MENTAL HEALTH

The Coronavirus Pandemic’s Impact on Middle School Students’ Mental Health

A Doctoral Capstone Project
Submitted to the School of Graduate Studies and Research
Department of Education

In Partial Fulfillment of the
Requirements for the Degree of
Doctor of Education

Evan Price Williams
Pennsylvania Western University
August 2023

Pennsylvania Western University
School of Graduate Studies and Research
Department of Education

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© Copyright by
Evan Price Williams
All Rights Reserved, August 2023

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We hereby approve the capstone of
Evan Price Williams
Candidate for the Degree of Doctor of Education

August 2, 2023
_________________________

__________________________________
South Butler County School District
Doctoral Capstone Faculty Committee Chair

_________________________

__________________________________
David Hatfield, Ed.D.
Superintendent of Schools
Halifax Area School District
Doctoral Capstone External Committee Member

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Dedication

For all the children who suffer in silence: may the light shed by the coronavirus pandemic
lift the stigma from mental health and embolden the silent to seek help.

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Acknowledgements
I would like to thank my late parents who instilled in me the desire to do what is
right and to trust in my talents. I have a debt of gratitude to all my teachers, and
especially the late Mr. Earl Rader who encouraged me to “swing his birches,” Mr.
William Pensyl who demanded of me an “Evan Williams answer,” the late Professor

Theodore Kornweibel who allowed me to pursue my interests and insisted upon directing
me, the late Professor William Whyte Watt who impressed upon me the fact that
something can be both true and great independent of anyone’s personal opinion, the late
Professor John Condit who insisted upon humility above all things, and Professor
Bernard Freed who taught me the breadth of a principal’s responsibilities.
Over the years I have been blessed to have many, many devoted professionals as
colleagues, and it is upon the shoulders of those giants that I have stood.
Certainly, without the cooperation of my wife Sue this, and all my academic
accomplishments, would have been impossible. I owe her, my sons, my daughter-in-law,
and grandchildren many thanks for their tolerance and understanding.
I must thank Professor Sylvia Braidic for her help, and Dr. Timothy Foley and Dr.
David Hatfield for their kind assistance and support.
Finally, I am eternally indebted to the Reverend Godfred Effisah who admonished
me to ever trust in the Lord.

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Table of Contents
Acknowledgements

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Table of Contents

vi

List of Tables

ix

List of Figures

xi

Abstract

xii

Chapter I. Introduction

1

Background

1

Focus of the Study

2

Research Questions

3

Expected Outcomes

4

Fiscal Implications

4

Summary

6

Chapter II. Review of the Literature

8

The Evolution of the Middle School

9

Critiques of Middle Schools

12

The Evolution of the Emphasis on Mental Health

14

The Rise of Educational Specialists

15

The Development of Special Education

16

The Development of Mental Health Support
Mental Health Support in Pennsylvania
Early Adolescents
Bullying in Schools

17
18
18
21

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Mental Disorders in Early Adolescents

22

School-Based Mental Health

24

Mental Health and the Coronavirus Pandemic

29

Effects of the COVID-19 Pandemic

39

Recommended Changes in Mental Healthcare Delivery

42

Summary

45

Chapter III. Methodology

47

Purpose

48

Research Questions

49

Setting and Participants

50

Research Plan

52

Research Design, Methods, Data Collection

55

Research Design

55

Methods and Data Collection

56

Validity

65

Limitations

67

Summary

68

Chapter IV. Data Analysis and Results

69

Data Analysis

69

Limitations
Results

71
72

Triangulation

87

Discussion

88

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Summary

89

Chapter V. Conclusions and Recommendations

91

Fiscal Implications

99

Limitations

101

Future Research

102

Summary

104

References

107

Appendix A. Institutional Review Board Approval

116

Appendix B. Guidance Counselor Survey

118

Appendix C. Depressive Symptoms Statistics Tables

120

Appendix D. Bullying Statistics Tables

128

Appendix E. Moral Order Statistics Tables

132

Appendix F. Religiosity Statistics Table

140

Appendix G. Neighborhood Attachment Statistics Tables

142

Appendix H. Family Conflict Statistics Tables

146

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List of Tables
Table 1. Data Collection Timeline

57

Table 2. School Domain Risk Factor – Low Commitment to School - “How important do
you think the things that you are learning in school are going to be for your later
life?” Halifax Area Middle School

59

Table 3. School Domain Risk Factor – Low Commitment to School - “How important do
you think the things that you are learning in school are going to be for your later
life?” Millersburg Area Middle School

60

Table 4. School Domain Risk Factor – Low Commitment to School - “How important do
you think the things that you are learning in school are going to be for your later
life?” Upper Dauphin Area Middle School

61

Table 5. School Domain Risk Factor – Low Commitment to School - “How important do
you think the things that you are learning in school are going to be for your later
life?” All Respondents

62

Table 6. COVID-19 Impacts

64

Table 7. Depressive Symptoms Mean values by Question

74

Table 8. Percentage, Number and Total of Negative Respondents by Year and Grade
Level

75

Table 9. Summary of Items 1-3

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Table 10. Number of Suicide Attempts

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Table 11. Number of Attempts Resulting in Injury Requiring Medical Intervention
78
Table 12. Instances of Self-Harm; Cutting, Scraping, Burning

79

Table 13. My Learning Improved Online

82

Table 14. Answers to the question, “Where were you bullied?”

94

Table 15. Instances of Cyber Bullying

95

Table 16. Question: My learning improved when classes were taught online due to
COVID-19.
Table 17. Amount of Sleep Nightly

97
98

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List of Figures
Figure 1. Secondary Multi-Tiered Systems of Supports in Pennsylvania

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Abstract
This study was begun to understand the coronavirus pandemic’s impact upon middle
school student mental health. Educators had academic measures with which to measure
learning loss; however, there was no test to measure the pandemic’s effect upon student

mental health. Through analysis of the Pennsylvania Youth Survey, PAYS, a student selfreporting tool, and guidance counselor interviews, the researcher hypothesized that the
coronavirus pandemic’s impact upon student mental health could be ascertained, as well
as a strategy for remediating that impact. The researcher sought to answer what mental
health challenges were revealed through PAYS, how those challenges correlated to the
guidance counselors’ observations, what the sources of student mental health challenges
were, and how schools and school personnel could confront those challenges. Through a
mixed-methods approach, this study analyzed PAYS data from three middle schools in
northern Dauphin County for mental health trends leading up to and during the pandemic.
Through in-depth interviews with the school guidance counselors, this study assessed the
conditions students reported, student reporting integrity, the conditions that guidance
counselors observed, and the possible strategies to combat the mental health impact of the
pandemic. The researcher concluded that the coronavirus pandemic had a significant
impact upon student mental health, producing anxiety and depression resulting in
increased suicidal ideations, and increased instances of self-harm.

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Chapter I
Introduction
In late 2019 neither the Unites States nor the world was prepared for the
emergence of the coronavirus that caused COVID-19. The genesis of the coronavirus is

disputed. It was traced by some to an animal in a Chinese outdoor market. Others claimed
it came from a Chinese research laboratory and was transmitted when a researcher
contracted the virus and entered the local population. Regardless, owing to the respiratory
virus’ highly infectious nature, travelers transmitted the virus around the world rapidly.
Although the threat of the virus was known in upper echelons almost immediately,
initially no serious efforts were made to limit transmission. Consequently, as reports of
rapid infection came in from around the globe, Americans were caught unprepared.
Background
In March of 2020, the coronavirus pandemic necessitated that public school districts
respond rapidly, and online education became an alternative as schools were closed.
Some schools and districts were better prepared than others. At the start of the 2020-2021
school year, school districts imposed regimens to monitor infection and returned to inperson education requiring masking for students and teachers, Kindergarten through
twelfth grade. Depending upon community spread of infections and reported cases,
schools were shut down and returned to virtual instruction for months, in some cases.
When the pandemic appeared to wane in the summer of 2021, hope abounded that
students would be able to return to schools unmasked.
These hopes were dashed first by the rise of the delta variant of the coronavirus in
the fall of 2021, and then the omicron variant in the winter of 2021-2022. Despite the

