Specialty (if any): Psychiatry, Pediatrics 

Keywords: Child mental health, COVID-19 pandemic, School-based interventions 

Background: The COVID-19 pandemic deeply affected child mental health and school communities across the U.S., particularly minoritized and under-resourced communities (Colao et al., 2020). In response, many school districts implemented mental health and social service programs, but few studies have evaluated the impact of these initiatives. This qualitative study examines one such initiative in a large, urban school district that temporarily expanded funding for mental health, attendance, counseling, and social services. 

Objective: This project explores the perceived impact of a school district's temporary expansion of mental health services in response to the COVID-19 pandemic, with a focus on under-served student communities.

Methods: Twenty-five focus groups were conducted in English and Spanish with 59 parents, 34 students, and 50 school staff from across the district in Spring 2024. Semi-structured focus group guides were used to explore types of services offered, impact of services, and challenges and recommendations. Focus group content was transcribed and analyzed using rapid qualitative analysis to identify main themes and subthemes. 

Results: Main themes identified were: parent engagement, student wellbeing, social resources, and safety. A reciprocal, direct relationship was found between access to social services and enhanced parent engagement. Staff noted that assistance with services such as Medicaid applications served as a "foot in the door" to engage parents, while parents reported an increase in accessibility to school staff to address material needs. Educational workshops held after school also fostered stronger school-community relations. Safety was identified as a challenge and top priority. Participants noted a key impact of the initiative was hiring additional staff, which led to increased supervision in high-risk areas for violence, such as school entrances, hallways, and bathrooms. Regarding student wellbeing, parents highlighted the need for services tailored to Spanish-speaking and bilingual students, especially for those who newly migrated. Staff recommended standardized recruitment and orientation to maintain continuity after completion of the initiative, as well as continued allocation of school budgets towards mental health. 

Conclusion: This evaluation of a large, under-resourced urban school district affected by COVID-19 provides important lessons for guiding future school-based support initiatives, including in the areas of facilitating parent engagement to enhance a feeling of school community, prioritizing student safety and wellbeing, and ensuring continuity of programs. Schools and their mental health partners can utilize these findings to better support youth across districts nationwide.