Proceedings of a Workshop

Back in School: Addressing the Well-Being of Students in the Wake of COVID-19

Proceedings of a Workshop—in Brief

INTRODUCTION

To set the stage for the panel presentations and discussions at this workshop, several academic researchers provided an overview of the current evidence related to the impact of the COVID-19 pandemic on student health and well-being. The first researcher, Sharon Hoover (University of Maryland School of Medicine), gave her presentation at the start of the first day of the workshop. Amity Noltemeyer (Miami University) and Kristy Brann (Miami University) provided the second research perspective at the start of the second day of the workshop.

Noltemeyer explained what school has looked like in the context of COVID-19. Since March 2020, 97 percent of students have had their education disrupted. Additionally, she noted that preliminary research does suggest some learning loss occurred during the course of the pandemic, especially for Black, Hispanic, and economically disadvantaged students who were more likely to receive virtual instruction for a longer period and were less likely to have access to adequate technology.

Hoover described three themes that contribute to student stress. The first of these themes she labeled as anxiety and fears, including confusion and uncertainty about the future and worry and fears about the safety of self and others. The second theme she labeled as loss. This can include loss of tangible things, such as jobs and access to health care, loss of family members or friends, loss of intangible things, such as routines and transitions critical to development, and loss of relationships. The third theme she labeled as equity and inequities in the context of COVID-19, including the disproportionate effects of the pandemic on communities of color.

Based on results from a nationally representative survey of young people ages 13–19 shared by Hoover, approximately a quarter of respondents felt disconnected from peers and adults, and more than half were more concerned than usual about their family’s physical health. More than one in four reported an increase in sleep loss due to worry, feeling unhappy or depressed, feeling constantly under strain, and loss of con-

fidence in themselves. Furthermore, 40 percent of respondents reported they had not been offered social and emotional support by an adult at their school. Noltemeyer also shared that mental health-related emergency department visits are up 31 percent for children ages 12–17. Brann added that some students found increases in internalizing symptoms such as anxiety and depression, as well as externalizing symptoms such as opposition, defiance, and inattention. She also noted that the Centers for Disease Control and Prevention found that students receiving virtual instruction, compared to hybrid or face-to-face instruction, had worsening mental and emotional health.

Hoover emphasized that parents are also under stress. A poll conducted in spring of 2020 found that parents report significantly higher levels of stress related to COVID-19 than nonparents, and more than 70 percent of parents reported distance learning for their children as a source of stress. In one survey conducted by Noltemeyer and her colleagues, parents and guardians reported challenges with remote learning, health and mental health, employment disruptions, and challenges meeting basic needs. However, she noted, they also reported positive factors, including enhanced family communication and enhanced family cohesion.

The researchers also touched on the mental health of educators. Hoover shared that teachers report working longer hours following school building closures, and only a quarter of teachers feel their schools offer adequate support for mental health. Noltemeyer added to this, sharing a quote from one teacher: “Mental health concerns … have emerged, as well as adjustment concerns such as decrease in job satisfaction, damage to working relationships, lack of focus and energy, general grumpiness.”

All three researchers agreed that now more than ever it is essential for schools to have a robust, comprehensive mental health system, guided by a framework of multitiered systems of support (Figure 1). In the framework, family-school-community partnerships provide the foundation for mental health in schools, along with professional development and a health school workforce. At tier 1, all students are provided universal supports to promote mental health. At tier 2, additional supports and early intervention are provided for students at risk for mental health concerns. At tier 3, targeted interventions are provided for students identified with more serious mental health concerns. Hoover suggested that mental health screenings in schools could become just as important as physical health screenings. Because youth are six times more likely to complete mental health treatment in schools than in community settings, she said, schools are an essential place to provide mental health services. Brann added that schools could implement programs that build relationships with students, improve access to basic needs, and promote social justice to reduce systemic barriers.

To close, Noltemeyer reminded workshop participants of the saying, “we’re all in the same storm, but not in the same boat.” She said while all students are experiencing the pandemic together, each student has unique protective and risk factors that make it easier or more challenging to navigate.

VOICES FROM THE HIGH SCHOOL EXPERIENCE

Following the research perspective on the first day of the workshop, a panel of high school students provided comments on their experiences with school in the past year. The first panelist was Abby Frank, a sophomore in Ann Arbor, Michigan. Until May 2021, Frank participated in virtual school every day except Wednesdays. She shared that her biggest challenge in adjusting to online learning was the increased screen time, which initially caused headaches.

Frank noted that she was grateful to her teachers who have been considerate of their students’ mental health during this school year. Teachers provided more breaks during online classes, and these breaks allowed her to do things for her own mental health that she normally would not have time to do. Her teachers also took more time to talk to their students individually about life outside of school. Furthermore, Frank’s school also has a depression awareness group that hosted virtual events throughout the year to discuss mental health. Frank shared that it made her feel supported to see her school providing these activities and to hear school administrators talking openly about mental health.