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infection rates, throughout that time fierce debates arose targeting masks and parents’
rights, specifically the right to demand their children be unmasked in school. In the spring
of 2022, rates of infection and community spread finally dropped away to the point that
most mask mandates were lifted.
The conditions which disrupted in-person schooling took their toll upon students’
mental health. The hasty transition to virtual education, the pushback against lockdowns,
the pushback against masks, and disinformation circulating about the coronavirus and its
vaccines all weighed heavily upon students. Through a mixed-methods approach, this
study will utilize information on middle school student mental health through analysis of
the Pennsylvania Youth Survey, PAYS, results and guidance counselor interviews in the
three middle schools in the school districts of northern Dauphin County: Halifax Area
Middle School, Millersburg Area Middle School, and Upper Dauphin Area Middle
School.
Focus of the Study
At the onset of the pandemic, the uncertain virulence of the coronavirus
engendered lockdowns nationwide and in Pennsylvania. Uncertainty was indeed the
theme of the time and continued as the pandemic ran its course. The pandemic, and its
impact, was and is unprecedented. Educators expected to have a measurable learning loss
amongst students, and most schools and districts were already preparing through federal
grants to fight learning loss through targeted remediation. However, the pandemic also
had an insidious effect upon student mental health. Mental health was and is harder to
assess than academic performance for any number of reasons. In this case, examining
middle school students in early adolescence, this study assessed student self-reporting,

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the accuracy of student self-reporting, and the observations and opinions of guidance
counselors to understand the mental health impact of the pandemic.
Through a mixed-methods approach, this study analyzed PAYS data from three
middle schools in northern Dauphin County for mental health trends leading up to and
during the pandemic; specifically, PAYS results from the years 2019 and 2021. Through
in-depth interviews with the school guidance counselors, this study assessed the
conditions students reported, the integrity of student reporting, the conditions reported as
guidance counselors observed them, and the possible strategies to combat the mental
health impact of the pandemic.
Research Questions
1. What mental health challenges did the PAYS surveys reveal?
2. How did the mental health challenges revealed by the PAYS survey correlate
to the observations of guidance counselors?
3. As PAYS survey data and guidance counselors observations reveal, what were
the pandemic induced sources of middle school students’ mental health
challenges?
4. How can the schools and school personnel confront these challenges?
For question number one, PAYS survey reports for the three middle schools were
collected. Survey reports were analyzed using descriptive and inferential statistics. This
was possible as the PAYS grade report details specific responses for all items, some of
which were in a Likert-like scale. For questions two through four, school guidance
counselors were interviewed. Question three required renewed scrutiny of PAYS survey
data, particularly the data which directly reported pandemic effects, and question four

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was guided by the relationships revealed through statistical analysis and is also
speculative, dependent upon the guidance counselors’ opinions.
Expected Outcomes
This study shed light on the effect of the pandemic upon middle school students’
mental health, and the directions school personnel may take to ameliorate the pandemic’s
impact. As the schools have students for a third of the day, schools may make a
significant contribution to remediating the effects of the pandemic.
Fiscal Implications
A criticism often leveled at schools is that they tend to throw money at problems
indiscriminately. This study may identify the areas of need and strategies to address that
need. The pandemic has affected student performance as well as mental health: for some
students the two may be linked. A Brookings Institute study indicated that the most
effective intervention for math and reading achievement deficits in younger students, and
middle schoolers, is tutoring. Tutoring is expensive; however, each school district should
invest in time in-school and after-school to tutor individual students.
Undoubtedly, some of these areas of need can be addressed through faculty inservice training. In-service training is already part of the schools’ and districts’ expenses.
This study may find a focus for in-service training. If all three school districts can agree
upon that training focus, the districts can address those needs both collectively and
individually.
Training specific to improving rural school districts’ instruction is available
through Marzano Research. The districts can schedule a joint opening in-service to set the
focus and deliver preliminary training including practicum. Teachers would have access

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to a training website and email and ZOOM support. A session for administrators
outlining teacher assessment and coaching practices would follow at the first possible
administrative meeting. As the districts all have in-service on Columbus Day, the
districts can schedule a second joint in-service for collective reporting-out on preliminary
progress and an advanced training session. Once again, teachers would have website
access and email and ZOOM support.
Training specific to instruction will be expensive if it comes from a trainer such as
Marzano Research. An estimate from Marzano and a previous intermediate unit-wide
initiative may afford a clue. Learning Focused Schools charged the district $150 per
professional in 2023 dollars, which included publications. The three districts employ 281
teachers and administrators, and at $150 each the cost would be $42,150. Marzano
estimated three trainers in-person would be required. If the first in-service was followed
directly by an administrator training, this would lessen the cost. Follow-up presentations,
ZOOM trainings for groups, and email and FaceTime contact for individual
administrators and teachers would be provided for a base cost of $75,000 to $80,000.
Training specific to mental health and suicide prevention is free to community
partners through Wellspan-Philhaven. This training would need to be staggered and
delivered to individuals or small groups, including all staff. The only charge would be for
substitute teachers and the greatest challenge would be getting substitutes. Given the
numbers of teachers, each district’s expense would vary; however, given the number of
teachers thirty-five substitute days would be required. The average substitute cost is $175
per day or $6125 for the three districts.

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All school personnel must be aware of students’ mental health needs and to watch
for warning signs. However, there needs to be enough personnel to respond to perceived
needs, and those personnel are guidance counselors, social workers, and psychologists.
Unfortunately, given the difficulty in keeping and retaining a single full-time
psychologist for each district, the districts will have to look to maintain and increase the
number of guidance counselors and social workers.
As a cost estimate, given average salary and benefit costs, each district would
need to employ an additional guidance counselor for a cost of $120,000 per district. An
additional social worker could probably be shared or additional time purchased through a
counseling service. This expense would be $40,000 to $100,000.
The aggregate cost for each district for these new personnel would be less than
$165,000 a year. If the intervention is effective and requires six years, the intervention
would cost $990,000 per district. As the student population rose or fell, greater
expenditure could be required; however, over time the newly hired employees could be
absorbed into the bargaining units, thereby moderating the cost. Nonetheless, the price
would be worth paying for an effective intervention. Undoubtedly, state and federal aid
could rise, depending upon political will.
Summary
Some of the great challenges of the coming years in education will be identifying
the effects of the coronavirus pandemic and then moderating and possibly ameliorating
those effects. We have standardized tests to illuminate academic deficits, but we have no
such instruments to pinpoint the damage done to students’ mental health. This study will
endeavor to identify the observable mental health challenges of middle school students in

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northern Dauphin County and propose some strategies to treat those affected and also
improve service to all students.

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Chapter II
Review of the Literature
Late in 2019, a novel coronavirus was identified as the cause of several deaths in

China. Like wildfire, the coronavirus spread around the globe, reaching the United States
in late 2019, and spreading throughout the country during the first months of 2020. In
March of 2020, the coronavirus pandemic necessitated public school districts respond
rapidly, and schools were closed, forcing almost all schools to rely upon online
instruction. At the start of the 2020-2021 school year, some school districts imposed
regimens to monitor infection and returned to in-person education requiring masking for
students and teachers, Kindergarten through twelfth grade.
When the pandemic appeared to wane in the summer of 2021, hope abounded that
students would be able to return to schools unmasked. These hopes were dashed first by
the rise of the delta variant of the coronavirus in the fall of 2021 and then the omicron
variant in the winter of 2021-2022. In the spring of 2022, rates of infection and
community spread finally dropped away to the point that most mask mandates were
lifted. However, from the summer of 2021 through to the spring of 2022, in school
district and school after school, fierce debates arose targeting masks and parents’ rights,
specifically the right to demand their children be unmasked in school.
The conditions which disrupted in-person schooling, the hasty transition to virtual
education, the pushback against closures, the pushback against masks, misinformation
circulating about the coronavirus and its vaccines, led to a landscape in public schooling
rife with new challenges in mental health. Through a mixed-methods approach, this study
utilized information on middle school student mental health through analysis of the

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Pennsylvania Youth Survey (PAYS) results and guidance counselor interviews in the
three middle schools in the school districts of northern Dauphin County: Halifax Area
Middle School, Millersburg Area Middle School, and Upper Dauphin Area Middle
School.
The Evolution of the Middle School
In the late nineteenth century in concert with new compulsory education laws,
education scholars began an effort to influence restructuring of elementary and secondary
education. The National Education Association’s Committee of Ten advocated
elementary schools be limited to grades one through six, and secondary schools be grades
seven through twelve. Partial impetus for the change was to introduce subjects of
increased rigor such as Latin and higher mathematics to able students. Grades seven and
eight were considered “introductory” high school grades or “intermediate” schools,
“junior” high schools were grades seven through nine, and “junior-senior” high schools
were grades seven through twelve. These schools appeared, dependent upon the
preference of local school boards and state guidance (StateUniversity, 2022).
Throughout the first half of the twentieth century, types of junior high schools
flourished with grade alignment depending upon enrollment and community preference.
In addition to introducing students to higher level academics, these new schools helped
reduce overcrowding in elementary schools and reduce dropout rates, giving academic
students greater access to content and vocationally minded students access to
commercial, domestic, and vocational instruction. By 1960, eighty percent of the nation’s
early adolescents attended a junior high school (StateUniversity, 2022).

