A new state-by-state report shows Indiana’s child well-being ranking has dropped — in part due to Hoosier kids’ dismal math and reading scores, as well as increased rates of youth deaths.

Although Indiana continues to rank in the bottom half of states for its rates of teen births and children living in high-poverty or in single-parent households, those numbers are showing improvement.

The 2024 KIDS COUNT Data Book ranked Indiana 27th among states, three places lower than last year. It’s still a slight improvement, however, compared to 2022 and 2021, when the state ranked 28th and 29th, respectively.

In specific categories covered in the latest report, Indiana came in 15th for economic well-being, 17th in education, 31st in family and community, and 32nd in health.

“Indiana has significant opportunities and challenges ahead in supporting the well-being of our children,” said Tami Silverman, president and CEO of the Indiana Youth Institute.

“We should celebrate the progress we’ve made, especially in economic well-being areas such as parental employment rates and housing affordability; and we must acknowledge the disparities that persist for our kids,” Silverman continued. “Every child in Indiana should have access to quality education, regardless of their background or circumstances. By addressing these disparities head-on, we not only invest in the future of our children but also in the economic prosperity of our state.”

The report is prepared by the Annie E. Casey Foundation in conjunction with organizations across the county, including the Indiana Youth Institute. It rates states in 16 wide-ranging areas, which are lumped together under the categories of health, education, economic well-being, and family and community support.

Gaps in reading and math

The education portion of the latest edition — focused on student achievement — reiterates low numbers familiar to Hoosier education officials.

Just 32% of fourth graders nationally were at or above proficiency in reading in 2022, the latest year for which numbers were available. That was down from the 34% who were proficient in 2019, before the onset of the COVID-19 pandemic.

Scores were even worse for eighth grade math. Nationwide, only 26% of eighth graders were at or above proficiency in math two years ago, down from 33% in 2019.

In Indiana, one-third of fourth graders performed at or above proficiency in reading — a four percentage-point decrease from the 2019 rate of 37%, the report showed.

Further, only 30% of Indiana eighth grade students performed at or above proficiency in math, marking an 11% decrease from 2019, ranking the state 11th nationally.

Among Indiana fourth graders in 2022, Black students had an average reading score that was 23 points lower than that of white students. Students eligible for the National School Lunch Program (NSLP) had an average reading score 18 points lower than those not eligible for NSLP, according to the KIDS COUNT report.

Meanwhile, eighth grade Black students in Indiana had an average math score that was 31 points lower than white students. Hispanic students in the same grade had an average math score that was 19 points lower than their white peers.

The Casey Foundation report contends that the pandemic is not the sole cause of lower test scores, though. Rather, the foundation says educators, researchers, policymakers and employers who track students’ academic readiness have been ringing alarm bells “for a long time.”

U.S. scores in reading and math have barely budged in decades. In Indiana, state education officials have repeatedly pointed out that Hoosier literacy exam scores have been on the decline since 2015.

During the 2024 legislative session, state lawmakers took decisive action as part of an ongoing push to improve literacy and K-12 student performance.

Paramount among the new laws passed was one to require reading-deficient third graders to be held back a year in school.

Stats on youth health and family life

Health-focused portions of the report show that — after peaking in 2021 — the national child and teen death rate stabilized at 30 deaths per 100,000 children and youth ages 1 to 19.

But in Indiana, the death rate has continued to rise. While 29 deaths per 100,000 Hoosier children and youth were recorded in 2019, the rate increased to 36 deaths in 2022, per the report.

The Indiana Youth Institute (IYI) has already drawn attention, for example, to higher rates of mental health crises such as depression and suicidal ideation among the state’s youth. According to IYI data, one out of every three students from 7th to 12th grade reported experiencing persistent sadness and hopelessness. One out of seven students made a plan to commit suicide.

The most recent data available additionally show that nationwide and in Indiana, the child poverty rate improved and economic security of parents increased back to pre-pandemic levels.

Between 2018 and 2022, roughly 113,000 — or 7% — of Hoosier children were reportedly living in high-poverty areas. That’s a drop from 10% between 2013 and 2017, according to the report.

From 2019 to 2022, teen births per 1,000 declined from 21 to 17, and the percentage of children in single-parent families also dropped from 35% to 32%.

Still, some gains

Advocates pointed to “some bright spots” for Hoosier kids and their families in this year’s national report, as well:

Between 2019 and 2022, more parents (75%) had full-time secure employment in Indiana — which surpassed both the national average and that of the four neighboring states: Illinois, Kentucky, Michigan and Ohio.

In 2022, fewer children (22%) lived in households that faced a high housing cost burden, spending 30% of their income solely on housing expenses, in comparison to the national average (30%).
In 2022, more Hoosier teens (95%) between the ages 16 and 19 were either enrolled in school or employed, an improvement from 93% in 2019.
Far fewer children under 19 (5%) were also uninsured. Indiana saw the fifth-highest decrease nationally in uninsured children between 2019 and 2022 — a 29% improvement.

The report offers several recommendations for policymakers, school leaders and educators that include chronicling absenteeism data by grade, establishing a culture to pursue evidence-based solutions and incorporating intensive, in-person tutoring to align with the school curriculum.

“Kids of all ages and grades must have what they need to learn each day, such as enough food and sleep and a safe way to get to school, as well as the additional resources they might need to perform at their highest potential and thrive, like tutoring and mental health services,” said Lisa Hamilton, president and CEO of the Annie E. Casey Foundation. “Our policies and priorities have not focused on these factors in preparing young people for the economy, short-changing a whole generation.”

Indiana Capital Chronicle is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Indiana Capital Chronicle maintains editorial independence. Contact Editor Niki Kelly for questions: info@indianacapitalchronicle.com. Follow Indiana Capital Chronicle on Facebook and Twitter.

One-third of LGBTQ youth outed to their families were more likely to report major symptoms of depression than those who weren’t, according to the University of Connecticut research. Transgender and nonbinary youth who were outed to their parents reported both the highest levels of depression symptoms and lowest amount of family support. 

The first research to link teens’ nonconsensual disclosure of sexual orientation or gender identity to poor mental health, the report also found 69% said the experience was extremely stressful. Forcibly outed youth also reported low levels of family support. 

Since 2022, eight states have passed laws requiring schools to out transgender students to their families, potentially affecting more than 17,000 young people: Idaho, North Dakota, Iowa, Indiana, Tennessee, North Carolina, South Carolina and Alabama. Proponents say the measures are necessary to uphold parents’ right to information about their kids. LGBTQ and mental health advocates counter that the laws violate students’ privacy rights and can put them in danger of being abused or thrown out of their homes. 

Forced outing “is a relatively common experience, and we need to understand more about it,” says Peter McCauley, a doctoral candidate at UConn. “People should be coming out under their own terms.” 

The data, McCauley says, bolsters research on why queer students who are victimized in school often don’t seek help. According to research cited in the new report, 44% of LGBTQ youth say they have not reported harassment to an adult at school out of fear their parents would learn their identity. A majority of sexual-minority teen boys were threatened with outing by peers.

The new report used data from a survey of some 9,300 queer youth ages 13 to 17 collected in 2017 by the Human Rights Campaign and the university’s Department of Human Development and Family Sciences. Two-thirds of respondents identified as cisgender, and 70% said their LGBTQ status was not involuntarily disclosed to their families. Of those not outed, 36% said their parents did not know they were not heterosexual. Nearly half of gender-nonconforming students said they were not out to their families. 

The survey found no significant racial differences in the stress of being outed. Youth whose parents had postgraduate degrees reported few depressive symptoms and high family support. 

Previous surveys by The Trevor Project, GLSEN and other advocacy groups consistently find that nearly all LGBTQ youth say they are harassed at school — which many nonetheless say is a more supportive environment than home. Fewer than four in 10 queer youth say their homes are LGBTQ-affirming.

There is evidence that people who disclose their sexual and gender identities in adolescence experience less depression and greater life satisfaction in adulthood. But not all teens who come out do so to their families. Some share with friends or trusted adults other than their parents. Youth are often reluctant to come out because they have heard their caregivers talk negatively about LGBTQ people or issues.

In addition to the eight states that mandate outing, Florida, Arizona, Utah, Montana and Kentucky — which collectively are home to a quarter-million LGBTQ youth — have new laws that critics say encourage involuntary disclosure of students’ sexual orientation or gender identity. These measures mandate discipline for educators who “encourage or coerce” children to withhold information from their families, stop schools from “discouraging or prohibiting” parental notification about pupils’ well-being and grant caregivers broad access to mental health and other records. 

Fights over forced outing are also playing out at a local level throughout the country. In at least six states, families who believe student privacy protections violate their parental rights have sued districts. So far, none of the suits has succeeded.  

A Houston Landing investigation found that during the first two months after mandatory parental notification went into effect in August 2023 in Texas’ Katy Independent School District, 19 students were outed. After the story was published, the U.S. Department of Education opened a Title IX investigation into the district’s actions, which local advocates had complained discriminated on the basis of gender. 

At least six California districts require schools to disclose a range of information. In January, California Attorney General Rob Bonta warned districts that parental notification policies violate the state’s constitution and education laws. The admonition came after a judge’s October 2023 order temporarily halting the enforcement of an outing rule in Chino. 

As legislation seeking to restrict LGBTQ students’ rights has swept statehouses in recent years, the number of states fully administering the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System — the nation’s chief survey of young people’s welfare — has fallen. Some states, such as Florida, stopped participating altogether, while others refuse to ask questions about sexual orientation, gender identity, mental health and suicidality.

“Perhaps it’s the cell phones?” we wonder. “And the TikTok?” 

Sure, screens — and how kids engage with them — are part of this story. And yet, and especially, America tolerates relatively high levels of child poverty compared to peer nations. Nearly 50% of U.S. students qualify for free or reduced-price lunch subsidies because of their families’ low incomes. And yet, as has become custom, Congress recently missed a bipartisan opportunity to do something about this shameful, persistent American problem. 

To explain this latest congressional stumble, we need some history. In 2021, the Biden administration’s American Rescue Plan cut U.S. child poverty rates nearly in half by significantly expanding the country’s child tax credit. Critically, the expanded credit was administered in monthly payments, giving families a steady stream of new resources instead of a once-annually infusion at tax time. As Dr. Shantel Meek and I put it in a February 2022 analysis, “[M]easured against its goal, the expansion of the child tax credit is one of the great policy successes in recent memory. Few other big federal ideas have so suddenly achieved precisely what they intended.” 

But the measure expired after one year, and several efforts to reinstate it have floundered in Congress. 

Then, this year, a bipartisan group of House representatives drafted a compromise measure giving progressives a partial reinstatement of the expanded credit in return for a handful of corporate tax breaks prized by conservatives. The bill passed with strong bipartisan support in the House, but lost steam in the Senate — at least partly because of conservative concerns that it might help President Biden in an election year. “I think passing a tax bill that makes the president look good — may allow checks before the election — means that he can be reelected and then we won’t extend the 2017 tax cuts,” Sen. Chuck Grassley. (R-Iowa), told The Washington Post. 

Whatever else you think is causing young Americans’ pessimism these days, it pales in comparison with the impact of this sort of cynicism. Put aside the hand wringing about culture wars and polarization and “woke” indoctrination embedded into K–12 history curricula. U.S. kids don’t distrust Congress because their schools tell them an honest account of America’s complicated past. They distrust Congress because, when confronted with a tested policy solution to a substantive problem that affects their lives, elected representatives dither and find politically expedient excuses. 

Make no mistake: the case for providing cash support for families with young children is empirically airtight. Researchers have known since at least the 1966 publication of the famous Coleman Report that families’ socioeconomic resources significantly shape children’s educational performance and outcomes. Studies suggest that increases in family income produce better developmental, academic and life outcomes for children. As a policy matter, regular cash transfers to families like the Biden Administration’s expanded child tax credit —known as “child allowances” — appear to be a particularly efficient way to pull children and families out of intergenerational poverty. 

At this point in the waves of evidence, conservatives sometimes argue that, sure, perhaps there’s a case for investing more funding in low-income families, but only if we apply conditions and require that it be spent on particular things. Won’t families “waste” new resources unproductively? But this, too, is cynical and baseless political posturing: analysis showed that families overwhelmingly used their expanded child tax credit dollars on urgent, eminently reasonable necessities.

And yet, here we are, stuck. Legislative failures like these are the operational definition of a failing democracy. When democracies struggle to do simple things that we know would improve citizens’ — especially children’s — lives, they’re undermining their main institutional selling point. If representative government cannot accurately represent the public’s interest by identifying and addressing its problems, why bother with the messiness of organizing our political lives this way?
U.S. kids are not alright. But it’s not just because they’re living in an information sphere increasingly shaped by technology. Without a shift to a more pragmatic approach to these problems, that trust will only continue dropping — however well legislative sclerosis serves conservatives’ short-term political needs.

Gray grew up in the 1950s, when children were expected to spend long hours between school and dinner unsupervised. Afternoon games of Double Dutch and Red Rover became a hallmark memory for Baby Boomers, but they were only a few generations removed from the advent of Progressive labor laws that established minimum working ages and redefined childhood in America as a protected phase of life. 

Surveying the restrictions on children’s freedom today, he believes we’ve spent much of the last few decades moving backwards. “We’re basically back in the age of child labor again,” Gray said. “But it’s labor we’re imposing because we believe it’s good for children.”

A research psychologist at Boston College, Gray has spent his career studying the effects of free, unstructured play on young people — and what happens when it is edged out by activities overseen by adults, especially school. Abundant data suggest that children now spend much less time outside making friends and inventing games, and much more at home, doing homework and absorbing media under the watch of their parents.

The results have been catastrophic for their development and wellbeing, he has found. In an analysis published last September in the Journal of Pediatrics, Gray and several co-authors argue that the contraction of kids’ independent activity since the 1960s has made them markedly less resilient and triggered a well-documented rise in mental health disorders like depression and anxiety. He advances many of the same claims in a regularly updated Substack on play and happiness, where he critiques everything from Little League sports to the curtailment of school lunch periods.

Notable is the theory of social harm that Gray dismisses out of hand: the supposedly pernicious effects of smartphones and social media, which have increasingly come under scrutiny as experts complain that they monopolize kids’ time and attention. While some of the same critics share his views on the importance of play, he calls the data implicating addictive technology unpersuasive. 

Indeed, he argues, warnings about excessive screen time are worse than wrong — they’re a deflection from the ways in which adults have re-engineered the world around kids to exclude and control them. 

“It’s really the first time in human history that children have not been free to do a lot of independent things,” Gray said in a conversation with The 74’s Kevin Mahnken. “Children are designed to grow up with independence, so over the last few decades, we’ve been doing things in a way that’s historically abnormal.”

This interview has been lightly edited for clarity.

The 74: What is the relationship between unsupervised play and mental health, both in childhood and later life?

Peter Gray: There are certain obvious ways in which play is essential for mental health. First, play makes kids happy, and you really don’t have to do research to know that. If you take play away from kids, they’re a lot less happy, and the lack of happiness is a big part of depression. About this part there should be no mystery.

But play does more than make children immediately happy. It is also the means by which they acquire life skills and learn to make friends. It’s the means by which they learn to direct their own activities. In the process of doing that, they have to learn how to negotiate with their playmates, deal with disagreements and minor bullying, and so forth. If we’re supervising children all the time and not allowing them opportunities to solve their own problems, they grow up without the kinds of character traits and skills needed to deal with the bumps in the road of life.

So that’s the general hypothesis. But what not everybody knows is that, over several decades, there has been a continuous decline in children’s opportunities to play freely. Over the same decades, there has also been an increase in anxiety, depression, and suicide among children and adolescents. That doesn’t prove that one thing is caused by the other, but even from a theoretical position, it seems fairly clear that there’s a cause-effect relationship here: Play makes children happy and resilient, we’ve been taking play away from children, and, lo and behold, children are becoming less happy and psychologically resilient. 

What is the evidence that children’s play has declined in recent years? Is it clear in other countries as well as the United States?

It’s declined in the U.S. and some other countries, but it’s not universal by any means. 
Some of the most interesting evidence comes from the sociologist Markella Rutherford, who wrote a book called Adult Supervision Required. Her approach was to analyze articles and letters about children in parenting magazines — Good Housekeeping, for example, has been published almost 150 years — and look at the way people thought about play. What she found was that, through the first half of the 20th century, there was a lot of emphasis on independence. It was recommended that kids walk to their kindergartens and go to the grocery store when milk was running low, and they should be encouraged if they were afraid to do those things.

The advice from those sources was less likely to advocate for independence in the 1960s, and by the ’80s, things were changing quite dramatically. The very things that were previously recognized as important for kids to do independently were now seen as dangerous, and there was much more precaution about danger.

There is also data showing that lots of students used to walk or bicycle to school until the 1980s, when that declined sharply. Now we even have situations where people think that letting an eight-year-old walk to school is negligent, so parents send their children out and then get a call from police. 

This has all been a social experiment that obviously failed. It’s really the first time in human history that children have not been free to do a lot of independent things. Children are designed to grow up with independence, so over the last few decades, we’ve been doing things in a way that’s historically abnormal.

What would you say is normal in the history of human societies? Is it really true that kids have always enjoyed the freedoms of youth?

As part of my research, I have surveyed anthropologists who study hunter-gatherer cultures in seven different cultures across three continents. Even through the 20th century, there were still quite a number of people living that way.

Every one of the researchers told me that children were free to play and explore essentially all the time. Very little work, if any, was expected even of teenagers, and you were basically seen as a child until you had children of your own. Children explored, they tended to play at the things important to their cultures, the older kids looked after the younger ones, and the adults understood that this is how kids learn. In my mind, that’s the biologically natural way that children grew up across history. For 99 percent of our history, we were hunter-gatherers.

The anthropologist David Lancy, who co-authored our article about mental health and the decline in play, is one of the big experts on children around the world. He has found that certain cultures, more so than hunter-gatherers, do expect some work from children. But that work is independent activity; there isn’t an adult running alongside them and telling them what to do. If it’s a farming culture, kids help with the farming, or they haul and chop wood. And even in the context of those chores, they’re doing it with other kids, and there is play as well. The idea of parents following children around and micromanaging their activities is just not something that happens in many cultures.

You refer to historian Howard Chudacoff’s idea that the early 20th century was a “golden age of unstructured play.” But what about the 19th century, when lots of very young kids had to work outside of their homes? I’ve read enough Dickens to know that wasn’t a terrific time to be a kid.

You bring up a terrible time in history, the Industrial Age, where many children worked in factories amid tremendous poverty. But although it’s not a life we would want for our kids, I think those Dickens characters do play. In a Dickens novel, they have to be incredibly independent — to pick pockets, God forbid — and take risks and collaborate with other kids to figure out how to survive. So it’s a very different situation than what we have now, even if it is not the ideal. 

The way I’d put it is that our children are now less free to engage in independent activities than they have ever been, except in times of childhood slavery and the sort of sweatshop work that was fairly common in this country until about a century ago. The golden age of play in America came from our decision to end intensive labor for children and make them, in a way, more like children in hunter-gatherer cultures; they could explore and play in age-mixed groups around their neighborhoods. It was a sort of return to what a normal childhood looks like.

But Chudacoff, who wrote a great history of play in America, points out that we gradually took those freedoms away. When you count school and homework, kids are basically doing the equivalent of a full-time job. We’re basically back in the age of child labor again, but this time, it’s labor we’re imposing because we believe it’s good for children.

Don’t you think a lot of parents, while perhaps agreeing that kids are over-scheduled these days, would also point out that they really are much more likely to survive the risks of childhood and grow into adulthood in 2024 than in 1924? Maybe that’s a price we should be willing to pay.

Well, we’ve got vaccines and modern medicine now, and we’ve cleaned up the environment to a degree. We have much less desperate poverty than we once did, so that helps as well. Those are the main reasons why more children grow into adulthood.