Frank concluded her presentation by saying that while she is grateful for the increased emphasis on mental health in her school this year, she is concerned that this came only in the context of the pandemic. Her hope is that students feel this type of support every year, even as the pandemic recedes. It is important for teachers and schools to continue to find ways to check in with their students, and to continue to provide flexible time in class periods while students adjust back to in-person learning. She said she does not want her classmates to go back to feeling afraid to ask for an extension on an assignment or to take a day away from school for mental health. She added that having a moment to step away and talk to classmates or take a quick break can make learning much more engaging and meaningful for students. Just because coronavirus is going to be less of a concern in school next year does not mean students are suddenly going to become stress free. The normal trials of being a teenager will still exist, she said.

The second student to present was Lukas Tucker, who recently graduated simultaneously from high school and community college. Tucker’s presentation focused on the experiences of transgender and LGBTQ students during the pandemic.

Tucker moderates a large forum for transgender students, and he asked the members to share things they wanted to tell educators about returning to the classroom. The responses he received highlighted that many transgender students felt virtual learning protected them from some of the bullying and harassment they may experience in the classroom. However, many students, including Tucker, were unable to use their chosen names in online-learning platforms, which caused stress. Tucker also noted that many students felt unsafe in their homes during virtual learning because their families may not know or accept that the student identifies as LGBTQ. Protection policies in schools can help combat these concerns, Tucker said. In virtual settings, students should be able to choose their names and pronouns. Antibullying protections for LGBTQ students are also crucial in schools.

Tucker offered some suggestions for how educators can help these students. He said that including diverse groups of people in class lessons is important so that all students can see themselves represented in class materials. He gave one example of a math problem: Mark and his husband Jacob are going to buy wedding rings. They have $100 and they buy one ring for $60; how much money do they have left? On a larger scale, he noted, schools can include LGBTQ history and literature in curriculum. Tucker said educators can also help by making it known they offer a safe space. In his school, some teachers put stickers in their classroom window or added their own pronouns to signal to students their support. Tucker also agreed with Frank that prioritizing mental health for students is crucial. Tucker proposed an acronym to help educators remember how to support transgender students—TRANS: Time to get to know them as a person; Respecting their names and pronouns; Asking them what they are comfortable with; Normalizing LGBTQ students in the classroom; and Speaking up for your students. Last, he noted that appropriate training for educators will better prepare them to support and meet the needs of all students, including those who identify as LGBTQ.

The third student to present in this panel was Brianna Attey, a high school senior in Endicott, New York. She started the school year in a hybrid model, where she was in school 2 days a week, virtual learning 2 days

a week, and using Wednesdays for meeting with teachers for help on assignments. She returned to full in-person learning in March 2021. She noted that her school offers rapid testing for COVID-19 and also offers vaccines for students who wanted to participate in events like prom and graduation. For Attey, the hybrid-learning model helped her figure out what type of learner she is. She noted that this is important because hybrid-learning models are likely to become more common, especially as she transitions to college.

Attey shared that she felt some of the same grief during the COVID-19 pandemic that she felt when she lost her mom several years ago. Initially, she felt she did not have time to grieve the loss of normal high school experiences because she was too busy figuring out how to navigate the new normal. When virtual learning started, she said, her teachers focused on getting back to the academic piece of school, and did not spend much time talking about how students might be feeling. She noted that coming out of the lockdown, she needed some transition time to adjust to being around her peers again and to learn to talk to her advisors and teachers about how to cope with this new normal. Attey said it took her time to learn how to cope.

Attey also commented that she felt the racial and ethnic inequities of the pandemic served as a wakeup call for many in the United States. Her school offered support for students of color, recognizing that they were not only coping with the pandemic, but also were witnessing disproportionate numbers of people of color dying from COVID-19. She is now working with her teacher and the 4H-UNITY project to come up with student-led activities to teach students how to advocate for themselves and to build a better social environment in their communities. Attey has been able to work with her school to ensure messages of inclusivity continue after the pandemic so that students feel safe, not only physically but also mentally and emotionally. She is also working to create a diversity café at her school, which will give students a platform to talk about race, social justice, and other issues that do not typically come up in a classroom setting. She noted that some students see these topics as less important when compared to the pandemic, but she said combating the COVID-19 pandemic should serve as a model for combatting other issues that impact mental health, including racism.

Following these three presentations, Laurel Leslie (American Board of Pediatrics and, Forum member) served as a moderator for a question and answer session. First, she asked each of the students, if there was one thing they could highlight for educators, what would it be? Attey answered that students should feel empowered to talk about the issues that matter to them. By giving students agency, she said, adults can help students move forward with confidence. Frank agreed, saying adolescents are often in the awkward position between younger children who have no control, and adults who have full control. She said giving students space to be heard is really important. Tucker added that adults should be comfortable exposing themselves to new things so they can understand and support their students.