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The middle school concept grew out of criticisms of junior high schools; chiefly,
that they tended to follow the lead of high schools in curricula, grading systems, large
class sizes, schedules, regimentation, and impersonal climate. Ultimately, junior high
schools were faulted for not meeting the needs of early adolescents. As ninth grade
required the application of the Carnegie unit system for graduation requirements and
possible college matriculation, most high schools were restructured as grades nine
through twelve buildings. The goals of what became middle level education were to
provide a gentle transition between elementary school and high school which recognized
the importance of school climate and student development in the delicate years of the
onset of puberty (StateUniversity, 2022).
The first mention of a grades six through eight middle school appeared in the
literature in 1950, followed by mention of a grades five through eight middle school in
1965. The first book on the middle school concept was written by Donald Eichorn, a
Pennsylvania school district superintendent, who envisioned a grades six through eight
middle school with the following emphasis:
The book attempted to apply Piaget's theories regarding early adolescent
development in designing a suitable educational program. For example, Eichorn
proposed that middle schools offer frequent opportunities for active learning and
interaction with peers. He suggested eliminating activities that might embarrass
late maturers or place them at a competitive disadvantage (e.g., interscholastic
athletics and prom queen contests) and replacing them with less competitive
activities that welcome and affirm all students regardless of their current level of
physical or cognitive development (intramural athletics and physical education

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programs and flexible self-selected projects that allow all students to pursue
personal interests and develop further interests while making frequent use of a
well-equipped resource center). He proposed flexible scheduling to allow for
extended learning opportunities and flexible groupings of middle school students
for instruction (e.g., by current cognitive functioning or interests) rather than just
by chronological age or grade level. He called for a curriculum that featured
frequent use of interdisciplinary thematic units that reflected the interrelated
nature of different content areas and that balanced traditional academic subjects
with cultural studies, physical education, fine arts, and practical arts. (State
University, 2022, p. 2)
A scan of middle school grade configurations in Pennsylvania yields any number
of various designs – grades five through eight, grades six through eight, and grades seven
and eight (Pennsylvania Department of Education, 2022b). Most grade configurations
appear to have been selected in part because of the influence of scholarship, like
Eichorn’s work, and then tempered by local need. Again, when surveying programmatic
choices, many of Eichorn’s concepts were incorporated into Pennsylvania middle
schools; however, those concepts were selectively picked and chosen, particularly in
school districts having a lesser tax base, according to cost. The only programs
consistently seen throughout Pennsylvania middle schools are those mandated or
financed by the state or federal government, like Student Assistance Programs and Title I
Reading or Math.
According to Paul S. George, middle school grade configuration was a convenient
way to conform to racial desegregation after Brown v. the Board of Education of Topeka,

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Kansas (Gershon, 2017). Creating a middle school, whether grades five or six through
eight, allowed districts to form a new, integrated school, while maintaining elementary
schools segregated by geography, hence by race. Programmatic concerns did not surface
until the publication of A Nation at Risk, and the resulting focus on academic
achievement. George felt that real concern for early adolescents particularly did not
evolve until the 80’s and 90’s and is marked by the team approach. Also, in the 90’s out
of concern that educators know their students well, the practice of “looping” evolved,
having teams of teachers move through the grade levels with the same cohort of students
(Gershon, 2017).
Out of concern for the development of early adolescents, and in some cases,
concern for specific communities and taxpayers, the middle school developed and
morphed over time. Regardless of structure, middle schools were and are transitional
schools bridging the developmental gap between childhood and adolescence. Fortunately,
middle school grouping allowed educators to focus on the needs of the age group of
students. Unfortunately, that grouping tended to magnify the needs of that group of
students, needs that were perceived to be going unmet.
Critiques of Middle Schools
The California Department of Education published the first global critique of
middle schools, Fenwick’s Caught in the Middle, in 1987. In the forward, Bill Honig,
California Superintendent of Public Instruction, declared that the middle school must
accommodate its students’ maturation while meeting the academic demands for high
school preparation and do so in a manner nurturing the students’ self-esteem, and that
middle schools needed to connect with students, so students assimilated the schools’

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goals and purposes to bolster students’ self-esteem. Although any number of scholarly
works addressing middle level education cite the importance of educators’ cognizance of
student development, this foregrounding of “self-esteem” was noteworthy.
Fenwick (1987) reiterated all the arguments that middle schools were to be a
transitional bridge between the nurturing education of elementary school and the
impersonal factory, the high school. Middle school was to provide students with the room
to grow and experiment; however, Fenwick also pointed directly toward middle schools
second purpose – to prepare students for high school academics; hence, “…knowledge
and skills essential for success in secondary and post-secondary curricula should receive
priority attention in all middle grade courses” (p. 23).
Fenwick (1987) noted that academic success was abetted through assimilation of
ideals; namely, “hard work, responsibility, honesty, cooperation, self-discipline, freedom,
the appreciation of human diversity, and the importance of education itself” (p. 33). This
character education should be a common goal shared by teachers, administrators,
students’ parents, and the whole community.
The report also advocated for a strong counseling program dependent upon
parents in addition to students, teachers, and counselors. Parent involvement was
necessary to help guide students toward their best alternatives and courses in life. Every
student should have access to high level academic programs; however, harm can result
from ability grouping.
Presciently, the report recommended better English instruction to benefit diverse
students, English Language Learners, and minorities. Also, the report stated that “at-risk”
students, those not connected with school’s goals and purposes, were possible dropouts,

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and “the search for autonomy and independence annually leads a frightening number of
youths to disengage from home and school by the end of the middle grade years…”
(Fenwick, 1987, p. 78).
An argument can be made that these minority and at-risk students, and many
others, who do not honor a school’s goals and purposes, who do not fit in high-pressure
academics, and who are searching for autonomy and independence, were and are
precisely those students who become generally disaffected; hence are those students with
mental health concerns.
The Evolution of the Emphasis on Mental Health
At about the same time that educators were rethinking the structure of elementary
and secondary schools, they also began to realize that students needed to be seen as
individuals and that some of the elements of student lives left to the home had to be
addressed in schools; namely, health, vocational education, recreation, and mental
hygiene. The concern for mental health arose from societal factors like compulsory
education, child labor laws, immigration and the resulting concern for the social order,
urbanization, and public health, in accord with the advancements in psychology,
sociology, and education (Flaherty & Osher, 2002).
As early as the late nineteenth century, manifested in schools were the following:
higher enrollment of students, many of whom who were not ready to learn; concomitant
rise in discipline problems for teachers; the cultural distance between school staff and
students; and the resulting societal deficit in terms of public health and social control
from the inability to educate these students. In a nutshell, these are some of the problems
persisting to today – students not ready to learn and the attendant discipline problems, the

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necessity of teachers to be able to understand their students’ cultures, and the problems of
the undereducated, including dropouts (Flaherty & Osher, 2002).
The Rise of Educational Specialists
Social workers, reformers and educators have fallen into two camps – fix the
school and fix the student. The fixes to schools describe the evolution of grade
arrangements, schedules, grouping, and instruction; whereas, the earliest fixes to students
were the introduction of mental health services addressing academic and behavioral
problems among students. These two strands met in the form of the earliest types of
special education – nongraded and special classes. These special classes were often
places to house students with behavioral problems. As early as 1910, William Henry
Maxwell, New York City’s Superintendent of Schools advocated for special classes for
the mentally retarded, or what was then called mentally retarded (Flaherty & Osher,
2002).
Most of the varied reforms the Progressive Era advocated never came to fruition
in all corners of the country for some simple reasons: disparity in school finances
particularly during and after the Great Depression; segregation; community intransigence,
rejecting change; and teacher intransigence, refusing to modify instruction. However, the
realization that school was for all children and student motivation and learning readiness
were seminal, did survive, and grew (Flaherty & Osher, 2002).
In the early twentieth century and ever since, the established ancillary school
professions were instituted and codified in law, in certain cases. School nurses appeared
first in New York City – the Public School Code of 1949, still the law in Pennsylvania,
mandated a nurse for every 1500 students (Levin, 2015). The school psychologist, first

