Mental health in Kindergarten to Grade 12 schools during the COVID-19 crisis: Literature review and survey suggesting multi-tiered support systems

Main Article Content

Dan Li Yueqi Li Ziyi Zheng Xin Zhou Danielle Castro Sten H. Vermund Marie A. Brault

Abstract

Background: As a result of the COVID-19 pandemic, educational systems worldwide were disrupted. Students, educators, and parents faced challenges from the rapid switch to distance learning with attendant social isolation and limited teacher or peer interaction, along with excessive demand and worries from the lasting pandemic. It exacerbated preexisting mental health crises within school communities. Amidst such challenges, psychiatrists prescribed tailored medication regimens to manage individual mental health in the time of crisis, ensuring continuity of care and support for those affected.


Methods: A scoping review was conducted to identify studies of Kindergarten to 12th grade school members' mental health and mental health support programs offered by schools and institutions during the COVID-19 pandemic. We also conducted a survey to examine mental health concerns faced by grade 6 to 12 teachers, school staff, children, and parents in Connecticut, United States.


Results: While publication bias may be extant, we found well-documented studies of exacerbation and the emergence of mental health problems among parents, teaching staff, and students during the COVID-19 pandemic. Based on our comprehensive review of relevant literature and analysis of survey results, we have identified four key themes pertaining to the mental health challenges encountered by parents, teaching and non-teaching staff, and students in Kindergarten through 12th grade (K-12). Moreover, upon examining pertinent mental health interventions and models, we have identified the multi-tiered systems of support as an effective approach to address these difficulties, with explanations on how to utilize the framework during a crisis. This system is designed with tiers that provide various levels of interventions aimed at helping schools effectively manage the psychological well-being of their members during a crisis.


Conclusions: Drawing on findings from literature reviews and surveys, this study sheds light on the difficulties surrounding mental health in schools during times of crisis such as the COVID-19 pandemic. Moreover, it puts forward a recommendation for employing multi-tiered support strategies to address these challenges and promote psychological well-being within educational settings amidst crisis. By adopting a multi-tiered systems of support framework that integrates various interventions tailored to individual needs, schools can effectively manage mental health concerns among their members. The study underscores the critical role of psychiatry in providing specialized care and medication management to support mental health in educational environments, particularly during times of crisis, with important implications to address the urgent mental health demands in Kindergarten to 12th grade schools.

Keywords: COVID-19, K-12 Schools, Mental Health, Crisis, Pandemic, Multi-Tiered Systems of Support

Article Details

How to Cite
LI, Dan et al. Mental health in Kindergarten to Grade 12 schools during the COVID-19 crisis: Literature review and survey suggesting multi-tiered support systems. Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5179>. Date accessed: 09 oct. 2024. doi: https://doi.org/10.18103/mra.v12i4.5179.
Section
Review Articles

