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  • California looks to the health system to sustain mental health funds in schools

    California looks to the health system to sustain mental health funds in schools


    Credit: Photo: Julie Leopo/EdSource

    To create an education system that has stable funds for mental health, California educators and leaders are turning to the health system and launching a statewide behavioral health initiative to fill funding gaps in fluctuating, sometimes unpredictable school budgets.

    “The health systems and the education systems are not bound together successfully enough to make sure we engage in both prevention and treatment,” said David Gordon, a commissioner at the Mental Health Services Oversight and Accountability Commission. “That’s particularly true for the most underserved communities.”

    Funding for mental health in California public schools typically has come from general education budgets, a reason funds have never been stable. As the need for more mental health services and specialists skyrockets, administrators and experts are turning to the health system to better serve needs that existing education budgets just can’t cover. 

    Schools bridge some gaps by placing nurses, social workers, school counselors and psychologists on campuses, but there’s never enough money to fully meet student mental health needs. Without a built-in, statewide system to fund mental health in schools, districts are left to figure it out themselves. 

    “We’re so used to trying to provide external funding to fund us to some sort of equitable level for every student,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s never been the general fund will cover us — it’s just sort of baked into the cake.”

    It’s been that way since at least the late 1980s, when Whitson began her education career, she said.

    The Local Control Funding Formula, legislation that changed the way education was funded in California, created more funds for mental health and “a more holistic view and review of schools,” Whitson said. “But if there’s not enough money to go around, then school district administrators need to make very hard decisions.”

    If districts have to rely on general fund money for mental health providers, it creates competition with funding for teachers and education programs, Whitson said. If budgets had more funds specifically for mental health, it would mean more money for education. 

    If we piecemeal it like it’s been, then we’re always trying to find money through categorical programs or grant funding.

    Loretta Whitson, executive director of the California Association of School Counselors

    California doesn’t mandate districts to provide school counselors, social workers, nurses or psychologists, but it is encouraged. Some experts say mandates could ensure there would be mental health specialists at every school. But that goes against the idea of local control, Whitson said, which allows districts to make decisions based on their community’s needs and resources. 

    Grants for mental health have helped, but it’s not sustainable, Gordon said. School districts will receive grants for a few years or even less, and when those dollars run out, the services or mental health specialists do too if districts don’t have money to keep them going. 

    Similarly, districts turned to pandemic relief dollars to boost staffing for school counselors, social workers, psychologists and nurses, but those funds expired in September. 

    Nonprofits and community organizations have stepped in to help fill needs at lower costs, put therapists on school campuses, and taken over doing burdensome paperwork. But if the services aren’t free to school districts, then most money for mental health has to come out of the education budget. 

    Blending two systems

    Gordon credits Gov. Gavin Newsom’s Children Youth and Behavioral Health Initiative for beginning to merge the health and education system. The goal for two major systems to come together is reachable, Gordon said, “but it will take a lot of coordination and collaboration.”

    A key component of the behavioral health initiative is to support partnerships between Medi-Cal managed care plans and schools to increase access for children receiving Medi-Cal — nearly 5.7 million kids in 2022. Another goal is to increase access to early interventions and preventative mental and behavioral health care.

    The behavioral health initiative was part of the Budget Act of 2021 and the governor’s Master Plan for Kids’ Mental Health. The California Department of Health Care Services will invest $4.7 billion over multiple years in youth behavioral services.

    According to the master plan, more than 240,000 children cope with depression, and 66% don’t receive treatment. Suicide rates among 10-18-year-olds increased by 20% in 2019-2020.

    Efforts to implement the behavioral health initiative started in January 2022. So far, hundreds of millions of dollars in funding have been disbursed to dozens of organizations for training and retention of providers, loan repayments and scholarships to increase providers in underserved areas.

    But some of the funding is distributed as grants and won’t last long, Whitson said. 

    “I think it’s important to consider: How do we sustain this? A lot of programs come in as temporary programs, so seed money,” Whitson said. “We look at sustainable money as Medi-Cal a lot of times.”

    The amount of money school districts can bill to Medi-Cal recently increased, thanks to new legislation. The California Education Code was updated in January after AB-2058 passed, allowing districts to bill Medi-Cal for mental health services provided by school counselors.

    A 2018 statewide count of school counselors tallied about 11,000, Whitson said. She estimates there are about 14,000 now. 

    “School counselors are one of the biggest billing forces in the state. It should be bringing in quite a bit of money,” Whitson said. “It could be used to lower the caseloads on all levels — social workers, psychologists, school counselors.” 

    However, the process for school districts to bill Medi-Cal can be long and cumbersome. 

    Sometimes districts won’t get a full refund, and it could take a few years before the money is returned, said Marlon Morgan, founder and CEO of Wellness Together, a nonprofit that brings mental health providers to school campuses in California and New York. 

    “Schools are pretty reticent to use that billing option because they could end up spending $1 million but only get $500,000 back,” Morgan said. “If you’re on a school board and looking at ways to stabilize your budget and to know what to expect, that’s a huge wild card, and frankly one that doesn’t get used very often.”

    In Sacramento County, schools are partnering with the Sacramento County Health Department to have one mental health provider at every school, said Gordon, who is also the superintendent of the Sacramento County Office of Education. The partnership works well because the county health departments already manage Medi-Cal and Medicaid plans — which insure more than 60% of people in the county, he added.

    The purpose isn’t only to provide direct services at schools, but to have someone from the health system stationed at schools interacting with staff, students, and families every day, Gordon said. The goal is to have “centers of wellness and prevention, rather than a center of let’s go out and seek treatment for a problem that should’ve been caught many years ago,” he said.

    Some organizations are combining billing insurance and grant funding to bring providers to schools. Campus Clinic, which aims to remove barriers to health care access by putting providers at schools, has brought mental health providers and other physicians to 14 districts and more than 600 schools in California, said Thomas Shaffer, the organization’s founder and president. 

    Most districts haven’t had to foot the bill. Campus Clinic started paying for all the costs, Shaffer said, and was able to sustain its offerings through billing insurance, including Medi-Cal, and applying for grants. One burden Campus Clinic and other similar organizations lift from districts is handling the paperwork and billing.  

    “We aim to complete, not compete, with existing resources,” Shaffer said. 

    Still, the need for mental health services and providers is too great to catch up with demand. Campus Clinic is contracted with 28 more districts that are still in the planning stages, Shaffer said. 

    Campus Clinic also offers universal health screenings that allow schools to quickly identify which students are showing signs of anxiety, depression and risk of self-harm, Shaffer said. Schools can see responses through a dashboard that includes real-time notifications for students who are at risk of self-harm. Campus Clinic has teams that start reaching out to families to offer services. 

    But it doesn’t come without challenges. Building trusting relationships with families so they feel comfortable accepting services can be an uphill battle.

    ‘The cultural and trust piece’

    Officials at Feaster Charter School in Chula Vista saw immediate results after Campus Clinic gave universal mental health screenings to students in grades six through eight in May.

    Out of the 350 students, roughly 40% were identified as having some level of anxiety and depression, said Karen Haro-Esparza, community school coordinator.

    Teams at Campus Clinic started contacting families right away, Haro-Esparza said. Although it’s a huge help, it also created challenges  — “the cultural and trust piece.” 

    “Because they are not a regular part of our staff, when Campus Clinic communicates with families, they have a lot of questions,” Haro-Esparza said.  “Our challenge has been, ‘How do we educate families further to destigmatize and normalize the partnerships?’”

    The stigma around mental health — especially among people of color and different cultures — is one reason families or guardians don’t seek or access resources for students. Something most mental health experts working in education can agree on is the importance of maintaining trust among schools, providers and families. 

    “It’s not just putting money out to buy services. It’s working to try to put the systems together so that they’re relating and families will come to know and trust the medical system even though they aren’t located in their community.”

