Editor's note: Any person who is feeling depressed, troubled or suicidal can call the National Suicide Prevention Hotline at 800-273-8255 or can reach trained counselors at Crisis Text Line by texting HOME to 741741. More resources are listed at the bottom of this story.
Nine months into the global pandemic, Riley Capuano told a grid of faces on a Zoom screen why she and her peers needed schools to reopen.
"I've never seen this many students struggling with mental health," the Los Altos High School junior said during a virtual school board meeting on Dec. 14. "Being cooped up in your home all day is really, really tough. I'm a pretty happy kid usually but I've never struggled more than I have this year because of being fully online."
Capuano said she'd hit a low point last fall, just before Thanksgiving break. She felt lost. She stopped running, even though she loves cross country and hopes to compete in college. She was going to bed late for no reason.
"I felt like I was just tired of waiting for it to end. I lost all interest in any schoolwork. I didn't find any of it interesting," she said. "I was sick of just waking up, talking to my parents, doing school, being too lazy to run and then repeating (it all over again)."
Capuano didn't feel hopeless, she said, but like there just "wasn't anything good" on the horizon.
Capuano is one of a vast many local teenagers who have been feeling this way since their lives in the last year have mostly shrunk to the walls of their homes and computer screens. Normally motivated students have become withdrawn and disconnected, and parents and health experts have been increasingly concerned about youth well-being as the coronavirus pandemic has kept most local schools closed for months longer than anyone anticipated. Desperate parents have called into school board meetings, describing children of all ages who are listless and disengaged. In February, one Palo Alto parent told the school board her children are "empty, zombie-like shells of what they once were."
From April to October 2020, hospitals across the U.S. saw a 31% increase in the proportion of mental health emergency visits by youth ages 12 to 17, according to the Centers for Disease Control and Prevention.
Locally, Santa Clara County's suicide prevention hotline saw a significant increase in calls from young people last year, particularly from those between 15 and 25 years old. In 2020, there were about 34,500 calls from youth to the hotline, compared to about 27,000 in 2019 — a 28% rise, according to data provided by the county.
"At the beginning of the pandemic we could still tell them, 'Hang in there. Eventually we will get out of this.' ... but now it seems endless," Suicide and Crisis Services Manager Lan Nguyen, who is often on the other end of the line with teens calling into the hotline, said in January. "They say, 'When is this going to go away? When will I be able to see my friends again? When can I go back to school? When is it going to end?' And unfortunately we can't answer that question for them."
While local schools are slowly starting to reopen this spring, life for teenagers is still far from normal, and many of them are still grappling with the ripple effects of sheltering in place for a year.
As her high school's student school board representative, Capuano has assumed the role of spokesperson for her peers. She's consistently advocated for reopening campuses even as some of the adults in the room, including the president of the teachers union, have taken the opposite position. When the district lacked students' opinions on the prolonged shutdown, she and the Mountain View High School student board representative conducted their own survey on student engagement and mental health during distance learning. Of the roughly 270 students who responded, over 60% rated their motivation as lower during online school, though about 18% said the opposite — that they're more motivated with distance learning.
About 58% of students rated their current mental health at a one or a two on a scale of one to five, while about 20% of students said their mental health is better now than when they're attending school in person. Students reported both positive aspects of distance learning — waking up late, more independent work and "school from bed" — as well as the downsides, including too much screen time, difficulty paying attention and connecting with teachers, and "feeling cooped up at home."
Gunn High School senior Andrew Kim's personal struggles during the shutdown also spurred him to action. Kim is the vice president of Advocacy Through Art, a student-led nonprofit that uses art to raise awareness about issues like mental health and race. The group organized a webinar this month featuring health professionals and teens and are hosting artist workshops in May to give students an opportunity to express themselves — and destress — through art.
"We want to help lessen the stigma of youth mental health during the pandemic," said Emily Chan, a junior at Castilleja School and president of Advocacy Through Art. "We've been stuck at home with our family and we're using Zoom eight-plus hours a day. I feel like it's affected our outlook."
