‘Our students and staff have suffered’: Schools brace for surge in demand for mental health services as in-person classes resume

At Unity Health's school-based mental health clinics in Toronto, therapists and pediatricians are bracing for what's anticipated to be a storm of referrals" in the fall as kids return to the classroom - some for the first time in over a year.

Elsewhere in the Greater Toronto Area, teachers are preparing lesson plans for kids and youth of all ages focused on the pandemic's emotional impact, strategies for how to cope, and where to find help should they or their friends need it.

These efforts are part of a larger focus across Ontario schools on the mental health of kids and youth as school resumes this fall. After enduring lockdowns, isolation and months of remote learning, experts and educators say students especially have struggled amid the emotional roller-coaster brought on by the pandemic. The goal is that mental health will not only take centre stage, but also be woven into the fabric of the curriculum.

The data is unequivocal that our students and our staff have suffered," said Louise Sirisko, director of education at York Region District School Board.

We know that if our students are not emotionally strong, they're not going to be in a positive place to engage with learning."

Data from the Hospital for Sick Children in Toronto and from agencies like Kids Help Phone suggests that kids and youth particularly struggled in the aftermath of the pandemic's second and third waves. In a Sick Kids survey of Ontario children and their parents, more than half of kids aged eight to 12 reported feeling significant symptoms of depression, and that number jumps to 70 per cent among adolescents.

At Kids Help Phone, there has been a substantial increase, between 42 to 49 per cent, in texts about self-harm, substance abuse, body image, suicide and grief between January and end of July compared to the same time-frame last year, according to data provided by the helpline in August. Since July, 33 per cent of Kids Help Phone texters said they were distressed about returning to school. Even at summer camp, counsellors reported kids having a harder time adjusting, with higher rates of irritability and homesickness.

To meet what's anticipated to be a heightened need for mental health support this year, School Mental Health Ontario, a provincially funded group tasked with assisting school boards in enhancing student mental health, developed a resource package sent to mental health leadership teams, comprised of clinicians and superintendents, at all 72 Ontario school boards in August.

The package includes tips on how to ease children back into an in-school environment, and how to identify whether a child needs extra support with their mental health, said Kathy Short, executive director of School Mental Health Ontario.

It's about providing really inclusive, culturally responsive classroom settings," Short said. It's also around skill-building, so how can we support students when they are feeling less resilient?"

While most students will be returning to school in-person, some are still opting for online learning. Data from the Toronto District School Board, the largest in Ontario, shows that 24 per cent of students will still be learning remotely. For those students, Short said a different set of resources were developed for teachers to help them identify and address if a child is struggling.

The resources are an addition to previous tools provided to school boards last spring, which included instructions for virtual field trips" teachers could use, Short said, built to teach children and youth different coping mechanisms for stress and anxiety. These resources are sent to mental health teams at school boards and are then relayed to individual teachers and classrooms.

Some schools are also being supported by external programs, like the Model Schools Pediatric Health Initiative run out of St. Michael's Hospital in Toronto and Unity Health, which serves over 50 inner city schools through clinics based in Sprucecourt Public School and Nelson Mandela Park Public School. Dr. Sloane Freeman, a pediatrician and lead of the clinics, said she anticipates a storm of referrals" as schools reopen for in-school learning.

It's very difficult to identify kids' needs virtually, whether it be educational needs, mental health needs or developmental health needs," Freeman said, adding that features of ADHD and autism, for example, are much harder to pick up on through a screen.

Freeman said she anticipates some children returning to the classroom will display symptoms of anxiety and depressed moods, but also problems with emotional outbursts. We've always seen challenges with kids' self-regulation and having a hard time managing big emotions, and I think we're going to see more of that."

Short acknowledged that one challenge in the last year has been navigating teacher burnout, and figuring out ways to deliver mental health as part of the curriculum without putting additional pressure on teachers. We know that all of our educators are working flat out and that online learning is hard for teachers too," she said.

To address this, Short said School Mental Health Ontario tried to create resources that are easily implemented in lesson plans. For example, teachers are encouraged to incorporate little wellness activities in the first 10 days of school in between lessons. It's just little things that can be slotted into those early days of school that help with reminders about wellness and taking care of yourself and each other," Short said, without adding extra strain on the teachers themselves.

For Sirisko at York's school board, these preparations underscore the increased role over the last few years of schools in ensuring kids are not only up to speed academically, but also emotionally and mentally. We're in a position to notice when a student may be experiencing some challenges," Sirisko said. Universally, we need to be creating classroom environments that are reflective of our students."

She added the emphasis of being there for students is even more profound, as many things were likely missed during remote learning. We now have the benefit of seeing them in person to be there for them."

Nadine Yousif is a Toronto-based reporter for the Star covering mental health. Follow her on Twitter: @nadineyousif_