Position Paper Arguing for Mental Health Days in Maryland

Send to District 15 State Senate Representative Brian J. Feldman

Dear Senator Feldman,


My name is Benedict Ballman, and I am a senior at Winston Churchill High School in Montgomery County, district 15. I am writing to ask you to sponsor a bill in the Maryland State Senate to establish Mental Health Days across the state of Maryland. 


I slept an average of three or four hours per night during my junior year of high school. Juggling school, sports, extracurriculars, and more, I constantly felt one mistake away from letting it all crumble. Unfortunately, this kind of high school experience is not an anomaly -- in fact, it is now the norm. Any student aiming to achieve a higher education must play sports, participate in extracurriculars, and engage in school clubs and activities on top of good grades -- anything to set themselves apart from their competitors in the college application process. And that does not even begin to account for the huge number of students who have to work part-time jobs to support their family, take care of younger siblings, or manage other responsibilities. The stress of high school came to a head my junior year. The anxiety of academics, the perpetual game of catch-up with my ever-increasing extracurricular workload, the fear of my future, and the burden of everything else that accompanies adolescence whittled away at me. Some days it confined me to my bed, unable to get out. I felt trapped in a cycle of ever escalating work. But even more than that, I felt alone. I stayed quiet about what I was going through, because I thought I was the only one to have gone through it. It has taken me a long time to realize, through my own passion and research about the mental health epidemic, that my feelings are shared and commonplace. With data showing a consistent decline in student mental health over the past few decades, and with the COVID-19 pandemic amplifying and exacerbating problems for students, we are struggling. Now more than ever, we need you to support us. I strongly believe that implementing Mental Health Days in schools across the state of Maryland would help to support student mental health. 


To preface, I am defining mental health as the emotional, psychological, and social well-being of a given person. That being said, mental health is not simply the absence of a mental illness. Mental health lies on a spectrum, not oversimplified binaries like ‘depressed’ or ‘not depressed’, ‘student with a mental health problem’ or ‘flourishing student.’ Mental health is the summation of several complex factors within an individual’s life, all of which must be considered. 


In recent years, youth mental health has been rapidly developing into a crisis across America. Students everywhere are struggling with conditions like depression, anxiety, and substance use, among others. And as stated previously, even those students who are not diagnosed with a specific mental illness are often caught in a gray area, wherein their lack of mental health is still detrimental to their wellbeing. In the past decade alone, there has been a 10.6% increase in high school students who experience persistent feelings of sadness or hopelessness (CDC, 2019). This increase brought the total percent to 36.7% in 2019 (CDC, 2019). For well over a third of students in America, poor mental health is a daily struggle. Even more disturbingly, the percent of children and adolescents admitted to hospitals for suicidal ideation or self-harm has more than doubled in the past decade (Plemmons, 2017). This is reflected by suicide becoming the second leading cause of death for adolescents in America (CDC, 2019) Rather than a silent burden that many would endure in past decades, the poor mental health of students is being thrust into the national limelight. The mental health crisis is no longer confined to the minds of students. It now occupies the obituaries. 


Maryland is not excluded from this crisis. Maryland saw an increase of 8.6% in its suicide rate in this past decade (CDC, 2016), consistent with national trends. Also consistent with the nation, just below a third of Maryland high school students felt persistent feelings of sadness or hopelessness (Maryland Department of Health, 2019). Meanwhile, almost one fifth of students in Maryland seriously considered suicide (Maryland Department of Health, 2019). That is a problem. The entire front row of a regular thirty student class should not see suicide as their only option. 


Sadly, the COVID-19 pandemic is only intensifying these concerning trends. The stress students are experiencing as a result of the pandemic has been extremely detrimental to our mental health. A recent CDC Report from August 2020 showed that symptoms of anxiety have tripled, and depression symptoms have quadrupled for adults in the US (CDC, 2020). The pandemic has affected students in the same way it has affected adults, so why should the resulting impact be any different? Just like adults, financial instability, familial conflict, constant anxiety, and persistent fear for our own safety, and that of our loved ones, has weighed on students. These hardships are not only hurting students, but predisposing them to mental illnesses like depression, anxiety, and more (Guessoum, 2020). Above all else, however, social isolation has taken its toll on students. As everyone can remember from their childhood and teenage years, our relationships are vital to our development and wellbeing. But that has been stripped away from us: we are no longer able to decompress with friends, no longer have school as a reprieve from home life, no longer able to practice with teammates. Students are alone right now. Extended periods of isolation like these have been directly linked to increases in suicidal ideation and/or behavior (McClelland, 2020). During this pandemic, students’ mental health is at just as much risk as our physical health. It is time that we heed the warnings of researchers and experts, and act to support student mental health. 


