More States Are Allowing Students to Take ‘Mental Health Days.’ But Could the Practice Backfire?

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States attempting to address worsening mental health problems among students have hit upon a novel remedy: allowing them to take time off from school. The idea, which started catching on even before the pandemic began, has already been enacted in nine states. Lawmakers in several others, including Kentucky and Maryland, are considering similar proposals. 

Some educators and therapists have signaled their approval, arguing that the freedom to stay home from classes could allow kids to restore their energies and come back ready to learn. But other experts warn that, in itself, absence from an academic setting may not be a useful tool to address the issues facing troubled young people. The prospect of time off might also prod some students to miss class who otherwise wouldn’t.

“It seems perfectly reasonable, and nothing new, for parents to decide their kids can stay home from school for a day because they’re tired or don’t feel well,” said Paul Hill, founder of the Center on Reinventing Public Education and a professor emeritus at the University of Washington Bothell. “But I just don’t see a reason to make it some official category, or give kids a number of days they can tap into. All that does is encourage absenteeism.” 

Barbara Solish, director of youth and young adult initiatives at the National Alliance on Mental Illness, countered that mental health days offered students “the opportunity to pause, check in, and recharge physically and emotionally.”

“If a kid was feeling physically crummy, we wouldn’t hesitate to give that kid a day to rest and recover. The same goes for emotional wellbeing,” Solish said. “This time can be helpful for children who struggle with anxiety or depression, or even kids who’ve just had a rough week.”

Abundant evidence shows that the havoc inflicted by two years of COVID-related learning disruptions has left an ugly mark on students’ emotional wellbeing. In President Biden’s State of the Union address on Tuesday, he specifically referred to the setbacks afflicting schoolchildren, noting that their “lives and education have been turned upside-down.”

Curbing truancy

The push for student mental health days began in 2019, when Oregon Gov. Kate Brown signed a bill expanding the state’s category of excused absences to include those related to mental as well as physical health. The reform was drafted by a group of high schoolers known as Students for a Healthy Oregon, which recommended it as a salve for the long-running deterioration in teen mental health that has become undeniable in school districts around the country. 

The advocacy effort was the first of several led by students themselves, stressed by both world events and the everyday cares of childhood and adolescence. Hailey Hardcastle, one of the leaders of Students for a Healthy Oregon, said in a TED Talk that she suffered from clinical depression herself and that her mother informally allowed her to skip school up to three days per semester to cope. The new policy would essentially codify that option in state law and provide relief to hundreds of Oregon students she’d met who dealt with psychological crises of their own. 

“This not only will start teaching kids to take care of themselves and practice self-care and stress management, but it could also literally help save lives,” Hardcastle said.

States could benefit from approaching mental health absences in the same way that Hardcastle’s mother did, according to researcher Michael Gottfried. An economist studying absenteeism at the University of Pennsylvania, Gottfried said it was likely that some families are already keeping their children home multiple days each year as a result of emotional issues they experience at school. Adopting an Oregon-style policy — a few states have specified the number of absences students can take, whether two, three or five, while others simply direct districts to accept mental health as a valid reason to be absent — wouldn’t necessarily change the behavior of those families, but it could prevent them from being thrust into state truancy systems. 

“With this policy, what’s so great is that previously unexcused absences could now be coded as excused,” Gottfried said. “That’s important because unexcused absences lead to truancy, they get kids into trouble, they get parents into trouble, and they can lead to juvenile justice outcomes.”

Some evidence indicates that at-risk youth often suffer from a range of psychological challenges that make them more likely to become truant. One South Carolina study found that children actually saw their attendance worsen in the aftermath of court oversight and other truancy sanctions. Hedy Chang, founder and executive director of the advocacy group Attendance Works, said that when it comes to students dealing with adversity, “it’s just not been shown that the hammer gets kids to show up to school.”

“What improves attendance is when you identify why kids aren’t showing up to school and then resolve those barriers. Often, a legal threat doesn’t allow you to engage and form a trusting relationship with a family so that you find out what’s going on and improve it.”

‘Not really doing anything for those kids’

Millions of students have reported experiencing more negative emotions during the pandemic, when their in-person contacts with peers and teachers have been continuously unsettled. A recent article published in the journal JAMA Pediatrics, examining 36 studies in 11 countries, pointed to a strong connection between school closures and emotional distress among children. A paper released by the Centers for Disease Control in February found that among adolescent girls, the proportion of emergency room visits related to eating disorders doubled during the pandemic, while the proportion related to motor or vocal tics tripled. 

The evidence of COVID’s harmful effects on child well-being is clear. But if those harms are related to the disruption of school, some experts wonder, why would the answer be to offer students more time away?