Next, Leslie asked what piece of advice each of the students would like to give the new Secretary of Education about how to better support student mental health. Attey responded that funding of effective mental health programs and tools are important for students to develop lifelong healthy practices. Tucker agreed and added that increasing teacher salaries would help to address the teacher shortage, which would in turn reduce the burden on teachers and give them more resources to support their students. Frank commented that support for inclusive curriculum is also crucial to help dismantle discrimination and to make students feel seen and heard.

VOICES FROM THE PARENTS AND FAMILIES EXPERIENCE

Following the student voices panel on the first day of the workshop, a panel of parents and family advocates shared their perspectives. The first speaker in this panel was Chioma Oruh, founder of Chi Bornfree and mother to two young sons with autism. She began by sharing a story about her 8-year-old son who recently had the police called on him because his autism-related sensory challenges made it difficult for him to wear his mask on the school bus. Oruh used this story to introduce the concept of readiness, the idea that it is critical for schools to be prepared to meet students’ individual needs. She noted that this was crucial before the pandemic, but that it has become even more so in light of the pandemic. As part of the concept of readiness, Oruh suggested schools build integrated behavioral health systems that promote academic and social-emotional learning for students. Such a system would coordinate supports and integrate the needs of children, youth, their families, and the entire school community, including teachers and administrators. Oruh supported the idea of the three-tier system described in Figure 1. She added that families and youth should be included in discussions about schools’ supports, noting that this should include students with disabilities.

The second speaker on this panel was Lisa Math, statewide director of the Family S.T.A.R. Program for Family Network on Disabilities and parent of a young adult with multiple medical conditions and mental health challenges. Her own experiences taught her just how challenging it is to navigate multiple systems of care, and led her to help other families. She noted that a primary challenge for families during the past year was learning how to support multiple children learning in a virtual platform while also adjusting to working from home. Many families did not have the Internet access or technological equipment to support this situation. Math commented that many large companies stepped in to expand Internet access to families, which highlighted the potential for community and business partnerships. However, Math noted that there was a lack of support for families trying to navigate the new normal.

In returning to school for in-person learning, Math said that the students in her program are looking forward to feeling more grounded in their routines. They also want their fears and concerns to be acknowledged, and for school to feel like a safe space to discuss their emotions. Math commented that it is important for every school to have mental health professionals available to talk with both students and their families. She added that social-emotional learning will be a vital component of moving back to in-person learning. Math emphasized the need for adequate and appropriate ongoing training for educators and for families so that everyone is better prepared to deal with crises in the future.

The third speaker on this panel was Kerri Eaker, who served as the family support outreach coordinator for the Family Support Network of Western North Carolina and is a mother to a son with an intellectual disability, psychiatric disability, and chronic health conditions. Eaker focused her presentation on the challenges that rural communities faced with virtual learning during the pandemic. She noted that Internet access was of particular concern for many families living in rural areas. Lack of access to special education services was also a significant challenge for families of children with special needs. The mental health burden on families has also been huge—she noted that many families have called the hospital to have their children admitted to a psychiatric ward and suicidal ideation seems to be more prevalent.

Eaker also shared some unexpected benefits that she saw come out of the pandemic for her community. First, she noted that increased telehealth opened up access to both medical and mental health providers for some who previously lacked access to such care. She also said that many families were able to spend more time together, and some parents were able to be more involved in their child’s education because it was happening at home.

In moving forward, Eaker said it will be important to meet families and children where they are. She commented that the current system was not prepared to respond to this pandemic, and it will take time to rebuild trust with families. She added that schools and mental health providers need to collaborate to support children. As part of this, it will be crucial to build both the public education workforce and the mental health workforce. Eaker noted that it is important to involve families in rebuilding the system. She agreed with Math that social-emotional learning is also crucial for all students.

The next presenter on this panel was Jenna White, outreach chair for the Northern Virginia District PTA and parent of two. White has extensive experience in navigating and helping families cope with childhood trauma, which helped prepare her to respond to the COVID-19 pandemic. She shared that her son has a complex PTSD diagnosis, so when virtual learning started she was already used to thinking about how to focus on his emotional safety and had worked with the school to build in supports for him. She expressed gratitude for the kindness that his teachers displayed in the past year, noting that their flexibility benefitted all of their students.

White also expressed concern with the narrative around childhood resiliency, noting that while children might be able to cope with crises like a pandemic, they still need support from adults. She noted that children will not just learn coping and resiliency skills on their own. Moving forward, White said there is more urgency around creating trauma-informed schools where adults in the school community are prepared to recognize and support students impacted by trauma, and that this should not just be isolated to the pandemic but should remain in place in the long term. She noted that it is important to consider the experiences of all students in a community. White said that while we often think of mental health in terms of either health and wellness or sickness, it is more of a continuum where everyone experiences different degrees of mental health. She added that schools need to meet families where they are to best support them moving forward.