In this vein, establishing Mental Health Days across schools in Maryland will support the mental health of students, especially in this trying time. Mental Health Days are excused absences from school for mental health related reasons. Just how a student is allowed to take a sick day because they do not have the capacity to learn or work while struggling with physical symptoms, mental health days allow students who are experiencing symptoms of poor mental health to take time off school. Mental Health Days give students the ability to take a break from the stresses involved with school and to actively support their own mental health. In addition, enacting state legislation supporting student mental health reduces the stigma surrounding it, increasing the chance that students will seek help. Different variations of mental health days have been implemented in different states, none of which have required any financial investment by the state. The Mental Health Day bill in Oregon, for example, allows students to take five Mental Health Days within a three-month span. If a student were to exceed this limit, then they would have to meet with a counselor to check in on the student’s wellbeing. Limits such as these prevent students from abusing Mental Health Days, an understandable concern among parents, school leaders, and legislators. The limits also help schools to identify which students are struggling, allowing for active prevention of mental illness.  


As previously illustrated, high school today is an incredibly stressful, competitive place. We are facing increasing workloads and more rigorous coursework in school, with diminishing free time and less hours of sleep. This has escalated to the point wherein the number one pressure that students face today is getting good grades, with the need to look good or fit in socially less than half as commonly listed (Pew Research Center, 2019). As Noelle Leonard, PhD from NYU College of Nursing, puts it: The life of a rapidly growing number of high school students is “school, homework, extracurricular activities, sleep, repeat.” The chronic stress that students experience as a result begins to disrupt their ability to perform academically, fosters poor mental health, and leads to risky behavior (Leonard, 2015). What's worse, students are given no reprieve from this onslaught of work. Students need Mental Health Days to have a chance to support themselves. Whether school is disrupting them from caring for a diagnosed mental illness, causing increased stress, or resulting in them struggling in any other way, students should have the opportunity to take a break when they need to. A Mental Health Day could be used by students to catch up on sleep, make up missed work, or just to rest. Additionally, Mental Health Days allow students to address aspects of their lives that they are not able to as a result of school. Students' lives are more complex than ever due to the COVID-19 pandemic. On top of the stresses students already face in school, they have to handle familial disputes, financial anxiety, the loss of loved ones, and more. But because of the barrage of work students receive from school and extracurricular activities, many have difficulty finding the time to properly cope with these struggles. Mental Health Days gives students the respite they need to deal with all the intricate aspects of their lives that affect their mental health, in addition to academics. 


This past fall, the Montgomery County Board of Education almost unanimously voted to implement Mental Health Days. The single dissenting vote argued that there were existing avenues for students to take leave for mental health related reasons. However, this opposing argument actually underscores one of the main aspects of establishing Mental Health Days: the direct impacts are just as important as the symbolic ones. On its face, Mental Health Days give students a direct outlet to support their mental health. While some counties do offer recourse if a student needs an absence for mental health related reasons, there is no current state-wide policy supporting this. However, looking past the surface, passing state legislation supporting the mental health of students will serve to decrease the stigma surrounding mental health. By not only acknowledging, but actively supporting student mental health, Maryland would be validating what many students themselves see as weakness or failure. “We have a lot of kids that are dealing with [mental health issues] in silence,” says Jennifer Rothman, senior manager for youth and young adult initiatives for the National Alliance on Mental Health. “They’re embarrassed or they think people are going to judge them and not believe them.” The stigma surrounding mental health prevents students from seeking help when they need it. Overall, young people see the stigma surrounding mental health as the leading barrier to accessing mental health services, with 69.5% of young people perceiving it as a significant barrier to professional support (Bowers, 2012). State action on this topic signals to students that they no longer need to keep their mental health a secret. Instead, students can begin to talk to others around them, build a support system, and seek help from school resources if they need. Furthermore, as mentioned earlier, many counties do have an option to request an excused absence for mental health related reasons. Though, this option almost always requires parents calling their students in sick. There are two problems with this option. First, it labels the students' struggle as a sickness. This oversimplification of mental health contributes to the stigma, and prevents any conversation around the student’s mental health and wellbeing. Secondly, this option requires students to ask their parents for permission. But, due to the deeply rooted cultural stigma, many students are understandably worried about going to their parents, instead choosing to remain silent. However, having a proper mechanism for Mental Health Days will encourage students to start these crucial conversations with family, friends, and others, as they have tangible government policy to point to as they try to explain and justify their struggle. The de-stigmatization that will result from these conversations will make students feel more supported by their community and increase the likelihood that students seek professional support when they need to. Mental Health Days will “help reduce the stigma” argues John Larson, President of the Oregon Education Association. Students will no longer have to feign sickness, skip school, or lie just to support their own wellbeing. Instead, they can seek support from others in their lives, and address their mental health out in the open. 


