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Student mental health struggles intensify as high schools remain closed year into pandemic

Students are suffering from more intense symptoms of depression, anxiety and other mental illnesses, and a higher percentage of emergency room visits for teens are mental health-related, experts said.

Avery Sims, 17, a senior who goes to George Westinghouse College Preparatory High School, outside his Galewood neighborhood home, Tuesday, March 2, 2021.
Ashlee Rezin Garcia/Sun-Times

When the coronavirus pandemic first closed schools last year, one Chicago mother watched as her son — then a freshman at a public school on the North Side — became hyper focused on Gov. J.B. Pritzker’s daily briefings, spurring disappointment every time he announced a delay in reopening schools.

As Chicago Public Schools remained closed for the rest of the year and did not reopen in the fall, the mother said her son’s anxiety and depression manifested more severely as he became too angry to function.

He remains “emotionally miserable,” said the woman, who asked not to be named. “He’s in therapy, he’s taking medication. This has never been true before.”

High school students in CPS still have no idea when they will return in person this school year, even as kindergarten through fifth graders returned to classrooms last week and 6-8 graders return Monday. CPS officials on Friday said high school students could opt-in for in-person learning possibly later this spring, but no deal has been reached with the Chicago Teachers Union, and no details of how schools would look if they open their doors have been released.

Now nearing a year of schools being closed, students are suffering from more intense symptoms of depression, anxiety and other mental illnesses, according to mental health experts.

Nationwide, the number of children’s mental health-related emergency department visits increased steadily from April to October 2020, according to the Centers for Disease Control and Prevention. For children ages 12-17, the number of visits increased by 31% compared to 2019.

At Ann and Robert H. Lurie Children’s Hospital, from September 2020 to January 2021, the rate of emergency department visits for mental health concerns doubled compared to the year before, rising from 2.4% to 4.2% of all cases. While the pandemic more than halved the number of emergency room visits overall, the number of mental health visits remained about the same as the prior year.

Dr. Jennifer Hoffman, an emergency room physician at Lurie, said although there was a hesitancy to visit the emergency room during the pandemic, mental health concerns for some children were so high that families deemed the risk necessary.

Even before the pandemic, about 20% of children in Illinois faced mental health challenges by the end of high school, said Dr. John Walkup, chair of the Pritzker Department of Psychiatry and Behavioral Health at Lurie. With the added isolation, family economic challenges and other pressures of the pandemic, Walkup said more children are developing symptoms and seeking mental health care.

Outpatient visits for mental health services such as therapy have increased 15% since before the pandemic, Walkup said. That is in part because virtual visits allow physicians to treat more people.

Still, there are likely more teens who need help but can’t afford it, even with insurance, and even then Lurie doesn’t have enough staff to treat all the patients referred to the hospital, Walkup said.

Common symptoms of adolescent depression include an inability to experience happiness, restless sleep and low energy, Walkup said.

“We’re seeing more kids who are feeling suicidal, more kids who are worried about the future,” Walkup said. “We’re seeing kids who have more eating problems. And we’re seeing kids who are coming to the emergency department who have more physical symptoms that probably have a psychiatric cause.”

‘Hit a wall’

Avery Sims, a senior at George Westinghouse College Preparatory High School, said he used to be a “perfectionist” when it came to school, taking Advanced Placement-level classes and earning high grades.

But he hasn’t been able to keep up with the demands of remote learning, said Sims, 17, of Austin. He feels like he has “hit a wall,” he said. He reached out to his school counselor about seeing a therapist, but having to deal with insurance has been a deterrent, he said.

And though school counselors are trying their best to be available for students, Sims said, it feels like their workload has increased “tenfold,” helping seniors with college decisions and supporting students struggling with online learning.

“I go to bed, wake up with a certain anxiety, because I know if I can’t finish everything that needs [to be] finished, my grades suffer,” Sims said. “If I finish everything, my sleep suffers. It’s a never-ending cycle.”

Sims doesn’t anticipate returning to the classroom this year, nor does he want to unless there is a safe reopening plan, something he doesn’t expect, he said, since high school students change classes throughout the day. But if it were safe to return to schools, Sims said being in the classroom would “take a weight off my shoulders.”

Calls for help

Sara Cawley, a junior at Walter Payton College Preparatory High School, founded the Positive Mental Health Association at the beginning of the 2019-2020 school year to “fill a gap” and provide a space for students to talk about mental health in high school, she said.

The 16-year-old from East Humboldt Park knew the importance of being able to process mental health challenges among peers, having experienced obsessive-compulsive disorder for much of her life and depression at the start of high school.

Once the pandemic closed schools, Cawley increased the frequency of meetings from once to twice a week because students wanted more time to check in. She watched many club members’ mental health worsen, she said.

Sara Cawley, 16, a junior at Walter Payton College Preparatory High School, created a Google classroom for the school’s Positive Mental Health Association, a club she founded to allow students to talk about mental health. | Ashlee Rezin Garcia/Sun-Times
Sara Cawley, 16, a junior at Walter Payton College Preparatory High School, created a Google classroom for the school’s Positive Mental Health Association, a club she founded to allow students to talk about mental health.
Ashlee Rezin Garcia/Sun-Times

The National Alliance on Mental Illness of Chicago has seen that firsthand. In April last year, its helpline received 78 calls concerning people age 20 or younger, compared to 26 in April 2019 and 29 in 2018. The high volume of youth calls carried through the end of the year, with 62 in October 2020.

Youth calls are only a fraction of the calls NAMI Chicago receives, said Alexa James, the organization’s CEO. But many students feel powerless over back-to-school decisions and have lost support they found in trusted adults like teachers, coaches and advisers, James said.

Cawley said schools being closed hasn’t triggered her mental illnesses, something she attributes to medication and continual therapy that has helped her cope. But that hasn’t been the case with her friends or other members of the club.

“It’s not just the social isolation, but it’s also really hard for specifically CPS students because we’ve been spending eight hours on a computer every day for almost a year now,” Cawley said. “That’s just been, for a lot of people, a negative experience.”

Cawley said the district needs to prioritize getting older students back to school.

Not all students have been negatively impacted by remote learning. At Dr. Martin Luther King Jr. College Preparatory High School, school counselor Sarena Newby said many students have told her remote learning has worked well for them. Newby and school social worker Karyn L. Aguirre have been holding weekly wellness Wednesdays, a non-academic online meeting for students to relax and socialize.

Still, Aguirre said most students are “ready to get back into the building,” she said.

Prepping to return

Students who experience social or separation anxiety could struggle with the transition of returning to school during the pandemic, with some fearing something bad will happen to them or their families, said James of NAMI Chicago.

Others will dread having to return to an environment surrounded by classmates. Transparency throughout the reopening decision-making process is critical to helping ease that transition, she said. CPS is holding a virtual town hall for high school families from 5-6:30 p.m. Wednesday.

The CPS parent with the sophomore son, who attends a North Side school, said she doesn’t fault anyone for closing schools in March 2020, saying it was the “right thing to do at the time.” But a year later, her son is experiencing “tremendous anxiety” wondering if he’ll be able to return to the classroom this school year.

Her son tells her he has nothing to look forward to, she said, and feels they “took away all the good parts of high school and left us only with the work.”

“What we need is for schools to be open,” the CPS parent said. “At the very least, they need to commit that schools will be open in the fall, that anyone who wants to attend in person in the fall will be able to.”

People seeking mental health support can call NAMI Chicago’s Helpline at 833-626-4244 or the National Suicide Prevention Hotline at 800-273-8255.