    David Gordon

    Campus Clinic providers aim to become part of the school community, Shaffer said. One strategy Campus Clinic providers use is to rotate through different classrooms to speak with students about health and wellness for 15 minutes to become more familiar and create connections. 

    Wellness Together is investing in interns to diversify the workforce and build trusting relationships between communities and mental health providers, Morgan said. Before mental health professionals receive their licenses, they need to complete hundreds of hours that typically are unpaid — some programs won’t even allow future providers to have paid internships. 

    Morgan, who started his career as a school counselor, said he’s seen dozens of people never get their licenses because they can’t afford to work for free. It contributes to the lack of diversity in the behavioral health workforce, he said. Now, the nonprofit has more than 30 partnerships with universities in California to ensure interns are paid liveable wages and receive benefits. 

    Wellness Together pays interns working toward their licenses to be social workers, clinical and mental health counselors, licensed marriage and family therapists, and a pupil personnel services credential. 

    “The biggest challenge is finding staff and making sure the staff reflects the communities they’re serving,” Morgan said. “By paying interns and paying associates, we now have an option and an opportunity to really hire the best person for the job and often hire a person who is local and from the community.”





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  • Special education teachers need more mental health initiatives

    Special education teachers need more mental health initiatives


    The federal government has not fully funded special education in decades, leaving the bulk of the costs to school districts and the state.

    Alison Yin/EdSource

    When Erica Mazariegos heard that a shocking number of special education teaching positions remain vacant, she was not surprised. With over 27 years as a special educator, Mazariegos is dedicated and passionate, yet says “the stress of recent years has led me to question my ability to carry on. There will come a point when I must prioritize my health over my career.”

    Like Erica, special education teachers throughout U.S. public schools have been vocal about their concerns regarding working conditions after the pandemic, particularly the shortage of resources and staff support. The attrition rates among special education teachers soared following Covid-19, and educators have endured heightened levels of job-related stress, prompting an increasing number of them to exit the profession.

    This exodus has left schools grappling with severe teacher shortages. According to the National Center for Educational Statistics, 45% of schools reported unfilled positions in special education roles, with 78% citing difficulties in hiring special education staff for the current school year. The situation in California closely mirrors the national shortages, with the Learning Policy Institute describing the teacher shortage in California as a “five-alarm fire.”

    The stress experienced by special educators is not only deeply ingrained in the inherent nature of their roles but also in the perceptions surrounding them. A key contributing factor is the idealization of special education teachers by schools, often portraying them as extraordinary individuals who are characterized as nurturing and self-sacrificing, willing to prioritize their students’ well-being over their own. It’s commonplace to hear general education teachers express sentiments like, “I could never do what you do.” This portrayal creates unrealistic expectations for special educators, adding to the systemic sources of stress, which include unequal resource allocation and a shortage of adequately trained support staff.

    Padma Vajhala, an early-career special education teacher with two years of experience, highlights many stressors in her job, such as individualized education program meetings, conducting paperwork checks, navigating uncertainties about parental consent, encountering subtle racism in schools, and adhering to the core mission of special education — differentiated teaching for each student. But, she underscores that these stressors are overshadowed by the primary source of stress: daily management of challenging behavior exhibited by her students in class without enough staff support. She points out that her stress affects students by hindering effective instruction, classroom management and the modeling of social-emotional skills. Stressed teachers are more likely to react unpredictably and employ ineffective behavior management strategies.

    While it remains crucial to address such systemic causes of stress as lack of staff support in the classroom, schools must simultaneously implement programs dedicated to teaching self-care strategies and allocate resources to support these educators’ mental health and overall well-being. These initiatives should involve professional development programs that prioritize physical wellness, encompassing exercise, dietary choices, and sleep, to sustain energy levels and enhance emotional resilience.

    Additionally, it is imperative to equip special educators with training in social-emotional learning skills. This training should cover the establishment of clear boundaries between their professional and personal lives, mindfulness practices, participation in yoga, and learning relaxation techniques. Acquiring these skills can significantly reduce stress levels among special educators while providing positive role models for students concurrently learning these skills in their classes.

    Most importantly, special education teachers can create communities of practice informally with their colleagues based on shared interests, facilitating connections with colleagues, mentors, and therapists to seek guidance and share their experiences. Moreover, these communities of practice can leverage self-reflection practices to recognize and manage stressors effectively.

    A notable approach is reflexive visual journaling, a creative process that intertwines written reflection with images, drawings, and other visual elements. This practice has demonstrated considerable effectiveness in early detection of burnout indicators, pinpointing triggers, and aiding individuals in navigating and coping with stress. Zachary McNiece, assistant professor of counselor education at San Jose State University, emphasizes the importance of visual journaling, stating, “In today’s post-Covid world, while teachers act as front-line mental health advocates, they can experience the after-effects of trauma their students have faced over the last few years; visual journaling creates a means for teachers to slow down, allow space for their feelings and reactions, and let go of the emotional residue of secondary trauma exposure, so they can improve their wellness and support their students.” These self-reflective practices can also be embedded into teacher preparation programs to support new special education teachers.

    Preventing burnout in special education cannot be solely an individual responsibility; it requires collaboration from schools, districts and policymakers. Special educators are pivotal in fostering an inclusive and equitable education system.

    It is essential that schools prioritize special educators’ well-being by supporting and implementing targeted self-care strategies to sustain their passion and dedication. This approach not only safeguards the mental and emotional health of educators but also enriches the educational experience for students with disabilities, ultimately contributing to the development of a stronger and more compassionate society.

    ●●●

    Sudha Krishnan is an assistant professor at San Jose State University’s special education department, Lurie College of Education, and a Public Voice Fellow with the OpEd Project.

    The opinions in this commentary are those of the author. If you would like to submit a commentary, please review our guidelines and contact us.





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  • What to know about public health guidelines as LAUSD students return from the holidays

    What to know about public health guidelines as LAUSD students return from the holidays


    Third graders at Hooper Avenue School in Los Angeles wear their mask during class.

    Credit: Carolyn Cole/Los Angeles Times/Polaris

    As students return to school after holiday travel and festivities, respiratory illnesses are at high levels in Los Angeles, with many suffering from a mix of Covid and the flu. 

    During the week leading up to Dec. 28 and with Covid-19 strain JN. 1 having become dominant, the LA County Department of Public Health reported an average of 621 cases each day, marking a 25% increase from the previous week. 

    The Department of Public Health also said the figures are an “undercount” since most tests are done at home and not reported to medical staff. Meanwhile, for the first time this season, the county has entered the CDC’s “medium” category for Covid hospitalizations. Mask mandates have been reinstated in health care facilities.

    “There have been notable, yet not unexpected, increases in COVID-19 reported cases, hospitalizations and deaths,” according to a news release from the LA County Department of Public health. 

    “While recent increases are significant, they remain considerably below last winter’s peak and common-sense protections are strongly recommended to help curb transmission and severe illness as the new year begins.”

    Earlier this season, 23% of LA County residents participating in a text message survey said they had experienced a cough or shortness of breath within a week of Dec. 10, according to the Los Angeles Times. 

    More specifically, they reported that about 18% of specimens tested at Sentinel Surveillance Labs in LA County came back positive for the flu — marking a 4% increase from the previous week. And, in the week leading up to Dec. 16, more than 12% of specimens came back positive for RSV. 

    “Respiratory infections among children and adults are increasing this winter season. These infections are not limited to Flu and COVID-19,” read a message from LAUSD. “We are also seeing a rise in Respiratory Syncytial Virus, also known as RSV.”

    Before going on winter break, between Dec. 6 and Dec. 12, LAUSD also reported 528 Covid cases, according to the district dashboard. 

    LAUSD and the LA County Department of Public Health suggest parents follow these guidelines for determining when a child should be home, come to school and how to stay healthy. 

    What should I do if my child tests positive for Covid? 

    Whether symptomatic or not, students with Covid should stay home for five days, following either testing positive or experiencing symptoms. 