Various methods for tackling mental health in schools have been validated by research evidence, with some of the most successful organized as whole-school interventions that aim to make schools more welcoming and connected settings for kids. School climate can be improved by training teachers and staff to identify students under strain, or by emphasizing social and emotional learning that prepares students to communicate their own emotions more fluently. Even changes enacted by state legislatures, such as anti-bullying laws, have been linked to significant declines in self-harm.

But by definition, when students are absent from school, they can’t access the resources available there. Gottfried said that schools would need to keep careful track of students who took repeated mental health days, reintegrating them into their classes and offering support where necessary.

“Putting them right back in the classroom after they’ve had a mental health departure from school is not really doing anything for those kids,” he said. “You just let them deal with their mental health off-site. If you really want to address mental health, maybe what we should do is think of school more as a community and provide services there, rather than simply giving students another way to not be at school.”

State policymakers have raised some of the same concerns. When Connecticut was considering a proposal last year to allow students to be absent from school up to four days each year for mental health reasons — on top of the 10 days already allowed for physical illness — state education Commissioner Charlene Russell-Tucker said that simply excusing absences would​​ “not necessarily achieve the outcome of improving the student’s well-being.”

“We are concerned that the extent of a student’s mental state may not be known if they are not in school, and there may be adverse outcomes if the child is allowed to remain out of school,” Russell-Tucker wrote in public testimony.

The policy was later adopted, though the number of excused mental health absences was reduced to two nonconsecutive “Mental Health Wellness Days.” A spokesman for the Connecticut State Department of Education said that the office has not yet begun collecting data on student use of the sanctioned days away from school, though it had issued a memo to school districts encouraging them to consider ways to communicate with families and screen students for additional aid.

“We know our students are best served when they are present in school and have access to the supports provided there — including mental and behavioral health supports as well as academic supports,” the spokesman said in an email.

Chang, of Attendance Works, called the argument in favor of mental health days debatable, adding that being absent could potentially worsen the apprehension of a student already avoiding school for other reasons. While the proposal could work as a strategy for taking the problem of absenteeism out of truancy hearings, she argued, it might not actually improve students’ wellbeing.  

“The danger is that we think we’ve solved the problem when we haven’t,” Chang said. “What you’ve solved is making sure it doesn’t lead to courts. What you haven’t solved is making sure kids have the resources to address their anxiety.”

Effects on learning

With several large states already implementing K-12 mental health days, experts will be able to gather data on their effectiveness at reducing academic and interpersonal stress. But we will also learn more about their impact on school attendance — and whether they induce more students to miss time in school.

In the years before COVID fundamentally reshuffled their priorities, education leaders at the state and district levels were increasingly relying on attendance rates as a proxy for school quality. This focus resulted partly from the 2015 passage of the federal Every Student Succeeds Act, which charged states with developing a “non-academic indicator” in their accountability frameworks. Most chose to measure chronic absenteeism, generally defined as students missing 15 or more days in one school year.

The pandemic-era switch to online learning has proven a disaster for efforts to improve attendance, particularly among disadvantaged or low-performing students. Data from states like Connecticut and California, as well as big urban districts like Cleveland, show chronic absenteeism surging as much as 200 percent. Black and Hispanic students, disabled students, and English learners have all been disproportionately more likely to miss school over the last year.

Gottfried, whose research has closely examined the academic consequences of student attendance, theorized that excusing mental health absences might not alter the behavior of kids who already missed a great deal of school each year, or who missed none at all. But for those somewhere in the middle, being offered a free mental health day — or five, as is now the case in Illinois — could encourage them to take it, whether or not it’s actually needed.

Regardless of whether an individual absence is truly warranted, its effect on learning can be harmful. Gottfried considered the case of two students: one suffering from severe emotional problems, the other simply undermotivated to attend class. Each could be tempted to use their mental health day, particularly during periods on the calendar marked by unusual stress.

“They’re both missing school, and the pace of instruction is just going to continue moving forward without them,” Gottfried said. “And I’m guessing that a lot of this might happen at a time of year when it’s high-pressure — a lot of exams or finals coming up. That’s when we would be likely to find these opportunity gaps widening.”

If that’s the case, days spent outside of class could be felt in measurements of student achievement. In a 2017 study examining the specific timing of student absences, Gottfried discovered that missed school days in the spring (especially those that fell within 30 days of the administration of state exams) were more closely tied to test performance than those coming earlier in the year.

The National Alliance on Mental Health’s Solish rejected the idea of a tradeoff between academic participation and self-care, calling it a “false choice”; if we accept that children need to take time away due to physical illness, the same principle should apply to ailments of the mind.

“If a child had the flu and was coughing and sneezing and feeling terrible, they’re not absorbing what’s going on in the classroom. The same is true for a mental health issue: If a child is overcome by anxiety, or is so depressed that they can’t function, they’re not absorbing their lesson.”

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