Here’s another way of looking at it. Despite the fact that the first half of the 20th century was not an easy time — you’ve got world wars, the Great Depression, a lot of other problems — children seem to have been much happier then than they are now. We don’t have perfect evidence for all these outcomes, but we know the suicide rate for kids and teenagers was way lower then than it is now. Life was pretty rough, but they didn’t seem to suffer then as they do now. 

So what changed?

Between 1950 and 1990, school added more hours. By 1990, the school year was five weeks longer than it had been, and the school day was generally longer. You started seeing homework for elementary schoolers, who mostly hadn’t had it before. There was far less competition and worrying about grades back then. The combined result is that we’ve gradually increased what I call the “weight” of school, and the amount of time children spend on it.

We also began to believe that children were better off playing adult-directed sports than going out and making up their own games. We started Little League and all these other sports, and parents started thinking, “Better to get my kid into that than just have them go out and play.” But when you’re just making up your own games, as I did in the 1950s, you learn a lot more than you do when there’s an adult to take charge. You’re learning to create rules and keep everybody happy — particularly the people on the other team, who will go home if they’re not happy. All that is lost in a more organized setting. Little League is a great place to learn to bunt, or slide into second base, or throw a curveball, but it’s not a great place to learn anything else. 

Television would be another example. My family got a TV in 1954 or so, right when the Mickey Mouse Club started up. Before that, my friends and I would hang out after school or go fishing. But after, a lot of us would go home and watch whatever was on. It drew kids indoors, where they weren’t playing or exploring.

It seems like parents have become more worried about their kids’ safety as well.

A couple things occurred in the 1980s that played a big role in that. 

In 1979 and 1981, there were two highly publicized cases of young boys being kidnapped and murdered. Of course, those cases made news precisely because they were so rare. But they had a huge effect, and I still remember seeing pictures of kids on the sides of milk cartons in those years. As it turns out, the vast majority of those cases were runaways, and when kids are snatched away, it’s almost never by strangers. But the term “stranger danger” came into use, and when surveys asked parents why they wouldn’t send their kids out, they would cite fear of strangers. 

We talk a lot about helicopter parenting, but I don’t blame parents for this. The society has evolved in a way that changed cultural norms, and parents who try to resist those norms find it very hard to do so. 

I notice you tallied a huge list of factors without mentioning the ascendant thesis for youth behavior and mental health problems: the emergence of smartphones and social media. Do you believe they’ve been overhyped as an explanation?

I’ve looked at the papers in this area, especially the review papers. And if you want to dig out the research supporting the theory that technology is the main driver of our youth mental health problems, you can make a pretty compelling case. But you’d be cherry-picking.

There are so many studies trying to find a link between social media use and anxieties in girls, boys, people of different ages. People have tried to find a simple correlation: Are people who use social media a lot also more likely to be depressed? Some studies show a positive correlation with measures of anxiety, and some studies show a negative correlation. In a lot of studies, it kind of washes out. To me, there’s no really compelling evidence based on the correlational data.

In something of an acknowledgment of this, there’s been a search for other kinds of evidence. People point to experiments where people who say they’re anxious will agree to stop using social media for a period of time. They rate their anxiety levels at the beginning and the end, and what is often found is that those who stopped social media say they’re a bit less anxious. 

But there are two things wrong with these kinds of studies that anyone involved with research should know. The first is that when subjects involved in an experiment know what the purpose of that experiment is, most of them will be motivated to confirm the hypothesis. In this experiment, the hypothesis was very clear and couldn’t have been hidden. Countless social-psychological studies show that when subjects in an experiment believe something is going to happen, they make it happen. This is called the demand effect.

Second is the placebo effect. One of the reasons drug companies have such difficulty getting drugs approved for anxiety or depression is that these are extraordinarily subjective conditions. How anxious does a person feel? Well, if you believe you’re doing something good for you — like taking a drug — you’re quite likely to feel less anxious. In this case, college kids had undoubtedly heard that social media makes people anxious, and as part of their desire to be part of the experiment, they undoubtedly felt that it would be a good way to reduce their anxiety. 

The proponents of the social media theory have also found a few other countries where anxiety and depression increased over the same period that kids started using smartphones and social media. Apparently this is true in the U.K., Australia and a few other places. But I’ve looked at data from the European Union, who are not deprived of technology or the internet, and if you take all the countries of the EU together, there has not been an increase in anxiety, depression, or suicide over the same years. 

Taken together, I think this is just not compelling evidence.

But the more time kids spend on devices, the less they spend in the kind of unstructured, in-person play that you argue is crucial. Isn’t this just the modern equivalent of the television example you mentioned earlier?

There’s a difference between television and what kids today are using. The technology they’re using is far more interactive than TV, and a lot of it is essentially play. They’re not just doing social media, they’re communicating with one another.

There was a systematic study done near the beginning of the social media stage of teen life. The authors surveyed teens across the country about why they spent so much time on social media instead of getting together in person. Across the country, teen after teen said, “I’d love to get together, but I’m not allowed to go out.” Or: “My friend isn’t allowed to go out. This is the only way we can communicate.” That was already true in the early 2010s.

Teens, especially, need to hang out together away from adults. Thinking about when my son was a teenager, you’d see gangs of teens hanging out in malls. That’s what teens need to do! They need to get away from adults, to talk to one another in ways they don’t want their parents to hear. But we’ve created a world where they can’t really do that, except by way of the internet. In other words, I don’t think they’re on social media instead of getting together; they’re on social media because they can’t get together.

I will admit to being concerned that we’re raising kids who don’t even know about the possibilities for getting together because no one else is doing it. By this point, even some young parents didn’t have much chance themselves to socialize independently when they were kids, so they grew up thinking the only way to communicate with your friends is on a smartphone.

Do you think that can be even partially reversed?

I’m involved with a group called Let Grow, and we help organize play clubs at schools. It’s an hour of mixed-age free play for all the kids in an elementary school. Everyone plays at once. There are lots of different ways of playing, but there are two rules: no hurting anybody, and no phones. It’s been extraordinarily successful, as are summer camps when phones are removed. In places like these, where kids can interact with one another freely, it’s not a bad idea to ban phones. 

Instead of speculating about what makes kids anxious, you can look at surveys that ask them directly about what makes them anxious. The great majority say school, and nothing else comes close. The American Psychological Association did a study in 2013 that surveyed teens about their anxiety levels, which were very high. But they were much higher during the school year than the summer, and when asked what the source of their anxiety was, something like 83 percent listed school. The thing that came in second, among high schoolers, was fear about getting into a good college and having a decent future.

The reality is, we’ve frightened children by imposing this pressure and telling them that they’ve got to perform so well academically or else their life will be worthless.

You’ve written a bit about the changing structure of the school day. Can you go into more detail about how you believe the experience of school has evolved in a way that’s unhealthy to kids’ development and wellbeing?

In one of my recent Substack threads, I asked my readers when they attended K–12 schools and how long the lunch period was when they attended. I believe historical data would confirm this, but just based on the information I collected, lunchtime ran about 60 minutes from the 1950s to the 1980s. Then it suddenly went down, to around 35 minutes in the ’90s. Nowadays, the average that I’m seeing is about 30 minutes, though it appears there are schools that only provide 20 minutes. 

Twenty minutes isn’t a lot of time to wash your hands, stand in line for food, find a seat, and eat. Lunch hour used to be a time to hang out with friends, and now it’s not even a time to eat your lunch. Studies show that a lot of the federally mandated meals we provide to students are getting thrown out because kids don’t have time to eat them. Would we, as adults, stand for it if we were being treated this way? 

In some schools, recess has been cut out entirely, and in many, it’s only 15 minutes long. This certainly wasn’t a rule, but I remember having a half-hour of recess in the morning and afternoon in the fifth and sixth grade, along with a whole hour for lunch. So of our six hours of school each day, two were spent playing or socializing in whatever way we wanted. It’s now so strictly controlled in some schools, it’s really wrong to call it play.

In many schools, we have also taken away the things that were thought of as fun because of the concern over standardized test scores. Music and art classes have often been reduced so that more time could be devoted to subjects that are measured by the tests. It’s really time to evaluate the effects of No Child Left Behind and Common Core not just on test scores, but also on children’s emotions. I think the whole push around social media and smartphones is a distraction from the real problem. 

What is your advice for families trying to swim against these currents? I know you’re working with people like Lenore Skenazy to develop strategies for fostering more independence and resilience in kids, but so many parents complain that their communities just aren’t that kid-friendly.

It’s true that lots of people don’t feel they can, like parents in the past, just send their kids out to play. Among other reasons, there aren’t as many kids to play with.

Still, one of the things I advise parents is to get together with others in their neighborhood — granted, this works more for little kids than teens — and talk to them about the importance of real, physical play. Every Saturday afternoon, and maybe certain hours each weekday, everyone in the neighborhood should send their kids outdoors and not intervene unless it’s absolutely necessary for safety. And you have to keep the phones at home because many of the kids never had the opportunity to learn how to play without them.

If there’s a PTA or some venue where you can influence your school, get the school to start after-school or before-school play clubs through Let Grow. It’s still a small minority of schools doing this, but I’d like to see it at every school. It’s safe because there are adults there, but they’re trained not to intervene while kids play. It’s working beautifully where it’s being done.

And it’s possible to encourage this in other settings. More and more libraries are offering play opportunities, including even outdoor play. One in Austin hangs out a sign saying, “Joyful noise welcome!” They have kids playing inside and outside the library, and if adults bring kids, the librarians just let them know that play is for kids, and there’s a separate space for parents. Kids gather there, sometimes a hundred at once, from the ages of three or four to the early teen years. I would love to see more of that, and parents can simply go to their local library to ask about it.

There are lots of things that used to be much more common because American society isn’t as child-friendly as it used to be. In one of the towns I grew up in, there was a public park that essentially ran a free day camp all through the summer. A supervisor worked there who was probably just a teenager, and he would hand out equipment for games or crafts or whatever you wanted to do. It was free, and parents felt comfortable about their kids spending all day there because there was an adult around.

We could do all this easily. In terms of budgets, the cost of it would be a drop in the bucket compared with what we spend on schools. Unfortunately, we’re not going back to a situation where parents can just send their kids out with, more or less, total freedom. But we might get to a place where they feel comfortable not being there while their kids are playing — if there is a responsible adult there who can contact them and who knows how to handle emergencies. 

I believe we could get there if parents are willing to lobby for it.

This story mentions suicide.  If you or someone you know is contemplating suicide, please call or text the National Suicide and Crisis Lifeline at 988.

LOUISVILLE — Anthem Medicaid announced Wednesday it has launched a free digital mental wellness course, which is available to 1,512 students in 17 Kentucky schools.

The announcement comes during Mental Health Awareness month and as more adolescents, especially girls, report depressive symptoms.

Called “Understanding Mental Wellness,” the interactive program is for students in grades eight to 10. According to EVERFI from Blackbaud, which designed the course, it contains six lessons, each 15 minutes long.

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The course, Anthem says, exposes students “to the experiences of others in order to develop awareness and empathy, reduce stigma, and provide facts on the prevalence and symptoms of mental health conditions.”

Students then “explore their own mental health, identify challenges they may face, and develop concrete strategies for managing those challenges while increasing their awareness of resources and empowering them with the knowledge, skills, and language necessary to identify and support a peer in need or at risk.”

Online previews of the course show a tour of mental health through the program, starting with a lesson on what mental health is and ending with the chance to create a personal wellness plan.

Since the onset of COVID-19, mental health has worsened. In 2021, the Centers for Disease Control and Prevention found that sadness and hopelessness had increased from pre-pandemic levels, especially for teen girls. In 2017, 41% of female high school students and 21% of male high school students felt sad or hopeless. By 2021, those statistics were at 57% and 29%, respectively.

“Young people need resources and education from trusted sources to protect their mental health,” Leon Lamoreaux, market president for Anthem Medicaid, said in a statement.

The Understanding Mental Wellness program “will help us reach students from all over the Commonwealth and equip them with tools and strategies that will make a positive difference in their lives for years to come,” Lamoreaux said.

Tom Davidson, the CEO of EVERFI, said the goal in creating this program was to “(benefit) those who are impacted by mental health challenges, those who want to build and maintain positive mental health and those who have the opportunity to positively impact the mental health of a friend or peer.”

Kentucky Lantern is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Kentucky Lantern maintains editorial independence. Contact Editor Jamie Lucke for questions: info@kentuckylantern.com. Follow Kentucky Lantern on Facebook and Twitter.

The research, led by a prominent expert in the burgeoning field of happiness economics, is attracting attention as authorities in the United States and several other countries voice louder concerns about the influence of technology on kids. Its conclusions could add to the calls for more strict regulation of their access to social media, which have already led to phone bans in classrooms and contentious hearings in Congress about the fate of TikTok. 

In February, Dartmouth College economist David Blanchflower released a working paper that used survey evidence to show a pronounced increase in sadness and hopelessness over the past 15 years affecting people between the ages of 14 and 24. That trend mirrored a similar and dramatic rise in the time that young people, and especially young women, spent in front of a television, computer, smartphone, or gaming console over the same years.

All told, in 2022, more than 10 percent of young women said that they had a “bad mental health day” every day of the preceding month, a threefold uptick from the levels measured in 1993. Meanwhile, the proportion of young women absorbing four or more hours of screen time each day climbed from 8 percent in 2003 to 61 percent in 2022. 

In an interview, Blanchflower called the twin developments “a crisis of our kids” that would harm their ability to lead worthwhile lives and hamper social progress in the long run. While the tight correlation between rising unhappiness and the growth of screen time isn’t enough to decide the question of whether one causes the other, he added, the relationship was too obvious, and too dangerous, to ignore.

“You need a variable that starts in 2011 and is especially true for women, and you get screen time,” he said. “I don’t know of anything else, so if that’s not it, what is it?”

Blanchflower is hardly the first to offer this hypothesis. In the mid-2010s, just as American children’s declining mental health began to be noticed by both experts and the public, psychologist Jean Twenge accused smartphones of “destroying a generation” of kids. More recently, she has been joined by social psychologist and author Jonathan Haidt, whose new book, The Anxious Generation, levels a similar indictment. 

But with the arrival of Blanchflower’s critique, one of the world’s leading economists has entered the chat. And while pointing to similar data and results, his conclusions paint a distinctly new picture of the emotional trajectory experienced by much of the world’s population. Hundreds of studies previously tracked a consistent pattern to people’s long-term moods — one in which most start off relatively happy, become somewhat less so in their 40s and 50s, and then rebound later — but those rhythms have, for the moment, been upended.

Still, not all observers are as convinced as Blanchflower that technological shocks lie at the heart of the problem. While conceding that an excess of social media very likely leads to harmful consequences, researcher and commentator Will Rinehart said it would be exceedingly difficult to identify their exact effects, let alone change them for the better.

“The technology itself brings new social opportunities and new ways of interacting with your peers,” said Rinehart, a senior fellow at the right-leaning American Enterprise Institute. “When that box is open, it’s kind of impossible to shut it again.”

The shape of happiness

Blanchflower, a labor economist who gained public recognition by accurately forecasting the 2008 recession as an advisor to the Bank of England, has spent much of his career studying the economics of happiness — essentially an inquiry into the welfare and life satisfaction of people around the world. 

Such questions have often been left to psychologists, who traditionally take a broader view than social scientists of human motivation and behavior. As more economists expanded the sub-field, however, they generated new insights about the growing happiness of African Americans compared to whites and the particularly adverse reactions of women to the experience of the pandemic.

Perhaps the most noteworthy finding has been that people tend to experience their greatest happiness in both childhood and old age, while enduring a trough during midlife. That consistent dropoff, usually coincident with the growing responsibilities of career and parenthood, is referred to as the “U-shape” of personal well-being — high on either side, low in the middle. Its reverse, a depiction of negative emotion, would be conceived as a “hump shape.”

But according to another paper, released by Blanchflower and his co-authors earlier this month, those descriptions are no longer accurate. In an analysis of over 1.4 million survey responses across 34 countries, Blanchflower and his collaborators discovered that young adults’ widely-reported increase in fear, depression, and anxiety in recent years has contorted the hump shape of unhappiness; instead, people appear to be most unhappy around age 18 and become less so as time goes on.

Blanchflower said that reports of freefalling indicators of mental health for teenagers and young adults, including increased hospitalizations for self-harm and greater suicidality, led him to check on the latest data from benchmark surveys such as the Centers for Disease Control’s Behavioral Risk Factor Surveillance System, which conducts health-related interviews with 400,000 adults every year. The results from the past half-decade were eye-opening, he recalled, and were equally present in figures from the United Kingdom as well as the United States.

“I got in there early and said, ‘I’d better take a look at this because I’ve got endless research saying there’s a happiness U-shape,’” he said. “And I started to look and said, ‘Holy moly, it’s gone!’” People in their late teens and early 20s are now the most likely to report experiencing despair, with people in their late 60s and early 70s substantially less apt to say the same.

An additional overview of findings from the Global Mind Project, which polls a vast swath of international respondents, also demonstrated a steep rise in fear, anxiety, and suicidal thoughts among adults in dozens of countries (again including the U.K. and the U.S.).

COVID has often been cited as a major force playing on the anxieties of young people. But the survey responses strongly indicate that the pandemic actually accelerated pre-existing trends, Blanchflower and his co-authors noted. The sense of displacement brought on by online instruction in the early 2020s may have only intensified the same alienation triggered by online interaction in the 2010s. 

Devorah Heitner is a parent and author who has personally canvassed children around the country to learn how they and their peers navigate a world mediated by screens and social networks. While intermittently skeptical of the most vocal critics of smartphones and social media, including Twenge, she said many young people express a desire to limit their interactions with technology.

“Kids are very aware of their relationships with their phones,” said Heitner, whose book on the virtual lives of kids, Growing Up in Public, became a bestseller last year. “They wish they could take a break from it, or that they could get their friends to use them less.”

The ‘cost of not doing something’

Educators, parents, and politicians are increasingly open to considering restrictions on how children can engage with the internet and social media.

In Florida, Republican Gov. Ron DeSantis recently signed a law banning social media accounts for children younger than 14 and requiring 14- and 15-year-olds to obtain parental permission. Last month, the U.S. House of Representatives passed a bill that would force the sale of the Chinese-owned platform TikTok, citing concerns both about users’ data security and the app’s effects on its youngest users. (The proposal has since been tied to a comprehensive package of foreign aid that is expected to win approval in the Senate.)

Heitner said that social media companies should curb their most “manipulative” features, including location sharing, which allows users to see where their friends are at a given time. Yet she also believes that full-on bans risk curtailing some of the constructive ways that adolescents use technology. While many are bullied or harassed online, for example, others find outlets for their stress and connections with new friends.

“Many of the girls I’ve talked to are using social media in really positive ways: to stay connected to friends, to do activism, to do creative work,” Heitner said. “It really does vary.”

Mitch Prinstein, a neuroscience professor at the University of North Carolina and the chief science officer of the American Psychological Association, struck a similar note. The existing research revealed a correlation between the introduction of mass smartphone use and the decline of youth mental health, but not a firm causal connection, he argued. While some studies offered more suggestive evidence — including one experiment that paid students to deactivate Facebook, which left them happier and less polarized than before — potential contributors to the well-being crisis could also include a worsening political climate, along with the frequently circulated fears of environmental disaster and school shootings.

“We can certainly demonstrate that some features of social media are bad for kids,” Prinstein said. “They don’t fit kids’ brain development, they’re depriving kids of alternative experiences — absolutely. I just bristle at the idea of saying this is the singular cause of the youth mental health crisis.”