    Those who are immunocompromised, however, may isolate for longer periods, according to the district. 

    If my child tests positive for Covid, when is it safe for them to return to the classroom? Do they need to provide a negative test result before coming back? 

    Students do not need to provide a negative antigen test to return to class between days six and 10. And following day five, if your child has been without a fever for 24 hours without taking fever-reducing medicines, and their symptoms are improving, they can return to the classroom. 

    If, however, the symptoms come back after the isolation period, the student should test again, according to the district. 

    What does it mean if my child is a “close contact?” What do I do then? 

    If your child is in the same indoor space for Covid for 15 minutes within 24 hours with someone positive, they are a “close contact.” 

    In that case, the district asks that your child’s health be monitored for 10 days following the exposure. They also recommend masking and testing between the third and fifth days. 

    What about other illnesses like the flu or RSV? Do the same rules apply? 

    If your child has a fever of 100.4 degrees or higher — or if they are vomiting or have diarrhea —  they should stay home, according to the district. 

    What should I communicate to the school? How do I ensure my child’s absence is excused?

    If your child has Covid, upload the result onto the Daily Pass. 

    And regardless of the sickness, absences due to illness are excused. To excuse an absence, provide the school with documentation within 10 days of your child’s return to class. 

    If the school does not receive documentation, the absence will count as uncleared or unexcused, meaning it can count toward truancy. 

    Where do I find free Covid tests, vaccinations and treatments to keep my child healthy? 

    LAUSD provides Covid-19 home test kits at each school site. Libraries and other community centers may also supply tests. 

    Additionally, as of Nov. 20, the federal government provides each household with four home tests for free, according to the LA County Department of Public Health. 

    How do we stay healthy? 

    The LA County Department of Public Health suggests testing, not only if you have been exposed or have symptoms, but also if you have attended larger gatherings or have visited individuals who are more susceptible to illness.  

    They also recommend washing hands frequently and masking in crowded indoor areas as well as in spaces that are poorly ventilated to prevent Covid, RSV and the flu. 





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  • Through comedy, students can take ‘big swings’ for mental health

    Through comedy, students can take ‘big swings’ for mental health


    Two teaching artists lead a group of students through improv exercises during a Laughing Together workshop at San Joaquin County Office of Education's Peer-to-Peer Summit in September 2024.

    Teaching artists lead students through improv exercises during a Laughing Together workshop at San Joaquin County Office of Education’s Peer-to-Peer Summit in September 2024.

    Top Takeaways
    • Many school districts are using comedy and improv workshops to teach students social-emotional skills, encourage self-expression and foster social connection. 
    • Through the comedy program Laughing Together, professional comedians and mental health clinicians develop workshops based on exercises that can improve student mental health. 
    • Game-based learning and interactive play can engage students who might have fallen behind academically or socially during the pandemic.

    “If you were an object, what object would you be?” 

    Chris Gethard, a veteran comedian and improv teacher, posed this question to a group of high school students in Northern California at a Laughing Together workshop he was leading. He remembered one who identified as a fruit. 

    “When I was a kid, I convinced myself that I hated avocados,” Gethard remembered the student saying. “And then I tried one, and I actually love ’em. And that’s been my experience the past few years as I’m learning to love and embrace myself.”

    It quickly became obvious to Gethard that the improv wasn’t about avocado or any fruit for that matter. It was a big moment, and the student was taking a big risk to figure out something about themselves — their gender identity in real time.

    “Young people right now are living in a world where those experiences are often held up in the spotlight and politicized,” Gethard said. “So to see a kid being able to take a comedy exercise, which feels light and accessible and not too heavy, they can let their guard down and take a big swing like that.”

    Many school districts are turning to comedy as a way of supporting student mental health. In 2023, Gethard co-founded Laughing Together, a program based on research that comedy can be an effective tool for students’ social-emotional learning and social connection with their peers. 

    Nearly 6,500 students and educators across 26 different schools, districts, or youth organizations, have taken part in their workshops since Gethard co-founded the program with Marlon Morgan, CEO of parent nonprofit Wellness Together. 

    “One of the reasons that we [partnered with Gethard] is that he had already shared about his own mental health through his comedy special on HBO,” said Morgan, who is also a former school counselor. “He can make dark and scary things funny, which really helps students gain insight into their own emotions and become better at connecting with each other.” 

    ‘Taking chances in the spotlight’

    Research shows that students who practice social-emotional skills in safe environments with well-defined goals have improved social behavior, emotional regulation and academic performance. 

    “We have clinical psychologists who go through all the improv exercises,” Gethard said. “They get to say — ‘these ones are about making people funny, and they also prioritize nonverbal communication, strengthening eye contact, being comfortable with failure and taking some chances in the spotlight.’”

    Christina Patterson, a senior and peer counselor at Lincoln High School in Stockton, said pandemic shutdowns forced her to spend nearly entire days scrolling through social media, hoping for something new to interact with (“But, there never is anything new,” she added). 

    For the first time since her school implemented a cellphone ban, Patterson said taking part in the Laughing Together workshop, even for an hour, met the level of engagement she had always been looking for on her phone. Like Patterson, students in recent years report better cognitive, social and academic outcomes through game-based learning and interactive play, compared to lecture-based instruction. 

    “I feel engaged with people who are interactive — they’re not trying to teach at you, but they’re trying to teach with you together,” Patterson said. 

    Laughing Together workshops are led by one of the program’s teaching artists, including professional comedians, actors and performers, alongside children’s psychologists, drawing on art, play and game therapy research, to develop social-emotional learning and communication skill-building into each exercise. For Gethard, a workshop is successful if he can teach students something without them realizing it. 

    “We want kids to leave feeling more connected and comfortable with each other, not like they just watched a slide show or that they were just spoon-fed these lessons,” he said. “We want them to feel that they’re allowed to at least throw an idea out there, and no one’s going to judge them, pick them apart, or criticize them.” 

    Sofia Stewart-Lopez, a senior and peer counselor at Lincoln High School, helped set up a peer-to-peer summit, where she and other student mentors took part in a Laughing Together workshop. She remembered starting the day anxious about a big presentation about mental health resources she had later in the day, but after a few skits and improv games, she felt more confident, relaxed and connected to the people around her. 

    “I learned that a big part of balancing heavy topics of mental health, like anxiety, depression or substance abuse, is learning how to combat them with things that can help you with those feelings,” Stewart-Lopez said.

    Markus Alcantar, a senior and a peer counselor at Lincoln High School, said his favorite part of the workshop was one in which he got to become an apple. He had to think on his feet about why he felt like one, and then he improvised a skit with someone who had decided they were a tree. In another exercise, he said a volunteer started with juggling a ball, after which students added another ball, followed by another, and then another — until they couldn’t keep up anymore. 

    “It was a fun representation of how you can have a lot of things going on in your head mentally, and that you can learn to unravel those thoughts and organize them for yourself and other people,” Alcantar said. 

    About 1 in 5 teenagers, and most of Stewart-Lopez’s friends at school, she said, have experienced symptoms of anxiety or depression. So the workshop, she said, was particularly helpful in understanding how laughter exactly works in the brain — like how endorphins and serotonin receptors can alleviate some feelings of sadness or anxiety — to be able to have fun and build healthy coping skills with friends at school. 

    “The [improv exercises] also taught us that thinking on our feet better prepares us to be able to respond in different types of situations,” Stewart-Lopez said. “We learned that different people need different types of support, which betters us as mentors.”

    Middle school students attend a Laughing Together workshop at San Joaquin County Office of Education’s Peer-to-Peer Summit in September 2024.

    Most recently, Gethard completed nine workshops at a high school where over half of the student body are on Individualized Education Plans (IEP), or accommodations for students with learning, developmental, or behavioral disabilities. During the first workshop, he noticed most students reaching for their phones in the middle of an exercise or while on stage. To ease students into the experience, he’d tell them to simply take a breath and try to be present. 

