Enhancing the School Mental Health Initiative Amid COVID-19

The mental problems of children and adolescents have become an important mental health issue in most countries. Notably, 10%–20% of children are observed to have mental disorders, and over the past 10 years, the rates of self-injury and suicide have increased, and the frequency of emotional and behavioral problems have also increased. As it has become known that 50% of adult mental illnesses have their first onset before the age of 14 years, the importance of mental health at a young age and prevention and early intervention strategies have been strengthened [1]. In this context, since school is an educational system where most children and adolescents spend a lot of time, and at the same time is an optimal place to systemically provide mental health services, school-based mental health programs have been playing a central role in youth mental health promotion since the early 2000s in several countries. The COVID-19 pandemic has changed the daily lives of most people around the world unprecedentedly and rapidly. Face-to-face activity restriction and social distancing strategies for high risk of infection, quarantine, and prevention of spreading the disease have had a greater impact on children and adolescents who are particularly vulnerable to social environment changes. Schooling, which plays a central role in daily life and the growth of students, has also undergone significant change. As we were confronted with school closure during the pandemic wave period, in accordance with national policies, classes and activities were replaced with unexpected homeschooling and online classes requiring considerable efforts from students, home, and school systems to adapt. The mental health of children and adolescents during the COVID-19 pandemic showed an increase in negative outcomes, such as elevated symptoms of depression, anxiety, suicide ideation, trauma, and decrease in well-being. The mental health risk factors related to the pandemic include a fear of COVID-19 infection, change in the academic environment, conflict with parents at home, and changes in a healthy lifestyle, such as decreased physical activity and home confinement, unstable daily routines, and increased screen time [2,3]. As the school closure period becomes longer, peer relation and disruption of connectedness with the school increases and school-based mental health service decreases, it results in difficulties to identify and intervene with students facing psychological difficulties, making it more difficult to address mental health problems than before COVID-19. Alternatively, when there is high social anxiety and difficulties in peer relations or a good family support system, school closure reduces the schooling burden of students and improves the mental health problems; therefore, the impact of lockdown needs to be observed in various ways depending on the individual differences and social context [4,5]. WHO and several countries have presented expert opinions in predicting the COVID-19 endemic, and recovery in daily life is slowly progressing, and along with this, schools are also trending towards carrying out academic schedules in place before COVID-19. The normalization of school attendance should be done in an integrated manner tailored to school and individual situations, without separating the academic achievement and physical and mental health recovery strategies of students. A nationally representative survey by the CDC [6] demonstrated results that showed high school students had worse mental health at present than before the COVID-19 pandemic and an increased rate of experiencing continuous sadness and despair, showing concerns about intensifying mental health problems. To youth students who have experienced distress and severe disruption, the strategy of school connectedness, such as the care and support provided by the school and a sense of belonging, is effective in reducing suicidal thoughts and negative emotions. In particular, strengthening connectedness is a key program of critical protection for students who have experienced social distancing due to COVID-19 for years [6]. Mental health support can refer to the multi-tiered system of support (MTSS) framework, which consists of systematic and evidence-based instructions that meet the complex mental health conditions This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Enhancing the School Mental Health Initiative Amid COVID-19