In both of the new papers, Blanchflower and his co-authors identified additional factors that may have contributed to rising rates of depression and dismay. In particular, the after-effects of the Great Recession may have altered the family lives of huge numbers of children by putting their parents out of work. A significant majority of the young women feeling despair between 2020 and 2022 also reported having suffered one or more adverse child experiences, such as cohabitating with a mentally ill person, living through their parents’ divorce, or being physically or sexually abused.

But the mounting data pointed to a clear role played by the shift of socialization to the internet, he remarked. While adding that it could take 50 years or more to establish the relationship conclusively, Blanchflower said that all the existing evidence argued in favor of enacting hard limits to the exposure of young people to social media and smartphones. Acting decisively could save lives, he said.

“We could fart around about causality, but the potential cost of not doing something is so much greater than the cost of doing something and being wrong. It doesn’t look to me like there are actually detrimental consequences of acting.”

Nearly one fourth of respondents reported being physically harmed or threatened during the previous year. Youth who were physically attacked or menaced were three times more likely to attempt suicide. 

A third of those surveyed were victimized in school because of their perceived sexual orientation or gender identity. One-fifth were prevented from wearing clothes that align with their gender and 11% were disciplined for standing up to bullies. Seven percent said they left a school because of mistreatment.

“Our country is grappling with a youth mental health crisis, and it is particularly pronounced for LGBTQ youth,” says Ronita Nath, Trevor’s vice president of research.

Suicide rates among transgender and nonbinary youth are significantly higher than for their cisgender peers. 

More than 8 in 10 overall wanted mental health care, but half were unable to get it. More than 40% said they were afraid to talk to someone. Cost and transportation were frequently cited as barriers, says Nath. Young people also said they were afraid to ask their parents or caregivers for help.

Ninety percent said the political climate has had a negative impact on their well-being, while 45% reported they or their family have considered moving to another state because of LGBTQ-related politics or laws. 

Nath says, “It’s very important that this year we contextualize this in a political context.” 

According to Trevor’s tally, so far in 2024 lawmakers have considered 540 anti-LGBTQ bills nationwide. Nath says she expects headlines and political rhetoric to continue to spark anxiety and depression among queer youth in the runup to the presidential election.

Two-thirds of LGBTQ youth said they had recent symptoms of anxiety, a rate that rises to 71% among gender-nonconforming young people. More than half suffer from depression.  

Consistent with past surveys, the new poll found more youth get support at school than at home, work, church or in the community. A little more than half — 52% — of respondents said school is affirming, versus 40% who said they feel supported at home. Transgender and nonbinary youth  are slightly more likely to find school affirming but feel unsupported at home.

Reasons for feeling safe at school include the existence of a club such as a gay-straight alliance — also known as a GSA — zero-tolerance anti-bullying policies, and the ability to wear preferred clothing and use desired pronouns. 

Nine percent of students who were able to use a gender-neutral bathroom at school attempted suicide, versus 15% of those who were not. Young people who said their school is supportive were four points less likely to have tried to take their own life, 10% versus 14%. 

“There is a real critical need for schools to adopt protective policies,” says Nath. 

The annual survey, the organization’s sixth, was administered to 18,000 LGBTQ people ages 13 to 24 last fall. In response to virtually every question, gender-nonconforming youth reported more negative experiences than cisgender gays, lesbians and bisexuals, and young people of color more than their white peers.

Asked about ways people in their lives can show support, nearly 9 in 10 of those surveyed said they wanted to be trusted to understand their identity and 81% want others to stand up for them. 

Among transgender and nonbinary youth, 13% said they take gender-affirming hormones, while just 2% are on puberty blockers. Two-thirds of those who take hormones worry about losing access to care.

“Every time we look at one of these variables, across the board we saw higher rates of suicidality,” says Nath. “LGBTQ youth face hardships their cisgender, straight peers simply don’t.”

The young adult was set to speak at a webinar about one of CalHope’s new experimental apps. 

“I saw how many participants there (were)  and I was like, I’m about to use the app so it could calm me down,” said Paniagua. 

But Paniagua had some strategies from the app — including exercises to deal with anxiety. 

According to a study conducted by the California Department of Public Health, the state saw a 20% increase in suicides for young people ages 10 to 18 after the pandemic. To deal with the rising mental health crisis, the Department of Health Care Services (DHCS) has launched two new app-based programs, BrightLife Kids and Soluna, to be a first response resource for children and participants up to age 25.

“I never really knew how to express myself,” said Esther Verdugo, another Soluna participant who had experienced anxiety from her busy life before she started using the built-in journaling exercises. “The people around me always expressed themselves that I didn’t know how to share my own emotions so I shared them through journaling, and all of this I found through the . . . app.”

The release of both apps is part of California Governor Gavin Newsom’s Master Plan for Kids’ Mental Health, which launched in 2022 with a proposed budget of $4.7 billion. The two apps are free and are focused on providing a variety of resources. 

The BrightLife Kids app was introduced to California children under the age of 13 to be able to access mental health resources with their parents and guardians. Children can navigate the app under their guidance and request family or one-on-one coaching. 

The Soluna app is made for California teens and young adults from the ages of 13 to 25, covering a range of topics based on Soluna’s research of interviewing over 300 California youth on what matters to them, including body image, discovering identity, anxiety and depression.

These topics are laid out in the app as a series of constellations, with each star in the constellation featuring a different exercise such as: articles, podcasts, videos and quizzes all built into the app. One of the exercises, a meditative breathing exercise, was made in partnership with the Calm app, Apple’s 2017 App of the Year.

 “It turns out that the needs for the younger kids are quite different than the needs for older kids and young adults,” said Amrita Sehgal, vice president of business operations at Brightline, the company that made BrightLife Kids. “Especially for younger kids, there’s a big need to involve parents and caregivers and families into their care; versus for older kids, folks may want to interact more independently.”

For many Californians, getting help for mental health issues hasn’t always been easy. Dr. Beth Pausic, vice president of clinical excellence & safety at Kooth Digital Health, said, “When you look at US healthcare at the moment, there’s a provider shortage, there’s not enough therapists, there’s not even enough psychiatrists.” This can be especially difficult for teenagers that are of color or LGBTQ.

Because the core belief is that mental health should be an ongoing conversation that is happening not just when problems arise, the apps focus primarily on prevention and early intervention. The individual coaching sessions are not meant to replace therapists or other traditional forms of behavioral health, but act as a first-response method.

“Mental health just needs to be a conversation that we’re having and not in a way that trends when something bad happens in the news,” Pausic said. “Covid put a spotlight on mental health, but there’s always been a mental health crisis. We just haven’t been talking about it.”

For kids and teens interested in using the services, they can be downloaded on the Apple App Store; and BrightLife Kids on the Google PlayStore with Soluna soon to follow.

This article is part of a collaboration between The 74 and the USC Annenberg School for Communication and Journalism.

The Alaska House of Representatives voted by a wide margin and with bipartisan support on Friday to ban children younger than 14 from using online social media.

House Bill 254, from Rep. Sarah Vance, R-Homer, also requires companies that provide internet pornography to check whether an Alaskan viewing that pornography is at least 18 years old.

The bill, which passed on a 33-6 vote, advances to the state Senate for further consideration.

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Vance said the age requirement, which also requires parents to sign off on 14- and 15-year-olds using social media, is about protecting children.

“It contributes to the well-being of our children, because we know that continued exposure to this kind of content affects their mental health, the way that they view themselves, the way that they view relationships, body images, and it really gives a twisted view of what healthy sexuality is,” she said before the vote.

The bill was originally written without the social media component, which was inserted via an amendment offered Wednesday night by Rep. Andrew Gray, D-Anchorage.

“I believe that with the inclusion of (a) social media (ban) for kids under 14, and only with parental consent for those under 16, we are achieving the goal of the underlying bill, which is to prevent young people from seeing online pornography,” Gray said before the vote.

The bill’s opponents — and even some of its supporters — said they believe it raises privacy and constitutional free-speech concerns. The bill requires pornography websites to verify ages via a “commercially reasonable age verification method,” which could entail submitting an ID.

Supporters who acknowledged those issues said they hope that the Senate will address potential problems, while detractors said the potential problems are too big to be overcome.

“There might be a scenario in the future where it is safe enough to protect people from privacy concerns, but really, I am very concerned about the privacy of all individuals who might have to comply with this type of commercial age verification technology,” said Rep. Genevieve Mina, D-Anchorage, who voted against the bill.

Rep. David Eastman, R-Wasilla and another opponent, said that right now, the United States has a very different view of the internet than a place like China, which puts restrictions on its citizens’ use.

“We are so close to going more in a direction with China’s internet,” he said, “where anytime you hop onto the Web, you have to upload your picture, you have to upload your template and again, you’re going have to do something to verify who you are, and then that will be tracked.”

The original version of the bill is similar to legislation backed by the National Decency Coalition, which says that 16 states have passed bills it supported.

Legal challenges in state and federal courts have had mixed results, and last month, the New Orleans-based 5th U.S. Circuit Court of Appeals upheld Texas’ version of the law in a 2-1 decision.

Gray, who added the social media ban to the bill amid bipartisan support, also successfully amended it to include a $100 per-year state voucher for parents who buy content-filtering software.

Under the language of the amendment, parents would submit a reimbursement request to the state.

Eastman, speaking to the voucher plan, criticized it as poorly worded and suggested that Alaskans might be able to receive reimbursements for their Netflix subscriptions because that company offers content-filtering features on its video streaming service.

Vance said legislators should not lose sight of the bill’s ultimate goal.

“In the end, we’re protecting the most vulnerable among us,” she said.

Alaska Beacon is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Alaska Beacon maintains editorial independence. Contact Editor Andrew Kitchenman for questions: info@alaskabeacon.com. Follow Alaska Beacon on Facebook and Twitter.

New data confirm that these issues are top of mind for school leaders, and that education innovators are working to find solutions. The Canopy project, an ongoing national study of schools that focus on designing student-centered and equitable learning environments — and challenge assumptions about what school must be — just updated its database with survey results from 189 innovative schools. 

In the survey, most participants agreed that teacher workforce issues, AI and the mental health crisis will shape the future of education. They are also working on solutions — but are concerned about having adequate resources to sustain those efforts.

School leaders selected teacher workforce issues as the top factor that they think will transform the education sector. While some respondents said they have struggled to recruit teachers in general, they particularly have trouble finding those with skills geared to working with non-traditional instructional models. A leader from Bostonia Global, a charter school that’s part of Cajon Valley Unified School District in California, wrote that credentialing programs need to “shift to meet the needs of our current and future workforce.” The school’s competency-based instructional model requires teachers to implement an individualized approach, not just teach the same content at the same pace to a classroom of 30 kids.

Canopy’s survey data show that many schools are innovating to solve these workforce-related issues: 65% reported they implement some form of flexible or alternative staffing model. For example, the Center for Advanced Research and Technology, a high school that enrolls students from two partner districts in California, brings in industry professionals to work alongside teachers. Several Canopy schools foster collaboration, using staffing models such as Opportunity Culture, which provides mentorship, opportunities for small-group teaching and professional development. 

Artificial intelligence was the second most-selected driver of change. School leaders’ responses showed they want to harness its potential while staying attentive to issues of access, privacy and equity. Only 7% of Canopy school leaders said they have a policy in place governing students’ use of generative AI, but 38% said they’re developing one. Despite the shortage of formal policy, experimentation appeared abundant.

Howard Middle School for Math and Science, based at Howard University, said the school’s policy is to use AI “to enhance educational outcomes, personalize learning experiences and streamline administrative tasks, while ensuring the safety, privacy and well-being of all students and staff. Anastasis Academy, an independent microschool in Colorado, wrote, “We have trained a GPT on our model, our writings and our curriculum to help personalize learning.” 

The mental health crisis claimed the third spot on the list of factors that school leaders believe will transform K-12 education. Four in five leaders reported that their schools are already integrating social and emotional learning into all subject areas and student activities, making it one of the practices most commonly implemented across Canopy schools this year. Additionally, two-thirds of schools surveyed provide mental health services to students, either directly or through a partner like a community-based health organization, and just under half said they support adult wellness, too.

Some responses pointed to an even bigger problem beyond students’ acute mental health needs: battling despair about what the future may hold. One leader wrote, “Students are developing an increasing sense of hopelessness about the world beyond school.” Many lower- and middle-income young people, he said, feel that social mobility is “not possible for them.”

Many schools are working toward solutions that combat that sense of hopelessness. As in previous years of Canopy surveys, most schools reported designing solutions to meet marginalized students’ needs. At BuildUp Community School in Alabama, the school’s mostly Black and economically disadvantaged students split their time between classrooms and work-based learning in construction and real estate, revitalizing their communities and paving a path to homeownership. And 5280 High School, in Colorado, helps students recovering from addiction to reengage in their education and explore their passions in a setting that prioritizes mental health.

A majority of leaders worried about their ability to sustain resources in the coming years. Of those, the top concerns were the availability of local public, private and philanthropic funding. Over a third of those with concerns also said they worried about staffing shortages, inflation and the expiration of federal stimulus funding.

A few leaders pointed out that inadequate funding will not just make it harder to keep the lights on — it will stunt the development of innovative ideas to solve the enormous challenges ahead. Indeed, recent reporting shows reduced philanthropic investment in broader systemic change in the sector.Funding shortfalls in many districts and states will also mean even basic education services may lack adequate resources, making it harder for leaders to defend funding for higher-risk innovation efforts.

Too often, the scale of K-12 sector problems lead education leaders, policymakers and funders to bemoan a lack of bold solutions or flock to attractive but still-theoretical ideas that fail in the implementation stage. School-level innovation efforts are worth watching because they show unconventional ideas in the process of becoming reality — and some may hint at what success can look like. Canopy schools are prime examples of this, whether it’s a New York City charter school accelerating student learning and well-being through summer programming or a North Carolina district school achieving high growth rates with an innovative staffing approach. 

The Canopy project will release a full research report later this year. For now, the headlines from this year’s survey should prompt education leaders, policymakers and funders to take note of schools, like those in Canopy’s national dataset, that are working toward bold and unconventional solutions. 

Indeed, one answer to what will drive K-12 transformation in the coming years is that it will arise from innovation not just in ed tech companies and think tanks, but in the nation’s schools.

But being awakened in the middle of the night by sharp pains was new for Coreano and their family. Rats had begun to bite them in their sleep. Later that morning, they went to their Kensington school and pretended nothing happened.

Chronicling the life of Corem and two other Puerto Rican students from Philadelphia, author Nikhil Goyal presents harrowing accounts of childhood in his latest book Live to See the Day: Coming of Age in American Poverty. 

Readers see Corem, Ryan Rivera and Giancarlos Rodriguez grow up overpoliced and underfed. By the time they reached high school, the system threatened to close some 37 schools, and only after continued protests from Giancarlos and many other school community members, shuttered 24. 

In some cases walking an hour one-way to school without transportation after an eviction left them displaced, Corem, Ryan and Giancarlos give low-income children a human face and serve as a cautionary tale. The Census Bureau has revealed the rate of childhood poverty has doubled, and the country will soon see pandemic-era relief for families, schools and childcare providers come to an end. 

“If we believe that schools should be equitable and humane and child centered, then we’ve got to be willing to fight for an agenda that will end poverty,” said Goyal, who for the last two years served as the senior policy advisor for Senator Bernie Sanders on the Senate’s Health, Education, Labor, and Pensions and Budget Committees. 

Their stories illuminate exactly how economic instability and harsh discipline policies impact children’s ability to learn safely, making the case for change, particularly as educators nationwide grapple with how best to support students academically after pandemic disruptions.

Making economic stimuluses like the Child Tax Credit permanent, Goyal added, would mean “the lives of educators and school staff and counselors would be a lot easier.” 

Named one of 2023’s best books by the New Yorker, Live to See the Day also illuminates how school policies governing students can disproportionately shape entire futures, particularly for students of color who are more often suspended and expelled than their peers. Zero tolerance discipline policies, for instance, put children like Ryan Rivera in juvenile incarceration and harsh schooling isolated from friends for years, after being pushed to light a trashcan on fire at 12 years old.

In conversation with The 74, Goyal reflects on school closures, community schooling, chronic absenteeism, and what policies stand to make a difference for the nearly 9 million kids living in poverty nationwide.

This interview has been lightly edited for length and clarity.

You frame childhood poverty as a crisis to be urgently addressed — why release this book now? What’s happening?

The Census Bureau released its annual poverty report for 2022 — child poverty more than doubled. More than 5 million children are plunged into poverty. It was the single largest increase in poverty in recorded history, just an astonishing development in public policy that I think deserves enormous attention as well as a full-throated response from people in Washington and people in power. 

The increase in child poverty coincides with the expiration of the expanded Child Tax Credit, economic stimulus payments, expanded unemployment insurance, and a number of other programs that have enormously benefited children and families, whether in terms of food assistance, or housing assistance, or Medicaid access. 

We’re also at this moment where a lot of districts throughout the country are facing dropping enrollments, facing fiscal cliffs with the end of ESSER funds. People are anticipating a lot more consolidations, and possibly something like what happened in Philadelphia where a school system weighed closing dozens of schools. What are some lessons that school leaders might glean from what happened in Philadelphia? 

In 2013, the school district proposed closing some three dozen. The argument was that the district was bleeding in a major fiscal deficit. In the book I cite a major report by Boston Consulting Group, commissioned by the district to evaluate the fiscal state of schools. One of the recommendations was a mass closure of schools. They also recommended a mass firing of teachers and other school staff and a very market-oriented approach to public education. The key recommendation was taken up by the school district, against the wishes of students and parents and educators and unions, who were an incredibly robust coalition. 

Pew Research and others have found that school closures haven’t actually yielded the balance of savings that the architects originally envisioned. They cause a lot of displacement, educational instability. And, and in many instances, students are not actually necessarily attending so-called “higher performing schools” after their schools shut down. 

I read about Fairhill School, this extraordinary school in the poorest neighborhood of Philadelphia, which had been serving generations upon generations of children of the working class. This was a school that had been deeply underfunded. And in spite of that, they were still able to provide children with a nurse, a safe environment. 

Their test scores weren’t as good as suburban districts, sure. But does that mean that we should necessarily be closing a school like that which has been an anchor of the community? I don’t think so. I think if we provide public schools with equitable resources, and the type of respect that they deserve, so many of the issues that folks might point you to in public education, I don’t think would exist. 

The charter movement has capitalized on this. But if you go back to the history of charter schools, and you go back to Minnesota and some of the earliest charter schools, these were laboratories of progressivism. We’re gonna bring innovation, bring the best, experiment with interesting ideas in pedagogy and curriculum and instruction and the teaching force. See what works and then bring the best ideas into the public system. That is the model that I would prefer, where charter schools work in tandem with public schools, not as competition.

Something I appreciated while reading is that you give these trends and the political events around them a human face, from the war on drugs and no tolerance policies for violence that led to thousands of incarcerated youth. What’s currently underway that you think might be on track to cause more devastation? Particularly for Black and brown children?

I think there’s a dramatic rise in the privatization movement. We’re seeing a dramatic increase in the voucher schemes as well as charter expansion. In Philadelphia alone, nearly 40% of children attend either charter schools or cyber charter schools. There’s cities all over this country where traditional public schools have become dismantled, and we’re seeing a rise of the private sector intervening in public education. There’s obviously some really amazing organizing and efforts by teachers unions and advocacy groups like Journey for Justice fighting back against those policies all over the country.

What’s at stake, if these models are to continue at the scale that they have? What would be the impact for students, based on your research and experience with Philadelphia?

If we continue down this path, where more and more charters replace traditional public schools, where voucher programs siphon even more dollars away from the public system into the private system, particularly the religious sector, then I think that’s one of the most grave and profound threats to American democracy. I think the foundations of American democracy are found in public education. I think it’s one of the areas of our society that has not been fully transformed and taken over by the market.

