In the three years since the onset of the COVID-19 pandemic and subsequent lockdown policies, there has been a dramatic uptick in mental health concerns among kindergarten through 12th-grade students. According to the Children's Hospital Association, during the height of the pandemic in 2020, the number of children visiting the emergency room for mental health rose dramatically. By 2021, U.S. Surgeon General Vivek H. Murthy issued an advisory declaring a mental health crisis for American children. The report noted that “an alarming number” of young people struggle with “feelings of helplessness, depression, and thoughts of suicide.”

In the ensuing years, school districts have looked for novel ways to support students in need. Many states have prioritized hiring counselors and school psychologists or offering social-emotional curricula designed to raise awareness of mental health concerns. A few states have started allowing students to take excused absences to manage mental and behavioral health concerns.

The Value of Mental Health Days

Students with ongoing mental health struggles often need time during the school day to get the care they need. Appointments with providers may overlap with school hours and lead to absences. Students adjusting to medication changes or managing periods of mental health crisis may not be well enough to attend school.

Excused absences allow students undergoing mental health treatment to take the time they need without concern about truancy violations or having to repeat a grade. Furthermore, a policy of excusing absences for mental health ensures that students can get support from teachers as they make up missed work.

Many students who don’t have diagnosed mental health conditions experience periods of mental distress or emotional fatigue. In an interview with the Washington Post, Barb Solish, director of Youth and Young Adult Initiatives for the National Alliance on Mental Illness (NAMI), noted that an excused day off is beneficial to those students as well.

“When students are feeling physically unwell, there is a universal understanding that they should stay home and they should take time to feel better,” Solish said. “School policies that recognize mental health as an acceptable reason for absence can help students take the time they need to care for themselves and restore their health. Practically speaking, if you have a fever, you’re not paying attention in class, right? You’re not learning the lesson. If you’re feeling overwhelming anxiety, you’re not learning either.”

What States Allow Mental Health Days in School?

As of summer 2023, 12 states have passed laws explicitly excusing school absences for mental health reasons. The specifics of the laws vary, with some states requiring a written excuse from a mental health care provider and other states asking only that students and parents explain the reason for their absence. Some states limit the number of days students can be absent for mental health care.

• Arizona: As of 2021, students in Arizona are allowed to take mental health days off from school, though each school district can set its own policies.
• California: In 2021, California enacted a law that allows students to miss school due to mental or behavioral health concerns. In addition, all public schools must include mental health content in their health education curriculum.
• Colorado: In 2020, Colorado passed a bill allowing students to take mental health days and requiring school district attendance requirements to include a policy for excused absences for behavioral health concerns.
• Connecticut: In 2021, Connecticut passed a law permitting all students to take two non-consecutive mental health wellness days per year.
• Illinois: Starting in 2022, Illinois public schools must allow students to take up to five mental health days per year and treat them as excused absences. Students and parents will need to explicitly state that they are using a mental health day absence when they call into their school.
• Kentucky: In 2022, Kentucky passed a law making days off from school for reasons related to mental health excused absences.
• Maine: In 2020, Maine enacted a bill that would allow students to take days off school for mental and behavioral health reasons.
• Nevada: In 2021, Nevada passed a law allowing students aged 7-18 to miss a day of school for mental health reasons with a written note from a mental healthcare provider.
• Oregon: In 2019, Oregon passed a law allowing students to take up to five days off school within a three-month period, including days for mental health or physical illness.
• Utah: In 2021, Utah adopted a law making mental or behavioral health an excused absence.
• Virginia: In 2019, Virginia passed a law allowing students to use mental health as a valid excuse for absence.
• Washington: In 2022, the state of Washington enacted a new law that will allow students to use mental or behavioral health reasons as a valid excuse for an absence.

A handful of other state legislatures have proposed laws to revise state absence policy to include excused absence for mental health concerns. Since 2019, lawmakers in New York, Maryland, Massachusetts, Pennsylvania, Michigan, Ohio, New Jersey, and Delaware have tried to pass legislation in support of excused mental health days, but the bills were unsuccessful. It is not clear if lawmakers will try again in the future.

States With No Official Policy on Mental Health Days

The majority of states have no official guidance about mental health-related absences. That doesn’t mean students can’t take time out of school to care for their mental health, however. Even in states where there aren’t laws on the books, individual school districts may have policies that accommodate students who need time for mental health care.

For example, Maryland failed to pass a law about excused absence for mental health reasons. However, the New York Times reports that Montgomery County, home to the largest district in the state, implemented a policy of excusing absences taken for “student illness and well-being” beginning in 2021.

Adults should contact school administrators to find out the attendance policies for their school district and discuss how to arrange for the time their child needs for mental health care.

What Counts as a Mental Health Day?

Lawmakers have worked to balance the pros and cons of mental health days for students. Some of the laws protecting time off for mental health reasons are meant as a way for students to access professional mental health care. California’s law was written to “ensure that student absences for behavioral health concerns will be treated the same as excused absences for physical health concerns.” The law’s advocates hope that allowing students to miss school for mental health reasons will reduce barriers to getting the care they need.

In contrast, Connecticut supports mental wellness days for students who may not have ongoing mental health concerns. The law allows time for kids who need a break to recharge. “The idea behind providing two mental wellness days is first to support self-care and help create good mental wellness habits early in life,” said state Rep. Liz Linehan, co-chair of the Committee on Children. “Secondly, by classifying mental health days, we reduce the stigma of mental health concerns and give our kids a way to talk to the adults in their lives about their struggles.”

In Illinois, schools are required to follow up with parents when students take more than one day off for mental health reasons. This gives school counselors an opportunity to offer support if the student needs it. Schools can refer students for counseling or work with parents to open a dialog with their students about what they need.

Changing Policy in Your State

If your home state doesn’t offer excused absences for students to seek mental health treatment, you can advocate for change. Residents can contact state lawmakers directly to tell them why students should have mental health days. Most lawmakers post their contact information on their official websites. In addition, residents can reach out to state and local boards of education to ask for better policies around student mental health.

Local and state-level education groups like the PTA often have committees that advocate for state policy changes that benefit students. Joining your school’s PTA and speaking to leadership is a good way to connect with others working to support students. In addition, organizations like the National Alliance on Mental Illness (NAMI) advocate at the state and local levels. You can get on their email list to receive alerts about opportunities to advocate for student mental health.

In the short term, adults caring for children with mental health concerns can talk to teachers, counselors, and school administrators about accommodating the child’s need for care. There may be local resources available to assist you.