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appearing in 1915, is now found in almost every district that can find one to hire. Special
Education requires a psychologist – a student cannot have a required Individualized
Education Plan, IEP, without a psychologist’s evaluation. School counselors, guidance
counselors, appeared in the early 1900s, and, although employing them is not mandatory,
it is almost impossible to find a school without one. Social workers came out of the
earliest reforms and are found in many school districts, although there is no mandate for
their employment (Flaherty & Osher, 2002).
The Development of Special Education
Today, there is a mandate for special education for needy students of all differing
identifications. Teachers of special education have become a part of every faculty and
their numbers have expanded. In the early part of the twentieth century, those classified
as “mentally retarded” were the first to receive special education, usually a combination
of one-on-one and small group instruction. In the late 50s and 60s, behavior disorders
became the major field of training (Flaherty & Osher, 2002). Pennsylvania today
recognizes seven teacher certifications for special education, though three have sunset, as
follows: Special Education, PK-8, sunset 12/31/21; Special Education, 7-12, sunset
12/31/21; Special Education, PK-12; Hearing Impaired, K-12; Mentally and Physically
Handicapped, K-12, sunset 8/31/03; Speech and Language Impaired, PK-12; and
Visually Impaired, PK-12 (Pennsylvania Department of Education, 2022a). The
Individuals with Disabilities Education Act, IDEA, specifies fourteen identified
categories of special needs students. Three of the current certificates address limited
special populations. Special Education PK-12 supplies the bulk of teachers, and these
teachers are divided into uncertified specialties to teach eight different identifications, the

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vaguest being Other Health Impairment, OHI (Center for Parent Information and
Resources, 2022).
Therefore, it appears as if the concern for mental health grew out of a desire for
behavior control which originally attributed misbehavior to mental deficiency.
The Development of Mental Health Support
Prior to and shortly after World War II, those with mental issues were typically
removed from the community and institutionalized. The Commonwealth of Pennsylvania
maintained a system of state hospitals which were mental institutions, the oldest being
Harrisburg State Hospital, established 1845 (“Pennsylvania State Hospitals,” 2022). In
the post-World War II era, concern for the mentally ill grew nationally, resulting in the
Community Mental Health Centers Act of 1963. Preventing mental health problems was
central to the act; hence, schools were seen as places to institute initial screening and
diagnosis. This “evolution” was consistent with the rising social conscience movement of
the 1960s, known as the War on Poverty and its various legislation which included
funding for programs like Head Start. The genesis of these community programs helped
give rise to school-based programs. Additionally, these community and then school-based
programs were to help keep children with problems in their community and school, not
institutions (Flaherty & Osher, 2002).
In 1992, the United States Congress passed the Comprehensive Mental Health
Services for Children and their Families Program, specifically designed to promote
community and school organizations to support mental health. These “systems of care”
organized local public and private organizations to act in concert as “teams” to service
needy children’s physical, emotional, social, educational, and family needs. These teams

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included social workers, mental health workers, child welfare agents, juvenile justice,
vocational rehabilitation, substance abuse, and others (Flaherty & Osher, 2002).
Mental Health Support in Pennsylvania
Before the U.S. Congress acted, in 1984 the Pennsylvania Department of Health’s
Office of Drug and Alcohol Programs allocated grant funding to support a “pilot Student
Assistance Program(s), SAP, throughout the Commonwealth under the auspices of the
Pennsylvania Department of Education” (Commonwealth SAP Interagency Committee,
2004, p. 1). Initially four school districts sent teams to be trained to aid and support
students identified as having problems such as poor grades, substance abuse, depression,
absenteeism, withdraw behaviors, suicidal ideation, and discipline problems. Teams were
composed of an administrator, teacher volunteers, the school nurse, and a psychologist, if
the district had one. The program was a success, and the participants afforded the
program particularly high ratings, so much so that the program expanded the following
year to include twenty-one additional schools.
In 1985-1986, the Pennsylvania Masonic Foundation for the Prevention of Drug
and Alcohol Abuse Among Children volunteered to support the program, and the Masons
have underwritten elementary and secondary SAP training programs, the
Commonwealth’s SAP Network, and local SAP programs. At the outset, SAP was for
secondary schools exclusively; however, it was expanded to include elementary schools
beginning in 1990 (Commonwealth SAP Interagency Committee, 2004).
Early Adolescents
Marshall and Newman (2012) address at length the nature of early adolescent
students, middle school students. These students are in a transition from childhood,

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elementary school, to late adolescence-early youth, high school. By their nature, they
vary widely. Middle school students show a wide range of talent. Middle-school-age
students are in a transition from concrete thinking to abstract thinking. These early
adolescents are intensely curious but have little tolerance for work in depth. Early
adolescents prefer to be kept busy and involved; hence, middle school students prefer to
interact with their peers in schoolwork. Early adolescents are preoccupied with identity
formation and are emotionally fragile. Early adolescents are always observant of adults,
inquisitive about adults, but often challenge adults in many ways. Middle school students
are often altruistic, yet many quickly wonder “what’s in it for me.” Nonetheless, middle
school students are often concerned about others. Middle school students are trying to
develop their own moral judgments instead of relying upon adults; however, middle
school students still rely on their parents and fall back upon their parents’ moral views.
Middle school students are greatly in need of affirmation from adults but will reject adult
opinions if those opinions do not affirm their own. Middle school students are the prey of
their own development – their maturity varies widely, bodily changes and growth vary
widely, sexual awareness and sexual maturity underlie many of their actions, and they
need physical activity, but their performances can be greatly skewed by lack of motor
control.
It is a simplification to say only that the human brain is complex; however, it is
not a simplification to state that early adolescents behave the way they do because their
brains are in critical stages of development. Their brains are prepared for action! But their
brains have not yet developed the mechanisms to screen for misjudgment (Marshall &
Newman, 2012). Do all kids misfire? At times; however,

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the overwhelming majority of teens, something like 80 percent, get through this
difficult period without running away, without hurting themselves, without
serious accidents, and without alienating most of humanity. It’s not a smooth,
uneventful journey, but most teens (and parents) survive the experience without
permanent damage. (Marshall & Newman, 2012, p. 15)
There is so much going on in middle school students’ minds, yet most of them turn out
fine, even those who experience trauma. This is perhaps because so much of early
adolescence is devoted to changing and evolving identity.
Puberty floods the body with hormones – it is a biological event: adolescence is a
developmental event in which children transition to adulthood. Puberty happens like
clockwork, but adolescence runs on its own clock:
We often think of puberty as the onset of adolescence as there is some obvious
overlap, but some children reach puberty by age ten while others don’t until age
fifteen. Whereas puberty lasts about two years, adolescence is generally thought
to begin at about age twelve or thirteen and extend into the mid-twenties.
(Marshall & Newman, 2012, p. 21)
Identity formation takes place during adolescence, and middle school children are
just entering this developmental period. According to the psychologist Erik Erikson the
“conflicting forces at this stage are identity (defining who we are) versus identity
diffusion (failure to develop a clear sense of identity)” (Marshall & Newman, 2012, p.
23). Middle school children struggle to define who they are, who they want to be, what
groups to belong to, how they wish to dress, and what they believe. In short, this stage is