Look at health care, look at energy, look at housing. By and large, public education has withstood a number of those assaults over generations, but I think public schools are facing their most serious threats. The pandemic didn’t help. We can debate about school closures, the efficacy of that or not, but I think the reality is that they breed a distrust among parents who were rightfully frustrated about making sure that there was a place for their children to be during the day and be educated. 

One exception to this threat you’ve identified to the traditional public system is the expansion of 3K and pre-K programs in many cities. 

The early childhood education space is very fascinating to me. Public dollars might go to both public providers as well as private providers, and you’re seeing that there’s not a sustained level of federal dollars. A lot of those private providers cannot remain open because their margins are so low. 

There is a growing interest from states all over this country as well as cities like Tulsa, Oklahoma, where they have poured an enormous amount of money into public pre-K. We’re talking about an area of great optimism. I am deeply encouraged by efforts by states and cities to expand early childhood education, because it is not only the right thing to do, it is good for our economy and society.

At one point in the book, you say their story is one of survival, where 18th birthdays are not rites of passage, but miracles. That it’s a story of social contract in tatters. In this reality, where so many children grow up in poverty, what are some best practices for school systems?

I think every school should be turned into a community school, where they have wraparound services, social and health supports. Universal free school meals, extended hours, restorative justice, well paid teachers and staff and modernized infrastructure. 

There are incredible examples of community schools all over this country. I will point to Cincinnati as the gold standard for community schooling, because they’ve converted virtually all of their public schools into Community Learning Centers. I am always struck by the fact that they have dentists and mental health professionals and other medical staff and doctors who are literally based in the school itself to provide care to students. 

We have to recognize that the issues and challenges that young people experience in their homes and in their communities don’t get left behind when they go to school every day. It affects their ability to learn. It affects their relationships with their teachers and counselors, and their relationships with their peers. 

We’ve got to really recognize that poverty and economic insecurity is the root cause of many of these educational inequalities. That schools can be places where children can get access to healthcare and all their social support. I’m very encouraged by that trend across the country. And the research shows that community schools have a positive impact on absenteeism, on truancy, on graduation rates, and student engagement. 

It’s the idea of, meet people where they’re at, provide them with the basic, basic building blocks for dignified life and you will see many of the social problems that once existed, either be reduced or eliminated.

A third of students were chronically absent by the end of the last school year, and we’re hearing more and more about school avoidance. What does Corem’s story reveal about this trend and its links with mental health, which is what some believe to be a root cause right now? 

It’s a great crisis. I would say that Corem has a harrowing, fascinating story with a lot of lessons. Today Corem uses they/them pronouns. When they were growing up, they lived with their mother who was disabled. They endured consistent housing and food insecurity. They would run out of food. They had to endure evictions. They moved in some years, twice or three times, which meant that they had to constantly switch schools and never really settle into one school. That meant Corem’s academic performance faltered. 

I know they’ve suffered from absenteeism at times, not due to their own failings, but simply because they were deprived of the basic necessities of a decent life. They didn’t have the tools and resources that would allow him to get to school on time every day. There’s one moment in the book where the landlord tells their mother that sorry, we just sold the house and you have to leave immediately. 

That means, in the middle of the school year, they have to walk more than an hour from the new home to the old school. Their mother was able to get them a public transit pass, but it just goes to show homelessness and housing insecurity are huge obstacles to consistent and regular school attendance. 

There’s a lot of research to show that homeless students in particular make up a significant part of the population that is going to be absent. As emergency rental assistance winds down and now we’re more than two years since the end of the national eviction moratorium, our families are really suffering through the housing affordability crisis. And I think we see that play out with children.

The report from Gallup and the Lumina Foundation surveyed more than 14,000 respondents in the fall of 2023 — including about 6,000 enrolled college students, 5,000 students who left college and 3,000 adults who never enrolled.

More than 40 percent of Black and Latino students considered leaving compared to 30 percent of white students — with stress, mental health and cost leading the reasons why.

“The fact that stress and mental health concerns continue to be the number one concern for Black and Latino students is alarming,” said Dr. Courtney Brown, vice president of impact and planning at the Lumina Foundation. “It’s something we need to pay attention to because it’s almost like a cry for help for [postsecondary] institutions to do something about this.” 

Brown said Black and Latino adults’ enthusiasm for enrolling in a traditional four-year college has waned in comparison to certificate and associate degree pathways.

Most recent enrollment gains were carried by community colleges with a vocational program focus compared to those with a transfer focus.

“Black and Latino adults recognize the cost is high and their time is limited,” said Brown. “So if they can invest in something like a certificate or associate degree that gets them into the workforce as fast as possible it makes more sense.”

Here are four key takeaways from the report:

1. Black and Latino students are more likely to leave postsecondary programs than their white peers.

More than 40 percent of Black and Latino students were likely to consider leaving college compared to about 30 percent of white students.

Black students experienced slight improvement compared to 2022 but their likelihood of leaving remained higher than 2021 and 2020.

Latino students also saw improvement compared to 2022 returning them to similar levels in 2020.

2. Emotional stress, mental health and cost are consistent reasons across racial groups for why current students considered leaving their postsecondary programs.

More than 50 percent of students said stress was their biggest reason to consider leaving college — followed by mental health and cost by more than 40 and 30 percent respectively. 

Brown said Black and Latino students are more likely than white students to balance coursework with a part or full time job in addition to taking care of family members.

“All of these students greatly value getting a degree and understand how important it is, but all these things accelerate their stress level,” Brown said. 

She added how the competing priorities in their lives influence their desire to leave their postsecondary education to join the workforce and earn income faster.

“Black and Latino students often don’t have the money to actually enroll or stay enrolled,” Brown said. “So it becomes hard for them when they can get a job but the opportunity is lost because they’re in class.”

“It’s short-sighted and they end up losing that opportunity cost because with a degree they would be able to get a better job in the long-term,” she added.

3. Black and Latino adults who have considered enrolling in a postsecondary program are largely interested in certificate and associate pathways.

Nearly six in 10 unenrolled adults have considered enrolling in a postsecondary program in the past two years.

But, Black and Latino adults are more likely to consider a certificate or associate program compared to a slightly smaller number who have considered a bachelor’s degree. 

Brown said postsecondary institutions can help Black and Latino students who have difficulty working towards a bachelor’s degree by providing resources such as healthcare, mental health services and childcare facilities.

“A bachelor’s degree is a lot more involved and it’s going to take a few years minimum if you’re going full time,” Brown said. “So providing these services will give them a leg up to completion.”

4. Financial aid and scholarships hold larger importance to Black and Latino adults than their white peers.

Nearly 60 percent of Black and Latino adults said financial aid and scholarships are important to get them to enroll in a postsecondary program in the next year compared to about 50 percent of white adults.

Also, more than 40 percent of Black and Latino adults said emergency aid would influence their enrollment compared to about 30 percent of white adults.

“I hope this data becomes a call to action for [postsecondary] institutions,” Brown said. “Their attainment rate is very low because our system has failed them again and again, so we can and must do better.”

Natasha Kulviwat, having been interested in neuroscience and mental health from an early age, noticed that neuroscience wasn’t making as much progress in mental health diagnoses and interventions as she thought it should.

So, the 17-year-old from Jericho High School in Jericho, New York embarked on a search for a biomarker related to suicide, wondering if there was a way to use neuroscience to identify those at risk.

Kulviwat looked at brain tissue for those who died by suicide and found there was an increase in a protein biomarker in suicide decedents. The biomarkers could also identify genetic vulnerabilities that could lead to suicidal ideation. 

So, for instance, pathologists could find spikes in the protein biomarkers and, along with a self-report questionnaire, could catalyze suicide prevention in the future.

“My research serves as a small puzzle piece that will hopefully advance the way we view diagnostics for suicide in the future,” Kulviwat said.

It was huge news. At the time, an autism diagnosis frequently meant life in an institution for the child in question. The opening of a path to a version of a “normal” life seemed nothing short of a miracle. Few people questioned the history of Lovaas’s research or the ethics of his methods.

Rather, determined to do right by their children, parents fought hard to get the new therapy, dubbed applied behavior analysis, or ABA — though it was as expensive as it was supposedly game-changing. Today, there is an excellent chance that a child diagnosed as autistic will receive a referral to a provider of ABA, routinely described as “gold standard” therapy that uses behavior modification techniques to eliminate traits deemed undesirable. 

As the rate of U.S. children identified as autistic has risen to 1 in 36, an entire industry has grown up around them. Where once parents had to sue to force school systems, social service agencies and insurers to pay for what was billed as an autistic child’s only fighting chance, today there are ABA treatment centers where families and schools can send a child; therapist degree programs; at least 100 companies running networks of ABA centers; countless standalone programs; dedicated ABA schools that students attend full time at public expense; and ABA training for special education teachers. With all this comes the potential for profit — up to $2.45 billion a year, according to investment firms — and thus an army of lobbyists and public relations specialists making sure ABA is the first, and often only, therapy available. Armed with testimonials of success, parents became — and many remain — their zealous ambassadors. 

But 37 years after Lovaas’s bombshell article, researchers, therapists and autistic adults who themselves were ABA patients as children are pushing back. Proponents of other approaches and some educators — as well as the U.S. Education Department — have expressed frustration over the depth with which ABA has become ingrained, to the exclusion of other therapies and the potential detriment of potentially hundreds of thousands of children. A critical mass of advocates is challenging the notion that non-disabled diagnosticians should get to decide how autistic children should be treated — indeed, how the entire concept of disability should be defined. 

The U.S. Department of Defense, among other research organizations, has called into question whether ABA actually works. And scholars are investigating whether it causes harm to the children subjected to it. Some who experienced the intervention say it absolutely does.

The problems with ABA started early on, beginning with Lovaas’s own beliefs.

“You start pretty much from scratch when you work with an autistic person,” he told Psychology Today in 1974. “You have a person in the physical sense — they have hair, a nose, a mouth — but they are not people in the psychological sense.” 

This lack of humanity, Lovaas did not shy away from saying, justified using electric shocks, slaps, withholding of food and other forms of physical punishment to “extinguish” autistic traits — even joyful ones — and replace them with “normal” behaviors. 

Simultaneously, Lovaas was using the same methods to “treat” suspected homosexuals and transgender people — so-called conversion therapy, which was quickly recognized as a human rights abuse. But the same reasoning that propelled the research community to turn away from using “operant conditioning” on LGBTQ people was not extended to autistic children. Instead, proponents charged ahead — even though Lovaas’s own landmark study does not come close to what many current researchers deem credible. The Norwegian-born psychologist, who died in 2010 at age 83, had personally decided which children received his pioneering intervention and which became the control group. Six years after his initial publication, Lovaas conceded that ABA becomes less effective over time, because, “These people are so used to pain that they can adapt to almost any kind of aversive you give them.” 

More concerning, a growing body of research from, among other sources, the U.S. Department of Defense and a multi-disciplinary team of university scholars called Project AIM has found the evidence base for ABA is too thin and of too poor quality to justify its widespread adoption. The majority of studies that have found it effective are rife with industry conflicts of interest. 

And many former patients who were subjected to ABA as children believe the treatment is abusive. One 2018 survey found that just 5% of autists ​​— a term used by some people with autism — support the therapy, with a majority of neurotypical relatives of autistic people opposing it. 

As neurodivergent adults have moved into the ranks of academic and independent researchers, some have begun compiling evidence that ABA subjects are more likely than other autists to suffer from PTSD and other serious mental health problems. 

“It doesn’t seem to be on anyone’s radar that these interventions could cause harm,” says Kristen Bottema-Beutel, a Boston College professor and an author of the Project AIM meta-analysis. “There seems to be this unwillingness to listen to autistic people who say that it does.”

It’s a Catch-22, she continues: “There’s no evidence. But the reason there’s no evidence is because we are unwilling to collect it.”

‘My monkey tricks were impressive but dehumanizing’ 

Unlike Lovaas, most of today’s ABA therapists don’t wield paddles or electric shocks. But they continue to push for compliance in ways many parents and autistic adults describe as controlling and abusive. There’s no more slapping, but toys, treats and — possibly most damaging — attention are frequently withheld when a child is not compliant. The goal remains “extinction” — the term still used for the process of drilling until an autistic behavior no longer takes place. The centerpiece of this conditioning still bears the name Lovaas gave it: the discrete trial.

Often delivered for long periods, and beginning at ages when children are too young to sit still and obey commands, ABA involves a therapist giving an instruction — such as asking the child to make eye contact, fold their hands in their lap or speak out loud. Positive and negative feedback comes repeatedly and rapid-fire, sometimes including physical reinforcement like turning the child’s head or holding their hands down. When the patient complies, a new command is introduced. 

Sometimes, the targeted behavior is dangerous for the child, such as head-banging, or exhausting for caregivers, such as smearing food or feces. Other times, it’s simply a visible deviation from “normal.” Either way, the goal is to train the child to respond differently to the surrounding environment. 

The upshot, say many adult autists, is that because patients appear more neurotypical, non-disabled people may believe they are “better,” when in fact they may well have sunk into a state of burnout and are developing mental health issues. 

From a non-autistic perspective, many of ABA’s goals seem entirely reasonable — indeed, even a kindness undertaken to facilitate a child’s chances of social acceptance. It’s hard to make neurotypical friends, the reasoning goes, if your affect is flat or you make guttural noises when you are excited. Teachers can’t deliver lessons if they’re trying to keep a student from bolting from the classroom. It’s nigh unto impossible for a parent to finish the grocery shopping with a kid who has melted down and may be physically out of control.

ABA, autistic adults say, may train a child to stop some of these behaviors. But it does nothing to address the underlying causes or teach coping skills, and comes at a tremendous psychological cost. To someone who is easily overstimulated, buzzing fluorescent lights, hyperactive siblings or continual changes of setting and activity can make classrooms and public spaces a sensory nightmare.

Take, for example, the common ABA goal of asking a child to make eye contact. While there are several levels of expertise, and therapists’ training varies, the board that certifies ABA practitioners “requires no education and training on autism in general, let alone [its] cognitive and neurological characteristics,” the journal Cogent Psychology reported in 2019. So therapists who compel eye contact — even going so far as to turn the child’s head so they are face to face — may not know that it overstimulates the portion of autistic children’s brains that is primarily responsible for anxiety. 

One way autists cope with anxiety is to “stim” — make sounds or movements, such as hand-flapping or rocking, that discharge this overstimulation. The more overstimulated a child gets, the more pronounced the behavior. Unable to self-soothe or leave an overwhelming environment, the child is likely to melt down. In trying to eliminate stims, the authors of the Cogent Psychology article report, ABA makes “arbitrary distinctions between which movements are pathological and which are not.”

“A lifetime of being punished for certain movements, and being forced to engage in eye contact despite the physiological pain and discomfort of doing so, is psychological and physical abuse,” they write. “A lifetime of being forced to sit still with no regard for actual cognitive abilities can create further emotional and psychological harm.” 

Autists describe attempting to appear “normal” as masking or camouflaging. It often takes so much effort that it can suck up all of a person’s energy, meaning they may not actually hear a lesson being delivered or be able to engage with a conversation. If directed to do something that is a physical impossibility, a child may not even be able to mask. 

Nor will behavioral therapies do anything to change what a person’s neurotype — the scientific label for a brain and body that operate differently — physically prevents them from doing.

“They are neurological problems, not problems with my social understanding or intellect,” one adult who experienced ABA told researcher Laura Anderson for a 2022 report published in the journal Autism. 

Research on the harms of masking is mounting. A 2018 study published in Advances in Autism found ABA participants were 86% more likely to meet the diagnostic criteria for PTSD than autistic people who were not exposed to the therapy. Nearly half of those affected displayed PTSD symptoms that would be considered at “extreme levels of severity.” 

An emerging body of research suggests that separate from mental health conditions, camouflaging is associated with heightened risk of suicidality, already much greater for autists than the general population. 

Summarized one participant quoted in Anderson’s report: “My monkey tricks were impressive but dehumanizing.” 

Who wouldn’t want to hear, ‘I love you’?

When Elizabeth’s daughter Lily was diagnosed at age 3, she was told to start ABA as soon as possible, preferably for 40 hours a week. “It’s just overwhelming,” Elizabeth recalls. “I didn’t know anything about the diagnosis. I didn’t understand what it could mean.” (To protect the child’s privacy, Elizabeth and Lily are pseudonyms for a mother and daughter who live in a Massachusetts city that is home to a number of universities.)

A scientist, Elizabeth downloaded all the research she could find and immediately became concerned. Because of ABA’s focus on how many correct responses a child provides, there was data galore. But it documented the number of times it takes to extinguish or create a behavior. None of it told her how Lily’s life might change. 

Lily is hyperlexic, meaning that for such a little girl she had a huge vocabulary. But she is sometimes nonverbal. For some autists, speaking out loud may be physically difficult, even impossible. Coordinating the complex physical and mental functions that go into talking may take so much effort that it wears them out or sends them into a meltdown.

A common criticism from autistic adults who experienced ABA is that they used precious energy struggling to say what the therapist wanted to hear just to get the exercise to stop. A therapist may eventually succeed in getting the child to name the toy they want, but it often stymies meaningful communication.   

Unaware of the hurdles speech can pose, parents are often thrilled when ABA teaches their child to speak — after all, who wouldn’t want to hear, “I love you”? They rarely realize that other approaches could facilitate more interaction while taxing their child less.

In fact, because ABA is frequently offered in place of speech-language therapy or assistive technology — such as programmable electronic “talkers” that allow children to piece together pictures or symbols into sentences or even stories — parents and teachers may not be aware of how much language a child actually has.

Lily spoke as a small child, but as she got older, she would stop talking for a day or two at a time. Elizabeth wanted to teach her to sign but was discouraged by health care providers who had heard from ABA therapists that children given alternate means of communication are less likely to become verbal. 

When Elizabeth was first looking into ABA’s research base, she saw that among the evidence that it works was data on the number of times a patient speaks. To her, this was a poor substitute for knowing whether Lily could describe how she felt or what she was thinking about.

Lily now has a device she can use when she can’t or doesn’t want to speak. Often, Elizabeth says, the girl is much more expressive with it. 

“You can train any mammal to do the things that ABA can train your kids to do,” Elizabeth says. “How a kid is feeling and growing in terms of their relationships and their anxiety and feeling comfortable with people — that’s really different than sitting at a table and pointing at a picture nine times out of 10.” 

Based on data gleaned from the nearly 10 million military dependents it insures, the U.S. Department of Defense has repeatedly called the evidence supporting ABA “weak,” noting there is no research to determine whether the small number of participants who show improvement — 15% — do so because of treatment or simply because a child has matured. After a year of the therapy, the department reported to Congress in 2019, 76% of 16,000 participating autistic children saw no change, and 9% worsened.

(The private nonprofit National Academies of Sciences, Engineering and Medicine is conducting a federally mandated review of the Defense Department’s autism intervention research. Its findings are slated for release in summer 2025.)

Even accepting more typical behavior and communication as legitimate goals, research has found scant evidence that the treatment achieves those outcomes. Results of a randomized trial in England, for instance, “suggest lack of clinical effectiveness,” researchers concluded in 2020. A 2010 review of the “Lovaas Method” by the U.S. Department of Education’s What Works Clearinghouse looked at 58 studies, concluding that only two even partially met its standards.  

Project AIM’s meta-analysis, published in 2020, found little high-quality research — and little evidence in the investigations that did meet rigorous standards — that supported ABA’s efficacy. Of the 150 investigations undertaken between 1970 and 2018 the Project AIM team examined, 70% had serious conflicts of interest, which less than 6% disclosed. 

After an autistic researcher, Michelle Dawson, pointed out that Project AIM had not considered whether the studies it analyzed reported side effects or harm, members reexamined them and found that only 11 included even cursory mentions of participants’ psychological or physical distress.

Including adverse events data should be standard, says Bottema-Beutel, the Boston College professor and Project AIM author: “It is in other fields, and it absolutely isn’t in autism research. … It’s especially important because there is an enormous community of autistic people who say that they have been harmed by participating in these interventions.”

