School has never been just about the curriculum. It’s also about students’ health and development. As the nation debates reopening schools during the COVID-19 pandemic, the focus has been on creating physically safe environments through social distancing, mask wearing and hand washing. But keeping students physically safe does not guarantee students’ psychological well-being.
In fact, though many advocates of returning to in-person schooling maintain that it should be done precisely for children’s psychological health, they are failing to appreciate how the significant changes necessitated by the pandemic will render schools nearly unrecognizable. No lesser authority than the Centers for Disease Control and Prevention is urging schools to reopen in order to provide “the development of social and emotional skills” and a “safe environment for learning.” But schools can’t fill those needs while an epidemic is raging. It is quite possible that reopening schools could actually be worse for children.
The first thing to recognize is that students will not be returning to the traditional school settings they are familiar with, which itself can be disorienting and distressing. After spending the past six months restricted to a small group of people, entering or reentering a school with perhaps hundreds of people in masks, plexiglass partitions and one-way signage is going to feel uncomfortable at best. Adults and children alike comment on watching movies and feeling viscerally nervous at seeing people in large crowds.
Additionally, asking elementary school children not to hug their friends or teachers, not to share crayons and not to socially interact is unnatural. Asking high school students not to participate in extracurricular activities and remain socially distant from their friends is going to deprive them of important components of adolescent development as well as a key outlet for the stresses of high school. One patient in my practice said to me, “Why would I send my kid to prison [i.e. school] to wear a mask for six hours, sit in isolation and only go to the bathroom on a schedule?”
Even explaining the need for the extreme measures to students could do damage. We’ve learned that after schools initiated active shooter drills to keep children physically safe, the drills had negative psychological consequences for some participants. How we explain such threats to children impacts their ability to feel safe in school, and in the larger world as well.
Similarly, the protocols necessary to protect against the spread of COVID-19 in school may be frightening unto themselves, especially to younger children. Children who don’t feel safe, even if they are physically, are not going to be ready to learn. There is a truism in psychology that anxious people can’t listen; anxious children certainly won’t be able to pay attention to instruction. This problem is compounded by the fact that there is little agreement among adults about what is responsible behavior, and the issue has even become politicized, the ability to communicate what to do and why in a consistent and reassuring manner seems far-fetched.
Another significant challenge to children’s mental health will be to manage their fear and guilt if someone they know at school gets sick or, worse, dies. They are being instructed to protect themselves from people they know and are supposed to trust. Is that a burden we really want to put on children, regardless of their age? It is inevitable that some children, and perhaps some adults, will blame themselves if someone gets sick.
Outside the family, they could be shamed for testing positive for COVID-19. Thus, returning to school will pit children against each other and the adults around them. Even the child who merely manifests the symptoms of a benign illness but causes a classroom to quarantine for 14 days or close school altogether while awaiting test results is subject to a heavy psychological toll. Are we creating a modern-day “Scarlet Letter” for children who get sick that will cause deep emotional scars?
Sadly, the emotional distress for students returning to school can extend beyond the fear of making others sick. Acts of bullying and discrimination are common, particularly during middle school, and the anxiety and uncertainty of the pandemic provide fertile ground for such behavior. A patient of mine who’s a middle school teacher told me that just before her school went remote in March, some of her Asian students were bullied and accused of having started the pandemic. “There is no way I can protect all the kids in my class every minute of every day,” she said with frustration. “Even if there is no recess and they eat lunch in the classroom, kids find ways to tease and torment other kids.”
Furthermore, children with pre-existing mental health concerns and special education needs could have particular difficulty adapting to the changes necessitated by COVID-19. One patient in my practice is worried that her son, who exhibits Obessive-Complusive Disorder, will spend his day correcting other students — and perhaps worse, teachers — who are wearing their face masks wrong. She suspects his anxiety will spike and he will be ostracized by his peers. Another parent that I see has a son with ADHD. “The only reason my son goes to school and works to pass his classes is so he can play football,” he told me. “Without football, I don’t see him making it in school.”
Being able to trust others is the foundation of good mental health. But returning to schools amid a pandemic creates the opposite type of environment. As a guidance counselor said to me, “If we are telling the kids it’s safe to come to school, but I won’t be able to give you a high five, or worse yet, we may be closed tomorrow if someone gets sick, how are they going to trust us?”
Inconsistent messaging in particular breeds anxiety and mistrust. Like children caught in a custody battle between warring parents, students are being asked to bear the brunt of conflicting messaging about what is safe. Teenagers in particular are attuned to inconsistencies from adults in their world.
Another patient of mine talked about how bitter her teenage daughter is. She sees the adults all around her being hypocritical, not going into their offices but seeing friends for cocktails without wearing their masks. She asked, “Why am I supposed to go to school, but stay away from my friends?” Creating school environments that meet the needs of these burgeoning young adults is critical to stem an increase in mental health issues.
It’s understandable that many children want to return to school to see friends and engage in class activities. It’s understandable that parents want to see their kids in a normal school setting with the higher level of instruction it brings, even in the face of uncertainty. The limitations of remote learning are well documented, and keeping children and teenagers cooped up is also potentially damaging. And of course, many parents are desperate for the child care and space schools provide.
But those benefits are sadly not available to us now, much as we wish they were. And the premature effort to regain them could well make things worse, as schools will likely need to close at a moment’s notice. Given the length of time children have been out of school, the hurried way that schools closed, and the uncertainty about how safe it is to be in a school building, the erratic school schedule may increase incidence of school phobia, not decrease it.
As each school, district and state struggles with the question of how to reopen safely, we must remember that behind the protocols and plexiglass, there are children counting on us to get it right so that when they do go to school, they can feel emotionally as well as physically safe, and be ready to learn.