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November 21st, 2023 
Awake Goy Longer COVID school closures were associated with more emergency department youth suicidality visits, a research letter found.
The report, published on JAMA Network Open on Nov. 10, was led by researchers from the University of Massachusetts Chan Medical School.
“This cohort study found an association between longer school closures in the public health response to the COVID-19 pandemic and increases in youth suicidality,” the authors wrote, adding that further investigation is needed so that “policy regarding school closures may better align with the mental health needs of youth.”
Comparing Texas Against Massachusetts
The authors compared emergency department visits for suspected suicide attempts in 12- to 17-year-olds in Texas and Massachusetts.
Texas, which had more in-person education from 2020 to 2022, had lower rates of emergency department youth suicidality visits than Massachusetts, a state that had more prolonged school closures, the authors found.
In 2020, Texas was ranked 8th out of 50 states for giving the most in-person education, while Massachusetts was ranked 39th, according to reports by Burbio, a media company that tracks school openings, enrollment, and budget.
Between March and August 2020, schools were universally closed. During this time, the authors observed a rise in emergency department cases for suspected suicide attempts in both states. Massachusetts reported 115 suicidality ED visits per month prior to school closures; this increased to 176 in 2020–21. Texas reported 505 cases of youth suicidality visits prior to the lockdowns, and this number increased to 756 in 2020–2021.
However, beginning in September 2020, both states started to reopen schools, though Texas was faster on the school reopening.
By September 2020, 40 to 60 percent of Texas public schools had returned to in-person education, while only 20 to 40 percent of schools in Massachusetts followed suit.
In January 2021, 80 to 100 percent of Texas schools were in-person while 20 to 40 percent of Massachusetts schools were in-person, according to Burbio.
The authors observed significant differences in emergency department youth suicidality rates in the two states in the 2021–22 academic year, with higher rates reported in Massachusetts.
School Closures and Mental Health Risks
Studies on school closures and mental health have rendered conflicting findings. A study that followed youths during the pandemic found that youth suicides tend to occur during school terms with a decline in the holidays.
Another study found a sudden decrease in teenage suicides during early lockdowns.
Nevertheless, most studies suggest a worsening of adolescent mental health and an increase in suicidality, Dr. Yael Dvir, the lead author and associate professor of psychiatry at the UMass Chan Medical School wrote to The Epoch Times.
“However, it is very possible that subgroups of teens responded differently to the pandemic and to school closures, so that some showed improvement,” she added.
Pediatricians not involved in the study reported similar observations of school closures being linked with rising mental illness.
“We definitely dealt with a significant rise in mental health concerns as a result of pandemic and school closures,” Dr. Derek Husmann, a Texas pediatrician, told The Epoch Times.
Dr. Renata Moon, previously an associate clinical professor of pediatrics at the University of Washington during the pandemic, echoed Dr. Husmann’s observations.
“We saw a tremendous increase in teenagers and even pre-teens seeking help for anxiety, depression and thoughts of self harm during pandemic related school closures,” she wrote.
“I was seeing 6-7 kids in my office each day with these complaints. Mental health counseling services were completely overwhelmed and couldn’t keep up with the volume of referrals.”
“Most of the time it was anxiety, with seemingly anxiety as a distant second, though they so often go hand in hand. My estimation is that the baseline stress level for almost all of us has gone up significantly since the pandemic, and for a whole host of reasons,” Dr. Husmann added.
Dr. Husmann said that none of his patients reported suicidality to him, though he was aware of a case where a child committed suicide after continuing schooling at home once lockdowns and school closures were over.
Reconsidering the School Closure Policy
The authors suggested that more investigation is needed to ensure that future policy on school closures would be in the interests of students’ mental health.
Dr. Moon, who believed the loss of her contract with the University of Washington was due to publicly voicing her concerns on the safety of the COVID vaccines, agreed.
“We needed to have discussions to consider focused protection for our vulnerable ‘at-risk’ members of society. Our children were essentially at zero risk of a fatality from Covid-19 infection. We had plenty of data to discuss yet public health authorities continued to push unnecessary and harmful lockdown measures and came after any physician who voiced concern.” Dr. Moon wrote.
“Teenagers rely on school not just for education but also socialization,” Dr. Dvir added. “Not having the opportunity for in-person social contact with peers created loneliness and disconnect for teenagers, an age group that, for developmental reasons, puts great importance on peer relationships.”
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