The last speaker on this panel was Vanessa Rodriguez, a project coordinator for Family Voices and a parent of a child with DiGeorge syndrome. Rodriguez began her presentation by commenting that no one was pre-

pared for COVID-19, and families had to rush to find space, buy equipment, and make accommodations for their children to participate in online-learning. Lack of access to Internet and technology, as well as lack of knowledge about how to navigate online learning platforms, proved to be challenges for many families. This was exacerbated for parents who struggled with a language barrier or who do not read or write. Rodriguez shared that her own son’s intellectual disability and autism made it so difficult for him to sit in front of the computer for more than a few minutes that it has been recommended for him to repeat the grade.

In addition to navigating online learning, Rodriguez said, many families also worried about job loss, loss of health insurance, housing instability, cost of utilities, and more. Furthermore, nursing and home health aide coverage was more difficult to find. Rodriguez also noted that the pandemic took away opportunities for respite, outdoor activities, and socialization, all of which increased stress for many students.

Rodriguez offered several suggestions for how to transition back to in-person learning. First, she said the transition will need to include mental health supports for both students and their families. In addition, students who did not have access to therapies or Individualized Education Programs during this time will need increased support.

Following the presentations from this panel, Rebecca Baum (American Board of Pediatrics, Forum member) asked each of the panelists what one recommendation they would give to the Secretary of Education as students return to in-person learning. Oruh commented that the Individuals with Disabilities Education Act should be fully funded to support positive developments for all students. Eaker added that school systems need to collaborate with mental and behavioral health systems, rather than work in isolation. Math suggested that mental health training be required for teachers and administrators. White added that the mental health needs of teachers also require consideration.

VOICES FROM THE EDUCATION FIELD

The first panel on the second day of the workshop featured presentations from educators working in the field. The first speaker was Ka-Shara Jordan, a school social worker in the Niagara Falls City School District. In her district, students have the option of hybrid learning or remote learning. The school loaned WiFi hotspots and laptops to students who needed them for the year.

Jordan commented that there have been challenges with virtual learning for some of her students. Many students have expressed difficulty staying focused because they are distracted by siblings and parents who were also working from home. Some students also struggled with time management and did not always set aside the time to do work that is normally done in the classroom. Jordan also said students felt isolated and lacked personal connections when they were unable to be in school. She also said that even though the school provided laptops, technology was still an issue for many students. Jordan noted that she encourages students to choose the hybrid-learning option because she noticed that so many students were struggling with fully remote learning.

The second speaker in this panel was Tami Santa, director for mental health and wellness in Westerville, Ohio. Like Jordan’s district, Westerville City Schools also offered students both a hybrid- and a fully virtual-learning model. To provide support to students, the student well-being staff in Westerville created virtual offices that provide resources on topics such as social-emotional learning, stress management, and executive function. They also offer the ability to schedule an appointment with a staff member. Santa said that even when students returned to in-person learning, they requested that the virtual offices be kept open.

Santa’s district is considering both immediate and long-term impacts for its students. Creating spaces and places for students to feel they are a priority, she said, is important. They are creating recharge rooms, where students can use biofeedback to understand what their bodies need for emotional regulation. The high schools are also launching Hope Squads, peer-led suicide prevention and mental health education programs. She said that her team is seeing a high need for mental health services in their students, and their goal is to make sure students know how to access the services they need either through the schools or from external sources. She emphasized that they strive to ensure their students are seen, celebrated, and heard each day.

Santa added that they also recognized staff need support, and thus created a well-being tool to provide support to them as well. In this tool, staff can choose things including cooking and baking, yoga, self-care, gratitude, and more. They also offer professional training for staff, particularly focused on trauma-informed resiliency and equity.

Last, Santa noted that they are working to build mental health education at the community level. They offer “parent-prep” events, both virtually and in person, that provide resources and education to parents. They are also developing community resources through the Hope Squads. She noted that while there has been a greater emphasis on this work because of the pandemic, they plan to continue this work even after the pandemic recedes. She added that community partnerships have been crucial during this time, both to provide basic needs for their students and to provide mental health supports, including crisis resources.

The third speaker in this panel was Concepcion Pedroza, chief of student support services in Seattle Public Schools. Pedroza noted that concerns about stress, well-being, and socioemotional health, including racialized trauma, have been at the center of all of their decisions this year. They instituted a Whole Child Whole Day (WCWD) system, which provides staff with high-quality training to create safe and welcoming environments, as well as supports to improve school climate. WCWD is a tiered, wraparound model of support for students, with a specific focus on educational justice for students of color. Currently, this model is in 32 schools, and the district is working to scale it up for this fall.

Pedroza noted that attendance has been a challenge for her district during the pandemic. Students either did not log into online-learning platforms or did not participate. Additionally, many of their students experienced increased anxiety and stress. She added that more students have been admitted to Seattle Children’s Hospital for crisis and mental health supports. To respond to this need, Pedroza shared that all of her district’s high schools have health clinics on site, and they are working to ensure all of these clinics offer mental health supports when students return to the school in the fall. They are also working on a plan to ensure elementary and middle schools are able to offer mental health supports to students.