    “After the first few workshops, a teacher came up to me and said, ‘their ability to lock in and focus on that is leaps and bounds compared to week one,” Gethard said. “She said, ‘they just never got their ability to focus back after Covid, but if we can keep going with this, it’s going to change the game for these kids in the room.’” 

    Rates of anxiety and depression — which shot up by 70% among California children between 2017 and 2022 — are the top health-related drivers of absenteeism since the onset of the pandemic. Research indicates that reduced social interaction, coupled with overreliance on screen time, also worsened students’ social cognition skills, such as cooperation and communication, and executive functions, such as attention and memory.

    Alcantar was in seventh grade when schools shut down, and when he returned to in-person instruction as a high school freshman, he said he found it difficult for him to initiate conversations with people around him. Stewart-Lopez said that after schools lifted mask mandates, she kept hers on for a while because she was worried about meeting social expectations about what she should look like. 

    “The pandemic had added to my sense of anxiety about, ‘What if I don’t fit in? What if I’m different from everybody else?” she said. 

    For Stewart-Lopez, laughter feels like home. It’s how she and her sisters got through their parents’ separation and also how she plans to take new risks with new people at college this year. 

    “We’re creating that safe place for students to get real-time responses to the risks they’re taking — and everyone’s taking risks — which makes it okay,” said Morgan, the CEO of nonprofit Wellness Together.





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  • Survey: Californians are worried about student health, lukewarm toward a state school bond

    Survey: Californians are worried about student health, lukewarm toward a state school bond


    Credit: Alison Yin / EdSource

    Californians remain anxious about the mental health of public school students four years after the Covid virus closed down schools, according to a new survey released Wednesday. They also indicated they’re lukewarm toward passing a statewide school construction bond.

    In the Public Policy Institute of California’s survey of 1,605 California adult residents, 81% of all adults and public school parents said they were strongly or somewhat concerned  about students’ mental health and well-being – a view that, for most part, cut across race, political party affiliation and family income. The number reflects a continuing worry about the persistent impact of the pandemic two years after students returned to the classroom following school closures of more than a year.

    SOURCE: PPIC Statewide Survey, April 2024. Survey was fielded from March 19-25, 2024 (n=1,605 adults, n=1,089 likely voters, and n=252 public school parents).
    PPIC

    Advocates for a statewide bond to build and repair TK-12 school facilities may face an uphill battle to pass it – assuming Gov. Gavin Newsom and legislators put the issue before voters in November.

    Only 53% of likely voters said they would vote for a state bond, while 44% said they’d vote no, with only 3% undecided, according to the Public Policy Institute of California, which on Wednesday released its annual survey of voters’ view on TK-12 education issues. The number is well below 60%, the standard level of favorability that comforts backers of an initiative heading into a campaign.

    The mid-March survey also found mixed views on how Newsom and the Legislature are handling the state education system; 51% of all Californians and 60% of public school parents said they liked how he had managed education. That’s the lowest number since his election in 2018, and consistent with PPIC’s most recent survey on his overall job performance. The survey had a margin of error of 3.3% plus or minus. 

    Newsom’s highest rating was in April 2020, when 73% of likely voters approved and 26% disapproved of his performance on TK-12 education. That coincided with the emergence of the coronavirus, and his decision to close schools. “Newsom got a bump in the early days of the crisis for responding decisively amid the shock of the pandemic,” said Mark Baldassare, survey director and chair of public policy for PPIC. 

    The Legislature and State Superintendent of Public Instruction Tony Thurmond also received roughly 50% approval in the latest survey; however, the poll also showed that most Californians agreed with their positions on social and political issues that captured headlines in the past year.

    • 69% of all adults said they strongly (43%) or somewhat (26%) oppose individual school boards passing laws to ban and remove certain books from classrooms and school libraries; a smaller majority of public school parents (30% strongly, 25% somewhat) agreed. Last year, Newsom threatened to fine Temecula Valley Unified and replace a social studies textbook that the board rejected because it included a reference to the late gay activist Harvey Milk; the board reversed its position.
    • 58% of all adults and 55% of public school parents oppose individual school boards creating policies to restrict what subjects teachers and students can discuss in the classroom.
    • More than 80% of adults and public school parents strongly or somewhat favor teaching about the history of slavery, racism, and segregation in public schools; more than 50% of all respondents strongly held that view.
    • Local schools got good marks for preparing students for college, but less so the workforce. 60% of all adults and 72% of public school parents said their schools did well preparing students for college, while 51% of all adults and 65% said they did a good job preparing students for jobs and the workforce.  Only 45% of African American respondents said the schools did a good job for college, compared with 64% of Asian Americans, 61% of Latinos and 61% of Whites.

    As with these and many of the issues surveyed, there was a sharp partisan division, with most Democrats supporting Newsom’s positions and most Republicans opposing them.

    California adults were about evenly split (50% support, 49% oppose), however, on whether to allow books with stories about transgender youth in public schools. Three in four Democrats support this, while eight in 10 Republicans oppose it, and independents are divided (51% support, 48% oppose). Only 42% of public school parents support the idea, and 57% said they oppose it; they also opposed including lessons on transgender issues by the same breakdown.

    Newsom and the Legislature have committed billions of dollars to phase in voluntary transitional kindergarten for all 4-year-olds. Two-thirds of all adults, including 77% of public school parents, 80% of Democrats, 41% of Republicans, 84% of Blacks, and 57% of Whites, said that’s a good idea.  

    Uncertainty about bond issue

    Newsom said in January that he supports placing a school construction bond on the November statewide ballot; voters last passed a state bond in 2016, and the state has run out of money to contribute to districts’ share of new construction and renovations.

    However, Newsom and legislative leaders have not negotiated the specifics. School consultant Kevin Gordon, president of Capitol Advisors, said that polling results could affect the size and scope of a bond. Instead of a $15 billion bond that legislative leaders have discussed, it could be much less; instead of including money for the University of California and California State University, which polls less favorably than TK-12, it could include money only for TK-12 and community colleges, he said.

    Gordon and Baldassare disagreed on how much to read into the 53% support of the bond eight months before the election.

    “All of the not-so-good news about the state budget, with billions of dollars in red ink, has had an impact on voters’ attitude that affects the bond issue now,” Gordon said. “But after this summer, with a balanced budget adopted, and with economists optimistic about the latter part of 2024, voters’ attitude could change.”

    Credit: Public Policy Institute of California, April 2024 survey

    Four years ago, voters rejected a state bond 46% to 54% in the March 2020 primary election. But, Gordon said, voters have never defeated a state bond initiative in a November election, which attracts more people to the polls.

    Baldassare said the bare majority support in the survey shows “there is a lot of economic anxiety among voters over inflation and anxiety over taking on more debt.” That showed in the bare passage last month, with 50.2% of the vote, of Proposition 1. It will determine how to spend money on housing for unhoused people suffering from mental illness.

    The survey also produced mixed, and perhaps puzzling results to the same questions asked in previous surveys:

    Asked “how concerned are you that California’s K-12 public school students in lower-income areas are less likely than other students to be ready for college,” 39% this year said “very concerned.” That’s the lowest percentage since the question was introduced in 2010, when 59% said they were very concerned.

    Asked, “How would you rate the quality of public schools in your neighborhood today,” 49% of likely voters gave their schools an A or B. That’s nine percentage points higher than last year and in pre-pandemic 2019.

    Asked whether the quality of education has gotten worse over the past few years, 52% of adults said it was worse, 11% said it had improved, and 34% said about the same. That was an improvement from last year, when 62% said education had gotten worse and only 5% said it had improved – and far better than in 2011. That was during the depths of the Great Recession, when school districts were slashing budgets following cuts in state revenue: that year, 62% said schools had gotten worse.