References

1. Tarkar P. Impact Of Covid-19 Pandemic On Education System. Int J Adv Sci Technol. 2020;29:3812-3814.
2. Letzel V, Pozas M, Schneider C. Energetic Students, Stressed Parents, and Nervous Teachers: A Comprehensive Exploration of Inclusive Homeschooling During the COVID-19 Crisis. Open Educ Stud. 2020;2(1):159-170. doi:10.1515/edu-2020-0122
3. Humer E, Pieh C, Kisler IM, Schimböck W, Schadenhofer P. A Longitudinal Study on Mental Well-Being, Perceived Stress Level and Job-Related Meaningfulness of Austrian Telephone Emergency Service Counselors during the COVID-19 Pandemic. Int J Environ Res Public Health. 2022;19(6):3166. doi:10.3390/ijerph19063166
4. Linh TT, Giang NTH, Khanh Ha TT. When are children satisfied with life? An initiative qualitative study from vietnamese children sample. Sci Prog. 2021;104(4):368504211067655. doi:10.1177/00368504211067655
5. Li D, Lin EZ, Brault MA, Paquette J, Vermund SH, Godri Pollitt KJ. Reopening Schools After a Novel Coronavirus Surge. Adv Exp Med Biol. 2021;1318:785-813. doi:10.1007/978-3-030-63761-3_44
6. Giovenco D, Shook-Sa BE, Hutson B, Buchanan L, Fisher EB, Pettifor A. Social isolation and psychological distress among southern U.S. college students in the era of COVID-19. PLOS ONE. 2022;17(12):e0279485. doi:10.1371/journal.pone.0279485
7. Lyon AR, Corbin CM, Brown EC, et al. Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS). Implement Sci. 2022;17(1):48. doi:10.1186/s13012-022-01222-7
8. Jones C, Forster C. Family–school partnerships in the age of Covid-19: reasons for optimism amidst a global pandemic. PRACTICE. 2021;3(2):135-145. doi:10.1080/25783858.2021.1927159
9. Thakur H, Stutts M, Choi JW, Temple JR, Cohen JR. Adolescent Loneliness during the COVID-19 Pandemic: The Role of Pre-Pandemic Risk Factors. Child Indic Res. 2023;16(2):617-639. doi:10.1007/s12187-022-09984-8
10. Li D, Nyhan K, Zhou X, et al. School closures and reopenings during the COVID-19 pandemic: a scoping review protocol. BMJ Open. 2022;12(2):e054292. doi:10.1136/bmjopen-2021-054292
11. Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013;15(3):398-405. doi:10.1111/nhs.12048
12. Education: From COVID-19 school closures to recovery | UNESCO. Accessed February 4, 2024. https://www.unesco.org/en/covid-19/education-response
13. Sorakın Y, Akarturk H, Öznacar B, et al. Educational reflections on the coronavirus pandemic in three different countries. Eurasia J Math Sci Technol Educ. 2022;18:em2180. doi:10.29333/ejmste/12514
14. Schwartz KD, Exner-Cortens D, McMorris CA, et al. COVID-19 and Student Well-Being: Stress and Mental Health during Return-to-School. Can J Sch Psychol. 2021;36(2):166-185. doi:10.1177/08295735211001653
15. Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi:10.1016/j.psychres.2020.112934
16. Kurtz H, Lloyd S, Harwin A, Chen V, Furuya Y. Student Mental Health during the Pandemic: Educator and Teen Perspectives. Editorial Projects in Education, Inc; 2021.
17. Parsons AA, Maholtz D, Gilliam J, et al. The Case of the United States: The Impact of the COVID-19 Pandemic on Social Connectedness and Isolation in Low-Income Communities. Int J Soc Qual. 2021;11(1-2):231-257. doi:10.3167/IJSQ.2021.11010214
18. Xiang M, Zhang Z, Kuwahara K. Impact of COVID-19 pandemic on children and adolescents’ lifestyle behavior larger than expected. Prog Cardiovasc Dis. 2020;63(4):531-532. doi:10.1016/j.pcad.2020.04.013
19. Clemens V, Deschamps P, Fegert JM, et al. Potential effects of “social” distancing measures and school lockdown on child and adolescent mental health. Eur Child Adolesc Psychiatry. 2020;29(6):739-742. doi:10.1007/s00787-020-01549-w
20. Grubic N, Badovinac S, Johri AM. Student mental health in the midst of the COVID-19 pandemic: A call for further research and immediate solutions. Int J Soc Psychiatry. 2020;66(5):517-518. doi:10.1177/0020764020925108
21. Kweon YS. Enhancing the School Mental Health Initiative Amid COVID-19. Soa Chongsonyon Chongsin Uihak. 2023;34(1):2-3. doi:10.5765/jkacap.220045
22. Zolopa C, Burack JA, O’Connor RM, et al. Changes in Youth Mental Health, Psychological Wellbeing, and Substance Use During the COVID-19 Pandemic: A Rapid Review. Adolesc Res Rev. 2022;7(2):161-177. doi:10.1007/s40894-022-00185-6
23. Adams SH, Schaub JP, Nagata JM, Park MJ, Brindis CD, Irwin CE. Young Adult Anxiety or Depressive Symptoms and Mental Health Service Utilization During the COVID-19 Pandemic. J Adolesc Health. 2022;70(6):985-988. doi:10.1016/j.jadohealth.2022.02.023
24. Beames JR, Christensen H, Werner-Seidler A. School teachers: the forgotten frontline workers of Covid-19. Australas Psychiatry. Published online 2021:10398562211006145. doi:10.1177/10398562211006145