The final speaker in this panel was Noel Candelaria, a high school special education teacher from El Paso, Texas, and the current secretary treasurer of the National Education Association (NEA). Members of the NEA, he said, share the belief that students in public schools should have an education that prepares them for the responsibilities of community, regardless of their race, ethnicity, or family income. He noted that the pandemic highlighted the inequities experienced by many students who live in marginalized and neglected communities across the United States. While some challenges from the pandemic are knowable, he said, some will be unknown for quite some time. Candelaria noted the American Rescue Plan was the single largest investment ever in public education and said the funding could be used to reduce class size; modify spaces to comply with social distancing; modernize HVAC systems; hire more school custodians, nurses, and counselors; and facilitate social distancing on transportation services with additional buses and drivers.

Candelaria noted that student experiences vary, but the pandemic had a negative impact on school performance for many. Based on focus groups conducted by the NEA and the National Parent Teacher Association, students reported that their schoolwork suffered and that they missed the lost personal interaction with friends and teachers. Many also reported diminished academic progress during the pandemic. However, Candelaria added, students also experienced some unforeseen advantages. They reported increased bonding with family and time for hobbies and exercise. Some also expressed a commitment to science and medicine to help prevent future pandemics.

Following this panel, David Willis (Center for the Study on Social Policy, Forum member) asked each of the panelists what kind of supports have been put into place for students who were struggling with attendance during the pandemic. Candelaria noted that attendance can be impacted by a variety of factors, including what is happening at the community level. He said that some students may have left school to work in order to help provide for their families, while others may have been displaced and thus disconnected from school. Because of this, Candelaria said, it is important to leverage all of the resources that a community can offer to support not only students, but also their parents and caretakers. Pedroza added that just calling families to check in throughout the pandemic helped to keep students engaged. Santa and Jordan both agreed that this was effective in their schools as well.

To close this panel, Willis asked each of the panelists how to build classroom environments that consistently include practices that address student wellness, rather than viewing it as something outside the classroom. Candelaria responded that it is crucial to invest in public schools so they have the resources to lift up communities and to provide adequate support and training for teachers. Santa added that relationships are key—schools need to support teachers, and teachers need to support students. If all students feel seen, heard, and celebrated, she said, that will contribute to everyone’s mental health and wellness. Pedroza agreed with the importance of centering relationships, and emphasized that this includes school staff. Jordan noted that this can be accomplished relatively easily. She started a monthly newsletter that provides mental health tips for teachers, and said that a quick check-in at the beginning of class can help students feel supported.

VOICES FROM EDUCATION LEADERSHIP

A second panel on the second day of the workshop provided a national perspective on the school experience during the COVID-19 pandemic. This panel included four speakers. The first was Dana Godek, who works on state policy issues for the Collaborative for Academic, Social, and Emotional Learning (CASEL). Godek shared four key goals in her work at CASEL: (1) building the foundational support and plans for socioemotional learning; (2) strengthening adult competencies and capacities through professional learning; (3) promoting student socioemotional learning through a strengths-based approach in tier one services; and (4) reflecting on data for continuous improvement. She noted that more than 40 states are connected to CASEL’s Collaborating States Initiative and highlighted Delaware, Kansas, Minnesota, and Wisconsin as examples of states with strong socioemotional learning initiatives. In Delaware, for example, the chief state school officer has developed socioemotional learning competencies with academic crosswalks, and hosts professional learning communities. The state also hosts virtual socioemotional learning restorative renewal communities where educators are encouraged to reflect on their own state of well-being. Godek added that the funding for public education in the American Rescue Plan offers the opportunity to leverage foundational socioemotional learning, engage with local communities and stakeholders, and support training for educators in socioemotional learning competence. She noted that this funding can support long-term efforts, and provides an opportunity to redesign the current education system to better support socioemotional learning for students.

Next, Kate King (National Association of School Nurses, [NASN]) discussed the integral role of school nurses in supporting socioemotional learning for students and school staff. She began her presentation by noting that 25 percent of schools in the United States do not have a school nurse, and more than 35 percent only have a school nurse part time. School nurses are often the first contact for students at risk for adverse health and educational outcomes, said King. Sometimes, they see students whose socioemotional distress manifests in physical symptoms, such as headaches, stomachaches, falling asleep in class, or acting out. She noted that while school nurses have historically been silent health care partners in schools, the pandemic brought a spotlight on their efforts. To respond to the increased need, NASN developed a COVID-19 interactive toolkit to help schools and school nurses in their planning.