A related flaw in the overall body of research, Bottema-Beutel adds, is that it disregards what autistic people say they want in the way of therapeutic support. “It would be difficult to find studies that were well designed, that don’t have risks of bias [and] that show improvement on meaningful outcomes that autistic people care about,” she says. “Show me an ABA study where they improve quality of life.”

‘It was so humiliating being there’

Concerned about the way ABA-affiliated researchers defined and quantified success, Elizabeth went back to the internet and searched for opinions from autistic adults. “I just wanted to hear from older autistic people who experienced therapy,” she says. “And try to understand that from my daughter’s perspective, because at the time, she certainly couldn’t tell me.”

What she heard were responses like these:

“It resulted in corrosive damage to self-esteem and deep shame about who I really am,” a former patient told a University of California researcher in 2017. “No effort was made to explain autism to me or to explain the role of sensory overload in issues like meltdowns, shutdowns, etc.”

Therapists, another former participant told researchers at the Autistic Self Advocacy Network, “teach you to anticipate that when you say ‘no,’ they’ll bulldoze through that because you don’t own your own body.” 

Another said she was left with crippling social anxiety: “All of those things that I was doing wrong would automatically go through my head any time I was in a social situation. … I would be inherently super judgmental and self-critical about everything I was doing to the point where even in some social situations, I just shut down.”

And: “It was so humiliating being there.” 

Perhaps the most painful element of the swelling controversy about ABA is the clash of perspectives of neurotypical parents and autistic adults who say — often bluntly — that the effort families are making to do right by their child is misguided. The conversation is especially freighted because both groups have unhappy histories. Until Lovaas, poor parenting was blamed as the root cause of autism. For their part, many autistic adults are enraged that they are not routinely invited to help shape research and policy. 

Autistic adults who believe they were harmed by ABA are quick to say they believe their parents were doing the best they could with the information and resources they had. “I am not mad at them for their effort,” one autistic woman told researchers looking into trauma rates. “They weren’t disrespectful. They just had a flawed paradigm for autism, and therefore, what they tried didn’t work. That doesn’t make them bad people.”

Many parents wholeheartedly believe ABA delivers great victories. Often, they are proud that after their struggles to find services and pay for them, their child talks, follows directions and has far fewer disruptive behaviors.  

One of the most visible advocacy organizations, Autism Speaks has played a leading role in helping families of autistic children press for expanded access to ABA and other services. 

The organization’s stance on ABA is that it may be effective for some people and not others; therapies should be tailored to the individual and should not attempt to enforce behaviors based on social norms. When implemented properly, the organization holds, “ABA can lead to improvements in IQ, adaptive behavior, communication skills, social skills and a reduction in challenging behaviors.” 

The evidence behind behavioral science is sound, says Andy Shih, Autism Speaks’s chief science officer. But as with any other treatment, there can be differences in how a therapy is conducted — particularly given the range of training and experience among therapists. A skilled practitioner working in the right conditions can succeed in changing behavior, he says, most notably eliminating those that endanger a child.    

“Everybody experiences ABA differently,” says Shih. “The setting in which we see them, the quality of the service provider, they all make a difference, I think. In general, even though there are established standards and criteria in terms of what a good autism service should look like … just like in other branches of medicine, what is ideal and what is actually delivered, sometimes there’s a big gap.”

Eileen Lamb, director of social media for Autism Speaks, credits nine years of ABA for helping one of her children, who is nonverbal and has a potentially dangerous eating disorder called pica. The boy, Charlie, is now able to express his basic needs.

“He’s also learned safety skills like being able to ‘stop’ when someone asks him to,” Lamb said in a statement provided by Autism Speaks. “ABA was also successful in helping Charlie through his fear of the doctor and dentist. We don’t have to put him under anesthesia for dental exams/interventions anymore, which is incredible.”

Similar glowing recommendations from parents abound. Last summer, a group of Indiana parents staged a protest after being alerted by their kids’ therapy centers that the state wanted to cut reimbursement rates. They gathered outside the governor’s mansion, holding signs that said, “ABA is the way” and, “They wouldn’t be who they are today without ABA.” 

In Virginia, then-Delegate Bob Thomas kicked off a 2019 press conference announcing a push to expand access to autism therapy by asking the grandson of a local advocate to step to the dais. 

“Mark is a great example of why we are here today,” Thomas said, explaining that the child had once been unable to speak. “Thanks to the services and the resources Mark had access to, he’s now able to stand here in front of a roomful of media, media cameras and lead us in the Pledge of Allegiance.”

In response to a reporter’s question about what was at stake, a mother of three autistic boys stepped to the mic: “If it weren’t for the behavior therapy that we receive, we would not be able to go out in public like this today.”  

Add to displays like these effusive testimonials on ABA center websites, memoirs penned by parents who credit ABA with their children’s miraculous recoveries and whispered confessions from caregivers that the therapist’s arrival gives them a much-needed break from kids who require constant supervision. 

Research has begun to probe the disconnect between parents’ and children’s perceptions. The 2018 Advances in Autism study, for example, predicted that nearly half of autistic children exposed to ABA will meet the threshold for a PTSD diagnosis within four weeks, while caregivers’ satisfaction will rise as the treatment goes on.

Still, the study noted, 9% of caregivers surveyed discontinued the therapy because they didn’t see enough progress or saw negative changes. Overall, “caregiver satisfaction was generally reported within the neutral range. The longer a child was exposed to ABA, the more likely a caregiver was to rate the intervention as effective for improving overall functioning.” 

Have you seen Mr. Potato Head?

Denise’s son Logan was 27 months old when a neurologist at the prestigious Boston Children’s Hospital diagnosed him with autism. He was smart and carefree but very rambunctious, more likely to throw toys than play with them. He never spoke words but used his voice to stim. (To protect Logan’s privacy, he and his mother have been given pseudonyms. The family lives in western Massachusetts.) 

Home to numerous elite research universities — including Harvard, where behaviorist B.F. Skinner planted ABA’s conceptual roots — Massachusetts is considered a great place for autistic children. It was one of the first to mandate insurance coverage for autism services and now contracts with 22 companies to provide intensive early interventions. ABA dominates the offerings. 

Eager to get her son as much help as possible, Denise got him on wait lists for two treatments: ABA and a lesser-known approach called Floor Time. Within two weeks, an ABA therapist was spending 14 hours a week with Logan. 

For a while, Denise says, things went fine. But when COVID-19 forced the therapy online, Logan balked. 

“The idea that he was hiding in the closet because I was turning on the computer for ABA was just like a total alarm going off,” she says. 

Denise told the therapist the discrete trials didn’t seem like a good fit, fears that were compounded when in-person services started back up. At her first visit, the therapist invited Logan to jump on a trampoline with her. She pointed a finger skyward and said, “Up, up, up.” Pointing his own finger, a delighted Logan started shouting the word with her. Saying words out loud was new for him.

The victory was short-lived. The therapist moved on, asking Logan to put his hands in water. Still excited, he kept pointing and chanting, “Up, up, up” instead. The response was gentle but devastating: The therapist folded his finger down and moved his hands where she wanted them. The boy shut down. 

“To see the joy disappear from his face — all of a sudden he’s no longer a willing participant,” Denise recalls. “There was no abuse or anything, but she made him comply.” 

Denise canceled Logan’s ABA. Meanwhile, his name had come up to the top of the Floor Time wait list. Floor Time uses play-based activities that the child chooses. The aim is to make interactions increasingly complex.

During the first session, Logan picked up a Mr. Potato Head and threw it. Denise watched with bated breath, anticipating negative reinforcement. But the new therapist started throwing toys, too. And then wandered the room picking up toys and asking in a silly voice if they had seen Mr. Potato Head.

“All of a sudden, [Logan] is picking up a toy and perfectly imitating her intonation — without words, but her tone perfectly,” says Denise. Next, he held toys in front of his mouth and said words for them. Soon, Logan was a chatterbox, talking about the dream he had the night before, ways to defeat bad guys, becoming a superhero — everything. 

Insurance codes and new markets to mine

As recently as the year 2000, insurance coverage was not required for autism therapies, which researchers estimate cost from $10,000 to $100,000 per year. After fierce lobbying, by 2017 advocates succeeded in pushing laws requiring reimbursement in 46 states. As this sea change was taking place, ABA therapists were among the few people with formal credentials who could step into jobs created to help families access newly covered services. 

This meant that ABA practitioners were often the ones who created insurance billing codes, referral networks and other systems, making them de facto gatekeepers. As a result, though many states require coverage for other types of therapy, getting care other than ABA can be incredibly difficult. Parents who get referrals for speech and occupational therapists, or for augmentative and assistive communication technology for their nonverbal children, often find that the only available providers typically offer ABA.

Revel Weber has firsthand experience with this. A clinical social worker and the autistic parent of four children, one of them autistic and two with ADHD, several years ago she was asked to create a program to serve autistic children belonging to the White Earth Nation in northern Minnesota. As part of her research into treatments that would both benefit tribal families and qualify for public funding, Weber took some online ABA training courses. 

She quickly decided it wasn’t appropriate for White Earth children. In addition to being uncomfortable with the focus on compliance, Weber, who is not American Indian, believed ABA could play negatively into historical trauma associated with attempts to assimilate Native children. 

Like many states, Minnesota requires insurers to pay for a number of autism therapies, but as Weber explored alternatives to ABA, she ran into a maze of red tape. In their rush to provide the greatest access to services, the government created Medicaid reimbursement codes — the backbone of health care billing — that reflected the most available treatments. The majority were ABA. Thirty-seven years after Lovaas’s bombshell study, there are numerous ways to become an ABA therapist, ranging from full-fledged degrees to online courses. But there are far fewer providers of other kinds of treatments. Those ABA therapies are now locked into the codes, meaning billing for anything else can be difficult.

The ABA sector’s strategies for making its services widely available were smart, says Jeffrey Guenzel, head of the International Council on Development and Learning, which provides Floor Time training. But it has made it challenging for other therapies to become established. 

The intervention’s rapid spread has also resulted in uneven quality, even supporters like Shih, of Autism Speaks, say. Some practitioners hold credentials that may require an advanced degree and long experience, while others — typically identified as technicians — may have taken only a few hours of virtual training.    

Venture capitalists are up front in saying the increase in autism diagnoses and continued unmet demand suggest the sector is poised for explosive growth. In a market overview, one investment company asserted that there are about 1 million autistic children in the United States. In 2020, the analysis said, ABA programs generated $1.4 billion — a figure expected to grow to $2.45 billion by 2025. And there are new markets to mine.   

“ABA treatment is widely recognized as the most effective method for treating [autism], but its evidence-based treatment methods are applicable beyond [autism] alone,” the brief asserts. “Mental health issues in schools and the provision of more providers will ultimately expand ABA recognition beyond [autism] exclusively.” Other areas of opportunity, the investment bankers’ materials say, include ADHD, Obsessive-Compulsive Disorder, Panic Disorder, Oppositional Defiant Disorder and PTSD.  

The one and only option

For the first few years after earning a degree in special education, Ryan Haenze, himself autistic, taught in Twin Cities school districts. His training was to let students’ interests steer his instruction, but this wasn’t what his higher-ups wanted. They wanted behavior management, he says — specifically, compliance. 

The kind of instruction he favored because of his autism — sensory accommodations, interactive projects and movement breaks for the kids — earned him bad evaluations. “I had administrators saying, ‘What you are doing is not best practice. You need to physically put these kids into chairs, do hand-over-hand,’ ” says Haenze, meaning moving the child’s hand with his own. “It needed to be those specific, very structured methods.” 

Haenze repeatedly pointed out that those strategies often lead to explosive behavior. Once, he said, he watched helplessly as one of his third graders was removed from school in handcuffs. 

At many schools like Haenze’s, administrators adopt ABA principles because they are viewed as best practices. But other places take a more formal approach. For example, Boston Public Schools now offers ABA in every school. Between 2011 and 2021, The Nation reported, the number of behaviorists in the district doubled. Families with autistic kids in Cambridge Public Schools are routinely placed in ABA-aligned classrooms.

Many communities have privately operated ABA schools that students attend full time at district expense. Haenze says most of his students received therapy at ABA centers as toddlers and preschoolers. In kindergarten, they began spending half their day at school and the rest at an ABA center — a common arrangement.

However, the U.S. Department of Education’s Office of Special Education and Rehabilitative Services has warned schools not to let ABA crowd out other services that are supposed to be considered for students’ Individualized Education Programs. Specifically, the department said it had received reports that a growing number of children were not being evaluated by the range of professionals who typically determine what the appropriate — and under a child’s IEP, legally mandated — services are.

“Some [special education] programs may be including applied behavioral analysis (ABA) therapists exclusively without including, or considering input from, speech language pathologists and other professionals who provide different types of specific therapies that may be appropriate,” the department warned. “We recognize that ABA therapy is just one methodology used to address the needs of children with [autism] and remind states and local programs to ensure that decisions regarding services are made based on the unique needs of each individual child.”

Communication support is one accommodation that has become increasingly scarce as ABA’s strategies for teaching children to be verbal have spread, says Zoe Gross, director of advocacy at the Autistic Self Advocacy Network. Because many people believe spoken words are superior, special educators often aren’t trained in the alternative technologies, she says. 

For Haenze, being an autistic teacher unable to convince his co-workers he had useful insight was maddening, he says. Receiving poor evaluations from supervisors unwilling to consider that his ideas might make classrooms calmer and students more engaged was demoralizing. Worse, he says, was neurotypical teachers’ misunderstanding of their students’ capacity for self-expression — and, by extension, their intellect.

Midway through his sixth year, Haenze quit teaching and went to work for the Minnesota Disability Law Center as an advocate.

‘I don’t ever want them to feel shame’

Given the prevalence of ABA, it is difficult even for parents who don’t want to engage with the treatment to avoid it entirely. Denise says that for a long time, she was asked at Logan’s pediatrician check-ups whether he was getting the therapy. It made her nervous to say no, over and over again, and know that answer is being entered into an official record. Eventually, though, it was so clear the boy was thriving that the conversations stopped. 

Elizabeth, too, rejected offers of ABA interventions many times, simply saying her family doesn’t think it is a good fit for Lily. She believes she got away with turning down services because her daughter doesn’t engage in many behaviors that schools typically try to eliminate.

Weber has gone a step further — choosing, based on her experience as both a therapist and an advocate for her children, not to have her autistic son diagnosed or evaluated for special education, where she would have to fight to turn down ABA-related services. 

“I am trying to avoid that,” she says, choosing instead to work with the boy and his two neurodivergent brothers herself, at home. “I don’t ever want them to feel shame. I always want to instill pride in who they are.”

The 1975 passage of what is now known as the Individuals with Disabilities in Education Act established that every child, no matter how profound their needs, has a right to a “free and adequate” public education. In 1990, the Americans with Disabilities Act enshrined in law the right of people with disabilities to enjoy the fullest possible access to jobs, housing and other pillars of a life of dignity. It meant they were entitled to have a wheelchair ramp, sign language interpreter or other forms of assistance that would help them literally take a place at the tables where discussions of their needs were underway. 

Once included, people with disabilities pushed for a shift in thinking about how disability issues should be framed. In the past, the non-disabled people making decisions about how to meet the needs of people with disabilities employed what was often described as the medical model. The goal was to determine how to make up for physical, neurological and intellectual deficits. 

Today, many disabled people prefer what they call the social model, which instead identifies systemic barriers to participation in society, including ignorance, bigotry and social exclusion. The new goal is to make the environment more inclusive and hospitable to everyone. 

Nowhere has this change of attitude been more apparent than among autistic people. Autism, once blamed on poor parenting, is now understood, in scientific terms, to be a neurotype — not a condition resulting from a lack of anything physical or psychological, but a body and brain wired differently. Not only is it impossible to fix or cure autism, many autistic adults say, it’s not desirable; autists have abilities that non-autistic people don’t. 

And they are demanding a voice in how their own needs should be met. As the motto of the Autistic Self-Advocacy Network puts it: “Nothing about us without us.”

One flashpoint is applied behavior analysis — long described as the “gold standard” intervention for autism. Developed and nurtured into a multi-billion-dollar industry by neurotypical researchers, parents and service providers, ABA is now the chief therapy recommended when a child is diagnosed as autistic. 

Created in the 1980s, ABA aimed to condition autistic children to act as neurotypically as possible using punishments including slaps, electric shocks and withholding of food. Many parents saw its goals as desirable — autistic youngsters can exhibit behaviors that can exhaust caregivers and teachers, and make friendships difficult, if not impossible. Over the years, ABA has moved away from physical punishment, and many families credit the therapy with helping their child make miraculous strides. 

But many adult autists believe even its more recent methods of withholding toys, treats and attention and physically compelling patients to make eye contact — which some find extremely painful — can be extremely damaging to their mental health. Some, who have become autism researchers themselves, have documented harms ranging from dramatically higher incidences of PTSD to a debilitating focus on compliant behavior that impairs participants’ ability to act independently as adults.

And research from, among other sources, a multi-disciplinary team of university scholars and the U.S. Department of Defense — which insures thousands of autistic military dependents who have undergone the treatment — has found the evidence base for ABA thin and of poor quality. This is particularly troubling to critics of ABA, as it is often the only therapy offered to parents, to the exclusion of other, possibly more effective, treatments.

During a 2020 address at Drexel University, Julia Bascom, until recently the network’s executive director, offered an example of how changing the prism through which disability is viewed clashes with the most prevalent therapies and services:

“In the medical model, autism means that my senses are disordered. If sounds hurt me, the solution is to fix how my brain is processing those sounds, or teach me how to get used to it, or at least how to hide my discomfort. The problem is located in my body. In the social model, the solution to auditory overload is to give me a pair of headphones. 

“The social model also allows us to acknowledge complexity — that the same painful sensitivity might also make my experience with music uniquely transcendent. The same thing that makes wool unbearably itchy might also make water between my fingertips more soothing than anything else in the world. Maybe not all of those things need a ‘solution.’ Maybe autism might need a more nuanced approach than has traditionally been offered.”

There are also concerns that trying to alter a fundamental aspect of a person’s identity — especially without their consent, as in young children — violates their rights.

An assistant professor who teaches bioethics at the University of Pittsburgh School of Nursing, Daniel Wilkenfeld was diagnosed as autistic after an evaluation of one of his children — a common occurrence. ABA’s goal of trying to train youngsters to act in ways found socially acceptable is unethical, he wrote in a 2020 paper published in the Kennedy Institute of Ethics Journal.

“Autism advocates are fully justified in their concerns,” wrote Wilkenfeld and co-author Allison McCarthy. “The rights of autistic children and their parents are being regularly infringed upon. Specifically, we will argue that employing ABA violates the principles of justice and nonmaleficence and, most critically, infringes on the autonomy of children and (when pushed aggressively) on parents as well.”

The most basic problem, they say, is that the therapy is promoted even though it may not benefit children themselves: “If we are correct that the use of ABA at least frequently violates the standard principles of bioethics, then this has massive implications for health care and society generally.”

Like many critics, Wilkenfeld notes that ABA was developed in tandem with so-called conversion therapy used to “treat” suspected homosexuals and transgender people — in the same lab, by the same researchers. But the reasoning that soon turned the research community away from using “operant conditioning” on LGBTQ people has not been extended to autistic children. “Thankfully, most of society recognizes that being gay is not a problem,” he says. “There is less recognition that, for the most part, being autistic is a perfectly valid and helpful identity to have.”

Indeed, one rarely discussed aspect of attempting to replace autistic traits with more “normal” ones is that it can wipe out the ways in which neurodivergent people like to socialize and play. “Stims” — self-soothing rocking, hand-flapping and vocalizations that some autistic people use to cope with overstimulation — can also be expressions of joy. ABA discourages both.