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a crucible for the young in which they attempt to blend various aspects to form a whole,
as they begin to think in abstracts and choose moral paths.
Through this process, individuals form their self images. This new self often has
evolved attitudes and behaviors that conflict with parental values and expectations.
Unfortunately, early adolescents who take a divergent path from their parents are at
greater risk for adopting risky behaviors, such as smoking, drugs, sex, and, in our present
day, excessive and obsessive use of electronic media. Also, early adolescents as a group
are extremely susceptible to interpersonal harassment, a legal term, rendered in the
vernacular as “bullying.”
Bullying in Schools
Bullying research and prevention scholarship begins with the work of the late
Norwegian/Swedish scholar, Daniel Olweus. Olweus defined bullying as “a subset of
aggressive behavior characterized by repetition and an imbalance of power” (Smith and
Brain, 2000, p. 1). The aggressor targets a victim repetitively. The victim cannot readily
defend himself or herself for one or more reasons – the victim may be outnumbered,
physically weaker or smaller, or less “psychologically resilient” (Smith & Brain, 2000).
Victims tend to be fearful of reporting they are being bullied; thereby recognizing their
status and weakness, which often results in low self-esteem and depression. This
helplessness indicates an obligation upon witnesses to report the bullying and defend
their fellows.
Dealing with bullying is not easy. Olweus himself developed an anti-bullying
program which is effective in that it requires the school instituting the program to
recognize bullying occurs, the program makes reporting bullying easier, and the program

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makes it easier to mobilize the school community to reduce bullying; however, the
Olweus program is recognized as only being fifty percent, 50%, effective, because
“power relationships are ubiquitous in human groups” (Smith & Brain, 2002, p. 2).
Unfortunately, there too many individuals who consider exercising power over others to
be exhilarating and profitable; therefore, bully-victim relationships are normative as they
can be expected in any established social group common to most members of a human
society, and endemic to schools. This is so verifiable, that bullying can be expected to
occur in some degree in every school. Recognizing bullying will occur is key to reducing
it.
Mental Health Disorders in Early Adolescents
Although most middle school students manage to find their way through the
various impediments they meet along their developmental paths, some do not. Hazen et
al. (2010) report that twelve percent, 12%, of children and adolescents suffer from a
serious psychiatric disorder which impairs their functioning, fourteen percent, 14%,
report suicidal ideations, and seven percent, 7%, have attempted suicide. Suicide is the
third leading cause of death in this age group (p. 1). Reisz (2013) noted mental health
problems occur at a higher rate in children of unequal socioeconomic status. Particularly,
chronic low socioeconomic status and declines in socioeconomic status predict mental
health problem in children.
The problem of treatment is compounded by the difficulty in recognizing genuine
psychiatric concerns, although most early adolescents find a way to resolve their
difficulties without treatment. Even professionals have a tough time distinguishing
healthy and normal internal conflicts from those conflicts with psychiatric concerns.

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Early adolescents’ lives revolve around two concrete places, home and school, and one
dynamic area, their social lives. If a psychiatric problem arises, it will manifest itself in
the home, at school, or in the child’s social life (Hazen et al., 2010).
The most frequently treated mental health problems for early adolescents are
anxiety, depression, attention-deficit hyperactivity disorder, obsessive-compulsive
disorder, substance abuse, mood disorders, conduct disorders, or psychotic disorders. The
symptoms of these problems may surface at home, at school, or in the child’s social life.
Depending upon who notices the aberrant behavior, an investigation of the source begins.
If it happens at home or at school, the first mental health professional contacted, or aware
of the behavior, is the child’s pediatrician. Although pediatricians are not psychiatrists,
they are often the gatekeepers who will initially prescribe medication and then refer the
child and parents to a child and adolescent psychiatrist. For those children whose parents
do not have medical insurance, they may be identified at school by a referral to the
school’s student assistance team. If the student and parents agree, the student may be
referred to a counselor. If the student has an Individualized Education Plan, the student
may be eligible for medical benefits which may cover referral to a child and adolescent
psychiatrist (Hazen et al., 2010).
Perhaps the unluckiest group of children find their way to treatment through the
judicial system, most commonly for adolescents who are substance abusers or who have
conduct disorders; however, adolescents that run afoul of the law through the commission
of crimes as diverse as petty larceny and assault often are sentenced to probation and
make their way to treatment through county probation. Adjudication may involve ordered

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drug treatment, therapy, and drug testing; it may involve psychiatric evaluation and
follow-up treatment through counseling (Hazen et al., 2010).
Colizzi et al. (2020) state that the early intervention is necessary to mitigate and
relieve the impact of mental health problems. Unfortunately, systems are still evolving to
diagnose and treat early adolescent mental health problems. First, the mental health
profession is still centered upon adults: any parent in need of a child and adolescent
psychiatrist has confronted this deficit. This is problematic because of the importance of
early childhood development and its impact on long term academic, social, emotional,
and behavioral trends into adulthood. Also, “most mental disorders have their peak of
incidence during the transition from childhood to young adulthood” (p. 2).
Ultimately, a blend of services from among various sources dependent upon the
child and the problem targeting mental health and behavior, physical or sexual health,
and alcohol or other drugs use customized through a team approach appears to be the best
practice in identification, evaluation, and delivery. Depending upon the identified
behavior or problem, the type of service as well as the service provider and the funding
source may be customized to the individual case. The best system would be accessible,
professional yet compassionate of early adolescents, delivered through a team approach
focused upon early intervention and evidence-based treatment, and sustainable within the
local community, state, and national network (Colizzi et al., 2020).
School-Based Mental Health
The passage of Section 504 of the Rehabilitation Act of 1973, Section 504,
followed by the Individuals with Disabilities Education Act in 1975, IDEA, obligated
schools to provide services to the disabled including those with serious emotional

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disturbances. Section 504 mandated a free and appropriate public education, FAPE, for
those with disabilities, including those with “physical or mental impairment that
substantially limits one or more major life activities,” and that those students should
“receive supports” (Hoover & Bostic, 2020, p. 38).
Shortly after the turn of the twenty-first century, the Surgeon General recognized
teachers as “frontline” mental health workers, because their work with children allowed
them to observe, identify, and address student mental health - teachers were well
positioned to observe “emerging or persisting” struggles among these children:
“Although teachers are not mental health clinicians, much of the education they provide
students relates to skills to manage stress, …, problem solve, work with staff and
students, and manage daily adversities and frustrations” (Hoover & Bostic, 2020, p. 38).
Therefore, embedding mental health supports in schools may lead to positive social,
emotional, behavioral, and academic results.
Although both the federal and state governments have invested in school-based
mental health supports and services, truly comprehensive systems are lacking, for typical
reasons. First, public schools are influenced by divergent and disparate interests that are
not data driven. Despite evidence that school-based mental health is effective, these
divergent interests make it hard to sustain local funding. Second, traditional mental health
and education systems operated separately; families, parents and children, have often
been averse to the stigma associated with school-based mental health, and attitudes
toward mental illness. Third, mental health systems do not always integrate well with
schools, including the monetary reimbursement for those services, and the availability
school district to school district varies widely. Last, renewed interest in school-based

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mental health often rises in the wake of a calamity, like incidents of gun violence.
Unfortunately, interest shifts to the next dramatic event before much is accomplished.
Therefore, the kind of concerted services and funding necessary to sustain a consistent
model beyond what the federal and state government subsidize is lacking (Hoover &
Bostic, 2020).
Nonetheless, Hoover and Bostic (2020) state that schools do enhance both access
to and quality of mental health supports for students; whereas the current community
system only services the neediest, often the adjudicated. Supporting and improving
student mental health is a service very much aligned to the missions of public schools,
which seek to improve student learning and cultivate life-long learners.
Atkins et al. (2010) opine that "education and mental health integration will be
advanced when the goal of mental health includes effective schooling and the goal of
effective schools includes the healthy functioning of students” ( p. 1). The researchers
propose a goal of integrating mental health services into the school environment, so it
seamlessly meshes with delivery of all that schools provide, which is notably idealistic.
They note that most schools deliver or accommodate a fair amount of mental health
delivery, most usually delivered through “pull-out” service. More effective delivery
systems integrating social and emotional learning with academic, physical education, arts
education, and vocational education are needed.
Atkins et al. (2010) believes this new school environment would be grounded
upon better instruction contingent upon professional development and administrative
support, effective cooperative learning strategies strengthening students’ interactional
skills, and peer-aligned learning and behavioral targets. The intent is to “optimize,