King described NASN’s Framework for 21st Century School Nursing Practice, which includes four key components. The first is care coordination, including providing direct care for students, referring students to external providers when necessary, and team collaboration to provide care for students. The second component is public health, including contact tracing for infectious diseases, mitigation of adverse health outcomes, and health education. The third component is quality improvement and data collection, made easier by the use of new electronic health records. The fourth and final component is leadership through education of school staff and community partnerships. King noted that it is important for school staff to coordinate efforts rather than work in silos, and that external partnership with organizations such as local children’s hospitals and parks and recreations programs is crucial.

King also said that the role of school nurses in supporting school staff also changed during the pandemic. Where previously school nurses might support some basic health programs like blood pressure screenings or weight loss programs before the pandemic, they have increased their services to include contact tracing and mental health promotion for school staff as well as for students.

The third speaker in this panel was Paul Imhoff (American Association of School Administrators, [AASA]), who discussed how AASA is working to support socioemotional learning initiatives in schools across the country. He noted that this is critical work because students cannot learn unless their well-being is addressed. He also added that equity is a crucial component of socioemotional learning.

The socioemotional learning work of AASA started prior to COVID, but Imhoff noted that it is now more important than ever. The AASA socioemotional learning cohort identified 10 high leverage superintendent actions based in the CASEL framework presented by Godek which include

1. Building the foundation: developing foundational support socioemotional learning among key stakeholders, including the school board.
2. Vision: engaging a diverse group of stakeholders to create a shared vision for the district that established socioemotional learning as core to student success.

3. Communication: communicating consistently about socioemotional learning as a district priority.
4. Resource allocation and alignment: building socioemotional priorities into staffing, funding, and budgeting for sustained socioemotional implementation.
5. District organization: organizing the district to promote collaboration among school and district leaders around socioemotional learning, academics, and equity.
6. Strengthen socioemotional knowledge: becoming versed in the science and implementation of socioemotional learning.
7. Lead adult socioemotional learning culture: modeling socioemotional learning through interactions with all district students, staff, families, and communities.
8. Policy alignment: adopting district policies that support socioemotional learning.
9. Family and community partnership: developing relationships with families and community partners to align missions and promote socioemotional learning.
10. Equitable outcomes: ensuring the district’s socioemotional learning implementation supports the goals of achieving equitable outcomes for all students.

Imhoff said he hopes schools do not return to the prepandemic version of normal. Instead, he hopes schools will come out of the pandemic better equipped to meet the needs of students. Last, he said that teachers will not be able to support students if the teachers do not feel adequately supported themselves. He noted that teachers are exhausted from this past school year, and moving out of the pandemic the socioemotional needs of adults who care for students is also important.

The last speaker on this panel was Celeste Malone (National Association of School Psychologists [NASP]). Malone pointed out that while the pandemic may have exacerbated mental health concerns, for many students these concerns were not new. She said that schools have long been a central place for students to receive mental health supports, as noted by King. She agreed with Imhoff that schools should not strive to go back to normal but should work to build a new system to better support the needs of students.

NASP collaborated with the American School Counselor Association to develop guidance for supporting socioemotional learning and mental and behavioral health of students during the pandemic. This guidance encouraged schools to consider a tiered model of mental health service delivery, as described in Figure 1. The guidance also emphasized the importance of relationships between students and school staff as well as among students themselves. Malone noted that it will be important for schools to have a plan for how they will conduct socioemotional learning and mental health screenings as students return to in-person learning. Part of that plan should include identifying students who may need more intensive support and making sure those students are referred to appropriate mental health services. This may include students whose communities were disproportionally impacted by the pandemic. Malone added that for students of color their stress and anxiety may have been further exacerbated by the ongoing racial violence in the country.

Following the four presentations in this panel, Willis asked each of the panelists to comment on key messages about returning to in-person learning in the fall. Malone responded that expectations need to be tempered. She said so many people are talking about getting students back into school buildings as if that will fix everything, but there are still other issues that need to be addressed. Returning to school is going to be an adjustment for students, and some students will likely experience anxiety about going back. Godek agreed with this, and King added that students and teachers need to be given time to readjust. Imhoff said schools should be prepared to meet students and staff where they are, rather than expect them to make up for lost time in the classroom.

NATIONAL POLICY CONSIDERATIONS

The third day of the workshop focused on policy perspectives, and began with opening remarks from Aaliyah Samuel, deputy assistant secretary, local, state, and national engagement at the U.S. Department of Education (ED). Samuel started her presentation by saying that the ED recognizes the value of social-emotional learning and mental health, and will continue to support both for students, families, educators, and school personnel. ED, along with other federal agencies, has released two guidance documents for

educators on reopening schools. Those documents emphasize the importance of social-emotional learning, relationship building in schools, and community stakeholder engagement. Samuel noted that ED worked closely with other agencies to elevate the importance of social-emotional learning and mental health, particularly in the context of schools reopening in the fall. She added that the American Rescue Plan provides funding for increasing the number of guidance counselors and other school support personnel in schools. Furthermore, she noted that the pandemic underscored the importance of supporting families, and as such, ED is hoping to bring on a senior advisor for family and community engagement and has been hosting a series of parent engagement sessions to learn from parents from diverse community groups. Samuel concluded her talk by commenting that there is an opportunity now to be more intentional across systems and agencies to put in place supports for students and families. Part of this, she said, requires reducing silos between child- and student-serving agencies at the federal level. In doing so, federal partners hope to model a level of engagement for local and state agencies.