Before the coronavirus, Kim was an outgoing teenager. Social interactions — meeting up with friends, casual conversations in the hallways between classes and at lunch — were a given in his day-to-day life. Since last March, though, socializing has required more effort than he often can summon. Eventually, he said, he stopped reaching out to friends and withdrew.
"That left me in a pretty dark place personally. That's how it became pretty bad because at first I didn't — I'm not somebody who talks about my emotions a lot," he said. "It's so easy to get lost in yourself."
While the barriers to reaching out for help ordinarily can feel high, several teens described this sense that seeking help has felt insurmountable during shelter in place.
"When you're talking to someone face to face in person you can tell how they're feeling ... but over Zoom or over text, you can't tell," said Mira Devgan, a junior at Menlo School. "Everybody is going through new things right now, but I think people are feeling really scared to reach out and admit it. For me, that's definitely been hard — not only to admit to other people that I'm struggling but to admit to myself I'm not in a good place right now."
Like Kim and Capuano, Devgan has also channeled her struggles into advocacy. She's on the youth board at SafeSpace, a youth mental health organization in Menlo Park. With SafeSpace, she helped to produce a film documenting teens' quarantine experiences and a podcast featuring student conversations about well-being.
Moana Kofotua's difficult pandemic journey landed her in the hospital.
When school moved online last spring, Moana Kofotua went from being a passing student to a failing one nearly overnight.
Then a sophomore at Menlo-Atherton High School, she had a hard time navigating Zoom. Without a computer and WiFi at home, she relied on a laptop and hotspot from the school, but the hotspot internet was patchy. She, too, lost motivation and focus. It was hard to get out of bed, much less participate in classes. An after-school support program that was helpful pre-pandemic just wasn't the same over Zoom.
"I couldn't function, going online," Kofotua said.
She didn't feel supported by her teachers, who contacted her only when she didn't turn in assignments. In December, she fell ill from anemia and was hospitalized. While there, she was also diagnosed with depression.
Kofotua doesn't feel comfortable talking about depression with her parents, both recent immigrants who don't understand mental health, she said.
"I had to go through it on my own," she said.
In February, Kofotua transferred to Redwood High School, a small continuation school where she's been able to attend classes in person. She feels more welcome there and has also found a support system at Youth United for Community Action (YUCA), a grassroots community organization for youth of color in East Palo Alto. Kofotua and her brother go to YUCA to do homework and participate in conversations around restorative justice.
"We've opened up the space for students who don't feel safe or comfortable at home and want to come and do homework here," YUCA Program Director Kenia Najar said. "We see the difference between them being on Zoom with us versus being in person."
The shutdown has been challenging for all teenagers but disproportionately so for those who lack the resources at home and, without being at school in person, are at risk of falling through the cracks. School closures have deepened the achievement gap -- many private schools reopened before public schools did.
"Educational inequities have the potential to translate into a lifelong barrier and a staggering number of life years lost," a group of UCSF health professionals wrote in an open letter in January calling for the reopening of schools. "School districts around the country are reporting higher rates of students failing classes, a phenomenon which has been disproportionately seen among low-income Latinx and African American children."
The coronavirus itself has also infected Hispanic persons to a greater magnitude, and the extra burden of caring for ill parents has fallen on local teenagers like Monica Reyes Lopez, a junior at Los Altos High School.
Over the holidays, both of her parents contracted the virus. Her father is a landscaper who continued working in person, and they think he may have been infected first. Her mother stopped going to her job as a housecleaner. Reyes Lopez's throat felt dry but she ignored it as she tried unsuccessfully to find testing appointments for her parents. Soon, she was sick, too — body aches, chills, fever.
Reyes Lopez recovered, but her mother's health worsened. Second semester started and her father went back to work, so Reyes Lopez had to balance school with taking care of her mother. She'd get up early, before her classes, to make her mother breakfast and bring her medicine. She'd put a mask on and crack open the door to check on her mother. She didn't tell any of her teachers what was going on at home, and only told one friend. She felt guilty and like she'd be blamed for getting infected.
