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Mental health days are the new sick days for students — and schools are OK with it

Mental health days are a response to the mental health crisis in children and teens, and experts say the benefits are worth the risks.
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Twelve states now allow students to take "mental health days" as excused absences, and experts say it's a huge step forward.

When Lori Riddle was in high school, she testified before Oregon’s state legislature in support of a bill that allowed excused absences to cover mental health. It worked: Oregon is one of handful of states that allow students to take time off for their mental health.

“I was going through my own mental health struggles and I knew that testifying for mental health days and being vulnerable was opening myself and my struggles to criticism,” Riddle, now 21 and a college student who lives outside Portland, told TODAY Parents via email. “ I think it’s important to take care of yourself.”

Since Riddle’s testimony, more states have approved excused absences for mental heath for school-aged children and teens. According to VeryWell Mind, states that have mental health absences include:

  1. Washington
  2. California
  3. Illinois
  4. Maine
  5. Virginia
  6. Colorado
  7. Oregon
  8. Connecticut
  9. Arizona
  10. Nevada
  11. Utah
  12. Kentucky

Could mental health absences be abused?

Some adults worry that "mental health day" policies could be abused. The experts said they don’t think that’s too likely.

“What is helpful about the way in which mental health days are being rolled out in some states is that there’s a certain number of days that is allocated to take off,” Dr. Christine M. Crawford, the associate medical director at the National Alliance on Mental Illness, told TODAY Parents. “If schools see a pattern in which the student exceeds the allotted number of mental health days that really signals to the school that perhaps a student requires more mental health support.”

Some students might take advantage of these days, much like they might try to put a thermometer under a light to feign a fever. Dr. Deborah Gilboa said that doesn’t mean states or school districts should shy away from the policies.

“We’re afraid, understandably, of giving children easy opportunities for poor behavior,” she told TODAY Parents. “But put that against the potential good that mental health days could do for children as kids and once they become adults, and it’s worth the risk.”

“The whole purpose of mental health days is to recognize ... mental health conditions can interfere with a young person’s ability to be fully present in school.”

Dr. Christine M. Crawford

About one in five children experience an episode of major depression during their teen years, the Centers for Disease Control and Prevention reports, and children’s mental health during the COVID-19 pandemic only worsened. According to the CDC, in 2020 children requiring emergency mental health services increased by 24% for those aged 5 to 11 and 31% for children aged 12 to 17, compared to the prior year. It’s become so dire that the U.S. Surgeon General issued an advisory warning about kids’ mental health.

“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade.” said Surgeon General Vivek Murthy. “The COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating.”

Mental health days are one way states are responding to this crisis, Crawford said.

Changing the mental health dialogue

“When it comes to mental health conditions, such as depression and anxiety, those are also medical conditions that can interfere with anyone’s ability to function at work and at school,” Crawford said. “The whole purpose of mental health days is to recognize and to acknowledge the fact that these symptoms from these mental health related conditions can interfere with a young person’s ability to be fully present in school.”

It also changes the dialogue surrounding mental health.

Gilboa said it's often hard for people, especially children, to express that they’re struggling before they get to a full-blown crisis. Allowing time off for mental health gives children the space to talk about tough feelings, she said.

If I woke up with a fever, we’d say ... you should be excused from your regular obligations. The same thing is true of mental distress.

Dr. Deborah Gilboa

“If I woke up with a fever, we’d say partially because it’s contagious and partially because you need to heal, you should be excused from your regular obligations,” Gilboa explained. “The same thing is true of mental distress … (mental health days) open the conversations with kids about mental health and mental distress and what they need to know, how do advocate for themselves and what they need to do.”

For Gilboa, she thinks of mental distress as more of a temporary bout with something like depression, similar to what might occur after the loss of a beloved family pet. Often, people recover from mental distress but it might require days off and working with a doctor or a therapist to improve.

“We don’t have a way to say, ‘I experienced severe mental distress that caused me to need to step back from my obligations or go see a doctor or get some professional help ... It ended and now I’m recovered,'" she said.

Setting aside days off for mental health also helps reduce the stigma often associated with such symptoms and conditions.

“That helps to normalize our mental health conditions, normalize the fact that people are impacted by these conditions,” Crawford said.

When and how to take mental health days

Crawford said said parents should consider allowing children to take days off if they say they feel overwhelmed, even if they do not have a diagnosis from a doctor. Everyone has bad days, and tending to one’s mental wellbeing is important.

“If you are mentally unwell that’s going to make you physically unwell and unable to fully engage in the entire school day,” Crawford said. “If you are always operating at a sub-optimal level, you don’t have a chance to re-charge your battery so that you can be fully present and engaged in the classroom.”

There’s no need to feel guilty about taking care of yourself.


Allowing kids to take time off before the symptoms continue for a longer period can help them prevent their condition from worsening.

“It only takes two weeks of experiencing symptoms of low energy, poor sleep, poor concentration and having negative thoughts about yourself … to meet criteria for a depressive episode,” Crawford said. “A lot of people don’t realize that. They think that you have to be very sad and fearful and having thoughts of suicide for months and months on end.”

The experts say mental health absences might look different for every child; parents should expect that their child might not want to do anything, or might want to do a hobby that they love.

“It could be baking a cake or watching Netflix — anything that allows your brain to get back to its baseline,” Crawford said. “Oftentimes people feel guilty about their chosen activity, whether that’s just staying in bed, getting some extra needed sleep, but there’s no need to feel guilty about taking care of yourself.”