Survey: Most parents believe schools should have a mental health professional | Image Credit: © Seventyfour - © Seventyfour - stock.adobe.com.

In a nationally-representative survey that featured 1016 parents and caregivers of public school children in grades K-12, Action for Healthy Kids and the CDC Foundation found that almost 80% of parents believe schools should have an employed mental health professional at their child's school.^1,2

Action for Healthy Kids and the CDC Foundation asked parents and caregivers about what worries them most regarding the health of their child in a 48-question online survey that was fielded in December of 2023. The goal of the survey was to better understand parent's perceptions of safe school environments and determine how the school can play a role in providing mental health support, according to a press release from Action for Healthy Kids.^1,2

Overall, nearly two-thirds of parents welcome training to better understand their child's mental health and well-being. Having someone the child can trust in the classroom is key, as nearly 70% of parents reported that their child feels safe and supported when this person is present.¹

Survey participants feel school staffs can play a large role in the safety and health of their child, as the majority reported a safe and supportive school environment was associated with transparent communications, engaged school counselors and social workers, emotional skills, and physical safety.¹

The American Academy of Pediatrics (AAP) noted that schools have increasingly become one of the largest providers for mental health services among children, as a large portion of their lives are spent in the classroom. Additionally, the AAP estimates that 1 in 5 children have an emotional, mental, or behavioral disorder. More than 75% of treated children are treated in school.³

Nathaniel Beers, MD, MPA, FAAP, executive vice president, Community and Population Health, Children’s National Hospital; clinical professor of pediatrics, Children’s National Hospital, Washington DC, previously spoke with Contemporary Pediatrics to help navigate school-based mental health services.³

“Part of our job as pediatricians is to figure out and support patients and families as they are navigating that process to make sure that their child can be successful,” said Beers in part. “That [includes] thinking with them about what services a child might be eligible for in school, as a child is spending most of their waking hours in school." Click here for the full article, "Navigating school-based mental health services."³

According to the survey, parents felt the largest hurdle preventing their child from receiving mental health help at school is the child themself not thinking they need help to begin with.¹

In a Q+A interview with Contemporary Pediatrics, James Wallace, MD, associate professor, Department of Psychiatry and Pediatrics, University of Rochester Medical Center, Child and Adolescent Psychiatry Faculty Trainer, The REACH Institute, explained children who have experienced a significant trauma are at risk to have mental health issues.⁴

"Behavioral health problems have genetic and environmental components (nature and nurture), so they tend to run in families, especially when the whole family is struggling," Wallace said. "Those who have experienced adverse childhood events are at risk, as are children who have been bullied, who are engaged in substance use, or who are in the LBGQT+ community. Non-English speakers, recent immigrants, people of color and other minority groups are at risk due to chronic stressors. They also face complex barriers to adequate health and mental health services, so they suffer doubly with greater needs and worse access."

Among high school parents surveyed, 69% said they are worried about their child struggling with mental health, as did 64% of parents of middle school children, and 63% of elementary school children.¹

When questioned about their child's physical safety, 74% of high school parents were worried about a student or another individual bringing a weapon to school. Less parents (64% and 64%) of middle school and elementary school students were worried of an individual bringing a weapon to school, respectively.¹

Robert Murray, MD, vice chair, Action for Healthy Kids Board of Directors, spoke with Contemporary Pediatrics in a Q+A interview to further discuss parental awareness of mental health services in the classroom and how pediatric providers can play a role.

Murray was previously a member of the AAP's Council on School health and is the immediate past-president of the Ohio Chapter of the AAP.

Find the Q+A interview below.

Related: How the pediatrician can play a role in limiting school avoidance

Contemporary Pediatrics:

How important is it that there has seemed to be a shift in parents’ awareness of mental health services in schools, with a majority, based on the survey, wanting a better understanding of mental health and well-being? How can this impact increased services?

Robert Murray, MD:

Our experience with COVID-19 made all of us acutely aware of the importance of schools in the lives of children and teens. All of us, adults and children alike, felt the same isolation. Parents observed the lingering mental health toll on their children and looked to their school’s teachers, psychologists, nurses, and counselors for help. Mental health problems affect every aspect of a child’s daily life and behavior, including learning. Awareness has fueled a national discussion about what services we need to provide students today to ensure that they feel safe and supported.

Contemporary Pediatrics:

Can you speak to how general providers have played a role in this awareness? Are more providers discussing mental health at well visits?

Murray:

While recognizing the initial necessity, the community of pediatric health-care providers were the first to raise alarms about COVID school closures. Schools provide an essential daily structure for children and teens, including good nutrition, cognitive engagement, and crucial interpersonal relationships. Even though many children may have faced extreme adversities or live in highly stressful situations, there is in school the potential to mitigate it.

Parents are the most powerful advocates for their own children. Action for Healthy Kids encourages active, vocal engagement between parents and their child’s school. Talk with the child’s teachers, their school nurse, the principal, and guidance counselor to ensure that their child’s needs are met.

Mental health is a novel challenge for schools. By sharing research findings and advocating for more in-school services collaboratively, parents and teachers, pediatricians, and other child professionals, can help to recalibrate the school environment to better prevent mental health crises.

Contemporary Pediatrics:

What can pediatricians or general providers relay to parents when it comes to being involved with mental health and their respective schools? What tips can they give out, as they directly deal with parents and the patients?

Murray:
Schools alone cannot resolve every student’s stress. The out-of-school environment is just as important. Parents should encourage close interactions with family and friends, provide regular encouragement, offer high-quality nutrition at meals and snacks, promote active time spent outdoors and at-play along with in-home experiences that compete with time on screens or on social media. Arrange daily family dinner as part of an evening routine and, very importantly, establish a regular bedtime that guarantees sufficient sleep. These are fundamental to the well-being of children and adolescents alike.

Click here to learn more about Action for Healthy Kids.

References:

1. National Survey: Parents share worries about their child’s mental health and want resources to better understand and support their child. Action for Healthy Kids. Press release. May 15, 2024. Accessed June 17, 2024.

2. Parent and Child Mental Health Survey. Action for Health Kids. CDC Foundation. Accessed June 17, 2024. https://www.actionforhealthykids.org/wp-content/uploads/2022/11/Wave1-Survey-findings-final.pdf

3. Fitch, J. Navigating school-based mental health. Contemporary Pediatrics. February 9, 2024. Accessed June 17, 2024. https://www.contemporarypediatrics.com/view/navigating-school-based-mental-health-services

4. Fitch, J. The role of the pediatrician in school-based mental health services. Contemporary Pediatrics. February 28, 2024. Accessed June 17, 2024. https://www.contemporarypediatrics.com/view/the-role-of-the-pediatrician-in-school-based-mental-health-services