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  • Michael Hiltzik: RFK Jr. is a Danger to Public Health

    Michael Hiltzik: RFK Jr. is a Danger to Public Health


    Michael Hiltzik, columnist for The Los Angeles Times, explains why Robert F. Kennedy Jr. is himself a danger to public health. Why did Trump pick him? RFK Jr. is neither a medical nor a scientific researcher. He has made his mark in public as a conspiracy theorist and a publicist for the idea that vaccines cause autism and other illnesses.

    Hiltzik writes:

    Americans have become woefully familiar with Health and Human Services Secretary Robert F. Kennedy Jr., the purveyor of flagrant misinformation about medical treatments. And with Robert F. Kennedy Jr., the minimizer of health crises such as the spreading measles outbreak. And with Robert F. Kennedy Jr., the antivaccine crusader.

    Now let’s meet Robert F. Kennedy Jr., the promoter of a costly, time-consuming and distinctly unethical order for testing vaccines. “All new vaccines will undergo safety testing in placebo-controlled trials prior to licensure — a radical departure from past practices,” HHS announced in a May 1 statement. What it didn’t say was that the “departure” is “radical” because it’s shunned by medical authorities as a bad thing.

    Just this week, Kennedy’s agency doubled down on this order with the appointment of Vinay Prasad, an oncologist at UC San Francisco, as head of the Center for Biologics Evaluation and Research, the division at the Food and Drug Administration that oversees vaccine testing.

    Prasad was a strident critic of the Biden administration’s approach to the COVID-19 pandemic, including the COVID vaccines. In a blog post in late April, he called for clinical testing of COVID boosters, along the lines of Kennedy’s order. Prasad succeeds Peter Marks, a widely respected expert who resigned from the FDA in March after clashing with Kennedy.

    “I was willing to work to address [Kennedy’s] concerns regarding vaccine safety and transparency,” Marks wrote in his resignation letter. “However, it has become clear that truth and transparency are not desired by the Secretary, but rather he wishes subservient confirmation of his misinformation and lies.”

    The HHS announcement about Kennedy’s demand for placebo-controlled trials was unclear about how it defined “new vaccines.” But his previous claims about vaccine safety have made clear that he’s referring not only to first-generation vaccines for diseases, but also boosters and expanded formulations. That’s an important point, as I’ll cover in a moment.

    The antivaccine camp, of which Kennedy has long been a leader, has pushed the claim that most childhood vaccines haven’t been adequately tested for safety because they haven’t been subjected to placebo-controlled trials — and therefore may be unsafe.

    “Except for the COVID vaccine, none of the vaccines on the CDC’s childhood recommended schedule was tested against an inert placebo, meaning we know very little about the actual risk profiles of these products,” Kennedy’s spokesman at HHS, Andrew Nixon, asserted in connection with the order.

    Both components of that claim are misrepresentations.

    Let’s take a closer look, starting with some rudimentary points.

    The testing that Kennedy and Prasad advocate are randomized control trials. They’re correct in asserting that so-called RCTs are the gold standard in clinical testing of drugs and vaccines.

    RCTs typically involve at least two groups of subjects: One receives the medicine in question and another — a control group — receives something else, such as a placebo, a concoction that’s designed to resemble the medicine but is essentially inert, with no evident effect on the disease. The placebo may be an injectable saline solution, or water, or a sugar pill.

    Kennedy, like other antivaxxers, is deceptive in saying that the safety of vaccines should be questioned if it hasn’t been tested against an “inert placebo.”

    That brings us to the ethics of clinical testing, and why Kennedy’s policy is so dangerous.

    Testing a vaccine against a true placebo is ethical and proper when it’s the first treatment for a disease for which no other safe and effective treatment exists. That’s not the case, however, when a known treatment does exist — say after a vaccine has been shown to be safe and effective and has become the standard of care.

    As vaccine specialist Paul Offit of Children’s Hospital of Philadelphia has explained, subjecting new versions of those vaccines to placebo-controlled testing — giving some subjects the new vaccine and the control subjects no treatment, would be unethical, because it would require depriving the placebo group access to a known treatment. That was the conclusion of an expert panel assembled by the World Health Organization in 2014.

    Offit, in a 2023 rejoinder to Kennedy’s appearance on a Joe Rogan podcast, in which he claimed that drug companies “never do placebo-controlled trials,” pointed to what may be the most famous vaccine trial to illustrate this point.
    That was the nationwide trial of Jonas Salk’s polio vaccine. In 1954, 420,000 first- and second-graders were given the Salk shot, and 200,000 got a shot of salt water. Salk objected to the trial’s design. Smaller trials had established the safety and efficacy of his vaccine, so the plan meant depriving 200,000 children of immunity to a disease that was paralyzing 50,000 children a year and killing 1,500.


    As Offit noted, in the full trial 16 children died from polio; all were in the placebo group. So were 34 of the 36 children paralyzed in the course of the trial. “These are the gentle heroes we leave behind,” Offit wrote.


    Now let’s examine Kennedy’s order as it applies to modern vaccines. As the veteran pseudoscience debunker David Gorski has pointed out, contrary to the assertion by Kennedy’s spokesman, almost none of the vaccines on the current childhood vaccination list is a first-generation vaccine warranting placebo testing. (An exception is Gardasil, which safeguards against human papilloma virus.)

    They’re upgraded preparations of vaccines that themselves underwent placebo-controlled trials, or formulations aimed at new variants of the targeted disease, or shots that inoculate against several diseases all at once.

    To demand that every new formulation be tested against an inert placebo would mean turning back the clock to reproduce trials that may have taken place decades ago, but resulted in the licensing of the original vaccine after safety and efficacy were established.

    That means it would have been unethical to test the new version against a saline control, because the control group would be deprived of any effective treatment. “The bottom line,” Gorski writes, “is that, if you trace back the history of the vaccines developed for a disease like, say, measles, you will eventually find the RCT testing the first effective vaccine against it and that vaccine will have had a placebo control.”
    He’s right. In a tweet thread, vaccinologist Peter Hotez traced back the history of several vaccines to their initial RCTs.

    What makes Kennedy’s order especially cynical is that designing and implementing a clinical trial is an extraordinarily complex, costly and time-consuming process. As a team of Canadian researchers observed in a 2018 Nature article, a full-scale Phase 3 clinical trial — the level at which drugs and vaccines are studied for safety, efficacy and dosing — requires as many as 3,000 participants and can take as long as four years.

    In an online posting last month, Prasad ridiculed “the mainstream media” for being upset about the idea that COVID boosters should in effect receive full randomized clinical trials before approval. He took particular issue with an article by Helen Braswell of STAT asserting that such a requirement might well delay approval of a vaccine targeting a new COVID variant until it was too late to protect users from that variant. Prasad called the argument false because “the virus spreads year round.”

    Is that so? At the height of the pandemic, new COVID variants sometimes appeared within months of one another. The virulent Delta variant, for example, appeared in the spring of 2021 and was overtaken by the Omicron variant, which also caused severe disease, that November.

    Delays in rolling out vaccines to combat newly emergent disease strains and variants could cost millions of lives. Under existing vaccine approval protocols, the COVID vaccines prevented as many as 20 million deaths globally within a year after they were introduced early in 2021.

    Prasad’s new job will put him in charge of developing vaccine testing policies and overseeing the design and approval of clinical trials. I asked him via email what policies he would pursue, whether he was in alignment with Kennedy’s approach, and how he expected vaccine developers to reconcile the costs and time constraints of undertaking clinical trials on the scale he advocates with the imperatives of public health. I didn’t receive a reply.

    So far, the Kennedy regime at HHS has lived down to the worst expectations of his critics. His devotion to unnecessary testing of vaccines that have already shown their safety and efficacy is only one aspect of a comprehensive assault on public confidence in science-based medicine.

