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As summer 2023 heats up and winds its way toward the beginning of a new school year, many kids and their families are trying to squeeze in as much fun and relaxation as possible. But for a growing number of young people, existing mental health conditions like anxiety and depression can be aggravated during the summer months.
"What we see with kids who are prone to mental health issues is once they get off a schedule, once they no longer have the structure of the school day, we see a decline in mental health and we often don't see those kids rising to the level of concern until school time hits again in August. Then, trying to get them back on a schedule, back on a routine when their mental health has declined can really be a challenge for families," said Jessica Holzbauer, LCSW. She is a licensed clinical social worker at University of Utah Health's Huntsman Mental Health Institute (HMHI).
Holzbauer manages the Kidstar Day Treatment Program for children ages 5 to 12 and the Teenscope Day Treatment Program for teens ages 12 to 18 at Huntsman Mental Health Institute. Her treatment teams are all mental health professionals including board-certified child/adolescent psychiatrists, psychologists, social workers, expressive therapists, education specialists and an addiction specialist when needed to treat teens.
...once they no longer have the structure of the school day, we see a decline in mental health and we often don't see those kids rising to the level of concern until school time hits again in August.
–Jessica Holzbaur, LCSW
Although both programs have existed for over two decades, the need for individualized evaluations, therapy, and treatment being offered through Kidstar and Teenscope keeps growing. Holzbauer said both programs have expanded to meet these challenges.
"What we have seen over the last three years is an increased demand for services that certainly reflects the mental health crisis our youth are experiencing. So, really, we have seen so much more school avoidance and social anxiety which I think we can clearly see is in response to the societal struggles we all had during the pandemic," she said.
Just as pervasive as the mental health issues that can arise when school is out of session are those causing an increasing number of kids and teens to avoid school completely. Holzbauer said the challenges parents face when a child is overcome by anxiety and stress at school can be overwhelming.
"Whether it is because of a social issue or an academic issue, their go-to is to not want to go to the place or activity that is causing them distress. I think that is a natural response. But where things get tricky for parents is that they will, with the best of intentions, help their child avoid the stressful situation or give them a day off. Then, parents have a hard time getting their kids back to school if they start a pattern of avoidance because the child's brain wants to avoid whatever caused the distress in the first place," Holzbauer said.
Conquering school avoidance is one of the issues Holzbauer and her team members deal with routinely when it comes to the patients and families they treat.
"What we see in day treatment are lots of kids who have not gone to school for extended periods of time – months – and then they come to us and they are really out of practice at tolerating the anxiety and distress that accompanies showing up to a challenging place and as a team with the family and child, we have to work hard to help rewire their brain by approaching, rather than avoiding the distress," Holzbauer said.
All the normal safeguards that might have better protected young people's mental health were stretched to the breaking point during the pandemic. Now, it appears they are paying a steep price for all the stress and chaos they were feeling right along with the adults around them.
"We can all agree that the surgeon general's alarming reports from 2021 and again this year affirm the mental health crisis that our youth are experiencing. As a society, I hope that we can accept that our kids need extra support, understand the causes and be dynamic in our response," Holzbauer said.
On top of the pandemic, which disrupted the structure of school, there is the impact of social media on kids' psyche, and the lack of enough mental health care providers, both practicing and in training, to deliver future services.
"We really have this perfect storm of increased demand and not enough services for our kids. So, what that has meant is long waiting times, and there has been more use of emergency rooms to manage the mental health crisis. We've seen that around the country," Hollzbauer said.
At Kidstar and Teenscope, Holzbauer and her team are working with schools to address the youth mental health crisis. She said, "We get a lot of data on what is useful for the adolescents and children that we work with and how we can be helpful in a classroom setting to meet their needs. So, we can make recommendations to the school for how to support that child to be successful." Staff might also suggest alternative schooling options that would be a better fit for a child dealing with mental health issues.
Schools are also proactively moving ahead to offer solutions for students navigating the brave new world of mental health challenges. "I must hand it to a lot of schools that are implementing more social-emotional learning curriculum at a young age because school is where kids spend most of their time. It will help to provide some of the youngest members of the community with skills to be able to maintain their mental health, resolve conflict, and tolerate disappointment," Holzbauer said.
It also appears likely that educators and mental health providers are going to get more support in the future from parents.
"We are really seeing a generational shift with younger parents having more awareness about mental health not only being a real part of our entire health profile but also recognizing that mental health requires the same kind of support as physical health," Holzbauer said
In the future, a back-to-school physical might be paired with a mental health checkup before classes start.
As parents and educators' attitudes toward the mental health of our children evolve, Holzbauer expects the supply of mental health professionals will struggle to keep up with the demand for their services. So, for the sake of future generations, Holzbauer would like to see more enthusiastic efforts to get people into the mental health field.
Holzbauer said, "We know that mental health treatment is historically underfunded and that providers are historically overworked. So, being able to compensate and fund mental health services more equitably will make for longer and much more sustainable treatment for our kids."
