Amid concentrated job losses and financial insecurity, disproportionate rates of contracting and becoming seriously ill from COVID-19, and nationwide protests in response to centuries of racial injustice and anti-Black racism, the past few months have exacerbated the already disparate mental health needs of many Black, Indigenous, and non-Black people of color (BIPOC). In particular, BIPOC students are experiencing all of these traumas on top of the isolation of social distancing and remote learning.
For many young people, school is the primary provider of mental health resources. School closures removed students’ main point of access to diagnosis and treatment while adding new stresses of remote learning and social isolation. As the next school year approaches, Congress must make significant investments in sustained, long-term care to help address the trauma of the pandemic as well as implement immediate solutions that can serve students remotely. It is critical that these efforts are approached with a racial equity lens, recognizing not only that BIPOC people are likely facing disproportionate stress and trauma right now—but also that not all BIPOC students have the exact same mental health needs.
The current economic recession is sure to bring cuts to already strained school budgets. Congress must prioritize school spending and invest directly in mental health support for schools. Students with better mental health not only have greater overall well-being but also greater education attainment. Hiring more racially diverse and culturally competent mental health professionals, increasing funding to resources such as telehealth options and anti-racist programs, and collecting and disaggregating data can all help schools make mental health services more accessible and specific to BIPOC student needs. Without additional investment from Congress, states, districts, and schools will be unable to make these necessary improvements.
The current state of student mental health
While less likely to experience serious symptoms of COVID-19, children and teenagers have been more affected by the isolation of a nationwide lockdown than adults. Young people are wired to rely on peer relationships to a greater extent than adults. With the boredom of remote learning, anxiety about an uncertain future, and the disappearance of summer jobs and internships, it is no surprise that young people are reporting major mental health strains as a result of the pandemic.
Student mental health was already a growing concern before this year’s onslaught of traumatic events. Anxiety, depression, and suicide are all on the rise, and victims of suicide are getting tragically younger. There has been nationwide disinvestment from mental health programs, and many remaining programs are more punitive than restorative. Laws such as the Florida Mental Health Act, also known as the Baker Act, can even subject students to involuntary institutionalization simply for disruptive behavior in class. In Florida, the Baker Act has been invoked more than three times every school day.
Schools are considered de facto mental health providers for young people, but in April, less than 25 percent of district leaders—and only 5 percent of urban superintendents—said they were able to continue meeting student mental health needs at pre-pandemic levels.
Unique mental health needs of BIPOC students
There are established social determinants of mental health. From education to income to environment, structural racism undergirds many risk factors for mental illnesses. As a result, there are racial disparities in rates of diagnosis, treatment access, and prognosis. According to the Agency for Healthcare Research and Quality, not only are BIPOC people in America less likely to have access to mental health services, but when they do receive care, it is often lower quality than the care their white peers receive. In schools, BIPOC students are less likely than white students to say they could reach out to a counselor if they need mental health support.
Many BIPOC students who are most at risk of coronavirus-related trauma are in schools and districts that already lacked full mental health services prior to the pandemic and risk being hardest hit by cuts due to state budget shortfalls. This is especially true for tribal populations, which have some of the highest rates of coronavirus cases and some of the lowest education funding.
There is no one way to address BIPOC mental health because there is no one mental health need for all BIPOC students. Across racial groups, there can be vast differences in underlying causes of mental illness, social stigmas, and access to effective treatment. Understanding these differences is critical to ensure resources are allocated in a way that will improve mental health outcomes for all students.
Native American students
Native American children have traditionally reported the highest depression rates of any racial group, and the suicide death rate for those between the ages of 15 and 19 is more than double that of their white peers. The National Tribal Behavioral Health Agenda, a blueprint for tribal behavioral health needs and proposed policy solutions, identified a lack of culturally competent care as a key barrier to effective treatment for mental health among Native teens. Indian Health Service hospitals, which are more likely to provide culturally competent care, are not easily accessible; most are built on tribal lands, but only 22 percent of Native Americans live on reservations.
Since March, the coronavirus pandemic has ravaged tribal populations. Navajo Nation has the highest infection rate in the country, and Native Americans across the United States are contracting and dying from COVID-19 at disproportionately high rates. Due to high rural populations, collateral effects of the pandemic related to remote learning and telehealth access have been especially devastating. Across the country, only 67 percent of Native Americans have high-speed Internet, compared with 82 percent of all other Americans. This would make remote learning and telehealth access difficult with extensive resources, but historic underfunding of Bureau of Indian Education (BIE) schools has limited the capacity for schools to respond at all.
