Schooling has a halo around it in society’s eyes, and halos tend to interfere with perception and judgment. Maybe that’s why nearly everyone, including journalists, whose job it should be to keep their eyes and minds open and report honestly to the public, continues to ignore the ever-growing evidence that school is a major cause of anxiety, depression, and even suicide in children and teens.
Every scintilla of evidence that social media may be contributing to the mental health crisis among young people gets blown up in the popular press (see here), while the overwhelming evidence for the role of the school is ignored. An exception is an August 2022 Scientific American article by Tyler Black, an emergency psychiatrist who works at a major children’s hospital,. Black shows clearly and starkly the temporal relationship between suicides and the school calendar.
I first became interested in the relationship between schooling and mental breakdowns in 2014, when a clinical psychologist who works with children told me that her business increases dramatically every fall when the school year begins and declines again in mid-to-late June when it ends. Her view was that children simply do better psychologically when school is not in session.
I wondered then whether I could find objective, published evidence for a relationship between mental breakdowns and the school calendar. I scoured the literature and found no research directly related to that topic, but I did find a graph, published online by one hospital, showing the month-to-month number of children’s emergency psychiatric visits to that hospital for every year from 2000 to 2013. The numbers were startling. The average rates of admissions were less than half as high during the school vacation months of July and August than they were during the months of full schooling. The online article made no mention of this striking and consistent relationship, but the data were clear. I published the data in a post on this blog, in August of 2014.
Four years later I conducted another search and found new research, and one older study that I had missed in the earlier search, confirming and extending what I had found for that single hospital. The research revealed that throughout the nation, suicides, as well as lesser mental health breakdowns for school-aged children and teens (but for no other age group), rise sharply at the beginning of every school year and then decline every summer. I summarized those findings in another post in May 2018. But now there are even more data. I begin with data presented in Black’s Scientific American article.
Children’s Risk of Suicide Increases on School Days
The subtitle here is the title of Black’s article. He showed graphically, using data from the Centers for Disease Control and Prevention’s Wonder database for the years 2000 to 2020, a tight relationship between the school calendar and suicides for school-aged children (under age 18). The data revealed that during school months, the suicide rate was consistently highest on Monday through Thursday, declined significantly on Friday, and was lowest on Saturday and Sunday.
His data also showed that, month by month over the 20-year period, the suicide rate was lowest in July, which is the only month that is fully vacation for nearly all schools; increased somewhat in August, when some children start school and most begin to anticipate school; increased much more in September, when most children are back in school; and by October was 43% higher than it was in July. The rate then remained about that high through the rest of the school year, except for a dip in December (when most children have a winter vacation), and finally declined sharply in June when summer vacation begins for most students.
His graphs show further that the relationship between month and suicide did not hold for young adults (age 18-30) beyond secondary school age. In fact, for them, the suicide rate was slightly higher in the summer months than during the rest of the year.
Other relatively new studies reveal a similar temporal relationship between school and suicide in other countries, including Germany, Finland, India, and Japan. The study in Japan encompassed a 40-year period, from 1974 to 2014, and revealed on average a roughly 40% jump in suicides at the start of each school year compared with the rate during summer break.
Suicides Declined When Schools Closed in the COVID Pandemic and Rose Again When In-Person Schooling Resumed
When COVID struck and U.S. schools closed in March of 2020, many pundits predicted that this disruption in children’s routines would be disastrous for their mental health. But at least three independent systematic surveys—one of which was conducted by the nonprofit organization Let Grow and which I published in the American Journal of Play—revealed that, on average, both parents and children themselves reported the children to be less anxious and depressed during at least the first three months of lock-down (when the surveys were conducted) than they had been before schools were closed. You can find my academic report of the Let Grow study and review of the other studies here (and my blog posts on the research here and here).
More recently, a research team headed by Benjamin Hansen of the National Bureau of Economic Research analyzed teen suicide data for the period before, during, and after pandemic school closures in the U.S. (published here). They found (in their words): “Teen suicides plummeted in March of 2020 when the COVID-19 pandemic began in the U.S. and remained low throughout the summer before rising in Fall 2020 when many K-12 schools returned to in-person instruction.”
