spotlight on children's mental health has spurred a response that's now being subsumed into the all-too-familiar school culture wars.

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