“Would you tolerate being told that the proper way to express happiness is to spin in circles, but then be punished when you smiled or laughed instead?” Chloe Everett, a psychology student at the University of North Carolina Asheville who experienced ABA as a child, asked in a regional Tedx talk. “I don’t think so.”

When confronted with this “age-old story,” as King calls it, she starts asking questions. Do you not like the class? Is something else going on? She checks their grades. And once she identifies the core issues, she provides the student with wraparound services, engaging school counselors, social workers, teachers and parents.

The main goal? To get students the support they need to return to class as quickly as possible. She calls school nurses “the sentinels,” arguing it’s their role to identify when there’s an issue and then pull together as many people as they can to support that child.

Her current school, World Language Middle School, a bilingual language immersion school in Columbus, Ohio, electronically tracks when students go to the nurse’s office so they can quickly identify these patterns.  

“My primary focus — and a school nurse’s primary focus — is that children are in school,” she said. “Many people think our primary focus is to send children home, but actually our focus is to keep kids in school.”

King’s experiences mirror the results of a new study of 21 nurses out of the University of Missouri Sinclair School of Nursing. Researcher Knoo Lee, himself a registered nurse, found that students who have many partial-day absences often seek out school nurses as a source of comfort and support. This puts school nurses in a unique position to intervene before their absences become chronic. 

“We discovered something that we haven’t seen before,” Lee told The 74, “where school nurses are actually in a position where they are able to identify students who are going through the early symptoms of partial-day absences.” Knowing that partial-day absences often lead to full-day absences, “we believe from these results that school nurses have the potential to play a key role in terms of really helping out with chronic absenteeism.”

Despite this, school nurses are often left out of policy-making decisions and conversations, Lee found. They also need access to greater support and resources to respond to the challenges students face that impact chronic absenteeism, including mental health concerns, homelessness, lack of transportation and food insecurity. And in order for school nurses to be effective, the report recommends that districts work to make sure schools are staffed with an adequate number who are trained and certified and that they have the needed supplies.

Especially post-pandemic, chronic absenteeism, when students miss 10% or more of school days a year, has proved to be an intractable problem. In the 2020-21 school year, at least 14.7 million students nationwide were chronically absent — more than double the number pre-COVID, according to Attendance Works, a nonprofit that aims to reduce chronic absenteeism. Children living in poverty are two to three times more likely to be chronically absent. Students from communities of color as well as those with disabilities are also disproportionately affected. 

Historically, researchers looking at chronic absenteeism have largely ignored partial-day absences, according to Lee, even though they are more prevalent and can be a precursor to full-day absences. And both types impact academic outcomes. Lee’s study is the first to examine the effect school nurses can have on partial-day absenteeism, which is tracked differently from state-to-state and sometimes not at all.

The study is based on interviews with the nearly two dozen school nurses in six online focus groups between June and August 2020. Their years of experience varied and they worked in rural, urban and suburban schools across greater Minnesota. Nurses were also asked to complete a pre-interview survey. The study was conducted in collaboration with the Minnesota Youth Sex Trading Project, which is associated with the University of Minnesota School of Nursing and works to prevent the sexual exploitation of young people.

The research is the first to reveal that students who miss school partially are inclined to initiate their own visits to the school nurse’s office, according to Lee. These scenarios could involve a student trying to avoid a particular class; proactively stopping by the nurse’s office each morning to receive a meal they weren’t getting at home or needing to lie down after working late hours to help support their family. Once there, the nurses were able to intervene with these students and provide support. Since they didn’t have to seek out these “at-risk” students, identifying them was a relatively low lift with potentially big positive outcomes.

This demonstrates the importance of advocating for a more holistic understanding of the role of a school nurse, the study argues, particularly when it comes to offering mental and emotional support.

It becomes much more challenging for nurses to identify these absenteeism patterns if they’re not in the school building every day, according to King, who also serves as president of the more than 17,000-member National Association of School Nurses. On average, about two-thirds of public schools have access to a full-time school nurse, according to the association’s  workforce study. In rural districts, this drops to 56% and in the West, it plummets to 16%. About 40% of school nurses rotate between at least two schools. 

Parents — especially those whose kids have chronic illnesses — feel more comfortable sending their kids to school when there’s a nurse in the building every day, according to King. This is particularly true when students lack access to medical care outside of the school building. “We’ve seen so many times, the school nurse is the only health care provider that students see,” King said.

 In addition to taking away that much-needed health care opportunity, when there is no school nurse for a student to see, they are more likely to be sent home: 18% of the time versus 5% of time, according to King.

While the number of schools that have full-time nurses has substantially increased since before the pandemic, King thinks that’s likely due to COVID relief funding. She worries a number of schools will once again lose access to a full-time nurse when that federal money runs out later this year.

Notably, the study took place during the first few months of the pandemic. Since then, chronic absenteeism has only gotten worse. While there have been lots of attempted interventions over the last few years, most school districts are still struggling to find the right mix, according to Lee, the researcher. 

His study, he hopes, will highlight that “school nurses can really take a huge role in this.”

Kids, teens and young people, who researchers say are historically more likely to be optimistic than older generations, are overwhelmingly concerned about peers’ and their own mental health, as well as their futures and the nation’s political environment.

“Gen Z is a group of people who care and have gone through a kind of collective trauma — I think we see it,” said Amanda Lenhart, lead researcher with Common Sense Media, which has just released a report on the state of kids and families in America. “They’re kind of fed up. They’re worried about the future and they really would like people to pay attention.”

When asked what would improve life for children in the United States, Gen Z said a better education system. They and voters point to a need for increased mental health care offerings and affordability, job preparation classes and free after-school programming. 

For Gen Z, schools are “where they see an opportunity for assistance and amelioration,” Lenhart explained. Across party lines older members of the generation shared the same desire: for schools to provide more wraparound services like health care and food pantries, aligned more with the community school model. 

Lenhart and fellow researchers are interested in what will come when the remaining Gen Z youth reach voting age, because “they have a lot of frustration about what they see as a little bit of a kicking of the American dream in the teeth. That is, a sense of my own opportunities are diminished; I see my peers burdened with this mental health crisis.” 

For many, feeling frustrated and stressed has impacted future aspirations: An overwhelming 75% of Gen Z has interest in at least one STEM field, with the next most popular fields being healthcare and arts, media or journalism – areas that offer long careers and support society. 

Yet many feel their goals are out of reach: less than a third will pursue STEM, according to Gallup and the Walton Foundation’s latest Voices of Gen Z report. Outside of environmental science applications, the majority haven’t been exposed to foundational material like computer programming or coding, robotics, or electrical circuits.

Here’s a recap of four key findings from the nearly 3,000 12-26 year olds surveyed late last year by Common Sense Media, Gallup and the Walton Foundation.

1. Mental health & gun violence are the most concerning issues for kids and teens right now.

Nearly a third of Gen Z feels that youth mental health challenges are the most pressing issue for their generation, with girls and white children citing the issue more than their peers. When asked about top concerns at schools specifically, the number grows dramatically: 53% said mental health. 

They attribute the cause of the mental health crisis to two main sources: bullying or discrimination, and social media. 

About 21% of Gen Z feels gun violence is the most pressing issue for their generation — even more so for Black kids and teens, 28% of whom cited gun violence. 

In just the first month of 2024, about 400 children and teens were wounded or killed by gun violence. 

2. Most of Gen Z are interested in STEM careers, but less than a third plan to pursue them.

A major gap is emerging between desire and preparedness for STEM careers. The gap is even more stark for girls, who are less likely than peers to pursue the field, due in part to a lack of mentors who students can identify with, imposter syndrome, and facing stereotypes about who is capable. 

“Half of gen Z is far less confident than the other half that they’re even good at this,” said Gallup pollster Zach Hrynowski of the gender gap, adding that prior research has confirmed the importance of having diverse STEM teachers and mentors, who can help students break through inadequacy, fear or systemic barriers. 

Having a teacher or mentor that looks like you or has shared life experiences can make a world of difference. For a Black student to have a Black computer science teacher, Hrynowski added, could “make you more likely to want to step through that door that currently is not something that you’re being pulled through by virtue of the curriculum.”

Simultaneously, there’s a huge discrepancy of middle and high school STEM offerings across the country that has left the majority of Gen Z high schoolers unexposed to basic courses and curriculum such as computer programming, 3D design, cybersecurity and hydraulics. 

Researchers fear a potential hit to the American economy. 

According to the Bureau of Labor Statistics, the number of STEM jobs will increase 11% by 2032. About 1.4 million technical jobs, in fields like engineering and computer science, may go unfilled by then if pipelines aren’t built up imminently. 

3. Most of Gen Z believe better education is the key to improving lives of children in the US

The majority of voters across party lines agree with young people — about 53% point to the education system as a saving grace for children in the U.S.

Likely voters, including some older Gen Zers, say their top education priorities are getting kids to read at grade level, teacher burnout and associated shortages, bullying, and student mental health. They believe individualized learning plans, increased teacher pay, more social, emotional and mental health support, and smaller class sizes would make the biggest impact. 

At the same time, young people feel like political priorities are misaligned. About 60% of Gen Z believe politicians do not reflect the needs, desires, and experience of young people in this country well. 

“They feel like people in elected office and people in positions of power aren’t listening to them, not doing a good job of representing what young people need,” said Lenhart.

4. They’re still optimistic: 70% of young people think they’ll be about the same or better off than their parents in adulthood

Despite coming of age during periods of extreme violence, social unrest, and historical traumas, including 9/11 and a pandemic, Gen Zers are still more cautiously optimistic about their future prospects than voters writ large. 

In contrast, only about 22% of likely voters who are not parents believe children today will be better off than they are now. 

Yet a majority of parents of color are in hopeful alignment with Gen Z: 60% of Black parents, 62% of Asian American and Pacific Islander parents, and 52% of Latino parents say kids today will be “better off.” Just over a third of white parents believe this to be the case.

Black kids and teens are the most hopeful subgroup, with just over half saying they will be better off. 

“The more we can help create a functional adulthood for our teenagers and our young adults,” Lenhart said, “where they’re not worried about meals, health care, their own safety, their ability to take care of their families when people get sick … if we can make that better, then people will feel better.” 

Disclosure: Walton Family Foundation provides financial support to The 74.

Districts that have faced historic enrollment losses could lose even more families if they don’t respond to student needs, according to the report, released Thursday and provided exclusively to The 74 by Tyton Partners, a consulting firm that has tracked the shifting education landscape since the pandemic. 

Based on a survey of what the researchers call “open-minded parents” — those who show interest in school choice options — 46% said their children’s mental health drove them to find something different. Among middle school parents, the rate was 54%, followed by 48% of high school parents and 44% of parents with elementary school children.

Adam Newman, founding partner at Tyton, said he was “dismayed — but not surprised — by how mental health concerns color parents’ choices.”

“For many parents, there’s a sense that ‘school’ isn’t working, and alternatives might provide a much-needed spark,” he said.

The survey results offer a different look at the youth mental health crisis that escalated in the wake of pandemic school closures. It comes as federal relief funds — and many of the mental health investments that went with them — are set to expire later this year. Many districts used the money for extra mental health professionals and special rooms for students experiencing anxiety or acting out in class.

With one counselor for every 385 students, the average ratio is the lowest it’s been since the mid 1980s, according to the American School Counselor Association. But it still doesn’t reach the organization’s recommended ratio of 250-to-1. Jill Cook, executive director of the association, said some districts might not be able to keep the additional counselors, social workers and school psychologists they’ve hired. 

“The hope is … that districts would choose to keep these positions because [they] contribute to student success,” Cook said. “Students who have access to a school counselor often have improved attendance, improved achievement and fewer disciplinary issues.” 

Due to staff shortages, schools have also expanded the use of teletherapy programs.  The federal government aims to boost the supply of mental health professionals through grant programs to districts, states and universities.

‘A big reason people leave’

But some students crying for help can’t find it. Erin Goldman’s daughter reached out to a counselor at her Houston middle school in the fall of 2022 when she received harassing messages on social media, like “KYS,” an acronym for kill yourself. But the counselor couldn’t fit her in.

“She couldn’t get on the calendar. Then the guidance counselor was just supposed to come find her when she had availability, but that never happened,” Goldman said. The cyberbullying was affecting all areas of her daughter’s life. “She would not get up in the morning. It was a constant battle, like screaming matches. Her grades were suffering.”

In the middle of the school year, her parents transferred her to Dietrich Bonhoeffer Academy, a small private middle school. 

“In less than two weeks, she was happy,” she said. “The person who I thought would never like school again likes going to school.”

Consultants who help families navigate school choice options aren’t surprised that emotional health concerns are prompting some parents to change schools.

“If your child is being bullied, that to me is a mental health issue,” said Colleen Dippel, CEO of Families Empowered, a Texas-based nonprofit. “It’s a big reason people leave their schools. Their child says things like ‘I hate school. I don’t want to go to school.’ That’s pretty common.”

Tasha Tarpley, a single mother in Texas, pulled her son Preston out of the Red Oak Independent School District, south of Dallas, after a series of confrontations he had with other students. After one fight, he was suspended.

“My child was afraid to go to school,” she said. “I have a tall 10-year-old. He’s a big guy, and quite naturally [they’re] going to blame everything on the big one.”

On the way to school, she said his mood would drop, and his face “looked like he’d just had a very emotionally, psychologically rough day.” A year ago, she joined Leading Little Arrows Homeschool Academy, a network supporting homeschool families with curriculum and online or in-person classes. 

“We’ve got our lives back,” she said. “He has healthy friendships, and I’m in a healthier state as a mom.” 

A ‘new arena of competition’

But sometimes, simply moving to another public school in  the same district, instead of leaving the system, can solve the problem, said Whitney Oakley, superintendent of the Guilford County Schools, which includes Greensboro, North Carolina.

The district offers 66 choice options and this year saw at least an 11% increase in applications for choice schools, compared with last year. Oakley took advantage of the system for her own son, who struggles with anxiety.

“I knew that he would probably benefit from a smaller middle school,” she said. “Every family deserves access to that kind of option.”

In addition to the relief funds, the district has received $20 million in federal grants for mental health services, and last school year, students and teachers participated in more than 10,000 therapy sessions, she said. While the district has seen small decreases in enrollment over the past three years, Oakley said some families who’d left the system have returned. 

“I think all public school systems are going to find themselves in this new arena of competition,” she said. “What can we offer here to make sure that choice doesn’t mean us or them? Choice means what best fits the needs of this particular student.” 

According to the Tyton report, the “enduring attraction of a traditional school environment” is what keeps some parents from pursuing other options. Among those who said they would consider switching schools, 41% said the “benefits of school culture and extracurriculars” are holding them back. 

Parent comments cited in the report also reflect concerns that students would miss out on “foundational experiences” if they cut ties to public schools. 

The report is the first in a three-part series about the “evolving landscape of parents’ K-12 education options.” In addition to holding focus groups, the researchers surveyed more than 2,000 parents last August. Almost two-thirds said they were only looking to supplement their children’s existing education through extracurricular programs, including tutoring or enrichment activities. 

Ten percent indicated they would transfer their child to a private school or even an alternative model like a microschool. And more than a quarter of the respondents said they would consider piecing together multiple options to provide their child a customized experience.

Following mental health, academic performance ranked second among the reasons parents said they would choose another schooling option. Forty-four percent of parents open to making a change cited academics as a driving factor.

Tarpley said her son was in fourth grade before she learned he was missing some basic math skills. 

“I needed to know way back in kindergarten that they were seeing some challenges with addition and subtraction — even if it’s just adding doughnuts and cookies,” she said.

Choice options certainly haven’t worked for everyone. For some families, the new arrangements didn’t meet their children’s needs. In other cases, private schools didn’t accept their kids.

Pamela Lang pulled her son, who has ADHD, out of the Kyrene School District, near Phoenix, when he was in fourth grade. She used Arizona’s education savings account program. But most independent and religious schools turned him away. 

Arizona also allows families to transfer outside of their district, but for her son, “schools are always magically full,” she said. Now 16, he attends a private school for students with disabilities, but she’s considered returning to the public system. “At this point, our options are so limited.”

Newman, at Tyton, said the researchers have not yet followed up with parents to see if those who changed schools are satisfied with their decision. But they plan to in the future. 

The second paper in the series will examine why parents decide not to switch, and the third will look at the rise of organizations like Dippel’s that advise families on their options.

Most of the parents that seek her group’s help are “making really good parenting decisions,” she said. “By and large, they’re not hysterical. They don’t want to rip down the [traditional] system. They’re just like, ‘I want to pack up my stuff and get my kid out of this toxic situation.’ ”  

Disclosure: Walton Family Foundation and Stand Together Trust provides financial support to Tyton Partners and The 74.

A Michigan jury found Jennifer Crumbley, the mother of the Oxford High School shooter, guilty of involuntary manslaughter Tuesday.

In a first-of-its-kind case, the jury found that Crumbley bore enough responsibility for the deaths caused by her son’s actions that she should be held criminally liable.

At age 15, Crumbley’s son shot and killed four of his classmates at Oxford High School on Nov. 30, 2021, days after his father bought him a gun. Crumbley’s son was sentenced to life without parole in December.

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Crumbley’s husband, James Crumbley, has a separate trial scheduled for March.

After two days of deliberations, a jury in Oakland County Circuit Court in metro Detroit delivered the guilty verdict for Jennifer Crumbley on four counts of involuntary manslaughter, one for each of the students killed: Madisyn Baldwin, Tate Myre, Hana St. Julianna and Justin Shilling.

The jury had been tasked by the court to determine whether Crumbley’s actions warranted involuntary manslaughter charges, which marks new legal ground for determining responsibility for a mass shooting.

Crumbley now faces up to 15 years in prison ahead of her sentencing scheduled for April 9.

Her defense argued during the trial that began on Jan. 25 that Crumbley couldn’t have known what her son was going to do. She was portrayed as an attentive parent who was aware that her son was going through a hard time, but nothing indicated he would become a school shooter.

“It was unforeseeable; no one expected this,” Shannon Smith, a lawyer for Crumbley, said in her closing arguments. “No one could have expected this, including Mrs. Crumbley.”

But the prosecution argued that Crumbley failed as a parent to perform her legal duty to exercise reasonable oversight to her son to prevent him from harming others and was negligent to the point that it harmed human life.

The prosecution proved Crumbley’s role in the shooting and how she could have intervened at several points beforehand to get her son help or secured the firearms in the home, but she didn’t, Oakland County Prosecutor Karen McDonald said in her closing arguments.

“We have proven beyond a reasonable doubt that she is guilty of four counts of involuntary manslaughter. It’s a rare case. It takes some really egregious facts. It takes the unthinkable and she has done the unthinkable and because of that four kids have died,” McDonald said.

Despite audibly crying at several points throughout the trial, Crumbley didn’t have a substantial reaction to the verdict being read. McDonald and other members of the prosecution hugged family members of the slain children.

In addition to the four students who were killed, the shooter injured six other students and a teacher. Molly Darnell, the teacher who was shot in the arm, was the first witness to testify at the start of the trial in January. A total of 22 witnesses spoke during the trial, including Crumbley, members of law enforcement and people who had interactions with Crumbley.

A major element of the prosecution’s justification for the involuntary manslaughter charges was Crumbley’s actions the day of the shooting after she and her husband were called to the school because the shooter had done a drawing of his gun on his math assignment.

Four days prior, the shooter and his father went to a gun shop and the father purchased the gun used in the killings on Black Friday as an early Christmas present.

After the meeting at the school where Crumbley and her husband were advised to seek out professional help for their son, the prosecution brought in witnesses from the school and law enforcement to show that neither parent took the shooter out of school for the day. Neither parent checked their son’s backpack where he had the gun. And neither parent asked their son where his gun was or checked to see if it was still at home.