25. Jakubowski TD, Sitko-Dominik MM. Teachers’ mental health during the first two waves of the COVID-19 pandemic in Poland. PLoS One. 2021;16(9):e0257252. doi:10.1371/journal.pone.0257252
26. Alzueta E, Perrin P, Baker FC, et al. How the COVID-19 pandemic has changed our lives: A study of psychological correlates across 59 countries. J Clin Psychol. 2021;77(3):556-570. doi:10.1002/jclp.23082
27. Palma-Vasquez C, Carrasco D, Hernando-Rodriguez JC. Mental Health of Teachers Who Have Teleworked Due to COVID-19. Eur J Investig Health Psychol Educ. 2021;11(2):515-528. doi:10.3390/ejihpe11020037
28. Goldstein D, Shapiro E. ‘I Don’t Want to Go Back’: Many Teachers Are Fearful and Angry Over Pressure to Return. The New York Times. https://www.nytimes.com/2020/07/11/us/virus-teachers-classrooms.html. Published July 11, 2020. Accessed February 4, 2024.
29. VanDerHeyden AM, Witt JC, Gilbertson D. A multi-year evaluation of the effects of a Response to Intervention (RTI) model on identification of children for special education. J Sch Psychol. 2007;45(2):225-256. doi:10.1016/j.jsp.2006.11.004
30. Bradshaw CP, Buckley JA, Ialongo NS. School-based service utilization among urban children with early onset educational and mental health problems: The squeaky wheel phenomenon. Sch Psychol Q. 2008;23(2):169-186. doi:10.1037/1045-3830.23.2.169
31. O’Connell ME, Boat T, Warner KE, Medicine I, Council N. Preventing Mental, Emotional, and Behavioral Disorders among Young People: Progress and Possibilities.; 2009:562. doi:10.17226/12480
32. Stoiber KC, Gettinger M. Multi-tiered systems of support and evidence-based practices. In: Handbook of Response to Intervention: The Science and Practice of Multi-Tiered Systems of Support, 2nd Ed. Springer Science + Business Media; 2016:121-141. doi:10.1007/978-1-4899-7568-3_9
33. Benner GJ, Kutash K, Nelson JR, Fisher MB. Closing the achievement gap of youth with emotional and behavioral disorders through multi-level systems of support. Educ Treat Child. 2013;36(3):15-29. doi:10.1353/etc.2013.0018
34. Tullius J, Beukema L. The importance of mental health literacy in times of crisis: Adolescent mental health during the COVID-19 pandemic. Eur J Public Health. 2021;31 (Supplement_3): ckab164.237. doi:10.1093/eurpub/ckab164.237
35. Fortuna LR, Brown IC, Lewis Woods GG, Porche MV. The Impact of COVID-19 on Anxiety Disorders in Youth. Child Adolesc Psychiatr Clin N Am. 2023;32(3):531-542. doi:10.1016/j.chc.2023.02.002
36. What is Cognitive Behavioral Therapy? https://www.apa.org. Accessed February 4, 2024. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
37. Kovacs M. The Children’s Depression, Inventory (CDI). Psychopharmacol Bull. 1985;21(4):995-998.
38. Kovacs M. Children’s Depression Inventory (CDI): Technical Manual Update. Multi-Health Systems, Inc.; 2003.
39. Multidimensional Anxiety Scale for Children | Second Edition. Accessed February 4, 2024. https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Personality-%26-Biopsychosocial/Multidimensional-Anxiety-Scale-for-Children-%7C-Second-Edition/p/100000735.html
40. Lee J. Mental health effects of school closures during COVID-19 (vol 4, pg 421, 2020). Lancet Child Adolesc Health. 2020;4(6):E16-E16. doi:10.1016/s2352-4642(20)30128-0
41. Chatterjee R. Losing a parent can derail teens’ lives. A high school grief club aims to help. NPR. https://www.npr.org/sections/health-shots/2022/07/24/1110916298/losing-a-parent-can-derail-teens-lives-a-high-school-grief-club-aims-to-help. Published July 24, 2022. Accessed February 4, 2024.
42. August GJ, Piehler TF, Miller FG. Getting “SMART” about implementing multi-tiered systems of support to promote school mental health. J Sch Psychol. 2018;66:85-96. doi:10.1016/j.jsp.2017.10.001
43. Arora P, Collins T, Dart E, Hernández S, Fetterman H, Doll B. Multi-tiered Systems of Support for School-Based Mental Health: A Systematic Review of Depression Interventions. School Ment Health. Published online February 28, 2019. https://aquila.usm.edu/fac_pubs/15914
44. Cleveland RE, Sink CA. Student Happiness, School Climate, and School Improvement Plans: Implications for School Counseling Practice. Prof Sch Couns. 2017;21(1):1-10.
45. Lapan R, Whitcomb S, Aleman N. Connecticut Professional School Counselors: College and Career Counseling Services and Smaller Ratios Benefit Students. Prof Sch Couns. 2012;16:117-124. doi:10.5330/PSC.n.2012-16.124
46. Whitaker A, Torres-Guillén S, Aclu M, et al. Cops and No Counselors How the Lack of School Mental Health Staff Is Harming Students Acknowledgements Cops and No Counselors. Published online March 4, 2019.