Students whose schools reopened sooner during the pandemic had lower rates of mental health problems than those whose schools remained closed, a new study found.
Researchers at Harvard T.H. Chan School of Public Health analyzed health diagnoses and medical claims for 185,735 privately insurance children ages five to 18 in California over the months before and after their schools reopened. According to the study, nine months after schools reopened, the probability that a child would be seen by a provider for a mental health condition was reduced by 43% compared with the period when schools were closed. This included fewer diagnoses of depression, anxiety, and ADHD.
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“Because schools reopened on different timelines across California, this natural variation allowed us to observe differences in mental health trends between children who returned to in-person school earlier versus later,” said health economist Pelin Ozluk, the study’s first author.
Health care spending associated with mental health diagnoses also decreased. By the ninth month following a school’s reopening, non-drug medical spending decreased by 11%; spending on psychiatric drugs decreased by 8%; and spending on ADHD-specific drugs decreased by 5%. These effects were stronger among girls than boys, researchers said.
While previous studies have established that youth mental health declined during the pandemic, the Harvard researchers say most of those studies relied on surveys and anecdotes from small study populations. Senior author Dr. Rita Hamad, professor of social epidemiology and public policy, said the new findings suggest that officials in some parts of the country placed more focus on infection and transmission than the social impacts of keeping schools closed.
“This is definitely a piece of evidence that I wish we’d had at the beginning of the pandemic to inform the conversations we were having. I think the decisions may have been different if we had seen that the benefits of school closures were being outweighed by risks like this,” she said. “As we consider future public health emergencies, this study suggests we need to prioritize safe school reopenings and ensure children have access to the social and emotional resources that schools provide. Policies should focus not only on infection control, but also on the mental wellbeing of children, recognizing that schools are a critical part of their support system.”
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The researchers noted that the study population included only children in relatively higher income areas in California who had private insurance and relatively better access to health care.
“Further study is needed to assess the relationship between school reopening and mental health among marginalized groups, among whom effects may have been even greater,” they wrote.