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augment, and enhance the goals of education” instead of creating a new layer of goals
enforced by yet another class of professionals (Atkins et al., 2010, p. 4). Ultimately, the
program must be focused, simple, and applicable to all students in the whole school
community, lest the new program become diffuse, spreading out excessively in too many
areas, and having no results to measure. Also, the program must enjoy parent support;
however, how this can be achieved is unstated.
Ultimately, both Hoover and Bostic (2020) and Jimenez (2020) propose that
mental health be treated in schools in tiers, in the manner of the Multi-Tiered Systems of
Supports, MTSS. The Multi-Tiered Systems of Supports grew out of the previous
Response to Intervention and Instruction Model which itself was an outgrowth of
Response to Intervention, which dates in Pennsylvania to 2006.
According to Hoover and Bostic (2020), national mental health performance
standards foreground comprehensive school mental health systems, CSMHS, which
manifest in tiers in concert with MTSS, as follows: Tier One, universal mental health
promotion and prevention for all students; Tier Two, selective mental health services for
students at risk for impairing mental health conditions; and Tier Three, onsite mental
health treatment for students impeded by mental health conditions. The Pennsylvania
Training and Technical Assistance Network, PATTAN, uses the following graphic,
Figure 1, to represent MTSS. The important part of this flow chart is the triangle in the
center – tiers escalate from the base, which is Tier One supports for all students; Tier
Two is supports for a smaller group, less than twenty percent, 20%; and Tier Three
intensive supports are for an even smaller group, less than five percent, 5%. As one
moves up the triangle, the intensity of support grows. This system of supports applies to

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academics, behavior, and social and emotional learning; hence, the system applies to
mental health (Pennsylvania Training and Technical Assistance Network, 2022).
Figure 1
Secondary Multi-Tiered Systems of Supports in Pennsylvania

Note. Adapted from Secondary MTSS in PA infographic, by Pennsylvania Training and
Technical Assistance Network, 2023 (https://www.pattan.net/Publications/SecondaryMTSS-in-PA).
Hoover and Bostic (2020) cite examples of Tier One universal mental health
instruction like the Good Behavior Game, which is a twenty-minute daily classroom
activity which instructs students how to work effectively cooperatively. This game, and
others, promote social and emotional competence. Tier Two interventions, secondary
interventions, target students identified as experiencing mild distress or being at risk, and

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these consist of small group activities lead by a counselor, individual coaching and
mentoring sessions, and classroom-based teacher supports, like homework checks. Tier
Three supports are individualized treatments to address a mental health concern in those
students already exhibiting the behavior and concomitant functional impairment.
MTSS relies upon universal screening which takes place throughout the day, class
to class, teacher to teacher, and encompasses evaluation of students’ academic,
behavioral, and social and emotional performances. Hoover and Bostic (2020) state that
federal and state governments should actively fund and support universal adoption of
MTSS. The key components supported by Hoover and Bostic (2020) include:
incorporating indicators of student mental health into school and district performance
ratings, requiring teacher education programs to include mental health literacy, requiring
K-12 mental health curricula, allowing mental health/social and emotional learning, SEL,
financing using Titles I and IV funds, and expanding federal grants to state and local
agencies to support mental health awareness and promotion in schools. School-based
mental health is not a panacea or a replacement for community services; it is a
complementary service increasing the likelihood that children’s mental health needs will
be met. Also, mental health concerns are more likely to be recognized in the school
setting. Students with identifiable concerns would then be referred to the school’s
Student Assistance Team, which would then offer the student and parents services.
Mental Health and the Coronavirus Pandemic
The coronavirus pandemic was officially recognized in the United States in
March of 2020 and continues to some degree to this day. The disease raged for months
due to variants of the original virus. Schools in Pennsylvania were closed for in-person

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learning the second week of March, specifically March 13, 2020. In the coming months
public school districts struggled to purchase electronic devices for online instruction.
Many public school districts did not manage to supply all their students with electronic
devices until the fall of the next school year, 2020-2021. Many Pennsylvania school
districts resumed in-person instruction in the fall of 2020 under strict guidelines, both for
masking to avoid infection and for coronavirus infections numbers which would trigger
additional temporary closures. The subject of masking students became a flashpoint with
a vocal minority of parents and community members openly protesting masking. At the
state level, there were protests against masking, pandemic restrictions, and the governor’s
authority. Many city schools did not return to in-person instruction until the 2021 – 2022
school year.
This upheaval took its toll upon children. In the fall of 2021, Pew Trusts
published a brief by Vestal (2021) which reported that after two months of school in
2021, the nation’s school children and their teachers were already exhausted. Vestal
states, “The grief, anxiety and depression children have experienced during the pandemic
is welling over into classrooms and hallways, resulting in crying and disruptive behavior
in many younger kids and increased violence and bullying among adolescents” (p. 1).
The Centers for Disease Control and Prevention reported a thirty-one percent, 31%,
increase in suspected suicide attempts in comparison to 2020. In October of 2021, the
American Academy of Pediatrics, the American Academy of Child and Adolescent
Psychiatry, and the Children’s Hospital Association assessed the decline in child and
adolescent health as a national emergency. Medical groups stated that adding to the social
isolation and family upheaval of the pandemic, over 140,000 children, predominantly

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those of color, lost a primary or secondary adult caregiver. The only positive to arise
from the pandemic as of the fall of 2021 is that it lowered the stigma around mental
health (Vestal, 2021, p. 2).
According to Nearchou et al. (2020) findings from multiple studies indicate the
coronavirus pandemic has had an impact on early adolescents’ mental health, particularly
depression and anxiety. The coronavirus pandemic was also associated with obsessivecompulsive disorder, psychological distress, and behavioral difficulties; “specifically,
emotional reactions…, such as stress, fear, and concern…” were noted (p. 15).
Walters et al. (2021) studied a group of 309 students in a northeastern
Pennsylvania middle school and found notable differences before and after the
pandemic’s onset as follows: seventeen percent, 17%, presented a significant increase in
depression; fourteen percent, 14%, exhibited a rise in impulsiveness; and eleven percent,
11%, experienced a significant rise in bullying victimization (p. 283). Although the
pandemic impacted a small percentage of students, its effects were significant. The
authors recommended these students speak with parents, teachers, and school staff and
discuss their problems, noting a study of the influence of this counseling would be a
valuable topic for further study.
Poole et al. (2021) wrote that the pandemic has given new emphasis to the
problem of hunger in America, that twenty-five percent, 25%, of American families do
not have reliable food supplies. Despite efforts of the federal government to limit “food
insecurity,” children of color and those living in poverty are at risk for physical,
cognitive, and emotional harm due to the lack of adequate nutrition. School closures,
hybrid learning, and suspended out-of-school programs all denied children food sources

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previously relied upon, exposing a flaw in the delivery system. Subsequently, many
schools packed weekly food supplies for drive-by delivery to needy students. In some
rural communities, teachers organized delivery for those without transportation. The
federal government created the Pandemic Electronic Benefits Transfer program, P-EBT,
which did provide equivalent funding to free and reduced lunch programs. This program
fed three million during the early closures; however, it covered weekday meals, not
weekend and holidays. The various increases in the Supplemental Nutritional Assistance
Program, the Coronavirus Aid, Relief, and Economic Security Act stimulus checks, and
charitable food networks have been helpful; however, once again, these supplements
covered weekday meals, and not days when school wasn’t in session. The various
unassociated attempts to feed children on weekends and holidays may have been
effective in part, but there is not much data to indicate those programs, usually
“backpack” programs giving children backpacks or bags of food for weekends, success or
failure. Nonetheless, there is some data to indicate participation in these supplemental
weekend programs has been inadequate. Ultimately, the pandemic has exposed the need
for a long-term federal approach which gets children access to food seven days a week.
Asbury et al. (2021) investigated the impact of the coronavirus pandemic upon
special needs children and their families. The researchers expected the impact to be
significant as this population was already subject to known stressors. Children with
special needs and their families are devoted to routine – closures and hybrid learning
exploded those routines, creating new realities with no preparation. One would expect a
mental health crisis and the study of 241 parents or caregivers found just that. The data
indicated that more parents than children experienced the effects; the data came from

