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      Chronic Absenteeism | A Tool For Gauging Students' Mental Health Needs

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      This isn't just about skipping school. This is about students with mental and neurodevelopmental disorders (or who self-harm) are more prone to chronic school absenteeism than their peers. And it’s about using absenteeism data to help identify students in need of vital support.  

      Skipping School Too Much May Be Child's Cry For Help

      The reasons for chronic absences are many and include poverty, language barriers, neighborhood violence, ethnicity, family discord, and physical health issues to name a few. But the focus of a study at Swansea, Cardiff, and Cambridge universities and National Health Service Wales was about how poor school attendance affects children’s futures – not just how it pertains to educational achievement but socially and developmentally as well. 

      “Health and educational professionals, services and policymakers should be aware that children with poor attendance may be experiencing emotional ill health, whether this is diagnosed in school or early adulthood,” says Swansea University professor Ann John, who led the study. “Absences and exclusions may provide a useful tool to identify those who require additional support.”

      As recently as the 2015-16 school year, more than 7 million students missed at least 15 days of school – the number of days that generally defines a student as being chronically absent. Those 7 million youth represented 16% of the total American student population – or about 1 out of every 6 students. 

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      There is no firm data on how many of those 7 million students were dealing with mental health conditions, but the Association for Children’s Mental Health cites a 2005 report that says 1 in 5 students have diagnosable types of mental, emotional, or behavioral disorders. 

      Many estimates indicate that 50% to 80% of kids between the ages of 6 and 17 never get the mental health care they require, the ACMH goes on to say. And yet, says John:

      “Early intervention will not only reduce immediate distress and difficulties for the young person but also may also interrupt poor life trajectories and improve outcomes in later life.”

      Disorders and Absenteeism Create Vicious Cycle

      The study, published in The Lancet Psychiatry, was based on the correlation between attendance (absences and exclusions) and neurodiversity, mental health, and self-harm found in more than 437,000 Welsh students between the ages of 7 and 16 during the years 2009 to 2013. Among the findings from the study:

      • The more recorded disorders a student has, the more likely they are to be absent or excluded

      • Absences that result in social isolation and poorer academic performance can result in greater mental health and attendance issues

      • Having “special educational needs” status reduced the probability of students being absent or excluded, illustrating the potentially positive affect of recognition, diagnosis, and educational interventions

      • School absenteeism and exclusion rates were higher among the general population of students over the age of 11 but disproportionally more so for those with a recorded disorder

      The latter of these findings is corroborated in a similar study reported by the National Center for Biotechnology Information that compares the number of days absent in a school year for students with and without mental disorders:

        Grades 1-6 Grades 7-10 Grades 11-12
      Days absent for students with mental health disorders 11.8 23.1 25.8
      Days absent for students w/o mental health disorders 8.3 10.6 12.0


      The relevance of these numbers are laid out by the National Alliance on Mental Illness, which says that students between the ages of 6 and 17 who have mental, emotional, or behavioral concerns are three times more likely to repeat a grade than their peers; and that high school students with significant symptoms of depression are more than twice as likely as their peers to drop out of school.

      Prevention & Intervention Make a Difference

      Just as the reasons for chronic absenteeism are many, so too is the fallout that occurs when that absenteeism is the result of neurodevelopmental disorders, mental health issues, and self-harm, according to the study. Examples include:

      • Disruptive behaviors resulting from exclusion

      • Somatic symptoms such as stomach pain and headaches may lead to authorized absences

      • Symptoms associated with anxiety and depression

      • Family problems

      • Peer problems such as bullying

      It’s worth noting that these issues don’t always apply equally to both genders. “Within the diagnosed populations, girls with neurodevelopmental disorders, depression and substance misuse were more likely to be absent,” the report says, “and boys were more likely to be excluded.”

      substance abuse ehr system information“This aligns with a view that boys express their mental distress through their behavior which in turn impacts the school environment resulting in their exclusion,” adds John, “whereas girls – especially with emotional disorders or delayed diagnosis of neurodevelopmental disorders – tend to be more anxious and withdraw from social contact.”

      What makes this study unique, says John, is that it links routinely collected primary and secondary healthcare data with educational data.

      “There is growing interest in school-based prevention and early intervention programs which focus on improving the school environment and culture for reducing adolescent mental health problems,” she says. “Other interventions have included psychological interventions focusing primarily on anxiety and depression symptoms. This has increased relevance as children return to school following closures and blended learning during the pandemic.

      “Attendance and exclusion data could provide useful information about where to focus limited resources,” she adds. “School-based mental health prevention strategies may also help build resilience, enabling pupils to develop strategies for managing and improving their mental health and wellbeing as well as to understand when and how to seek additional help.”

      Setting Up for Success

      The motivation behind studies like this is to equip students to achieve their full potential well into adulthood – to set them up for success by addressing mental health disorders at their earliest stages. How much of a difference might that make? Consider this:

      • Only 40% of students with emotional, behavioral, or mental health disorders graduate from high school

      • The overall high school graduation rate in the U.S. is more than double at almost 90%

      As the Association for Children's Mental Health notes, "Early detection and intervention strategies work." 

      That same concept applies when it to equipping mental health practices with superior behavioral health EHR software that provides reliable, long-term solutions that facilitate clinical and administrative workflow efficiencies. Again, the objective is to set you up for success.


      Watch: 5-Minute Snapshot of The InSync EHR for Behavioral Health

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      with graphical overlays and no fast-talking narrator. 

      5-minute InSync Mental Health Software Snapshot Demo


      As an industry leader, InSync Healthcare Solutions does exactly that for thousands of specialists across all 50 states. Developed specifically for behavioral health practices, our EHR system includes group therapy scheduling and group notese-Prescribing, eMAR, custom forms, and more.

      For a closer look at how our software system can dramatically improve workflows in your practice, schedule a demo now with one of our experts. We're happy to answer questions and explain how we can tailor our system to meet your particular needs.

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      U.S. Department of Education: Chronic Absenteeism in the Nation's Schools: A hidden educational crisis

      National Center for Biotechnology Information (NCBI): Internalizing Symptoms as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

      Association for Children’s Mental Health: Problems at School


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