Keep schools closed and support American families: A child psychiatrist's plea

Keep schools closed and support American families: A child psychiatrist's plea
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Last week, the director of the Centers for Disease Control and Prevention followed the American Academy of Pediatrics by urging schools to open in the fall, stating a larger public health threat to children should schools remain closed. However, the American Association of School Administrators and the American Federation of Teachers say more funding is needed to accomplish this

Having children physically in school does not mean they are learning. The debate about whether children should physically be present in school or not is a proxy war for social-economic inequality. We should respect our children and families and keep schools closed until there is adequate containment of COVID-19 through testing, tracing, and treatment

Our focus needs to be on fixing our broken social support system that blames and burdens children and families.

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Much of the push to return children to school is due to the harm that remote learning may have on the mental, social, and emotional well-being of children. As a child psychiatrist, I spend every day supporting differently-abled children in managing the social and personal stressors of their lives. 

My patients’ success with remote learning loosely fits a pyramid — a few are thriving, some are managing without major problems, and most are struggling. 

Some children of affluent, resourced parents are excelling. They have access to multi-modal media to supplement education, less emotional burden, and therefore more mental capacity to be creative, productive, and engaged in learning. 

My child psychiatry colleagues and I are pleasantly surprised at some patients who were struggling prior to the pandemic but are now faring better with schools closed. They are shy, have social anxiety, were bullied, or had problems with hyperactivity. We are now able to wean them off medication, as they no longer have the social distractions of school. 

Children say they have more flexibility in their schedules, waking at a more reasonable hour, having breaks between learning to go outside and play. They are no longer over-scheduled with after school activities. Some parents report gratitude at the ability to spend more time together and are more engaged in education, evaluating whether the curriculum is meeting their child’s needs.

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On the other end of the spectrum, however, shows the inequities in our social systems. A Pew Research study showed that 1 in 4 low-income teens do not have access to a home computer. Not all parents have flexible jobs and can provide additional educational support that many need. 

Children are experiencing more sexual abuse and domestic violence. Many with physical or mental disabilities rely on schools for counseling, and low-income students rely on schools for meals and shelter. Children who have English as a second language, or whose parents are not fluent in English are left behind, as a survey showed that only 35 percent of English learners were participating in online learning. 

The pandemic has shown that we have placed most social responsibilities onto one sector: education. Our schools and teachers are expected to manage hunger, domestic violence, and homelessness, while also being a surrogate parent and an educator.

We need to address these social and economic inequalities immediately. Children most vulnerable to the negative effects of school closures need to be prioritized by funding and supporting child and family protective services and social programs, and immigrant children must be supported.

The pandemic has also highlighted that our American social system does not support families to succeed. Many of my patients have lost their jobs and are suddenly without health and mental health coverage. Others continue to have work expectations similar to those before school closures and shelter-in-place policies.

Families are the most proximal source of support for children right now. But they are also a large source of stress for many children. 

Caretakers will bear the burden of managing the social-emotional learning that occurs in school settings. A recent Harris Poll for the American Psychological Association found that 71 percent of parents are worried about the impact of the pandemic on their children’s social development. More than half (55 percent) report their child has been acting out more since the start of the pandemic. 

But parents are burning out, carrying multiple roles and responsibilities, and are faced with unaffordable child care. We need to support the HEROS Act, passed by the U.S. House but awaiting approval into law, which proposes $3 trillion over the next 10 years and includes paid family leave, education, and childcare provisions. 

Children’s education must focus on complementing learning and not complicating children’s lives, regardless if they are physically in a school. It is our moral imperative to support families and the larger social systems that are meant to keep our children safe. If we don’t strengthen the foundation by eliminating disparities, then the entire pyramid crumbles. 

Suzan Song, MD, MPH, Ph.D., is a Harvard- and Stanford-trained child/adolescent psychiatrist and currently Director of the Division of Child/Adolescent & Family Psychiatry at the George Washington University Medical Center.