132. Mental Health Interventions Practiced by School Nurses and Changes Due to COVID-19


      Trends from national surveys of high school students indicate that mental health indicators, such as sadness and suicidal ideation are increasing. COVID-19 has exacerbated this issue in adolescents for myriad reasons including social isolation and family economic difficulties. The importance of school nurses in addressing student mental health has been highlighted by the pandemic, but little is known about their experiences addressing mental health in general or during the pandemic. The purpose of this study was to present the opinions of school nurses regarding the severity of mental health concerns, as well as whether COVID-19 has changed the frequency of mental health concerns for their students.


      We administered a 50-item Qualtrics survey to a national sample of school nurses (n=2536, 79% full time, 58.1% urban/suburban schools, 42% registered nurse) working with adolescents in grades 6-12 in the United States between April and June 2021. Severity of seven mental health concerns (disruptive behavior, short attention span, anxiety, depressive symptoms, trauma, suicidal thoughts, and social skills/peer relationship) were rated on a scale ranging from “not sure” (1) to “severe problem” (6). We calculated descriptive statistics to demonstrate school nurse perceptions of the severity of mental concerns seen in their students and whether the frequency of mental health concerns had changed after COVID-19.


      The average severity of the seven mental health concerns was 3.64 (SD= .97), with depressive symptoms (mean= 3.80, SD=1.32) and anxiety (mean =3.76, SD=1.26) being reported as the most severe. Over half of school nurses indicated that COVID-19 changed mental health practices in the care coordination principle (53.6%) with students, while less than half reported that practices in other principles changed. Additionally, 49.7% of school nurses reported that the number of students visiting the nurse with mental health concerns after COVID-19 has increased, while 36.3% reported no change, and 12.5% reported fewer students than usual.


      Our descriptive study offers important and novel information showing that school nurses are an important resource for adolescents in addressing mental health concerns and how COVID-19 has impacted their efforts. Given that there may be continued impacts on student mental health, above and beyond the concerns that already existed, as the pandemic continues, it is vital to better understand how to support school nurses in addressing mental health. More research is needed to specifically determine what resources can be provided to school nurses to support their practices in order improve mental health outcomes of adolescents.

      Sources of Support

      Robert Wood Johnson Foundation, Future of Nursing Scholars Program.