There had been other meetings with the shooter’s parents, Shawn Hopkins, the school counselor at the meeting the day of the shooting, said during the trial. He said he was hoping one of the parents would take the shooter home. Although Hopkins didn’t tell them they had to, he thought it was strange they didn’t.

“She sat down in the chair; [I] felt she was a little bit distant. … It felt like it was a little bit of an inconvenience to be there,” Hopkins said of Crumbley during the meeting.

Hopkins said the shooter showed signs of possible suicidal thoughts and he didn’t want him to be alone. Hopkins added that he did not know that the shooter’s father had bought him a gun.

In addition to the drawing of a gun, the shooter’s assignment had the words, “my life is useless” and “the thoughts won’t stop help me,” written in addition to other statements and drawings.

When school officials asked Crumbley and her husband to go to the school, Crumbley testified she thought the shooter had sketched the gun in defiance of a recent conversation they had about his falling math grade, during which he had his phone taken away and was told he couldn’t go to the shooting range until his grade improved.

This was the first time she and her husband had been called to the school on an “immediate” time frame, Crumbley testified and she had told her boss she would be back at work an hour later.

Crumbley said she expected her son to get in trouble and get suspended, but the meeting was “nonchalant” and “brief.”

“There is never a time where I would refuse to take him home,” Crumbley testified, adding that she told her husband to start calling mental health professionals suggested by Hopkins.

Crumbley said she and her husband lost everything, adding she doesn’t feel like she failed as a parent and she had no reason to think her son was a danger to anyone else. She said she doesn’t look back and think she would have done anything differently.

“You spend your whole life trying to protect your child from other dangers. You never would think you have to protect your child from harming somebody else,” Crumbley testified, adding that she wished he would have killed her and her husband instead of the other kids at the school.

The shooter’s father was responsible for gun storage as firearms were not really her thing, Crumbley said. The gun that was bought for her son’s use was secured using a cable lock and the key to unlock it was hidden in one of the many decorative beer steins throughout the house.

The prosecution “cherry-picked” evidence to make Crumbley look like a negligent mother and conflate the magnitude of the tragedy with Crumbley’s parenting, Smith said as part of Crumbley’s defense. Hours of the trial were dedicated to members of law enforcement going over the gruesome details of the shooting. But Smith said the case came down to the prosecution improperly asking the jury to come to the assumption that Crumbley could have conceived what no parent would think their child would be capable of.

“When you look back in hindsight, with 20-20 vision … it is easy to say this could have been different, that could have been different, this would have changed,” Smith said.

Due to the community impact of the shooting and the future legal implications for parents of mass shooters in the future, the case has garnered national attention.

The jury’s verdict stands as a reminder to parents and gun owners that they are responsible for ensuring children can’t access their firearms unsupervised, Nick Suplina, senior vice president for law and policy at Everytown for Gun Safety, said in a statement after the verdict was read.

“Plain and simple, the deadly shooting at Oxford High School in 2021 should have — and could have — been prevented had the Crumbley’s not acquired a gun for their 15-year-old son,” Suplina said. “This decision is an important step forward in ensuring accountability and, hopefully, preventing future tragedies.”

The decision marks Michigan setting a standard for the legal response to “when our kids are killed in their sanctuaries,” U.S. Rep. Elissa Slotkin (D-Holly) said in a statement Tuesday. She applauded several pieces of gun reform legislation Michigan will enact on Feb. 13, which includes safe storage laws for firearms.

“Today is a historic day in Michigan, and really for the whole country. Having watched the Oxford community go through this school shooting firsthand, and seeing the lifelong hole it ripped in the lives of everyone involved, this verdict feels like a small moment of relief,” Slotkin said. “It is my hope that it brings a bit of peace to the survivors and to the entire community, as I know everyone in Oxford has worked to heal together over the past two years.”

Michigan Advance is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Michigan Advance maintains editorial independence. Contact Editor Susan J. Demas for questions: info@michiganadvance.com. Follow Michigan Advance on Facebook and Twitter.

A high school student, her mother and mental health professionals from Emergence Health Network gathered on Thursday for a roundtable hosted by El Paso Matters.

More than 50 people attended the event at the El Paso Community College Administrative Services Center, ending with a question-and-answer session with the audience. The dialogue was the first in a series of events El Paso Matters is hosting this year that focus on different topics affecting the community.

Alice Cruz, a senior at Austin High School, said she began to seek help for her mental illness when she was 16 years old and a combination of therapy, psychology and psychiatry helped her get to where she is today.

“It’s like any other type of illness you’re going to have,” Cruz said. “You’re gonna have to take medication for it or you’re gonna have to go through therapy to recover from it.”

In a survey of 3,000 students across multiple high schools in three El Paso-area school districts, students said they wanted to learn how to cope with anxiety, said Krista Wingate, chief of child and adolescent services at Emergence Health Network. The second top response was about improving self-esteem.

Here are five highlights from the conference.

Signs my child is struggling with mental health

Gicela Lopez said she noticed changes in her daughter Alice Cruz’s behavior. Cruz slept and cried more than usual. She isolated herself in her bedroom and was no longer interested in playing soccer, socializing or eating. Cruz reassured her mother she was OK, but once Lopez noticed Cruz was cutting herself, she knew Cruz was not OK.

“I knew that something was wrong because I love to eat, honestly, and I was not eating at all,” Cruz said. “My mom gave me pasta or my favorite foods and I totally just threw them aside.”

While her mental health didn’t affect her grades, she did stop communicating with her teachers and friends, Cruz said.

In order to notice these changes in your kid’s life, you have to know your kid and have consistent conversations with them, Wingate said. This lays the groundwork for having tough conversations later.

How to get my child to open up to me

Wingate said it’s important for parents and caregivers to take a step back and understand mental illness is not directly caused by something they did.

Parents should make sure they’re in the right headspace before they talk to their child about mental health issues, especially when it’s a topic that feels uncomfortable or unnatural, Wingate said. Avoid having tough conversations when you’re feeling burnt out because it may be harder to pay attention to the child, she said.

Wingate recommended the “LUV” approach: listen with intention, understand and try to put yourself in your child’s shoes, validate what they’re feeling. Approach the conversation with an open mind, rather than anger, and take a second to pause and be present, she said.

Lopez said she made it clear to her daughter that they would go through the mental health journey together. Your child may not want to talk to you at first, so it’s important to establish trust, Cruz added.

“You have to work and grow that trust, that relationship, to be able to have those difficult conversations,” said Julie Tirrell, an Emergence Health therapist at Austin High School.

That means showing a level of respect for your child and their story, Tirrell said.

Rather than demanding that a therapist talk to you about your child – which may appear threatening in front of your child – start by asking your teen about what they talk about in therapy, Wingate said. A parent can ask their child for permission to sit in during the first 15 minutes of therapy, or have a collaborative conversation about what topics to discuss in the next family session.

Approaching my child about social media usage

Cruz said being on social media had a complicated effect on her mental health.

“I saw people that were happy when I was sad, that were having the best time of their lives traveling while I was in my room crying, so it definitely did influence me a lot,” Cruz said.

Tirrell said social media can be problematic for the developing mind, especially because “people only post what they want you to see.” This can lead to low self esteem as teens compare themselves to others. It’s hard for young people to understand what’s on social media – from filtered photos or selective angles – may not reflect reality, Tirrell said.

Wingate said the unpopular opinion is to restrict internet time, such as using wifi-blocking apps that limit screen time. This could also look like not letting children sleep with their tablet, cell phone or school laptop, which prevents them from staying up late scrolling through social media. Talk to your child about why you want to limit their social media time, she said.

Low-cost or free mental health services available in El Paso

“Your brain is one of the most important organs that we have,” Tirrell said. “Seeking help doesn’t need to be looked at in a negative way at all. It should be handled just like cardiac disease.”

Two organizations in El Paso offer mental health services to students on campus.

Emergence Health Network, a local agency that provides mental health services, offers on-campus therapy and case management in at least 10 different schools in El Paso County. Along with therapy, the organization provides case management and informal youth mentorship. 

Project Vida, a nonprofit in El Paso, offers on-campus services in at least 21 schools across El Paso and Hudspeth counties. Each mental health team from Project Vida includes a licensed professional counselor or licensed clinical social worker, who rotate between two campuses. Availability tends to fill up within the first three months of the school year, although clinicians can take new students in the middle of the school year if their clients finish their treatment plan early.

At the Ysleta Independent School District, students, staff and their families can access free treatment for mental health or substance abuse through Care Solace, which connects people to off-campus providers.

Borderland Rainbow Center offers LGBTQ youth and adults individual therapy, group therapy and peer support groups. Individual therapy is available on a sliding scale based on income.

NAMI El Paso offers programs in English and Spanish for parents and caregivers of children and adolescents who are diagnosed or not yet diagnosed with a mental health condition. 

Options besides therapy

There is a shortage of counselors and therapists in El Paso, but there are other services that can be beneficial in different ways from therapy, Wingate said.

Emergence Health Network offers caseworker services. A caseworker with a degree in psychology can provide psychological education to both parent and child. Social workers are overlooked, but they can help people learn coping skills and lay the groundwork for addressing mental health issues before jumping into therapy, she said.

Disclosure: Emergence Health Network, El Paso Community College and the Socorro Independent School District partnered with El Paso Matters to sponsor the mental health forum. Sponsors are not involved in the editorial content of El Paso Matters. The newsroom’s policy on editorial independence can be found here.

This article first appeared on El Paso Matters and is republished here under a Creative Commons license.

COLUMBIA — The number of mental health counselors in South Carolina schools doubled in a year and a half, according to a report released Thursday by the state’s Medicaid agency.

A 2022 statewide survey requested by the governor found a dearth of mental health counselors in the state’s schools, despite an increasing need for mental health services for children. On average, the state had only one counselor for every 1,300 students, and nine school districts didn’t have any counselors at all, according to the report from the Department of Health and Human Services.

The improvement is partly due to the agency nearly doubling what it pays licensed therapists working in schools. The rate for a 30-minute session has jumped from $37 to $71 since 2022, according to the department.

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The department hit its goal: In September of 2023, schools had one counselor for every 653 students, the most recent report found. Overall, the number of mental health counselors working in schools went from 600 in January 2022 to 1,200 in September 2023.

Every district in the state had at least one counselor as of September, according to the report. In some districts, counselors spend all day every day of class in an assigned school, while in others they rotate from school to school.

The numbers are still far below recommendations of one counselor for every 250 students set by the American School Counselors Association. Nationwide, the average is closer to 400 students per counselor, according to the U.S. Department of Education.

The long-term goal for South Carolina is to have one therapist for every 325 students. The biggest thing standing in the way of that is that the state just doesn’t have enough mental health clinicians to fill the need, said Jeff Leieritz, spokesman for the state’s Medicaid agency.

The agency’s report came out a day after Gov. Henry McMaster touted the progress in his State of the State address with a preview of the survey’s findings.

“In just the past two years, we have made significant progress in providing school-based mental health services to school-aged children,” McMaster said Thursday in a statement. “With an ongoing mental health crisis, especially among our young people, it is critical that we continue to build upon these efforts and ensure mental health resources are available and accessible to our state’s children.”

While children can get therapy outside of school, they are 21 times more likely to use mental health services available in their school, according to findings by the South Carolina School Behavioral Health Academy. That makes getting counselors into schools even more essential, said the state’s Medicaid director, Robby Kerr.

And the need for mental health services is growing.

Nationally, suicide rates for people ages 10 to 24 increased 62% from 2007 to 2021, according to the Centers for Disease Control and Prevention. In 2021, 2.5 of every 100,000 children in South Carolina died by suicide, according to data from the state Committee on Children.

Beyond pay therapists more, changing how they’re paid also helped South Carolina’s numbers.

The state Medicaid agency changed its policy to make it easier for schools to hire private clinicians and still send the cost to the agency, where before the need was filled by the state’s mental health workers.

That opened the door for districts to hire their own counselors, which was something nearly 60% of district leaders said they would prefer, according to the 2022 report.

As of the 2023 survey, around 600, or about half, of all in-school mental health counselors were employed by their districts instead of a state agency. School districts still have the option of partnering with the state Department of Mental Health or doing a hybrid model mixing state workers with private clinicians.

District-employed counselors can spend more time in schools instead of jumping from place to place, and less turnover means students are seeing the same person consistently, Leieritz said.

More counselors also means more support for students in crisis. Clinicians overwhelmed with day-to-day sessions often didn’t have the time to help children having mental health emergencies, leaving those situations in the hands of untrained nurses or administrators, the 2022 report said.

SC Daily Gazette is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. SC Daily Gazette maintains editorial independence. Contact Editor Seanna Adcox for questions: info@scdailygazette.com. Follow SC Daily Gazette on Facebook and Twitter.

Why Rural Matters 2023, the latest in a series of 10 research reports on rural education, shows that roughly 9.5 million students attend public schools in rural areas — more than 1 in 5 nationally. Nearly 1 in 7 of those rural students experience poverty, 1 in 15 lacks health insurance and 1 in 10 has changed residence in the previous 12 months.

Roughly half of all rural students live in just 10 states. Texas has the largest number, followed by North Carolina, Georgia, Ohio, Tennessee, New York, Pennsylvania, Indiana, Virginia and Michigan. Texas has more rural students than the 18 states with the fewest combined.

In 13 states, at least half of public schools are rural: South Dakota, Montana, Vermont, North Dakota, Maine, Alaska, Oklahoma, Nebraska, Wyoming, New Hampshire, West Virginia, Mississippi and Iowa. In 14 other states, at least one-third of all schools are rural. 

More key findings from this edition of Why Rural Matters:

• More access to psychologists and guidance counselors is needed. In non-rural districts, there are an average of 295 students per guidance counselor or psychologist. In rural districts, the ratio increases to 310:1, with seven states (Minnesota, California, Mississippi, Alaska, Louisiana, Indiana and Michigan) having ratios worse than 400:1. 

• More access to gifted and talented programs is needed for Black and Hispanic students in rural districts. Though 17% of students in rural schools identify as Hispanic, they represent only 9% of participants in these schools’ gifted programs. Similarly, 11% of the rural school population identifies as Black, but only 5% of the gifted student population in rural schools is Black. In contrast, 65% of rural students are white, as are 77% of participants in gifted programs. 

• Rural areas appear to offset some of the impact of poverty on educational outcomes. Overall, students experiencing poverty scored 27 points lower than their peers on the grade 8 NAEP math assessment and 22 points lower in reading; in rural schools, these differences were 22 and 18, respectively. Socioeconomic equity in reading appeared to be highest within rural schools in Arizona, Idaho, Texas and Oklahoma, and most concerning in Illinois, Mississippi and Virginia. For math, the most equitable states were Hawaii, Arizona, West Virginia and Oklahoma; the least equitable states were Colorado and Louisiana.

• Many rural areas continue to lack basic internet access. The pandemic made clear that adequate internet connectivity is essential to equitable education opportunities. However, 13% of rural households lack minimum broadband connection for streaming educational videos or engaging with virtual classrooms. In six states, more than 1 in 6 rural households doesn’t have at least a basic broadband connection: New Mexico (21.4%), Mississippi (20.6%), Alabama (18.9%), West Virginia (17.5%), Arkansas (17.4%) and Louisiana (17.2%). 

• Students in rural districts are more likely to graduate high school than their non-rural counterparts. In the majority of states with enough rural students to make data available, (34 of 46), rural students graduate at rates higher than their non-rural peers. Despite facing a range of spatial inequities, the unique strengths of rural areas —such as smaller schools and close community ties — combined to create graduation advantages of at least 5 percentage points in Nebraska, Connecticut, Maryland, Massachusetts, New York and Rhode Island.  

• Many states provide a disproportionately larger share of school funding for rural districts because of the higher relative costs of running rural schools. Fourteen states, however, devote disproportionately less: Nebraska has the greatest disparity, followed by Vermont, Rhode Island, Iowa, Delaware, South Dakota, Michigan, Indiana, Wisconsin, Connecticut, Idaho, Illinois, Massachusetts and Minnesota. 

• Rural school districts in Delaware, Oklahoma, North Carolina, and Nevada are the most racially diverse in the United States. In these states, two students chosen at random from a school in a rural district are more likely than not to be of a different race or ethnicity. 

• Communities surrounding schools in rural districts on average have a household income of nearly three times the poverty line. Rates were lowest in New Mexico (1.85) and highest in Connecticut (5.32).

As post-pandemic recovery continues, states and local districts must reevaluate what it means to provide a public education that meets student and family needs and prepares young people for life beyond pre-K-12 schooling (including college and career readiness and engaged citizenship). These challenges are widespread but are most intense in the Southeast, Southwest and Appalachia. What is needed is the will to address them.

The results published in Why Rural Matters 2023 make clear that policymakers cannot ignore the difficulties faced by rural schools and the students they serve.

Brian Miller is a fixture at Charles W. Harris School in Phoenix, a familiar face kids and parents encounter four days a week.

Mornings and afternoons, the school resource officer is in the parking lot directing traffic — and sometimes, he notes, defusing a little road rage. Before lunch, he’s on the playground herding students toward the cafeteria, or in classrooms where teachers have requested help. In between, he’s walking the campus or in his office, on standby for serious disciplinary incidents or lockdowns prompted by crimes nearby.

What he doesn’t do, Miller acknowledges, is provide comprehensive mental health services to the many students who need them. That’s where Cartwright Elementary District’s counselors and psychologists come in.

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District officials believe both types of positions are essential for a secure campus, which is why they asked the Arizona School Safety Program to fund one officer and one additional counselor at 19 of their schools, including Harris, this year. In all 19 cases, the state paid for only the officers, the result of a 2022 legislative requirement forcing the Department of Education to prioritize requests for campus police over mental health positions.

In fact, more than 100 schools throughout the state received officer funding while a counselor or social worker request went unfulfilled this year, as Superintendent of Public Instruction Tom Horne embraced the strings Republican lawmakers had tied to the grant money. In another 130 cases, schools that asked only for mental health positions did not receive them, according to an AZCIR analysis of School Safety Program data.

Overall, district and charter schools requested funding for 857 counselor and social workers and 301 campus officers, citing problems with bullying, trauma, suicidal ideation, truancy and more in the hundreds of applications reviewed by AZCIR. About a third, or 291, of those mental health positions went unfunded after the grant program ran out of cash.

The apparent mismatch between what schools need and what certain state leaders want to give them reflects an ongoing clash over which types of positions actually make a campus safer. In the wake of tragedies like the Uvalde, Texas elementary school shooting, proponents of campus police say officers are the professionals best equipped to respond to dangerous situations, while advocates for expanded mental health services argue counselors, social workers and psychologists could help stop many of those situations before they start.

In interviews with AZCIR, officials representing districts and charter schools in both rural and urban areas across Arizona were hesitant to criticize the School Safety Program, worrying they would be perceived as ungrateful for needed funding. But they indicated it should be up to school leaders, not politicians, to determine which positions are best suited to tackle the post-pandemic surge in mental health issues they’re observing among students.

“The schools know better what is needed,” said Monika Fuller, director of Prescott Valley School, a K-9 charter that received money for police but not a counselor this year.

Pointing to the breakdown of funding requests, she said the “numbers don’t lie.”

Arizona leaders expanded the School Safety Program, initially created to fund school resource and juvenile probation officers, to cover counselors and social workers in 2019. At the time, the state had the worst student-to-counselor ratio in the country — 905:1, nearly four times the recommended 250:1 — as schools continued to confront Recession-era cuts that had decimated the ranks of campus-based mental health professionals.

The program, which awards funding on a three-year basis, could not meet the resulting appetite for counselors and social workers, leading to a wait list nearly 90 schools long. That demand only grew after COVID-19 swept the state, leaving students to cope with new sources of grief, anxiety and anger.

