Maybe Your Teen Doesn’t Need a Mental-Health Day

The video opens with a platinum-blonde mom dropping her son off at school, while her daughter stays in the car. The two of them are going out for the day. There’s a shot of them crossing a parking lot, holding hands. A moody, minimalist soundtrack plays in the background as the little girl skips down the aisle of a bookstore and then sips a drink garnished with a flower at an upscale restaurant. The post is hashtagged #wholesome and #mentalhealthmatters and has 230,000 views. “I could tell my 8 year old needed a mental health day,” reads the caption.

One could spend hours down the rabbit hole of this TikTok micro-genre: “Mental Health Day” exaltations featuring mothers (and a few dads) excusing their daughters (and a few sons) from school and taking them to the Starbucks drive-through, Target, Dunkin’, the dollar store, and more. These videos reap extravagant praise in the comments. “This literally SAVES lives.” “The best mom I’ve seen on this app.”

Days off from school in the name of mental health have grown in popularity in the wake of the pandemic and the U.S. surgeon general’s and American Academy of Pediatrics’ declarations that the United States is in a youth mental-health “national emergency.” A recent survey of more than 1,000 American parents found that 56 percent have let their tween or teen take a mental-health day; 75 percent say these days can effectively support a child’s mental health. A dozen states from California to Kentucky have passed laws allowing or even requiring schools to consider mental-health days as excused absences. New York State introduced such a bill in the 2021–22 legislative session.

But as a journalist who follows education and youth mental health closely, and as a mom, I’ve discovered that while the occasional day off is probably fine, mental-health days can have a dark side. There haven’t been comprehensive studies on the efficacy of school mental-health days to address anxiety or depression, and when I spoke to therapists, parents, teachers, and a former attendance-enforcement staff member at a public high school, they had decidedly mixed feelings about the trend. The problem, they say, is that in many common situations they see, missing school can be counterproductive for kids’ mental health and become a slippery slope, worsening the problems these days are trying to address. And chronic school absenteeism has almost doubled in 40 states since the pandemic, with test scores in math and reading plummeting, too. (Chronic absenteeism is defined as missing 10 percent of the days in a school year, or 18 out of 180 school days. It correlates with both lower grades and lower graduation rates.)

On the one hand, the experts I interviewed all agreed that mental health is health. If students need a day for rest and recovery because they’re grieving or exhausted by stress, that reasoning is just as legitimate as staying home because of a fever or sore throat. But if kids say they are tired but are actually resisting school for an unspoken reason — perhaps because they’re afraid of a big test or have social anxiety — the evidence-based treatment is not avoidance but the opposite: controlled exposure to what they fear. “When you avoid things you’re anxious about, it rewards the avoidance,” says Sarah Rose Cavanagh, a psychologist and professor at Simmons University, who has written a book, Mind Over Monsters, arguing schools and campuses need to offer “compassionate challenge” to anxious students, not an invitation to stay home. If the problem is bullying, staying away can make kids even more socially isolated. If they’re struggling with schoolwork, missing class can drive them even further behind. If they’re depressed, a day spent lying in bed or scrolling through social media is likely to make them feel even worse.

As a parent, giving in to a kid’s anxious plea to stay home “signals to your child that I also think you can’t handle this. You’re reinforcing that school is scary,” says Laura Phillips, a senior neuropsychologist and senior director of the learning and development center at the Child Mind Institute in midtown Manhattan. “Instead, you want to validate their anxiety and also send the message: I believe you can get through it and we’re going to figure out how to do it together.”

Phillips says the best policy is to place strict limits on mental-health days, lest they snowball. “It’s a mental-health day, not a mental-health week,” she says. Among her New York City area patients, Phillips has seen a leap since the pandemic in extended “school avoidance” or “school refusal” — defined as behaviors like a kid dragging their feet so that they’re late every morning or claiming a stomachache. Every child does this sometimes; the red flags are intensity and frequency. Too often, Phillips says, parents pressure schools to make accommodations, like offering remote learning, and enable extended absences in the process.

One East Village father I met, whom I’ll call Rick, was generous with mental-health days — and is now in a difficult situation as a result. His daughter, whom I’ll call Kaitlyn, is 14 years old, and along with her 11-year-old brother, was enrolled in a highly regarded public school for children in grades six through 12. Rick says he and his wife have always taken a low-pressure stance when it came to academics. “We’re not straight-A parents who are like, ‘Ivy League or nothing,’” he says. But he also says that his kids are not the same children they were prior to a year of remote learning. “My kids went into lockdown as extroverts and they came back as introverts. Making friends was hard coming out of the pandemic for both my kids.”

Accordingly, their school attendance has not been great post-pandemic. “When they wake up and say, ‘I really need a day to decompress, a mental-health day,’ we’re like, ‘I kind of have to give it to you,’” he tells me.

So Rick and his wife didn’t think too much of it one Monday morning last fall when Kaitlyn refused to get out of bed. “We didn’t know how to handle it. The first day you’re like, ‘Okay, fine, take the day. We’ll get you back into it tomorrow.’ Then tomorrow comes around — same thing. Before you know it, a week’s going by. She’s discovered that no one can actually force her to go,” Rick says.

Experts say many teenagers seem to have latched onto the fearsome power of the phrase “mental-health day.” “Everyone freezes” at those words, says Cavanagh. “It stops people in their tracks — parents, and instructors too.” After all, what if a kid is really struggling, and your ‘tough love’ puts them in harm’s way? This is why the parent standing at the foot of the bed can feel so powerless.

Dominique lives in New Jersey and has three daughters, ages four, 12, and 13. She listens when the older ones ask for a day off. “Mental-health days seem very necessary,” she tells me. But she worries about the frequency. Recently her younger daughter asked for a Friday off school the week after winter break. “She was in tears, a puddle on the floor. Her dad was like, “No, you have to go school …” It is a tough call. With anything with parenting, you worry about whether you’re creating a bad habit.”

In the East Village, Kaitlyn never went back to her school. She tells me over text that she’s not lonely — she’s been spending her days with her Havanese and shih tzu dogs, her plants, and her devices. “I don’t feel better, but I feel like if I had been going to school these past few weeks, I would have gotten worse — and I’m scared that my mental health will get to rock bottom.”

Her parents recently enrolled her in an online school. “We know it’s not a great solution,” says Rick, “but at least she can pass her core classes while we figure out a permanent fit for her.”

He adds: “Everyone is telling us that this is pretty common. That’s actually quite reassuring.”