Following Samuel’s comments, the final panel of this workshop featured a discussion between policy leaders, moderated by Mary Ann McCabe (Society for Child and Family Practice, Forum member). The panelists were Chelsea Prax (American Federation of Teachers [AFT]), Allen Pratt (National Rural Education Association [NREA]), Susan Borja (National Institute of Mental Health [NIMH]), and Sarah Sliwa (Centers for Disease Control and Prevention, [CDC]).

McCabe started by asking each of the panelists to comment on their biggest concerns related to students’ well-being and learning. Prax responded that student mental health needs to be a primary consideration and noted that schools tend to serve as the pediatric mental health provider in the United States. She added that educators are usually the first to speak up and say students need more mental health supports, but that the burden cannot rest solely on educators. Other child- and youth-serving institutions must also be prepared to step in. Pratt agreed that educators on the front line often want to do all they can to support student well-being. He added that, during the pandemic, educators saw increased outreach and help from community partners and expressed the hope that this collaboration does not end as the pandemic recedes. Additionally, he noted the pandemic required innovation in schools, and he hopes that also continues in the future.

Borja said that prior to the pandemic, 37 percent of high school students were experiencing persistent sadness or hopelessness. Since the pandemic, risk factors for adverse mental health outcomes have increased, while protective factors such as time with friends or physical activity decreased. She noted that an increase in mental health concerns without expanded capacity for services is a meaningful challenge in caring for student well-being.

Sliwa commented that the pandemic highlighted how interconnected schools and communities are. What happens in a community impacts student well-being and their readiness to learn. However, she noted, the pandemic exacerbated existing community-level disparities and disrupted family life for many students, which in turn affected students’ emotional well-being and perpetuated existing academic disparities. Her biggest concern is the widening of disparities in communities and the effect that it will have on academic outcomes for students coupled with shortages of mental health support staff in schools.

Next, McCabe asked the panelists to speak about what kinds of strategies their organizations are using to support students. Pratt commented that part of their efforts have been focused on telling stories from different rural communities and sharing ideas about strategies that have worked on a local level. Furthermore, they have been focused on teacher shortages and students’ lack of access to technology, both of which were concerns before and were exacerbated by the pandemic.

Prax said that focusing on students is critical in all aspects of AFT’s work. Prioritizing students with disabilities, dual language learners, or students of color is a way to achieve success for all students. AFT offers professional learning to help educators build skills around supporting grieving students and implementing trauma-informed strategies. Prax also commented that federal recovery dollars can be used for specialized instructional support personnel.

Sliwa added that there is a lot of work left to do to make sure schools have access to fully trained, fully staffed mental health services. In the meantime, she said, students interact with so many adults on school grounds who can provide support in different ways. Considering this, she suggested people who are not traditional

service providers could be enlisted. For example, school nutrition staff were on the frontline throughout the pandemic and some schools provided these partners with mental health first aid training.

Borja added that this pandemic highlighted that while research can tell us quite a bit about child and youth development, there is still so much that is unknown. Recognizing this, NIMH is seeking to figure out how to leverage and extend the existing mental health workforce. Additionally, they are working to build equity into research to provide additional evidence related to students and families who have historically not been included. Furthermore, they are trying to learn from this pandemic to better prepare for the next pandemic or other major disruption to education.

Following these comments, McCabe asked the panelists to consider how equity might be prioritized in future strategies. Prax commented that elevating vulnerable communities and focusing on students who might be at risk for adverse outcomes is essential. She added that the AFT is committed to making sure educators have racial literacy so they have an understanding of the root causes of the some of the disparities that became apparent during the pandemic. Pratt added that individualizing learning experiences is key to making sure each student feels supported.

Next, McCabe asked the panelists to discuss how screening might be used to address students’ mental health and well-being. Borja commented that screening can be a useful tool to identify students who might need additional support or referral for services, but cautioned against using screening when appropriate interventions or supports are not available.

McCabe asked each of the panelists to share their thoughts about the strength and resiliency they have witnessed from students and educators throughout the pandemic. Pratt said he thinks schools learned how flexible students and educators can be. Prax added that teachers have demonstrated remarkable innovation and problem solving over the past year. She also said the data show that mentorship, physical activity, getting good sleep, and eating healthy meals are all part of maintaining mental health, and there is a need to continue to support all of those pieces for students. Sliwa responded by thanking students and acknowledging their willingness to adapt throughout the year. Borja noted that so many people have suffered more this year because of the impact of social determinants of health. “And so if we can address and deal with those,” she said, “we should have better health outcomes.”

