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Key points
- Mental health days give kids and families sanctioned time off for emotional recharge and recovery.
- Every child—whether they're high achieving or struggling—needs mental health days.
- Supporting mental health days will need careful monitoring to be applied equitably.
- Mental health days can improve early identification of more serious mental health needs.
When I was in fourth grade, I headed downstairs in my PJs and robe, expecting the usual routine of cereal then getting dressed and catching the school bus. To my surprise, my parents were waving the bus on—they had let me sleep in—and even more unexpectedly, they told me to go back to bed. They were giving me a rest day at home because I was working so hard at school. This was 1969, and no one ever talked about “mental health days.” I don’t know if I was showing some obvious signs of anxiety or stress—but they made the unusual decision to let me take a day to rest and recover from the everyday stressors of being 10.
In the last two years of the COVID epidemic, children have suffered unprecedented levels of disruption and loss to their daily lives, leading to escalating symptoms of depression and anxiety, with higher levels of demand for mental health services and higher acuity—more severe symptoms and needs—for those children whose parents are seeking care for them. These needs layer onto pre-existing mental health needs that have gone unmet for years before the pandemic. Mental illness in kids is a slowly unfolding epidemic layered on chronic, unserved needs.
In the context of trying to provide more support to children’s mental health and well-being, some states have instituted “mental health days” as excused absences for students. Many of these state policy initiatives have been led by students—because they are unwilling to live with the unrelenting demands in their lives, without acknowledging and addressing the need to take care of their mental health on equal footing with care for their physical health.
What exactly is a mental health day?
As a child and adolescent psychiatrist, I couldn’t be happier about this trend—and I hope it expands across the country. But what do the states and schools mean by a mental health day? And how should we and our children make the best use of them? There isn’t a formally agreed-upon definition anywhere in psychiatry or educational literature, but a common example given is a kid who has been pushing hard and needs a day to breathe and relax—a day away from the demands in the school building. A kid can tell their parents that they need a day off—and parents don’t have to say they were physically sick to “cover” for their need to recharge mentally and emotionally.
Offering children a chance to identify when they feel overwhelmed, exhausted, or sad, and supporting/condoning time to rest and recover helps kids and families in many ways. Learning to identify emotions—learning to know when and how to ask for help and learning how to advocate for their mental health needs—builds emotional skills children will need and use throughout their lifetime. It gives parents opportunities for normalized, not stigmatized discussions about how their child is doing emotionally—no need to keep it secret that a child needs a day to recharge.
Does every child need to get mental health days?
But what about kids who are struggling academically? Won’t they miss important material and fall behind if they take a day for mental health? Yes, they will miss material—but if they're being physically present in school yet emotional and mentally unavailable, it’s a lost day anyway—and could lead to things like behavior problems if we push them to go when their brainpower is drained. These kids suffer stress levels no less than the kids who are on target academically. Kids who are working hard but still not consistently succeeding need mental health days too.
Let’s take even one step further—what about kids who aren’t getting their work done—kids who can’t seem to get homework done or aren’t participating in class? They may even be getting into trouble at school or falling way behind. Yes—they need mental health days too. Their struggles may not look like mental health needs, and they may tell you that they don’t care but often, these are the very kids with high mental health needs. Days off to decompress or to not be in trouble all day can be a relief to a struggling child.
I worry that creating official “mental health days” in schools could unintentionally create a perception that these are only for children whose effort is visible and who are judged “worthy” of the days off. Mental health needs are often invisible—or they masquerade as behavior problems. Excluding children seen as “difficult” or “disengaged” will create a multi-tiered system of mental health support in schools—which is unacceptable.
Risks of inequitable/multi-tiered systems for using mental health days will also grow directly from deep roots of implicit bias and racism. We know that children of color are much more likely to receive disciplinary actions—even in pre-school—than their white peers. Ensuring equity in access to mental health supports in the school ecosystem will require proactive planning and active monitoring of outcomes—with a built-in capacity to challenge existing systems and replace them with equitable responses for all our students.
Can mental health days be part of broader mental health awareness in school?
Once we have made mental health needs a routine component of a child’s school experience, then we have created an infrastructure for earlier identification and response to brewing mental health disorders. If mental health days pile up, that tells us we need to stop, look, and listen. Hopefully, our improved awareness of mental health needs will help us consider possibilities beyond “behavior problems” such as learning issues, trauma, emotional concerns, physical or sensory challenges, or social problems such as bullying. Allowing for mental health days can help sort out temporary changes in emotional and mental energy versus more serious, long-term challenges.
Mental health days—like any sick day—will create extra challenges for many families. Finding someone to stay home with a younger child or a parent having to miss work to be with their child is difficult for most families. We have seen this with the pandemic upending many families' intricate balance of work, school, and childcare arrangements. Mental health needs escalate in scenarios without any break time—for parents/caregivers and children. Mental health days are a great idea—but families need to be able to use them.
Mental health days help children and families
I have never forgotten that “rest” day my parents gave me. I savored a “sick day” when I could eat anything I wanted, read my favorite books, or even watch TV. I hadn’t even been asking for time off—they saw the need and acted on it. I've been a big fan of mental health days ever since then. When my children were in school, mental health days created survival or rescue moments for all types of challenges—from feeling overworked to under-energized, from needing to catch up on work, to spending some one-to-one time with me. Each child needed different things at different times, but they appreciated those days and didn’t typically ask for more than I felt was appropriate.
Formally allowed mental health days are a new concept—but mental health needs have always been with us. Allowing for “no-excuses needed” days off from school—a few per year—supports students and families in new ways. Just like a child will get a cold or two every year and might need days off, most kids will have a couple of days per school year when their brain hurts, and they need some rest. They need extra time at home, a chance to take a break from work and productivity, and a chance to just “be” for a day. Rest and recovery are as necessary as working hard and powering through. It's an important lesson for kids—and adults as well.
