Remote learning impact on mental health may vary by age, race, ethnicity, family income

Remote school may do more harm to the mental health of older and Black and Hispanic kids and those from lower-income families, according to a nationally representative, cross-sectional study in JAMA Network Open.

“Youth may be uniquely susceptible to negative mental health outcomes if they are experiencing pandemic-related disruptions to in-person schooling in intersection with other adverse circumstances, such as racism, poverty, food insecurity, or home instability,” Matt Hawrilenko, PhD, of the University of Washington School of Medicine’s department of psychiatry and behavioral sciences, and colleagues wrote. “Loss of access to school-based mental health care may be of heightened importance for youth from low-income families, as they are most likely to receive mental health services solely from their school.”

Hawrilenko and colleagues surveyed 2,324 adults aged 18 to 64 years who had at least one child aged 2 to 17 years living at home from Dec. 2, 2020, to Dec. 21, 2020, about the child’s mental health challenges (emotional problems, peer problems, conduct, hyperactivity) and whether they were receiving remote, in-person or hybrid instruction.

Most children (58%) attended fully remote school, 415 (18%) attended hybrid classes and 55 (24.1%) had in-person school. While sociodemographic patterning was similar between in-person and hybrid learning, larger proportions of children in remote classes had parents of a race/ethnicity other than non-Hispanic white. For instance, 30.2% of remote students had Hispanic parents, while 18.2% of the in-person group and 17.9% of the hybrid group had Hispanic parents.

Children attending remote school were in households with about $10,000 lower income than children attending hybrid or in-person classes (mean difference, $9,719; 95% CI, $15,111 to $4,327; P < 0.001).

Age and education modality were significantly associated with mental health challenges (standardized effect size, 0.23; 95% CI, 0.07-0.39, per year of child age), with older children in remote classes expected to have more challenges than in-person students their age; younger children in remote school were expected to have fewer challenges than in-person students their age.

Higher income and education format were significantly associated with mental health challenges. In-person schooling was more beneficial for children from higher income families than for lower income families (B = 0.2; 95% CI, 0.1 to 0.3, per $10,000-increase in annual income; P < 0.001).

Mental health in hybrid education did not differ from other modalities with age or income.

Additionally, learning pods – in which 17.1% of remote attendees and 29.3% of hybrid attendees participated – “fully buffered the associations of hybrid schooling (d = 0.25; 95% CI, 0.47 to 0.04) but not remote schooling (d = 0.04; 95% CI, 0.1 to 0.18) with negative mental health outcomes,” Hawrilenko and colleagues wrote.

The study was limited by observational design, non-differentiation of whether remote learning was optional and exclusion of potentially important variables such as race/ethnicity of children.

The researchers suggested future studies examine the mechanisms between remote education and mental health challenges to help create solutions for children’s mental health challenges.

“Ensuring that all students have access to additional educational and mental health resources must be an important public health priority, met with appropriate funding and work force augmentation, during and beyond the COVID-19 pandemic,” they wrote.