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parents’ anecdotal reports. Information was coded and fell into six thematic categories:
worry, loss, mood, emotions and behavior, knowing what is going on, and overwhelmed
with an additional category of little or positive impact (p. 1776).
Worry indicated anxiety specific to special needs families, including worry for
their children’s food preferences, meeting their children’s needs, and who would care for
the children if the parent(s) were to die of the virus. Loss was manifest as loss of routine,
loss of support network, loss of specialist input, and loss of income for some. Responses
indicated that loss was felt acutely in special needs families, because the effort to care for
special needs children was greater. Moods, emotions, and behavior indicated low mood,
acting out, and behavior changes. Unfortunately, some of the manifestations of acting out
and behaviors, violence and destructive behavior, led to police involvement. Knowing
what is going on was seminal to some parents’ responses, particularly for children with
low understanding who could not comprehend the changes. Better understanding was
associated with better outcomes. Overwhelmed was the response of many parents
overcome by their new responsibilities, including meeting all their children’s needs
without support or respite. Not surprisingly, minimal or positive impact was expressed by
parents with higher functioning children who had difficulty with school. Special needs
families, both parents and children, experienced greater stress and significant mental
health challenges resulting from the coronavirus pandemic (Asbury et al., 2021).
Abidelli and Suemen (2020) surveyed parents and children through social media.
Parents reported the following: forty-one- and one-half percent, 41.5%, of their children
gained weight, thirty-four and two-tenths percent, 34.2%, slept more, and sixty-nine and
three-tenths percent, 69.3%, spent more time online. The children reported a positive

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quality of life, particularly for those who slept more; whereas physical and emotional
well-being, self-esteem, family, and school suffered for those who spent more time
online. Parents who felt their mental health impacted negatively by lockdown and who
were fearful of the pandemic were found to have overall lower emotional well-being and
family and friends scores. Overall, though most children self-reported higher quality of
life, it was not reflected in their parents’ responses (pp. 1-2). Though this is contradictory,
it is an example of the disparity between children’s experience and that of their parents,
and is owing to the parents’ role, carrying the brunt of responsibility for the family, even
when circumstances are beyond their control.
Lee et al. (2021) researchers from the University of Michigan, studied the
coronavirus pandemic’s impact on parenting activities and the transition to home-based
education. As they note, the immediate dislocation caused by the pandemic, movement to
online and home schooling, social disconnection, and economic hardship put
considerable stress upon parents and children. The researchers surveyed 405 parents, over
sixty-eight percent, 68.7%, were female and eighty percent, 80% had partners. Twentyfour percent, 24%, had a change in employment due to the pandemic. Seventy-eight
percent, 78%, were educating their children at home due to the pandemic. Forty percent,
40%, reported anxiety and depression, and parents reported that more than a third had
seen behavior changes in their children (p. 3). Results show that parents were engaged in
much more childcare activities than pre-pandemic – under different circumstances this
could be positive. Parents played games more often, they watched more TV, they played
with toys, they went on walks, read books, showed affection, and ate meals together: all
these activities scored increases of more than fifty percent, 50% (p. 5). Nonetheless,

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parents reported high levels of daily disruptions. The needier parents were extremely
stressed by the lack of school meals for their children. The depression and stress made
educating children more difficult. The researchers concluded that parents and children
needed more mental health services and recommended utilizing telehealth.
Jansen et al. (2020) studied the coronavirus’ impact on parent and child daily
activities, comparing what parents and their children were doing to a two-week prepandemic period. The comparison revealed that both parents and children were frustrated
by the lack of social contact, irritated with other family members, and worried about the
health of others. Adolescents struggled with boredom; whereas parents did not. Parents
worried more about the coronavirus. Due to social distancing, online contact with friends
was helpful for both parents and children. Parents were heartened by the increased family
contact and meal times; whereas children reported listening to music and isolation as
beneficial. Parents and children experiencing emotional problems varied household to
household which indicated that generally most families adapted, but some did not. The
researchers found positive affect sustained – there was a “we’re all in this together”
effect. However, parents who worried more tended to be more critical of their children;
whereas parents showing a positive affect were more supportive. Generally, adolescents
thought their mothers were more critical than fathers; however, this observation was
present pre-pandemic. “Intolerance to uncertainty,” coping with unspecified change,
produced a universal negative affect in both parents and adolescents, pre-pandemic and
during the pandemic; regardless, this “foreboding” did not influence parental interactions.
The researchers found that parents more so than adolescents experienced an increase
negative affect during the pandemic; however, positive parenting behaviors, such as

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warmth, did not change. Income, having COVID-19 symptoms, helping children with
school, working from home, going to work, and working with COVID-19 patients did not
explain this increase in parental negative affect. Therefore, as a “one size fits all”
approach would be insufficient, the researchers recommend that government and mental
health professionals work to find easier ways for all family members to maintain more
online contact including entertainment and coping strategies – in this way individuals can
find their own individual accommodation in the experience of the next health crisis.
Given that obesity was a risk factor for adults contracting the coronavirus and that
a significant number of parents reported their children gained weight, Abawi et al. (2020)
studied obese children to see if they experienced heightened anxiety of contracting the
virus. Utilizing telephone interviews, the researchers studied obese Dutch children not
identified with severe intellectual or behavioral disabilities as they felt their experiences
would be representative. Thirty-two percent, 32 %, of the children studied displayed
anxiety; the most common theme was worry they would contract the disease because of
their obesity (pp. 3-4). Therefore, the researchers concluded that healthcare professionals
should consider this heightened anxiety and its behavioral consequences. Addressing this
anxiety may lessen the negative impact on the psychological wellbeing and lifestyle
behaviors of these children.
At the onset of the pandemic in addition to masking, one recommended strategy
for avoiding infection was, and is “social distancing” – maintaining six feet of space
between individuals. The researchers Oosterhoff et al. (2020) studied adolescents’
motivation to comply with social distancing and the impact on mental and social health.
The study sample was 683 adolescents recruited through social media. Almost all, over

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ninety-right percent, 98.1%, complied. The subjects reported a myriad of reasons to
social distance; however, the most common theme was recognition of a social
responsibility and not wanting others to get sick, although twenty-one percent, 21%,
indicated personally not wanting to get sick (p. 179). Engaging in socially responsible
behavior was associated with greater disinfecting and less hoarding behavior shortly after
the coronavirus was declared a national emergency. Motivation to engage in social
distancing also correlated to mental and social health during the onset of the pandemic.
Adolescents social distancing to avoid personal infection reported greater anxiety but also
a feeling of doing their part. Youth who complied to avoid social judgment reported
higher anxiety, and those who complied because of peer pressure reported greater
depression. Of note is that the researchers did not find evidence that control, either by
parents or the government, was associated negatively with mental or social health.
Overall, researchers judged that social distancing can be difficult for some adolescents,
depending upon their reason for doing so; specifically, whether those adolescents have
been given what they consider a reasonable justification for social distancing. Parents,
educators, and the government may help by engaging adolescents in dialogue, explaining
reasons for social distancing, and providing alternatives, while nevertheless urging
compliance. Ultimately, teens’ motivations for complying may be related to individual
differences and specific motivations.
Another unfortunate result of the pandemic closures was an increase in child
abuse. Researchers from the University of Kentucky conducted a study on their database
of child abuse identified by medical coding immediately prior to the pandemic and during
the first six months of the pandemic indicated 579 encounters for children less than

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eighteen years of age; however, those 579 encounters occurred with 469 children.
Statistical analysis indicated that child abuse and mistreatment increased in the first six
months of the pandemic, particularly for twelve-year-old children (Salt et al., 2021, p. 4).
The researchers used health visit data giving them an estimate of cases requiring medical
care. As they note, most cases of abuse are of neglect, which may not require medical
care, making the increase in in-patient hospitalization even more alarming and suggesting
an inordinate increase in abuse factors coincident with the financial and social upheaval
of the pandemic. Also, despite state requirements for mandated reporting, “nonprofessional” individuals are unlikely to report child abuse. Therefore, the researchers
opine that in times of social isolation when in-person contact with professionals is
limited, two options arise: first, because of the need for professional oversight,
technological outreach must be considered for the at-risk population, and, second,
improved community-based contacts, for young children, and virtual school-based
contacts, for those of age, must be instituted to screen, identify, and report abuse. Sadly,
the study also validated the predictions by Interpol and similar international organizations
of increased child sexual abuse. Thirty percent, 30%, of “the child abuse and neglect
cases were coded as suspected or confirmed sexual assault” (p. 6). Unfortunately, yet
again, the researchers conclude that their work indicates the “magnitude of the effect is
immense” (p. 6). Needless to say, the researchers recommend further study, with an eye
towards courses to prevent child abuse.

