545 - The COVID-19 Pandemic and Mental Health-Related Visits in U.S. Schools

Poster Number: 545
Publication Number: 545.423

Tina Banzon, Boston Children's Hospital, Boston, MA, United States; William Sheehan, Children's National Health System, Washington, DC, United States; Carter Petty, Boston Children's Hospital, Boston, MA, United States; Marissa Hauptman, Boston Children's Hospital, Boston, MA, United States; Brett Shamosh, SchoolCare, Ramsey, NJ, United States; Lisa Bartnikas, Boston Children's Hospital, Boston, MA, United States; Wanda Phipatanakul, MD, Hopkinton, MA, United States

Background: Psychosocial stressors to youth have increased during the COVID-19 pandemic. Limited empiric data related to pediatric mental health during the pandemic is available, and no studies to date examining mental health-related visits in U.S. schools, the most common point of entry for accessing and providing mental health services to children.

Objective: To examine changes in number of mental health-related visits in U.S. schools before and during the COVID-19 pandemic.

Design/Methods: Design: In this longitudinal study, we analyzed school-based health visits (n=3,445,240). Data between January 1 to December 31 in 2019 (pre-COVID-19 pandemic) vs. January 1 to December 31 in 2020 (during COVID-19 pandemic) were compared. For each year, total visits to a school health center were calculated for general mental health, anxiety, and self-harm.

Setting: 3,300 schools with subjects in Kindergarten to Grade 12 across 29 U.S. states.

Participants: Students enrolled in Grades K-12 (age 4-20 years) at schools using a digital health platform providing digital health charting for school-based health visits.

Exposure: Total number of school-based health visits in each time period (2019 vs. 2020).

Main Outcome(s) and Measure(s): Change in the rate of general mental health, anxiety, and self-harm school-based visits in 2019 (pre-COVID-19 pandemic) vs. 2020 (during COVID-19 pandemic).

Results: There were 2,302,239 total school-based health visits in 2019 vs. 1,143,001 total school-based health visits in 2020. During the COVID-19 pandemic, the rate of school-based health visits for general mental health significantly increased by 30% (4.7 to 6.1 per 10,000 visits, 95% CI [18%, 43%]; p < 0.001), and visits for anxiety significantly increased by 25% (24.8 to 31 per 10,000 visits, 95% CI [20%, 30%]; p < 0.001). There was no significant difference in visits for self-harm across all ages combined during the COVID-19 pandemic.Conclusion(s): In this longitudinal study of students Grades K-12, there was a significant increase in the rate of school-based health visits for mental health and anxiety during the COVID-19 pandemic, suggesting the pediatric population is at-risk for increased negative mental health effects associated with the pandemic. This highlights a critical role of schools as a gateway for pediatric mental health care in the current pandemic and future.
CV Tina M. Banzon, MDCV Tina M. Banzon 11.29.2021.pdf
Figure 2.Rate across age per 10,000 total school-based health visits for mental health, anxiety, and self-harm in 2019 and 2020.