In 2019, 1 in 3 high school students reported prolonged and persistent feelings of sadness or hopelessness, according to the CDC. This was before they faced social isolation, academic challenges with remote learning, and unprecedented worry and uncertainty all brought about by the COVID-19 pandemic for much of the past 3 years. A growing number of children are suffering from emotional, behavioral, and developmental challenges, and schools are in a unique and favorable position to respond to their needs, provide care and support, and remove barriers to treatment. To foster resilience and promote optimal mental health, school professionals including school nurses, counselors, psychologists, and social workers, should maintain a flexible and collaborative whole-school approach.
Physical and mental health can be difficult to separate and the school nurse often sees the correlation or connection in students who frequently visit the school health office with somatic complaints like headache, abdominal pain, or fatigue. Additionally, visits to the health office may be associated with bullying, family problems, academic concerns, or socioeconomic stressors. Establishing healthy and trustworthy relationships with students and school staff, as well as being a voice and advocate for reducing stigma around mental health and implementing a school-wide approach to providing mental health care and support, sets the school nurse up to optimally promote and coordinate emotional and behavioral health in children.
Because of their position as trusted healthcare professionals and the general regard of the school health office as a safe setting, school nurses are frequently on the front lines of addressing student mental health complaints or concerns. According to the National Association of School Nurses, the school nurse should be equipped with the knowledge and skills to perform early assessments and screenings, care planning, interventions, and follow-ups when responding to the behavioral health needs of students. For many school nurses, it can be helpful to further expand their knowledge around general psychosocial skills, basic evidenced-based interventions, and appropriate mental health referral resources. Both Youth Mental Health First Aid and Psychological First Aid App are great places to brush up on how to best care for mental health-related school nurse visits. For school nurses working in schools that include K-6 students, NASN offers an Emotional Management Course that can serve to enhance the school nurse’s ability to identify and appropriately support and refer students with mental health concerns.
In a 2021 joint statement, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a “mental health state of emergency” for children and adolescents. In more recent months, initiatives for bolstering support for school-based mental health care, including programs and legislation to place mental health clinics in schools and raising awareness surrounding the youth mental health crisis, have gained momentum and emphasized addressing the numerous barriers to care. An example of this? In early 2022, a new law in the state of Illinois went into effect authorizing students ages 6 to 17 to take up to five mental health days off of school. Other states including Utah, Maine, Virginia, and Arizona have previously passed similar bills supporting mental health needs in schools, and numerous other states have started introducing comparable measures.
Establishing healthy and trustworthy relationships with students and school staff, as well as being a voice and advocate for reducing stigma around mental health and implementing a school-wide approach to providing mental health care and support, sets the school nurse up to optimally promote and coordinate emotional and behavioral health in children.
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