Peer-reviewed article
Effect of School Reopenings on Children's Mental Health During COVID-19: Quasi-experimental Evidence from California.
Ozluk P, Romine J, Sylwestrzak G, Hamad R ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how returning to in-person schooling during COVID-19 affected children's mental health in California. Researchers compared children in school districts that reopened at different times to see whether in-person learning improved mental health. They found that school reopening was associated with lower rates of depression, anxiety, and attention disorders, with stronger effects for girls.
Key points
- School reopening was associated with a 1.2 percentage-point drop in monthly prevalence of mental health diagnoses
- Related healthcare spending dropped by 10.6% after school reopening
- Anxiety and depression showed the largest improvements between in-person and remote school districts
- Effects were strongest among girls
- The study covered 24 California counties from March 2020 to June 2021
Limitations
The study used claims data from only the second-largest private health insurer in California, so results may not represent uninsured or publicly insured children, or children in other states. The research cannot determine whether improvements were due to in-person learning itself, peer socialization, or other factors associated with school reopening.
Abstract
Background School closures during the coronavirus disease 2019 pandemic disrupted children's education, socialization, and access to mental health resources, raising concerns about long-term effects on childrens' mental health. The objective was to evaluate the impacts of pandemic-era school reopenings on children's mental health and healthcare expenditures. Variation in the timing of school reopenings created a unique quasi-experiment. Methods We used difference-in-differences analysis to examine how staggered implementation of school reopenings affected diagnoses with depression, anxiety, and attention-deficit/hyperactivity disorder, and related healthcare spending among school-aged children during March 2020-June 2021 across 24 California counties. Data were drawn from medical claims from the second largest private health insurer in the state (N = 185,735). Results School reopening was associated with a 1.2%-point drop in monthly prevalence of mental health diagnoses [95% confidence interval (CI) = -1.59, -0.74], and a 10.6% (95% CI = -13.4%, -7.8%) drop in related healthcare spending. The mental health conditions that saw the largest differential between in-person and remote school districts were anxiety and depression. Effects were strongest among girls. Conclusions In-person learning is an important component of children's mental health. These results are informative for future policymaking during public health crises, to balance infection risk with the need for socialization and other critical resources that schools provide to children.