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Primary Submission Category: Infants/children/youth

School Instructional Choices and Mental Health Outcomes Post-Lockdown

Authors:  Juan Echenique, Brian Elbel,

Presenting Author: Juan Echenique*

Mental health is crucial to overall well-being and significantly impacts children’s health and academic success. School-aged children are particularly vulnerable to mental health issues, with rising rates of anxiety, depression, and suicidal thoughts and behaviors. This paper examines the effects of the lockdown period on key mental health factors, including the choice between hybrid and fully remote instruction, the impact of school closures on hybrid students, and the changes experienced by students returning to full-time in-person schooling.

Focusing on New York City (NYC) students, we analyze the reopening of schools after the spring 2019-20 shift to remote instruction due to the COVID-19 pandemic. Parents and guardians could choose between blended learning (hybrid) or fully remote instruction during this period. By June 2021, about 40% of public school students opted for hybrid instruction, though the number of in-person instructional days varied by grade and school.

We use a unique longitudinal dataset that combines individual-level data on all NYC K-12 public school children. This dataset integrates healthcare usage from emergency department visits, hospital discharge data, Medicaid claims, and educational administrative records.

First, we estimate parents’ preferences for hybrid learning during the 2020-21 school year. The dependent variable is if students are enrolled in hybrid learning; the value is zero otherwise. Independent variables include demographic characteristics (race/ethnicity, sex, and school grade), physical and mental health status, and spatial risk factors (neighborhood infection rates and travel time to school). Our results indicate that students with an emergency department visit primarily for mental health during the lockdown period are six percentage points more likely to enroll in hybrid learning. We also find significant differences across race and ethnicity. Older students have a higher probability of fully remote learning, while students in non-English-speaking households are more likely to choose blended learning.

We use an event-study design to assess the impact of school closures on hybrid students. This analysis compares students in hybrid learning before and after their shift to remote instruction between December 2020 and March 2021 for middle school students and between December 2020 and April 2021 for high school students. Our findings show that middle and high school female students in hybrid instruction experienced an increase in mental health-related emergency department visits and higher consumption of mental health-related prescriptions during closures. Further research will examine mental health effects based on the number of in-person instructional days (intensive margin).

Finally, we examine the differences in outcomes such as absenteeism, academic achievement, and mental health during the 2021-22 school year, when schools fully reopened, based on students’ exposure to hybrid and remote learning. This paper contributes to our understanding of the long-term implications of COVID-19 restrictions and the impact of different instructional modalities on children’s mental health. It also underscores the importance of mental health as a determinant of student choices, the role of uncertainty in mental health outcomes, and the costs and benefits of each instructional approach under varying circumstances.