    In a recent appearance on Sean Hannity’s Fox News program, Kennedy dismissed the severity of the current measles outbreak and denigrated the effectiveness of the measles vaccine. The current outbreak of 935 cases is by far the worst in the U.S. since 2019, when 1,274 cases were recorded; at the current rate, we are on the path to nearly 3,000 this year.

    Kennedy has promoted almost useless nostrums against measles, such as vitamin A, while describing vaccination as a personal choice. That’s devastatingly wrongheaded. Kennedy confuses “medicine” and “public health.” The former concerns itself with the individual; the latter with the community. Vaccine policy belongs in the latter category because vaccines are most effective when the effort is communitywide.

    Measles is among the most contagious diseases known to humankind, which means that communal vaccination is crucial. Professionals have concluded that a 95% vaccination rate is the minimum required to protect the most vulnerable, such as infants, from infection; as of 2024, the U.S. vaccination rate among kindergartners had fallen from 95.2% in 2019-20 to 92.7%.

    The Centers for Disease Control and Prevention, which falls within Kennedy’s jurisdiction, says the decline in measles vaccinations leaves 280,000 kindergartners at risk. Two children in the U.S. already have died from a disease that was thought to have been eradicated in the U.S. in 2020; Kennedy doesn’t seem concerned that the toll on his watch is poised to get much worse.



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  • ‘Looking at the whole child’: State leaders discuss ways to improve students’ mental health

    ‘Looking at the whole child’: State leaders discuss ways to improve students’ mental health


    Credit: Alison Yin/EdSource

    Bringing more mental health professionals onto campuses, training teachers and reducing negative stigmas surrounding mental illness are critical to students’ wellbeing, according to experts at Friday’s Select Committee on School Climate and Student Safety meeting. 

    From kindergarteners to high school seniors, students across California are still struggling with mental health challenges in the aftermath of the Covid-19 pandemic — and districts across the state have come up with various strategies to provide support. 

    “We need to shed light on the current state of student mental health, identify key challenges and explore potential solutions,” said State Senator Susan Rubio (D-Baldwin Park), who led the discussion. 

    Mental health challenges

    While most of society has moved on from the Covid-19 pandemic, a large proportion of students have not. 

    “A lot of us —  not only children, but adults as well — we became a lot more isolated,” said Jonathan Wicks, a social worker at YWCA San Gabriel Valley, at Friday’s hearing. “Now that we’re all reintegrating back into social spaces, a lot of times, it’s not as easy to connect, and so that connectedness that belongingness isn’t always there.” 

    Most mental health conditions start to manifest when someone is in their youth or young adulthood; Jeannine Topalian, former president of California Association of School Psychologists, who also serves on the California’s Advisory Commission on Special Education, cited an ACLU report which found that more than 63% of students reported experiencing an emotional meltdown, while nearly half said they were depressed.

    Wicks added that over the past few years, young people have increasingly turned to marijuana and other substances to cope, which has led some to “over indulging and going into psychosis.”

    Mental health staff

    Schools often don’t have the staffing and resources to support struggling students.

    According to Topalian, there are 1,041 students for every school psychologist in California and  7,308 students for every social worker. 

    “There are six year olds out there who are in crisis today, who are in need of a lot of support from mental health professionals,” she said. “And what better place than a school where that’s the hub of the community to provide these services.”

    Mental health professionals at schools are overwhelmed with hefty caseloads which makes it harder to pay attention to students’ individual needs or to take a more preventative approach. 

    Loretta Whitson, executive director of the California Association of School Counselors, said that some progress has been made in California’s counselor-to-student ratio. In the 2012-13 academic year, the ratio was 826 students to one counselor. Now, it’s roughly half that. 

    “I think 800 would be more like urgent care. We’re responding to crises,” she said. “….When you have 400, then you are able to do comprehensive strategic work.”

    The national suggestion is a 250:1 ratio, she added. 

    “We’re not where we want to be…., but we’re moving in the right direction,” Whitson said, adding that there are more counseling services in elementary schools now, where students start learning social skills and ways to cope. 

    Fifty percent of all school counselors nationwide in California, and 33 university programs in the state are turning out new counselors, Whitson added. 

    A ‘first line of defense’: involving teachers

    Involving teachers is a critical support for students in their mental health challenges, the speakers agreed. 

    Kim Griffin Esperon, a project director of Mental Health & School Counseling at the Los Angeles County Office of Education, emphasized the importance of creating step-by-step protocols that teachers and staff can be trained to implement. 

    Teachers should also be provided with guidelines to help them spot signs of depression, and their input should always be considered, Topalian said. 

    “We often tell teachers or staff what to do. It’s very important to think about asking them what they need and where their skill set is before we implement or develop programs,” she said. “They need to be part of the process rather than being the people who are in the frontline trying to do this work for our students.”

    Off campus 

    Reducing the stigma around mental illness is also critical to students accessing support, the speakers agreed. 

    “Traditionally, schools and communities have understood mental health supports and services to be necessarily only for those students who have been identified as having a mental health disorder, or they have assumed that all students experiencing mental health challenges require intensive mental health interventions,” Esperon said. 

    “Fortunately, our understanding has evolved to refocus our attention on prevention and earlier identification of students who are struggling as well as referral to the appropriate level of services to meet students’ needs.” 

    Wicks said there are several intergenerational families in the San Gabriel Valley — which can make it harder for students to access support because of varied attitudes toward mental health support and counseling. 

    “I could see the challenge, you know, for the youth to hear the information and maybe want to move in that direction [of seeking help],” Wicks said. “But when they would go home and have those discussions, they would kind of come back with a ‘No thank you.’” 

    He added that youth advisory opportunities, where students can interact with one another, can be particularly helpful. And some districts have explored peer-to-peer counseling, which can also reduce students’ feelings of isolation. 

    Other ways to expand access 

    The Los Angeles Unified School District has attempted to expand community outreach to reduce stigmas around mental illness — while using Telehealth options to provide students with mental health supports, according to the district’s Administrator of Student Health and Human Services Joel Cisneros. 

    He said LAUSD also has its own psychiatric emergency response team, which intervenes in crises where students could harm themselves or someone else. 

    “[It’s] going beyond the idea that we’re just producing students to an academic process in order to graduate and to be successful,” Whitson said. “It’s also looking at the whole child. And that shift in perspective, I think, is really contributing to some of the changes that we’re trying to do.”





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  • Helping students with mental health struggles may help them return to school

    Helping students with mental health struggles may help them return to school


    Credit: Alison Yin / EdSource

    Students who are chronically absent from school are much more likely to struggle with mental health challenges, with pre-teen boys and teen girls reporting some of the highest signs of distress.

    When students need help, availability of mental health support often depends on the income of families. “As household income increased, so did the availability of mental health services” in children’s schools, University of Southern California researchers found in a survey of 2,500 households nationwide.

    Their findings are part of an in-depth report on the continuing national school absenteeism crisis in which 25% of students, or about 12 million children, across 42 states and Washington, D.C., were chronically absent in the 2022-23 school year. That rate remains higher than the pre-pandemic national rate of 15%.

    EDITORS NOTE

    This in-depth report on chronic absenteeism is part of an EdSource partnership with the Associated Press and Stanford Professor Thomas Dee.

    For earlier coverage, go to EdSource’s Getting Students Back to School.

    — Rose Ciotta, investigations and projects editor

    While California saw a decrease of 5 percentage points in chronic absenteeism during the same school year, to 24.9%, districts statewide are still struggling to get all students back to school.

    “Chronic absenteeism in California is still twice what it was prior to the pandemic, and roughly 1 in 4 kids in public schools are chronically absent. That is just really striking and is a serious barrier to achieving academic recovery for this generation of students who were so harmed by the pandemic,” said Thomas Dee, a Stanford University education professor and economist who gathered nationwide data in collaboration with The Associated Press and the release of the USC research.

    Emotional and behavioral problems also have kept kids home from school. University of Southern California research shared exclusively with AP found strong relationships between absenteeism and poor mental health.