Lastly, McCabe asked each of the panelists what one funding request they would make to support schools at the local level. Prax responded that she would like to see increased partnership among high schools, colleges, communities, and departments of education to build pipelines for the workforce needed to support student well-being. Pratt added that pipelines might be strengthened by creating a mechanism to borrow teachers from other states or to quickly train other service providers to act as teachers. Borja said her personal wish would be for increased implementation of evidence-based care in schools. Sliwa added she would like to see increased financial support for local organizations working on teacher retention strategies.

FINAL REMARKS

To conclude the workshop, Baum highlighted the key messages shared by both panelists and workshop participants throughout the 3-day event. First, she commented on the tools, policies, and practices that should be considered when thinking about how to support students as they return to in-person learning. She noted that several presenters commented on the importance of school-based mental health services, including school psychologists, school nurses, school counselors, and school social workers. In recognition of the traumatic experience many families lived through in the past year, Baum also noted that several presenters commented on the need for a trauma-informed approach. Furthermore, several presenters spoke about issues related to lack of Internet access or technological tools required for remote learning, highlighting the need to consider equity in approaches to student well-being. Several presenters also emphasized the importance of social-emotional learning and wellness practices as part of healthy learning. Baum returned to the comments from the student panel about their appreciation for flexibility and patience from teachers throughout the pandemic, and their hope that these practices continue. Additionally, Baum noted, many of the speakers commented on the importance of support for school staff who are feeling exhausted and burnt out.

Next, Baum spoke about what progress might look like over the course of the next school year, and how students’ needs might change. She noted that some students appreciated online-learning opportunities,

and there may be room for more hybrid models in education in the future. There will also be a sustained need for mental and emotional support as both students and educators adjust to being back in in-person learning. Some students will feel more anxious about returning to the classroom, and schools should try to meet students where they are and give them time to readjust. Baum also noted that there will be a need for ongoing efforts to reengage students who became disengaged over the course of the pandemic.

Last, Baum commented on how these lessons learned can help reimagine what supporting student well-being may look like in the long term. She noted that nearly all of the presenters spoke about the importance of listening to and engaging students and their families. Furthermore, although the pandemic may have exacerbated mental health concerns for students, stress and anxiety are not limited to the COVID-19 experience. Thus, some of the strategies used to support students during the pandemic may also be useful in supporting students outside of the pandemic. Supporting student mental health and well-being is important for lifelong health and success, said Baum. She added that continued collaboration between different partners to support student and educator well-being will be important. In conclusion, she noted, there seems to be an increased appreciation for schools and all of the services they offer to students beyond an academic education.

PLANNING COMMITTEE ON BACK IN SCHOOL: ADRRESSING THE WELL-BEING OF STUDENTS IN THE WAKE OF COVID-19: A VIRTUAL WORKSHOP

Sandra Barrueco, Catholic University of America; Rebecca Baum, Mission Children’s Hospital; Mary Ann McCabe, Society for Child and Family Practice; Cheryl Polk, Safe & Sound; David Willis, Center for the Study of Social Policy; Erin Kellogg, Study Director.

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DISCLAIMER: This Proceedings of a Workshop—in Brief was prepared by Erin Kellogg, rapporteur, as a factual summary of what occurred at the workshop. The statements made are those of the rapporteur or individual meeting participants and do not necessarily represent the views of all meeting participants; the planning committee; the Board on Children, Youth, and Families; the Forum on Children’s Well-Being; the sponsors; or the National Academies of Sciences, Engineering, and Medicine. The planning committee was responsible only for organizing the public session, identifying the topics, and choosing speakers.

REVIEWERS: To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop—in Brief was reviewed by Nisha A. Sachdev, George Washington University. We also thank staff member Leslie Sim for reading and providing helpful comments. Kirsten Sampson Snyder, National Academies of Sciences, Engineering, and Medicine, served as review coordinator.

SPONSORS: This workshop was supported by contracts between the National Academy of Sciences and the American Board of Pediatrics (unnumbered award); Centers for Disease Control and Prevention (200-2011-38807, TO #69); and Health Resources and Services Administration of the U.S. Department of Health and Human Services (HHSH250201500001I/5R60219F34017). Additional support came from the American Academy of Pediatrics, Children’s Hospital Association, Family Voices, the Global Alliance for Behavioral Health and Social Justice, the Society for Child and Family Policy and Practice, the Society of Clinical Child and Adolescent Psychology, Well Being Trust, and ZERO TO THREE. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

Suggested citation: National Academies of Sciences, Engineering, and Medicine. (2021). Back in School: Addressing the Well-Being of Students in the Wake of COVID-19: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press. https://doi.org/10.17226/26296.

Division of Behavioral and Social Sciences and Education

Copyright 2021 by the National Academy of Sciences. All rights reserved.