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• Letter to the Editor: "Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context"
  Rick Yang
  Published on: 27 September 2024

• Published on: 27 September 2024

  Letter to the Editor: "Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context"

  • Rick Yang, Student Harvard University

  Dear Editor,

  I eagerly write in response to the perspective piece entitled “Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context.”1 The authors provide a timely and crucial analysis of the rising trend in emotionally based school avoidance (EBSA) following the COVID-19 pandemic. However, while their overview of the issue and proposed interventions are commendable, I believe there are several critical points that warrant further inquiry and discussion.

  The authors rightly identify the complex array of factors contributing to EBSA, including school, family, and child-based risk factors. However, their analysis would benefit from a more nuanced investigation of the socioeconomic disparities exacerbated by the pandemic. Research has previously shown that children from lower-income families were disproportionately affected by school closures and faced greater challenges in accessing remote learning resources.2 Such a preexisting inequality may have further exacerbated EBSA patterns among vulnerable populations—this deserves greater emphasis in developing targeted interventions.

  The authors acknowledge the need for multi-component approaches across education, health, and social care sectors, and their call for early intervention that does not impose strict absenteeism criteria is laudable. My only worry is that this approach may present challenges in terms of resource allocation and identifying those most in need of support...

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  Dear Editor,

  I eagerly write in response to the perspective piece entitled “Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context.”1 The authors provide a timely and crucial analysis of the rising trend in emotionally based school avoidance (EBSA) following the COVID-19 pandemic. However, while their overview of the issue and proposed interventions are commendable, I believe there are several critical points that warrant further inquiry and discussion.

  The authors rightly identify the complex array of factors contributing to EBSA, including school, family, and child-based risk factors. However, their analysis would benefit from a more nuanced investigation of the socioeconomic disparities exacerbated by the pandemic. Research has previously shown that children from lower-income families were disproportionately affected by school closures and faced greater challenges in accessing remote learning resources.2 Such a preexisting inequality may have further exacerbated EBSA patterns among vulnerable populations—this deserves greater emphasis in developing targeted interventions.

  The authors acknowledge the need for multi-component approaches across education, health, and social care sectors, and their call for early intervention that does not impose strict absenteeism criteria is laudable. My only worry is that this approach may present challenges in terms of resource allocation and identifying those most in need of support. There needs to be a more detailed discussion of how to balance early intervention with targeted support for those at highest risk.

  While the authors briefly mention the importance of addressing bullying and relationship issues in schools, I believe this point deserves more attention. Recent research has highlighted the significant role of peer relationships and school climate in influencing school attendance and mental health outcomes.3 A more in-depth analysis of school-based interventions that focus on improving social dynamics and fostering a supportive school environment would likely enhance the authors’ proposed multi-component approach.

  Additionally, the authors’ emphasis on parental engagement is well-founded, but their discussion would benefit from first addressing potential barriers to parental involvement. Factors such as work schedules, language barriers, and cultural differences can significantly impact parental engagement in school-based interventions.4 Addressing these challenges should be a key consideration in developing effective EBSA interventions.

  Lastly, while the authors mention the need for contextually-relevant interventions, there is limited discussion on how to tailor these interventions to diverse cultural and ethnic backgrounds. Given the increasing diversity in many school systems,5 culturally adapted interventions that consider varying attitudes towards mental health and education across different communities are essential.6

  Lester and Michelson’s perspective piece offers a convincing springboard for addressing the challenge of EBSA in the postpandemic era. Their work illuminates the pressing need for a paradigm shift in our approach to school attendance and mental health, in order to create more equitable educational ecosystems. The challenges posed by EBSA offer an opportunity to reimagine our evidence-based educational structures and support systems, potentially catalyzing structural changes that extend beyond the immediate issue at hand. In this light, as we continue to refine our understanding and approaches, we may find that the solutions to EBSA contribute to a broader reimagining of education that better serves the diverse needs of 21st-century learners.

  References

  Lester KJ, Michelson D. Perfect storm: emotionally based school avoidance in the post-COVID-19 pandemic context. BMJ Ment Health. 2024;27(1):e300944. Published 2024 Apr 5. doi:10.1136/bmjment-2023-300944
  Engzell P, Frey A, Verhagen MD. Learning loss due to school closures during the COVID-19 pandemic. Proc Natl Acad Sci U S A. 2021;118(17):e2022376118. doi:10.1073/pnas.2022376118
  Arseneault L. Annual Research Review: The persistent and pervasive impact of being bullied in childhood and adolescence: implications for policy and practice. J Child Psychol Psychiatry. 2018;59(4):405-421. doi:10.1111/jcpp.12841
  Reardon T, Harvey K, Baranowska M, O'Brien D, Smith L, Creswell C. What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies. Eur Child Adolesc Psychiatry. 2017;26(6):623-647. doi:10.1007/s00787-016-0930-6
  Hussar WJ, Bailey TM. Projections of Education Statistics to 2026. National Center for Education Statistics; 2018. Washington, DC.
  Rathod S, Gega L, Degnan A, et al. The current status of culturally adapted mental health interventions: a practice-focused review of meta-analyses. Neuropsychiatr Dis Treat. 2018;14:165-178. Published 2018 Jan 4. doi:10.2147/NDT.S138430

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  Conflict of Interest:
  None declared.

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