Recommendations for school districts, states, and the federal government to address Native student mental health
- Targeted district recruitment of counselors, social workers, and mental health professionals who understand tribal culture
- State-level broadband expansion and greater accessibility of telehealth options in remote areas
- Federal investment in Native education, including increased BIE funding and grants to support Native students who do not attend BIE schools
Racism has long been correlated with poor mental health outcomes, especially for Black Americans. Both individual-level discrimination and systemic exclusion of Black people from quality housing, education, and jobs have contributed to generational adversity. As yet another wave of extrajudicial killings of Black people inundate the news—and while Black patients are dying of COVID-19 at higher rates than any other racial or ethnic group—Black students are the most likely to return to school this fall with additional trauma.
Black people have long been at risk for higher rates of misdiagnoses, and many psychiatric diagnostic criteria have explicitly racist origins meant to pathologize Black peoples’ behavior. In schools, psychiatric problems for Black students are more likely to be disciplined than treated. Given this history, coupled with an enduring dearth of Black medical professionals, Black youth have an understandable distrust of the American medical system that may prevent them from seeking help when experiencing mental health concerns.
Recommendations for school districts, states, and the federal government to address Black student mental health
- Spaces and programming provided by schools aimed at breaking down mental health stigma
- Targeted district recruitment of Black counselors, social workers, and mental health professionals
- Federal funding for anti-racist and trauma-informed mental health practices
Latinx students report approximately similar or slightly lower rates of mental disorders compared with their peers, but they face greater limitations to treatment, especially in immigrant populations. For Latinx youth who recently immigrated to America, language barriers can affect the quality of mental health care they receive. Citizenship status also fuels disproportionately high uninsurance rates for Latinx families, making it difficult to access treatment in the first place.
Latinx communities have faced some of the largest economic consequences of the coronavirus pandemic. Hispanic women and immigrants are two groups reporting some of the highest rates of job loss. Undocumented immigrants as well as U.S.-born children with at least one undocumented parent were ineligible for coronavirus stimulus checks. Many students who know undocumented immigrants or are undocumented themselves reported anxiety about getting tested or otherwise seeking support due to fears of increased immigration enforcement tied to these resources.
Recommendations for school districts, states, and the federal government to address Latinx student mental health
- Support provided by schools for undocumented students and families and more information about what resources they can access without citizenship
- Targeted district recruitment of multilingual counselors, social workers, and mental health professionals
- Federal funding to address family economic instability and support mental health services for uninsured students
Although Asian American and Pacific Islander (AAPI) students report fewer overall mental health concerns than their peers, those who are diagnosed with a mental illness are least likely of any group to seek or receive treatment. Additionally, while depression and anxiety are reported at lower rates in the AAPI population, Southeast Asian refugees are especially likely to be diagnosed with post-traumatic stress disorder (PTSD) following their immigration as a result of conflict in the country they left or trauma adjusting to a new culture. The AAPI student population is especially diverse in its experiences and needs but lacks sustained research and accurate data to address these needs.
AAPI families have not been as likely as other BIPOC communities to experience job loss or casualties from the pandemic, but they have been the victims of increased bullying and violence since the coronavirus was first discovered. Four in 10 Americans agree that it has become more common for people to express racially insensitive views about Asian people since the pandemic began; in June, Asian Americans were more likely than any other group to report experiencing racist slurs since the beginning of the pandemic.
Recommendations for school districts, states, and the federal government to address AAPI student mental health
- Anti-racist and anti-bullying programs provided by schools
- Both statewide and districtwide increased data collection and disaggregation by race and ethnicity, including within the overall AAPI subgroup such as Native Hawaiian and Southeast Asian students.
- Federal funding for trainings in PTSD and other immigration competency for providers
The above recommendations all require more funding than schools were receiving before the pandemic. Given the possibility of spending cuts in response to state budget shortfalls, the ability to provide these critical resources is more at risk than ever. There are currently two opportunities to provide federal assistance: the HEROES Act and the Coronavirus Child Care and Education Relief (CCCER) Act. Both of these bills would bolster education funding broadly—preventing cuts to mental health programs—and would also provide greater access to necessary technology and internet service so that students could access mental health services remotely.
In 2019, 14 million students attended a school with a police officer but no counselor, nurse psychologist, or social worker. With increased calls to remove police from schools, there is a clear opportunity to reallocate resources to mental health professionals. This is an important first step, especially since more principals report a lack of funding as a barrier to providing mental health services than any other factor. But the racial disparities present in school policing will only be replicated in the social services if these resources are not allocated and implemented with racial equity in mind.
As students return to school this fall, they will all need immediate support to cope with the events of the past several months. But the trauma of the pandemic will likely outlast the virus itself, especially for BIPOC students, and schools must remain equipped to provide appropriate and racially equitable mental health treatment long after the emergency funding runs out.
Abby Quirk is a research associate for K-12 Education at the Center for American Progress.
The author would like to thank Azza Altiraifi, Neil Campbell, Khalilah Harris, Scott Sargrad, and CAP’s Executive, Health, and Race and Ethnicity teams for their contributions to this column.
To find the latest CAP resources on the coronavirus, visit our coronavirus resource page.