In 2021, the state Department of Education dedicated $21 million in federal pandemic relief dollars to unfunded campus counselor and social worker positions. The move eliminated the wait list, which had continued to grow, and further reduced the state’s student-to-counselor ratio to 651:1. But, with the federal dollars’ 2024 expiration date in mind, schools expressed a desire for a more stable, permanent funding source for mental health staffing.

Instead, the GOP-controlled Legislature decided to prop up the School Safety Program for another three-year cycle — and stipulated the additional $50 million had to go toward requests for school police first, before officials could consider counselor and social worker needs.

Though schools could technically apply for up to two School Safety Program positions of either type this year, Horne warned applicants that schools with “no armed presence” would “not receive a recommendation from this Department to the State Board of Education” if they didn’t request an officer. In some cases, this led schools to rank their requests for SROs as higher-priority than their requests for counselors or social workers, in an effort to make sure they got at least something.

Yet campus officers are not interchangeable with school counselors or social workers, even if some of their responsibilities overlap.

“Fundamentally, school resource officers are taking more of an enforcement approach … and often are viewing behaviors through a lens of threat,” said Angela Kimball, senior vice president of advocacy at national mental health policy coalition Inseparable. School mental health professionals, meanwhile, are “viewing behaviors as a manifestation of challenges a youth may be having in terms of their thoughts, their feelings, their perceptions” and “giving them coping skills,” she said.

Fuller, the Prescott Valley School director, is hopeful that whoever fills the charter’s School Safety Program-funded officer position can back up administrators on “heavy-duty” disciplinary issues. But she said the roughly 450-student school, which has been relying on a virtual counselor because it’s “all we can afford,” still needs in-person mental health support — both to provide targeted interventions for kids with emotional disabilities and to help educators address students’ pandemic-related trauma more broadly.

Cottonwood-based Mingus Union High School District, which has just one physical school, is much better off when it comes to campus mental health professionals: Its high school has counselors for each grade level, as well as one psychologist.

But even that team has struggled to fully meet what Superintendent Mike Westcott described as the mounting “needs of the students around social-emotional health,” particularly as the rural school finds itself having to “step up in ways that maybe schools in larger areas don’t.”

Like Prescott Valley, the district sought funding for both officer and counselor positions, with Westcott envisioning the additional counselor working as a liaison with area mental health agencies. The district also hoped a new counselor could help implement suicide prevention efforts, trauma-informed teaching strategies and grief management services, so the state’s decision to grant only the SRO request has left Mingus Union “in a bit of a lurch.”

Westcott also expressed concern over the patchwork of limited-term grants and relief funds districts have largely relied on to pay their mental health professionals, as did several other school officials interviewed by AZCIR. He urged the Legislature to view campus counselors and social workers not as “extras” but as “integral components of what we do,” and to fund them “in a way that can be sustained.”

Uncertainty about the positions’ staying power, as well as shortages of available law enforcement officers and mental health providers, has made it difficult for some schools to hire at all. As of October, more than 130 School Safety Program-funded SRO posts remained open, according to ADE, as did 148 counselor and social worker spots.

That month, the state’s School Safety Task Force unveiled a plan to fill campus police vacancies by shifting more than $18 million in grant funding for full-time SROs to part-time school safety officers. It offered no comparable plan to assist schools with counselor and social worker vacancies.

After the task force presented its final report on Dec. 7, Horne doubled down on his commitment to the police-first approach, saying he had “very little patience” for criticism.

“I’ve encountered opposition from people who say they don’t want a school-to-prison pipeline,” Horne said, referring to those who’ve questioned whether boosting the ranks of campus officers would ultimately push already-marginalized students out of the classroom and into the criminal justice system. “What they’re really saying is people should be able to violate the law without consequence.”

Under the part-time officer staffing plan, off-duty police sign up to work school safety shifts as their schedules allow, a change that has reduced vacancies but sacrificed the kind of continuity districts like Cartwright believe have made their officers successful.

Ema Jáuregui, the deputy superintendent who oversees the district’s SROs, said officers’ ability to have a consistent, visible presence at a specific school has been an essential part of building trust and goodwill with students and families in the Maryvale area.

“Our community, they value the SROs because they see them out on the playground. They see them out during (pickup and dropoff) traffic. They see them talking to kids in a positive way,” she said. “When Uvalde happened, you would not believe how many kids did not want to come to school because they were scared, and I think the police presence made our families and kids feel safer.”

Jáuregui acknowledged not every school system has had the same experience, calling Cartwright “very lucky.” Nationwide, school resource officers have made headlines for using excessive force against children, disproportionately arresting students of color and for contributing to what civil rights organizations have described as a threatening, rather than safe, school environment.

Arizona School Safety Director Michael Kurtenbach has repeatedly emphasized the importance of officer training when it comes to preventing such controversies. Kimball, the national mental health policy advocate, said she has seen training in adverse childhood experiences and trauma-informed care help school police shift their focus from rigid enforcement to understanding and prevention elsewhere in the country.

Still, she believes it’s better to hire mental health professionals directly, versus “hiring people that you have to train to be like mental health professionals.”

Harris School Resource Officer Miller, for his part, promotes a collaborative approach that involves school police and mental health staff working closely while deferring to each other’s areas of expertise.

To make the arrangement work, he said, police must adopt “a different mentality” when shifting from patrol work to a campus setting — and not every officer can do it.

“You don’t talk to people (at a school) the same way you do on the beat. It’s a different philosophy,” he told AZCIR. “And if you don’t have that desire to work with kids, this is probably not the position for you.”

AZCIR is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The national partnership includes The Carter Center and newsrooms in select states throughout the nation.

Since 2021, the company has seen more than a tenfold increase in sales from government contracts, primarily with school districts — from $174,000 to $2.13 million, according to GovSpend, a data service. The Holyoke, Massachusetts, and Akron, Ohio, districts are among those requiring all middle and high school students to slip their phones into the rubbery envelopes each morning and unlock them with a magnet at the end of the day.

“All signs point to 2024 being even busier,” said Sarah Leader, the company’s spokeswoman. With an estimated 2,000 schools using the pouches this year, the company has doubled in size to 80 employees to meet the demand. 

“It’s a game changer,” said Patricia Shipe, president of the Akron Education Association. She worked with district leaders to pilot and then adopt the Yondr system this year. Students are less distracted and schools feel calmer, she said. “The transitions between classes are faster because kids are not on their phones.”

Most districts already prohibit students from using phones in class for non-academic reasons. But phone-free advocates say tighter restrictions are necessary to refocus students on learning following the pandemic and to minimize the negative impact of social media on students’ mental health.

Such moves typically draw strong reactions. Some parents see phones as integral to staying in touch with their children during emergencies.

But many welcome the opportunity to curb frequent disruption. Teens report being on social media “almost constantly,” according to new data from the Pew Research Center. Efforts to break their habit, at least during school hours, could get a critical boost if Congress passes a bill that would create a $5 million grant program to cover the costs of “secure containers” like Yondr or wall-mounted phone lockers.  

“Widespread use of cellphones in schools are at best a distraction for young Americans; at worst, they expose schoolchildren to content that is harmful and addictive,” Sen. Tom Cotton of Arkansas, a Republican, said in a statement about his bipartisan proposal with Sen. Tim Kaine, a Virginia Democrat. “Our legislation will make schools remain centers of learning.”

Congress would still need to approve funding for the program. The legislation also directs the Education and Health and Human Services departments to study the impact of cellphone bans on student achievement, mental health and behavior. 

A ‘security nightmare’

Getting student violence and bullying under control is one reason the Akron school board approved its $180,000 agreement with Yondr in June for 10,446 pouches. Leaders hope locking up phones during the day will halt a troubling pattern of students not only using them to arrange fights on social media, but record the altercations on video. 

“It was happening daily in our buildings and multiple times a day,” Shipe said. As in many districts, physical attacks against teachers had also increased. “It was just a real security nightmare.”

Many students have rebelled against the changes. And Shipe warned that opposition to losing what she described as “an appendage” for most teens “gets worse before it gets better.” Online discussion threads among students include ways to destroy the pouches, and demonstrations on TikTok show how bending the magnetic closure prevents them from locking.

But as Shipe notes, those who sabotage the pouches typically keep their phones hidden during class, if only to avoid getting suspended. 

“There are just a lot of positives,” she said. 

Many researchers and advocates agree that school phone bans have more benefits than drawbacks. In October, nearly 70 child advocates, educators and mental health experts sent Education Secretary Miguel Cardona a letter asking him to urge schools to adopt phone-free policies. Late last month, an author of the letter met with a senior department official, but didn’t get the response she wanted. 

“The secretary does not intend to act on our phone-free schools letter,” said Lisa Cline, part of the Screen Time Action Network, a coalition focused on limiting children’s use of digital devices. 

Cardona has yet to reveal his opinion on banning phones, but he’s frequently mentioned the role social media plays in the mental health problems facing students. In March, Cardona said media companies should be held accountable for “the experiment they are running on our children.” Two months later, the White House announced that the department would work with other agencies to issue model policies for districts on phone use.

An Education Department spokesman said officials are still preparing that guidance and are working “in close partnership” with Surgeon General Vivek Murthy on the issue.

Under the Senate bill, districts would need to get feedback from parents on cellphone restrictions before applying for funding, and the bill directs Cardona to choose grantees that will “likely yield helpful information” on the impact of phone bans. The program also would allow exceptions for students with disabilities and those who need phones for translation apps or to treat health conditions.

While Yondr’s growth is one piece of evidence on the trend, a 2022 survey pointed to the popularity of phone bans among parents. In a sample of nearly 11,000 parents with a child in school, 61% agreed with getting phones out of the classroom. The National Parents Union is currently collecting more data on the issue, but the stance of its president, Keri Rodrigues, is firm.

“The data is clear,” she said. “[Phones] should absolutely be banned during the school day. Every parent I talk to has agreed.”

International research points to higher test scores when phones are out of sight, and some educators say students tune in to class more when they’re not scrolling on social media. In Massachusetts, where Rodrigues lives, the state education department already awards grants for districts that clamp down on use, and Commissioner Jeffrey Riley has hinted at expanding the program.

But some parents aren’t on board.

“Parents are afraid because of school shootings,” said Melissa Erickson, executive director of Alliance for Public Schools, a Florida nonprofit that aims to inform parents about education policy. “That’s a statement of the times.”

She called those in favor of strict bans “tone deaf” to the way students socialize. Kids depended on devices to stay connected to friends and teachers during the pandemic. Banning them, she said, sends a mixed message.

“We told them that one-to-one is everything and now we’re taking it away,” she said. 

‘The extreme end’

Florida has gone further than any state to curb use during school hours. Gov. Ron DeSantis signed legislation in May that prohibits students from accessing social media, especially TikTok, and from using phones except when teachers approve their use for educational purposes.

Districts, however, have some discretion. After instituting limits on use during class this year, Pasco County Schools Superintendent Kurt Browning is calling for a complete ban by the 2024-25 school year. The Hillsborough district board adopted a policy that allows students to keep their phones if they are “powered down, silenced, and stored out of sight unless authorized by staff.”

Last year, teachers tended to set their own rules, said Kendal Coulbertson, who graduated in May from Armwood High in Hillsborough. Some teachers, she said, didn’t mind if students used their phones as long as they were turning in their assignments and getting good grades.

But she thinks a ban goes too far.

“I was engaged in conversation. I was engaged in learning, and I think, honestly, that should be the goal rather than going to the extreme end,” she said. She added that guns in school are a “real issue” and students want to be able to reach their parents in case of an emergency. “There could be some type of middle ground.”

Like parents, educators are split on the issue. In some districts, including Akron and Florida’s Orange County, bans on phones extend through lunch, a time when teens typically check in with social media. 

“It has to be all or nothing,” said Shipe, the Akron union leader. Teachers, she added, shouldn’t have to haggle with students to lock their phones back up after lunch. 

Enforcement was a daily struggle for Dina Hoeynck, a former teacher in Cleveland who taught graphic design. At her school, students had access to their phones between class periods and teachers were in charge of ensuring they were locked up — a system she described as “impractical.”

“Going through the rigamarole of having students lock their phones at the start of class and unlock them at the end felt like a massive waste of time,” said Hoeynck, who kept needle nose pliers on hand to straighten pins on pouches when students bent them. “It led to a significant loss of instructional time and created unnecessary power struggles between teachers and students.” 

Mark Benigni, superintendent of Connecticut’s Meriden Public Schools, is among those who oppose a blanket policy,

“We must educate our students on the appropriate and effective use of cellphones as we do for all technology,” he said. “We also need to recognize that today’s cellphones offer numerous opportunities to enhance learning, organization and communication. Many students are emailing teachers using their cellphone and district-provided emails.”

Benigni happens to be Cardona’s former boss. Before President Joe Biden tapped him to be secretary, Cardona served as assistant superintendent in Meriden until becoming Connecticut’s education chief. While the district didn’t pass its cellphone policy until April 2021, Benigni said it closely follows practices in place when Cardona worked there: Students can’t use phones during instructional time unless a teacher permits it or if they’re necessary to access the district’s online learning platform. 

“The secretary always supported the safe use of technology when he was here,” Benigni said. “There are times when teachers need to have students put them away.”

RICHMOND, Va. — As a teacher and mother to a child with autism, Elizabeth Callahan is all too familiar with flaws in the Virginia mental health care system.

“I see the longevity of it, and there’s just so many holes,” Callahan said.

Callahan’s son was diagnosed by a developmental pediatrician at the onset of his symptoms, which included speech issues, she said. He went to occupational therapy for years until COVID-19 halted in-person visits.

Her child’s therapist quit during the pandemic because “she said she would make more on unemployment,” according to Callahan.

Callahan watches her students struggle to be seen by psychiatrists for diagnoses. Though schools provide some resources for students, they cannot provide an official diagnosis.

“I just see it taking forever for families to get appointments,” Callahan said. “It takes months.”

There is a significant shortage of practicing child and adolescent psychiatrists, or CAPs, across the United States, according to data from the American Academy of Child and Adolescent Psychiatry. These physicians specialize in the diagnosis and treatment of mental and behavioral patterns that affect children. They complete medical school and have a three-year residency.

The AACAP data classified states into four groups: States with a sufficient supply of CAPs, a high shortage, a severe shortage and no CAPs. Virginia is in a severe shortage, with just 264 CAPs in the state as of 2019, the most recent data available.

That means on average there are 14 CAPs available per 100,000 children in Virginia, which is also the national average. The academy defines a “mostly sufficient supply” as more than 47 per 100,000 children. Nationwide, few counties meet that standard.

For example, the city of Richmond has 22 CAPs and almost 40,000 children under the age of 18. By the AACAP ranking, the city has 55 CAPS per 100,000 children — considered a sufficient supply. It is 1 of 9 localities in Virginia that does, out of 133. Eighty-five counties in the state have no CAP.

Children have been unable to receive timely mental health care because of the shortage, according to Callahan.

Virginia ranks No. 37 among states when it comes to accessing mental health services, according to the 2022 Mental Health America state rankings. There are nine measures in the ranking, which include adults and youth who did not receive or could not afford treatment and mental health workforce availability.

Why are there so few CAPs?

Emily Moore, policy analyst with Voices for Virginia’s Children, said there is a lack of mental health care for children due to a system that is not “structured and designed with young people in mind,” and because COVID-19 exacerbated workforce issues.

People enter the field because they want to make change, she said.

“They’re realizing that they are up against a system that is not designed to support people the way that they need to be supported,” Moore said.

Moore encouraged families on long waitlists to look into nonprofit agencies in Virginia designed with mental health in mind, though they are not substitutes for treatment, according to Moore.

“Until we can truly transform the system rather than just patch it up and put Band-Aids on it, resilience is a part of our work,” Moore said.

She also said the state legislature needs to provide adequate funding for children’s mental health care, and that early mental health intervention should be prioritized and normalized to avoid mental health crises. The crisis system should not be the entry point to the mental health system, Moore said.

What is Virginia doing to fix it?

Mental health-related emergency room visits at the beginning and height of the pandemic went up, while physical-related visits went down, according to Dr. Bela Sood. Emergency room doctors and pediatricians were not prepared for the mental health emergencies they faced, she said.

Sood is lead CAP for the Virginia Mental Health Access Program, or VMAP, and oversees the work of all child psychiatrists involved in the program.

VMAP is a statewide initiative that strives to give kids greater mental health access by teaching pediatricians to function like psychiatrists. Pediatricians are taught how to screen, diagnose, manage and treat mental health in children.

“It’s amplifying the knowledge that we have as child psychiatrists into the world of general pediatrics,” Sood said.

Sood had tried to pitch programs like VMAP to the state since 2001, but said the program didn’t receive funding until 2018. The Virginia Department of Behavioral Health and Developmental Services is the umbrella funding agency for programs like VMAP.

Her biggest concern with the shortage is the lack of therapists.

“Even as a practicing child psychiatrist, when I refer for therapy, I have no idea who’s going to be treating the child I’m sending them, and what kind of treatment they’re going to deliver,” Sood said.

Virginia needs to design a platform that can be sustained through collaboration and shared resources, or else child health care will remain fragmented, according to Sood.

“As rich a country as the United States, the manner in which health care delivery is spun out into a place is shocking and unconscionable,” Sood said.

She also said Virginia needs to “ramp up” its ability to train therapists and saturate them across the state to help with the understaffing issue.

“Child mental health is one of those arenas where people are naturally collaborative,” Sood said. “The collaboration really yields very good results.”

Mitigating the CAP shortage

The Richmond Behavioral Health Authority, or RBHA, provided behavioral and primary medical services to over 5% of the population of Richmond in 2019. The agency states that one-third of its clients cannot pay for vital services.

RBHA serves adults and children. It has attempted to mitigate a CAP shortage through telehealth options, increased caseload for staff and temporary staff hired from temp agencies, according to John Lindstrom, RBHA chief executive officer.

The RBHA has tried to “get pretty creative” with solutions but cannot meet all the need, he said.

The community health agency has to occasionally “turn off the spigot” if they get overloaded in terms of capacity and certain service areas, Lindstrom said.

“Ideally we should not be running the vacancy rates that we run if we want to offer a robust set of services to anybody that needs them,” Lindstrom said. “That is really our goal.”

The child and adolescent behavioral health staffing shortage is part of a nationwide health care staffing shortage, Lindstrom said. There are incredible pressures on the system.

The RBHA is focused on immediate problems they can address, such as hiring incentives, job retention and recruitment efforts.

Funding mental health

Another way to increase mental health access is to increase their services in schools, said Moore, with Voices for Virginia.

“Our young people are asking explicitly for more support in the school system, and it really is both a matter of making it happen from a legislative standpoint and putting those laws and budget funding in place,” Moore said.

The state budget appropriated $2.5 million for integrated mental health services in schools during the last fiscal year. The amount was bumped to $7.5 million this year after lawmakers passed the budget in September.

More than $12 million was allocated for child psychiatry and children’s crisis response services, to be divided throughout the state based on current services already offered. The funds can be used to hire or contract child psychiatrists to provide clinical services, or to train. Mental health advocates have said the budget makes “significant investments” in mental health services across the state.

Despite the recent urgency behind the issue, Virginia still doesn’t have an adequate number of school psychologists or licensed professional counselors, Moore said.

“We're very lucky that there is now an urgency behind changing the system and also realizing at the same time that that doesn't mean tomorrow,” Moore said. “I hate to have to ask families to be resilient. It's not fair. They shouldn't have to be resilient.”

Families should continue to share stories with local leaders and lawmakers to illustrate the urgency behind needed changes, Moore said.

Callahan, who has taught for 15 years, does not know how things got this bad, but is ready for a solution.

“I eat, sleep and breathe this every day,” Callahan said. “The year that we’re in, how are we not having more resources readily available to families? Why is this taking months and months?”

VCU InSight journalist Daemon Hollinshed contributed to this report.

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