When students struggle academically, it is often the case that the root causes–and their solutions–can be found outside the school doors. The social determinants of health—economic and social conditions in which people are born, grow, work, live, age and learn—profoundly impact students’ ability to live healthy lives, attend school and thrive in the classroom.
For overall well-being, social determinants of health can even outweigh the importance of what we usually think of as health essentials. The World Health Organization says, "Social determinants can be more important than health care or lifestyle choices in influencing health." This is true for both physical and mental health, especially teens’ mental health. We know that youth from all backgrounds face mental health challenges, and those most vulnerable are young people existing systems have failed to reach: children living in poverty and children of color.
The COVID-19 pandemic has greatly exacerbated challenges with adolescent mental health. According to new data, more than a third (37%) of high school students reported they are experiencing poor mental health during the COVID-19 pandemic, and 44% reported they persistently felt sad or hopeless during the past year.
Though schools are not the cause of social determinants of health, they can be an important part of reducing the barriers social determinants create that stop children from learning and thriving. Here are three of the most common barriers students face, along with strategies schools can employ to ensure all children receive the care they need, when they need it:
This includes families having a reliable income, employment, and food and housing security— significant because currently 16.1% of children under 18 years old live below the poverty line. It’s incredibly difficult for families to prioritize the mental health care of their children when they’re focusing on how to put food on the table.
Schools must connect students with community resources that offer programs and services to students in need. Organizations like Communities in Schools and Casa de Maryland partner with schools to ensure students have necessary resources, bringing support to students, working to achieve equitable learning conditions by meeting basic yet critical needs like housing, food security, and healthcare.
Many students are unable to access mental health care because they live far from the nearest care facility, are unable to drive, or their parents or guardians do not have paid time off and cannot afford to leave work to get them to their appointment. Children may rely on public transportation, or face poor neighborhood safety. The barrier of travel can be eliminated by schools partnering with a qualified telehealth service to provide equitable access to mental health care by meeting students where they are, at school or at home.
Thanks to Medicaid expansion, the majority of children in the United States have insurance coverage, however, many still face high co-pays or deductibles or are unable to afford flexible insurance plans. Additionally, wait times for mental health support can be several months.
Schools must reach out to partner with mental health care providers, community health groups and agencies across multiple fields, connecting families and helping parents bridge the gap. A standard practice for school districts is to build a database of providers, making it easily accessible across all systems when support is needed. Navigating the insurance process can be complicated and overwhelming, but schools can develop partnerships with local providers and resources to help families understand their plan as well as anticipate any costs associated with mental health support.
Interventions targeting social determinants of health have tremendous potential to make progress toward health equity while creating positive outcomes for our youth. School districts must leverage their unique ability to tap into multiple community resources, removing barriers and bridging gaps for families to care for the whole child - their cognitive, physical, social, and emotional development - collectively and simultaneously. Working together, schools can ensure students receive mental health support, resulting in lifelong positive implications and ultimately creating a happier and more well-balanced society.