These researchers also developed a method to determine the day when individual counties reopened schools and found a tight relationship between that timing and the rise in suicides. For counties that opened schools in early August, the rise in suicides began in August; for counties that opened schools in September, the rise in suicides began in September.
A drop in teen suicides during COVID school closures has also been reported in China. The pandemic started earlier there than in the U.S., so Chinese schools closed much earlier in the school year than U.S. schools and began reopening for in-person schooling around the same time in March that U.S. schools were closing. According to the report, the reopening was accompanied by a sharp increase in psychological distress and suicides among students.
Why Do Mental Health Breakdowns and Suicides Increase When School Is in Session?
The answer to this question is probably not simple and may differ substantially from case to case. Hansen and his team suggest that a major cause of the suicide increase is persistent bullying. As evidence, they cite studies showing that bullying occurs more in school than in other settings and that bullying appears to be the immediate trigger for at least some suicides. Black suggests a more multifaceted set of causes. The bullying may not come just from students but also from teachers or even from the way the school is structured. He writes: “[School] can be incredibly stressful because of bullying, health- and disability-related barriers, discrimination, lack of sleep and sometimes abuse.”
In a study of “Stress in America” conducted by the American Psychological Association in 2013, teenagers of school age were found to be more stressed, by their own reports, than people in any other age group, and 83% of them said school pressure was a significant source of their stress. This was much higher than any other reported source, including bullying. Moreover, teens who were surveyed during the school year reported twice as many instances of severe recent stress than did teens who were surveyed during the summer. The idea that the pressure and competitiveness of schoolwork itself is a major cause of psychological breakdown is reinforced by research showing that students in “high-achieving schools” suffer from such breakdowns at higher rates than do those in schools where the concern for high marks is less strong (see my summary of such research here).
What Can We Do About the Problem?
So far, the most common approach of schools in addressing the problem is to try to change the children, not the school. They have brought in therapists, paid for courses in “social-emotional learning,” recommended drugs, and counseled parents, but they have done little to change schooling itself to make it more student-friendly. In fact, most school changes have been in the opposite direction, which may help explain why rates of suicide have increased from year to year for school-aged kids. Black suggests it is time for schools to modify their own practices. Among his suggestions (quoted verbatim) are the following:
• “Reduce homework (preferably get rid of it). Some of the best educational science available shows that excessive homework is of limited benefit and in fact harms children’s health and well-being.”
• “Restore funding for playtime, music, and art in school and de-emphasize academic overload. Children need relaxation, comfort, beauty, fun, and play. Children who have opportunities for play and rest will learn more in their academics, and they will also be able to sustain their development as they grow.”
• “End ‘perfect attendance’ awards and goals. … We should all, from time to time, recognize when we are at our limit and need a break.” [My words: The suggestion here is that just as adults sometimes take mental health breaks from work, kids should be encouraged, not discouraged, in taking breaks from school when they feel the need.]
• “Start school later. How many more decades of research do we need to show that children need more sleep and that adolescents do better in school when the day starts later? It’s time to make serious structural changes in the early-morning wake-up times.” [Again, me: One of the reasons given by parents for their kids’ improved mental health during the COVID lockdown, in our survey, was that they were able to sleep later in the morning.]
• “Be nonjudgmental and respect children’s identities and identity formation. This is not a ‘woke’ concept. This is a caring, compassionate concept that works for all children all the time.”
• “Recognize and address child abuse within schools. There exist (and many readers may likely recall) teachers who are abusive, punitive, and cruel.”
To Black’s suggestions for modifying schools, I add this suggestion to parents: If your child truly, consistently, says he or she hates school, or if the bouts of anxiety or depressions are severe, take that seriously and do research on alternatives. Alternatives are far more available, even to families with low incomes, than most people realize.
As regular readers of this blog know, I have conducted and written about research studies of young people who opted out of public or conventional private schooling, often because of traumatic experiences there. They opted for homeschooling or for democratic alternative schooling, and in those settings restored themselves, discovered and pursued their interests, and went on to highly successful adult lives in the whole range of careers valued by our society. Some even reported to me that they believed their parents’ willingness to take them out of conventional schooling saved their lives, and I believe them.