    For example, in the USC study, almost a quarter of chronically absent kids had high levels of emotional or behavioral problems, according to a parent questionnaire, compared with just 7% of kids with good attendance. Emotional symptoms among teen girls were especially linked with missing lots of school.

    Families with the lowest incomes reported a much higher rate of using mental health services if they were offered to their children in school — more than five times higher than those with the highest incomes. And, crucially, the researchers also found that 1 in 5 respondents would have used mental health services if they were made available at their school, with higher rates among Black and Hispanic families who were surveyed.

    “There is tremendous opportunity here for schools to increase the offerings but also, if they have the offerings, to increase the outreach to the kids and the families that need it because there is clearly an unmet need,” said Amie Rapaport, who co-authored the report and is the co-director of Center for Economic and Social Research at USC.

    ‘I had a very bad year’

    If Jennifer Hwang’s son made it to his first grade classroom, it was rarely without a fight.

    He struggled with severe attention deficit hyperactivity disorder (ADHD), and Hwang says his teacher’s habit of discarding art work in front of him would spike his anxiety, leading to violent outbursts and refusing to even get in the car or walk onto campus.

    “I thought I would have a good year in first grade, but I didn’t,” said her son, 8, whose name Hwang declined to share to protect his privacy. “I had a very bad year.”

    The absences began piling up during the second semester of that 2022-23 school year; he started missing two to three days most weeks. He soon became chronically absent, meaning he missed at least 40 days total. That classified him as chronically absent because he had missed at least 10% or more days in one school year. He began to see a therapist outside the L.A. Unified district.

    Hwang tried getting her son an individualized education program (IEP), which would grant him access to school-based counseling services given his ADHD diagnosis. But because her son’s academic performance was up to par, the school said he didn’t need it.

    She also inquired about him seeing a child psychologist who went to his Riverside Drive Charter campus in Sherman Oaks once or twice a week — but the waitlists were too long. Because he was already seeing a therapist outside of school, Hwang gave up on pressing for school resources.

    The USC report published Thursday highlights that pre-teen boys, which includes children ages 5 to 12, are struggling significantly with symptoms of hyperactivity and conduct problems, while teen girls, ages 13 to 17, are struggling most with emotional symptoms, such as depression and anxiety.

    Morgan Polikoff, a co-author of the USC report, said they cannot confirm there is “a cause and effect here,” noting that the correlation between chronic absenteeism and mental health challenges could “go both directions.”

    “In reality, it’s probably both ways. There’s probably some kids for whom increasing anxiety is leading them to stay home, and there’s probably kids who are missing a lot of school and that’s increasing their anxiety. So it probably is bi-directional or multi-directional,” Rapaport agreed.

    Both the USC researchers and Dee advocated for more research to better understand the causes of persistently high chronic absenteeism rates.

    LAUSD’s chronic absenteeism problem

    Last year, for second grade, everything changed, Hwang said, largely thanks to a teacher who adapted assignments to suit her son’s social-emotional needs and incorporated “brain breaks” into the school day, which Hwang’s son said helped him concentrate.

    “She understood him. She knew that he was bright and he felt things much more deeply, and he saw things differently and with a very different perspective,” Hwang said. “She allowed him to feel heard.”

    “One day (his teacher told me), ‘Oh, my goodness, your son just gave me a hug!’ Hwang said. “That doesn’t come cheap because he does not give out hugs very often. So that he actually hugged the teacher … that says a lot.”

    Hwang and her family aren’t sure what third grade will bring, but they were able to at least secure a 504, a type of plan that helps level the playing field for students with disabilities, so her son could have access to a special chair and space to doodle.

    LAUSD, the second-largest school district in the nation, has struggled with high rates of chronic absenteeism since the onset of the pandemic. Nearly 33% of their over 400,000 students were chronically absent during the 2022-23 school year, down from about 40% the previous year.

    Most recently, in 2023-24, preliminary data shows their rate is hovering at 32.3%, a spokesperson said.

    Still not enough

    LAUSD has increased its staffing of social workers and pupil attendance workers, but staffers say it’s just not enough.

    “We have what we can afford at this point — more than ever before — but still not at an appropriate ratio that I think this board, or myself, would feel comfortable,” Superintendent Alberto Carvalho said at a news conference Monday.

    Carvalho described the district’s staffing as “an unprecedented network” but did not specify how much staffing had increased.

    Ofelia Sofia Ryan is one of roughly 400 LAUSD pupil services and attendance workers trying to bring students back to school.
    Credit: Mallika Seshadri / EdSource

    Ofelia Sofia Ryan is one of LAUSD’s roughly 400 pupil services and attendance counselors who are on the front lines helping get chronically absent students connected with mental health resources and Medi-Cal so they can get back to school.

    This year, the 20-year district veteran works in five elementary schools, including Orchard Academies in the city of Bell.

    “Poverty is the No. 1 issue. Financial issues are … second — the inability of a parent to monitor because they are having two jobs, which also relates to the poverty issue,” Ryan said. “Mental health, I would say that will be maybe next.”

    Darlene Rivas, one of the district’s 800 psychiatric social workers (PSWs), is assigned to two East Los Angeles elementary schools: William R. Anton and Lorena Street.

    “We have to be team players because it can’t just be one person,” Rivas said. “I think that’s why you see a lot of exhaustion within PSW professionals.”

    There is a long waitlist for students in need of therapy, she said. If a parent can’t make it to an initial appointment, it can take months to reschedule.

    Adding staffing can come from school funding, but there are competing demands.

    This year Ryan said she started on an LAUSD campus two days a week. At the last minute, “boom,” they dropped a day, she said.

    “That’s very unfair, because (the district tells) you, on one hand, mental health matters, attendance matters. You’re working your butt off to get attendance improved. I improved attendance in all my schools. Everything was done by the book, and then (the school) just took the money away,” said Ryan. “You cannot do anything. You are powerless.”

    Carvalho regularly touts the district’s iAttend program, where he, among others, visits the homes of chronically absent students to coax them back to school. The district made more than 34,000 home visits last school year, contributing to a more than 4 percentage point decrease in chronic absenteeism, according to the district.

    What the public doesn’t know is how much work it takes after the house visit to get the child back in school, Ryan said.

    Local barriers require local solutions

    Researchers like Dee offer advice for lowering chronic absenteeism rates: “Be acutely aware of the problem” and “look to the really local barriers.”

    That advice appears to be playing out successfully farther north, in Placer County, where more and more of Roseville City School District’s 12,000 students are attending school regularly each year.

    Placer’s 2023-24 absenteeism rate is expected to be about 11% — nearly double what it was pre-pandemic. But that is down from 20% in 2022-23 and 26% in 2021-22.

    School staff have found the two main reasons for the absences are “misinformation and a lot of struggle,” said Jessica Hull, the district’s executive director of communication and community engagement. They zeroed in on these top reasons by closely tracking absenteeism over several years with their attendance system plus a notification system managed by a third-party team, SchoolStatus, that they hired specifically to address chronic absences.

    The misinformation largely centers on families being unsure of whether to send a child to school when they are sick, not knowing they can rely on independent study if the family is going on a lengthy vacation, or not understanding the importance of enrolling in pre-kindergarten known as TK.

    Roseville City School District’s attendance roadmap for parents.

    This misinformation is part of what Dee and other researchers are calling “norm erosion.”

    “The learning experiences of families and students during the pandemic, in particular the experience of remote schooling, may have reduced the perceived value of regular school attendance among students and parents,” said Dee.

    He cautioned against blaming parents for the erosion, saying that “we’re in a crisis now that merits immediate attention and perhaps a little less finger-pointing.”

    The struggles that Hull, from Roseville, said families face are often mental health challenges, particularly with middle schoolers, or families with unmet basic needs, such as unstable housing.

    One of their solutions to both barriers has been constant check-ins with those chronically absent students in order to offer resources, such as access to mental health specialists, gas cards to families facing transportation issues, and offering families bags of food from the local food bank.