It is important to acknowledge that this legislation will not single handedly overturn a stigma that has been so heavily ingrained in our society. Many students will remain silent about their mental health needs, and schools currently struggle to identify those students. The structure of mental health services in most schools revolves around the counseling department. If a student needs support, they can go to their counselor. Together the counselor and the student can work to address whatever is going on, involving professional services if needed. But this system relies on either the student actively seeking support, or letting their mental health deteriorate to a breaking point. “As a matter of public policy,” says Debbie Plotnick, vice president of mental health and systems advocacy at Mental Health America, “for decades we have waited until stage four, until crisis” to address the mental health of students. We have never tried to catch students before they fall. And Maryland high schoolers agree, according to a survey I conducted of over 400 Montgomery County students. When asked how well the counseling department at their school actively prevents mental health issues among students, 58.4% selected a 1 or 2 on a scale of 5. This indicates poor outreach to the student body by the counseling department. The result of the survey is not the fault of the counseling department, but rather the reactionary system of support that schools currently employ. If Mental Health Days are established in a similar approach to that of Oregon, then schools will have the tools to begin actively identifying and supporting struggling students. In Oregon, each student is given five mental health days within a three-month period. If a student exceeds this, they are required to meet with a counselor. As a policy, this creates an avenue for students to support themselves, while simultaneously enabling schools to practice active prevention of mental illness. Schools would have a device that highlights students in need of support, and be able to provide those students with the resources that already exist on campus. 


In an era of deteriorating student mental health, especially now during this unprecedented time of adversity and isolation, students need help. Establishing Mental Health Days at the state level will give us more of an ability to support ourselves, and more of an ability to cope with the hardships we are all currently facing. In addition, Mental Health Days will help to reduce the stigma surrounding mental health, a consistent barrier preventing students from seeking support, and will allow schools to actively prevent mental health issues within the student body. This is a measure with existing language in several other states; requires no financial investment by the state; and it has support from students, parents, and teachers alike. Now, we need your support to help the students of Maryland. 


Thank you for your consideration,

Ben Ballman

Maryland High Schooler




American Academy of Pediatrics. "Children's hospital admission for suidical thoughts, actions double during past decade." AAP Publications, American Academy of Pediatrics, 4 May 2017, www.aappublications.org/news/2017/05/04/PASSuicide050417. Accessed 1 Feb. 2021.


Bowers, Hayley. "Stigma in school-based mental health: perceptions of young people and service providers." Association for Child and Adolescent Mental Health, John Wiley & Sons, 19 June 2012, acamh.onlinelibrary.wiley.com/doi/10.1111/j.1475-3588.2012.00673.x. Accessed 1 Feb. 2021.


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Czeisler, Mark E. "Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic." CDC, 14 Aug. 2020, www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm. Accessed 1 Feb. 2021.


Guessoum, Selim Benjamin. "Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown." Science Direct, Elsevier B.V., Sept. 2020, www.sciencedirect.com/science/article/abs/pii/S0165178120318382. Accessed 1 Feb. 2021.


Horowitz, Juliana Menasce, and Nikki Graf. "Most U.S. Teens See Anxiety and Depression as a Major Problem Among Their Peers." Pew Research Center, 20 Feb. 2019, www.pewsocialtrends.org/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/. Accessed 1 Feb. 2021.


Leonard, Noelle. "NYU Study Examines Top High School Students' Stress and Coping Mechanisms." New York University, 11 Aug. 2015, www.nyu.edu/about/news-publications/news/2015/august/nyu-study-examines-top-high-school-students-stress-and-coping-mechanisms.html. Accessed 1 Feb. 2021.


Maryland Department of Health. "2018-2019 High School Risk Behavior/Youth Tobacco Survey Trend Report." Maryland Department of Health, Maryland, 2019, phpa.health.maryland.gov/ccdpc/Reports/Documents/2018%20YRBS%20YTS%20Reports/Maryland/2018_HS_YRBS_YTS%20Trend%20Analysis.pdf. Accessed 1 Feb. 2021.


McClelland, Heather. "Loneliness as a predictor of suicidal ideation and behavior: s systematic review and meta-analysis of prospective studies." Science Direct, Elsevier B.V., 1 Sept. 2020, www.sciencedirect.com/science/article/abs/pii/S0165032719329726. Accessed 1 Feb. 2021.


Results of my counseling department survey: https://docs.google.com/spreadsheets/d/1SUtPlIQppua4wS8Bz5UL-8COIESo6jtphfNVXAaRo0Y/edit?usp=sharing