Parents are reporting worse mental health for their children than they did a decade ago, but different groups of children are struggling with mental health in markedly different ways.

That’s what our team at the University of Southern California’s Center for Applied Research in Education found using a widely used mental health screening measure. More specifically, we found that preteen boys – the subgroup with the worst scores – struggle more in areas that include externalizing behaviors like hyperactivity, inattentiveness and conduct problems. For teen girls – the subgroup with the second-worst scores – struggles were especially pronounced in more internal problems like anxiety and depression.

These results confirm an upward trend in student mental health concerns that began before the pandemic but was likely exacerbated by school shutdowns, social isolation and other child and family stressors brought on by COVID-19.

Additionally, we found these mental health screener scores – which we refer to as “difficulties scores” here – are linked in important ways to grades and attendance. That is to say, those who had lower grades and lower attendance were much more likely to have difficulties scores in the highest, most concerning range.

Among students with good attendance at the halfway point in the school year, only about 1 in 14 had a high difficulties score. But among students who were chronically absent at the halfway point, nearly 1 in 4 had a high difficulties score.

Similarly, students who earn some Cs in schools are three to four times more likely to have a high difficulties score compared with students earning all As and Bs – 19% vs. 6%, respectively.

As high scores on the mental health screener are predictive of specific types of mental health diagnoses – like anxiety, mood or conduct disorders – these results provide new insights into the complex relationships between mental health and school outcomes.

Why it matters

Children are struggling with mental health in the aftermath of the COVID-19 pandemic. Various data sources have highlighted the increased rates of teen suicides, emergency room visits and anxiety and depression in school-age children. They are also struggling academically, while rates of chronic absenteeism continue to be higher than ever.

There are opportunities for schools to address these trends by providing school-based mental health services. These services include one-on-one counseling or therapy, case managers who can coordinate various services for students in need, and referrals to outside resources. And in fact, our research shows almost three-quarters of parents whose students use school-provided services are satisfied and find them helpful.

But many schools are not offering these supports – or at least, parents are unaware of them. Our study found that 59% of high-income respondents reported that mental health resources were available in their children’s schools, compared with 37% of low-income respondents. Yet low-income students are more likely to take up those supports when they are available. Over half of respondents from the lowest income group reported that their child made use of mental health services when available, compared with 11% of respondents from the highest income group.

There is considerable unmet student need for mental health supports, as 20% of parents whose children are in schools without such supports say they would use them if offered. These results suggest there is an opportunity for schools to invest in not only supplying mental health services, but ensuring they reach the students most in need.

What still isn’t known

While our research confirms important links between children’s mental health and their school outcomes, we do not yet know which is causing the other. For instance, some students may be staying home from school more because of anxiety and depression, while other students who miss school for illness or other reasons may develop anxiety over time as a result.

What’s next

For schools and families to address worsening child mental health and academic outcomes, researchers must seek to better understand the underlying causes of increasing mental health concerns and absenteeism in children. Research is also needed to explore differences in the relationship between mental health and school outcomes for different subgroups of students – by income level or by racial subgroups. This can potentially inform how schools to respond to problems that threaten student well-being.

The Research Brief is a short take on interesting academic work.

Amie Rapaport, Ph.D. receives funding from the Hewlett, Smith Richardson, and Bill and Melinda Gates Foundation and from the Institute of Education Sciences.

Morgan Polikoff receives funding from the Hewlett, Smith Richardson, Overdeck Family, and Bill and Melinda Gates Foundations, as well at the National Institutes of Health.