    Another help is clearly explaining the notices behind their child being absent. “Schools are all about the acronym and all about words that no one else understands, so we start sending letters home and talking about truancy and chronically truant and excused absence and unexcused absence — all of that’s a mess,” Hull said.

    Instead, parents can expect to see at schools half-sheets of card stock paper explaining the terms and printed in five languages from English to Ukrainian to Pashto.

    “It’s really trying to remove that language barrier when we are talking jargon, and they’re just saying, ‘my kid needs help, we need help figuring out how to get them to school,’” Hull said.

    In Oakland, districtwide efforts include creating a sense of belonging. Oakland’s African American Male Achievement project, for example, pairs Black students with Black teachers who offer support.

    Kids who identify with their educators are more likely to attend school, said Michael Gottfried, a University of Pennsylvania professor. According to one study led by Gottfried, California students felt “it’s important for me to see someone who’s like me early on, first thing in the day,” he said.

    The Associated Press contributed to this story.





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  • Treat chronic absenteeism in California like a public health emergency

    Treat chronic absenteeism in California like a public health emergency


    Credit: Alison Yin/EdSource

    A silent crisis is unfolding in our schools and impacting millions of California students: chronic absenteeism. The consequences of unchecked absenteeism are severe and far-reaching.

    It starts innocuously with a few missed days, but can quickly spiral, decimating a child’s future prospects. When dropout rates increase and college readiness declines, the ripple effects harm entire communities.

    Traditionally, students and their families are penalized for missing school, but this hasn’t resolved the issue and instead, targets marginalized student groups. As an educator with years of experience in the classroom and administration, I propose a radical shift in our approach — treating chronic absenteeism as a public health emergency. 

    The rise in social isolation, health concerns and economic hardships have dramatically increased the number of students consistently missing school nationwide. In California, we are seeing consistent, distressing high chronic absence rates, particularly among high school studeents and historically marginalized populations.

    We can’t simply discipline our way out of this crisis. Instead, we need a comprehensive strategy that addresses the complex roots of absenteeism, from persistent health issues to limited transportation access, from heightened stress to trauma.

    Imagine if schools treated chronic absenteeism with the same urgency and collaboration used during the Covid-19 pandemic. We mobilized resources to fight a global crisis, and we can apply that same level of commitment to ensuring every child attends school regularly. 

    By framing chronic absenteeism as a public health crisis, we open the door to more effective interventions. One crucial strategy for dealing with public health emergencies is risk communication, which helps convey urgency, provide accurate information, and mobilize stakeholders to take collaborative action. The impact of proactive attendance management has shown to improve attendance rates threefold for chronically absent students.

    Here are strategies schools can implement, drawing from public health approaches:

    1. Convey urgency: Research shows attendance is the most crucial predictor of school success. Schools must create a “relentless drumbeat” about the importance of attendance through daily text messages, visual aids, public recognition and personalized follow-ups with absent students.
    2. Provide accurate information: Transparency is key. Schools should share clear data on absenteeism and its effects. Implementing user-friendly attendance management systems can automate positive intervention letters and free up staff for more personalized outreach. Training teachers to analyze attendance data enables early, tailored interventions.
    3. Mobilize stakeholders: Thirty-seven percent of K-12 families want actionable steps to improve their children’s attendance. Schools must provide specific, consistent messaging about attendance importance to all stakeholders — students, families, educators, board members and policymakers. Offer concrete ways for everyone to contribute to the solution.
    4. Advocate for prevention: Positive messaging encourages attendance; punitive actions deter it. A multilevel approach works best:
    • District level: Superintendents should regularly communicate about the importance of attendance.
    • Building level: Principals should celebrate good attendance and offer incentives.
    • Classroom level: Teachers should reach out personally to families, highlighting successes and addressing issues promptly.
    1. Foster two-Way, equitable communication: A Harvard study found that students with the best outcomes for remote learning during the pandemic were in communities with high levels of trust. Schools must establish open dialogues with families in their preferred languages and communication channels. This approach helps identify root causes of absenteeism and builds the trust essential for consistent attendance.

    The responsibility for addressing chronic absenteeism extends beyond individual schools or districts — it requires a unified national effort. However, we needn’t wait for a grand solution. By prioritizing consistent, positive communication in our classrooms, schools and communities, we can make significant strides in reducing absenteeism.

    Treating chronic absenteeism as a public health emergency isn’t just a metaphor — it’s a call to action. It demands we recognize the severity of the issue and respond with the urgency, coordination and comprehensive strategies that have proven effective in addressing other public health crises.

    By reframing our approach, we can foster healthier educational environments and brighter futures for our students, one attendance record at a time.

    •••

    Kara Stern, Ph.D., is the director of education and engagement at SchoolStatus, a provider of K-12 data-driven communication, attendance and professional development solutions.

    The opinions in this commentary are those of the author. We welcome guest commentaries with diverse points of view. If you would like to submit a commentary, please review our guidelines and contact us.





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  • A chance to protect California high school students’ health: Free condom distribution

    A chance to protect California high school students’ health: Free condom distribution


    Credit: pixabay

    California’s 1.6 million high school students are starting another year, but without a critical school supply that I would argue is necessary for teens: condoms.

    Why should California public high schools be required to provide condoms to students? Because condom availability programs are an effective public health strategy supported by the federal Centers for Disease Control and Prevention (CDC) to help keep sexually active high school students safe. According to the CDC:

    This year, the Golden State has a golden opportunity to protect high school students in California from alarming statistics like these in the form of the YHES Act.

    The Youth Health Equity + Safety (YHES) Act (SB 954) would expand access to condoms by requiring public and charter high schools to make free condoms readily available to students, giving them the opportunity to protect themselves from STIs that negatively impact their well-being, shorten their lifespan and easily spread to the wider community.

    The organization I lead, the California School-Based Health Alliance (CSHA), helps improve health access and equity by supporting schools and health care partners to bring health services to where the kids are — at school. The alliance is a proud co-sponsor of this bill because providing condoms in California’s high schools equips young people to make healthier decisions if they choose to be sexually active.

    Although some districts, such as Los Angeles Unified, San Francisco Unified and Oakland Unified, already offer condom access programs, the majority of schools in California do not.

    An online survey by TeenSource, an initiative of Essential Access Health, found that 68% of California teens lack access to condoms at their high school, and 98% agreed that easier access would increase condom use among sexually active teens.

    SB 954 would require all public and charter high schools to make internal and external condoms readily available to students for free beginning at the start of the 2025-26 school year. Condoms would need to be placed in a minimum of two locations on school grounds where they are easily accessible to students during school hours without requiring assistance or permission from school staff.

    California’s high school students have a right to consent to and access medically accurate, confidential, culturally relevant, and age-appropriate health services in schools. Our state has made great strides in reducing unintended pregnancy among adolescents in the past 20 years. Unfortunately, half of all reported cases of STIs in 2022 were among young people aged 15-24. The scope of the epidemic requires bold action.

    This year marks the second time state Sen. Caroline Menjivar, D-Van Nuys, has moved this sensible bill through the state’s Legislature. Menjivar has secured $5 million to cover the costs of distributing free condoms in public high schools for three years. The bill also specifies that if funds are not designated for this purpose, schools have no obligation to provide free condoms — addressing any concern as to an unfunded mandate.

    To reduce public health disparities, we must ensure that California youth have equitable access to condoms in high schools. Advocates for youth health and education equity urge Gov. Gavin Newsom to sign the YHES Act into law.

    •••

    Sergio J. Morales, MPA, is the executive director of the California School-Based Health Alliance (CSHA), a nonprofit organization that aims to improve the health and academic success of children and youth by advancing health services in schools.

    The opinions in this commentary are those of the author. We welcome guest commentaries with diverse points of view. If you would like to submit a commentary, please review our guidelines and contact us.





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