When the anxiety and stress got to be too much, she'd go to the garage and break down. Reyes Lopez's room is next to her parents', and she didn't want them to hear her.
"There were moments where I felt very exhausted and stressed — especially because it was the start of the new year and I already went through a lot in 2020," said Reyes Lopez, a serious, first-generation student with high standards who became overwhelmed and anxious in the distance learning environment. "I just wanted a fresh start in 2021. I just wanted this year to be more peaceful for me."
Her mother eventually recovered. Reyes Lopez again feels productive and proud of her schoolwork, though her anxiety still ebbs and flows.
She knows her experience is just one of many among her peers, whose voices she feels like have gotten lost in the heated debates among adults over reopening schools.
"Being a high school student right is crazy. Each student has their own story and their own take on how they deal with the pandemic and distance learning," she said. "I think it's important that we hear them."
Both schools and community organizations have taken steps to reach students and families who may be struggling during the pandemic. Both the Palo Alto and Sequoia Union school districts have contracted with Care Solace, a free, online service that helps connect people to local mental health services based on the issues with which they're struggling, insurance options and other criteria. (Palo Alto Unified families can access Care Solace here and Sequoia families, here.)
The Mountain View-Los Altos school district expanded its partnerships with mental health nonprofits, hired a new district social worker and launched a student support group with Community Health Awareness Council (CHAC). CHAC is also hosting a series of events in May for Mental Health Awareness Month, including panels on anxiety, self-care and parenting.
In San Mateo County, mental health nonprofit StarVista started new, affordable telehealth groups for middle and high school students struggling with social isolation. (To participate, call 650-355-8787 or email [email protected])
Children's Health Council in Palo Alto, which has seen a 150% rise in calls during the pandemic, is already preparing for the next phase in teens' emotional recovery. The slow reopening of schools and the relaxation of public health restrictions, while positive, won't be a silver bullet for mental health challenges, Chief Clinical Officer Ramsey Khasho said. For some teenagers — especially those with social anxiety, who are on the spectrum or have been bullied at school — distance learning has been a respite.
"While we're excited about the reentry, we're also a little concerned that people are seeing this as a panacea for youth wellness," Khasho said. "In fact we feel like there's going to be a pretty jarring reentry and recalibration period that's going to impact kids."
The long-term effects of the pandemic on teens remain unknown, but experts' best guess at this point is that it will linger in trauma-like symptoms, Khasho said.
He anticipates mental health providers will see upticks in requests as schools reopen, both from students adjusting to campuses that don't function like they used to and from teachers and coaches who notice issues in kids they may have only interacted with online.
He encourages parents to reach out to CHC if they have any concerns. CHC requires no evaluation or commitment of the family to services.
To meet current and future demands, CHC is using a new $2.5 million grant from Jack Dorsey's COVID-19 relief initiative to hire more providers (CHC has already hired seven new clinicians in the last seven months) and to bolster financial aid and free counseling services provided in communities like East Palo Alto.
"Hopefully, what this pandemic has taught us, because none of us have gotten out of this unscathed, is to really focus on our wellness and mental health," Khasho said.
Anyone who is experiencing depression or heightened anxiety because of the public health crisis can find help through local resources.
If you are experiencing an emergency, call 911 immediately.
In Santa Clara County:
• 24/7 Behavioral Health Services Department Call Center: 800-704-0900.
• Crisis Text Line: Text HOME to 741741.
• 24/7 Suicide and Crisis Hotline: 855-278-4204.
In San Mateo County:
• Behavioral Health Services & Resources - 24/7 Access Call Center - Toll-free number: 800-686-0101 | For the hearing impaired: 800-943-2833.
For seniors, people with disabilities: The Institute on Aging has a Friendship Line for people ages 60 and older and adults with disabilities who feel isolated: 800-971-0016.
For youth: A list of local resources for young people who need mental health support, as well as their family and friends, can be found here.
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.