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Effects of the COVID-19 Pandemic
The 2022 Kids Count Data Book (Annie E. Casey Foundation, 2023) provides a
wealth of pre-pandemic and pandemic statistics. According to the data book the
following were observed prior to the pandemic:
1. 25% of parents of children ages 6-17 said their child had been bullied the
previous year.
2. 20% of “kids” struggle to make friends.
3. 35% of parents of children ages 6-17 expressed some anxiety about their
neighborhood’s safety.
4. 33% of families could not always afford meals.
5. 25% of parents said they had no one to turn to for parenting advice.
6. 33% said they were only doing “somewhat” well at parenting or not very well,
thus adding to household anxiety.
7. In 2016, 2553 children ages 10 to 19 died by suicide according to the United
States Centers for Disease Control and Prevention, CDC. (p. 3)
The coronavirus exacerbated the awful effects already evident. COVID-19 impacted vital
social activities; for adolescents schools and activities stopped. One month into the
pandemic, researchers found that parents reported a third, 33%, of their children were
“fussier and more defiant,” and more than a quarter, 26%, were anxious. Nationwide,
there was a twenty five percent, 25%, increase, 9.4% to 11.8%, in children with anxiety
and depression as diagnosed by a doctor or other healthcare provider – in Pennsylvania
the increase was higher, 27.5%, 10.2% to 13% (Annie E. Casey Foundation, 2020, pp. 67). To ameliorate this situation, the foundation recommends policymakers make the

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following changes. Policy makers must begin by prioritizing kids’ basic needs – relieve
poverty, raise the parents’ financial standing, make sure kids are fed, and have stable,
safe housing. Next, those responsible must make sure kids have access to mental health
care if they need it by making sure all children have health insurance, all schools have
psychologists, social workers, and nurses and that the ratio for guidance counselors be
reduced to 250:1. Finally, policy makers must improve experiential mental healthcare
which is tailored to what kids actually experience, like counseling on reactions to
violence in the community and in the home.
Chiesa et al. (2021) reviewed research from various databases specifically to
investigate the impact of being home bound – of social distancing and lockdown
measures. Fifty-one articles were distilled, all pertaining to the first wave of the
coronavirus. Half of the studies documented the impact of closures on mental health.
Although quarantine, isolation, and closure seem effective to control the virus’ spread, on
short notice these measures produced both alarm and anxiety. The common mental health
issues include anxiety, depression, and post-traumatic stress disorder. In children, the
aged, and healthcare workers there appears a link between quarantine and isolation and
post-traumatic stress disorder. Although travel restrictions have always been relied upon
to stifle pandemics, there is little overwhelming evidence they work, and so, too, there
appears to be no correlation between school closures and infection control. School
closures had adverse effects upon child nutrition, loss of learning, and socialization, and
closures did not seem to control transmission to grandparents. Furthermore, quarantine
was linked to depression, anxiety, and stress.

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In the wake of closures and social distancing, Magson et al. (2020) sought to
study the effect of isolation upon adolescents to judge risk and protective factors. Those
possible risk and protective factors were age, sex, disruptions to schooling, COVID-19
related distress, family conflict, media exposure, social connection, and compliance with
COVID-19 restrictions. The researchers found the same negative mental health impact
others had found; namely, increases in depression and anxiety, and lower life satisfaction.
Girls experienced greater mental health decline than boys due to internalizing problems
and their greater reliance upon social networks for support. Adolescents were not overly
concerned with the impact upon their educations, which is inconsistent with previous
studies. Predictably, they were more upset by their lack of social interactions. Also, there
was a higher incidence of depression amongst those who had difficulties with online
learning, like technology problems, inability to ask the teacher questions, and motivation:
these difficulties can be resolved if online learning continues.
Those adolescents who did become more anxious, were generally found to avoid
media exposure, and those who reported few problems were those who complied
faithfully with government directions. This is like other studies which found that
adolescents taking precautions to avoid infection, like masking, exhibited lower levels of
anxiety and depression (Magson et al., 2020). The study found that closures had a greater
effect upon anxiety and depression than fear of the virus; therefore, finding better ways
for adolescents to cope with changes to their immediate environment is important.
Helping adolescents, girls in particular, maintain their social networks seems especially
important and should be an emphasis for parents and educators. Early detection of mental
health problems like emotional distress, precursors to serious conditions, should be

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monitored both at home and at school. Also, positive home and school environments
lessen levels of stress in adolescents, even when they are separated from their peers.
Irrespective of all the researchers found, the researchers stressed that the coronavirus
pandemic was such an odd event and such a recent event that this study is hardly
conclusive; however, the study does demonstrate a decline in adolescents’ mental health
throughout the pandemic, especially among girls. The researchers felt more longitudinal
research is needed.
Recommended Changes in Mental Healthcare Delivery
A group of scholars from universities around the globe collaborated to make
recommendations for changes that may improve mental health care (Moreno et al., 2020).
Despite the differences around the world, all systems have attempted to change to
accommodate the demands of COVID-19. As these scholars note, the fact that the world
today is so connected made every society a prey to the virus; however, that
interconnectedness creates a structure to troubleshoot failings in the system and circulate
new best practices. The researchers note that most surveys of the general public indicate
increased symptoms of depression, anxiety, and stress as a result of COVID-19 and its
“psychosocial stressors;” routine disruption, fear of illness, and the fear of economic
effects. Also,
…phobic anxiety, panic buying, and binge-watching television, which has been
associated with mood disturbances, sleep disturbances, fatigability, and
impairment in self-regulation, have been reported, and social media exposure has
been associated with increased odds of anxiety, and combined depression and
anxiety. (pp. 813-814).

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Numbers of adolescents calling helplines complaining of anxiety increased. As alcohol
sales increased, so, too, increased the potential for physical and sexual abuse of the
young.
The researchers believe the coronavirus pandemic provides an opportunity for
improving both the scope and cost basis for mental healthcare. The researchers relate that
of signal importance is the necessity to include persons representing the populations most
severely impacted, and this would include mental health workers. Teachers should also
be included. Healthcare workers, teachers, food service personnel, bus drivers, tradesmen
and others servicing society’s infrastructure have reported the negative consequences of
the stress from fear of exposure, fear of self-infection, and fear of infecting their families.
In healthcare workers, these symptoms were more common in women than men, and in
nurses than doctors. Risk factors included a lack of social support, poor coping strategies,
and a lack of disaster training. Notably, “moral injury results when people are forced to
take action – or are unable to take action – that violates their moral code when they are
exposed to trauma for which they are unprepared” (Moreno et al., 2020, p. 815). These
circumstances are similar to what is seen in military conflict and resulted in decisions to
utilize shrinking resources in such a way that more deaths may have occurred than in
normal circumstances.
Therefore, Moreno et al. (2020) recommend the following changes they feel may
be sustainable. Those needing mental health services, in this case parents and children,
need to be prepared and ready to take the necessary steps to get well. One avenue is the
expansion of telemedicine. The greatest barrier to comprehensive telehealth is the
technology and training required to use it. The researchers recommend that the needy

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should be involved in the development of new mental healthcare systems, because “coproduction protocols” work, and because there has been criticism of the gender, racial,
and ethnic disparities in treatment during the pandemic (p. 817). Unfortunately, the
homeless have great difficulty accessing telehealth. If the homeless can get online, it is
probably in a public place, hence hardly private. The researchers felt schools and
community resources should renew and improve mental health screening – this is
particularly important for those in acute distress. Of course, Moreno et al. (2020) state
available technological tools, including smart phone apps, should be developed, tested,
and routinely improved and that in this “new world” for mental health services, the
availability, use, and effectiveness should continually be evaluated for improvement,
especially including those generally neglected like the healthcare workers themselves,
frontline workers, the special needs population, genders, and racial and ethnic groups.
Federal data documents the need in schools – seventy percent, 70%, of schools at
all levels reported an increase in the number of children seeking services, and seventy-six
percent, 76%, of faculty and staff have voiced concerns about depression, anxiety, and
trauma in students (Meckler, 2022). Most schools are struggling to meet the need.
However, most schools have school-based mental health services, over half offer teacher
training in helping students with their social and emotional well-being, and seventy
percent, 70%, have a social and emotional learning program in place.
Through the states, many schools have also made accommodations for attendance
for “mental health days” – twelve states have legislation on the books and as of April 10,
2022, action is pending in five others (Styx, 2022, pp. 1-2). Recognizing and attempting
to ameliorate the effects of the pandemic, schools have listened to what teachers, parents,

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and students are saying. Although “school” has always had an inherent element of stress,
the pandemic has served to foreground it. That said, the criteria of what constitutes a need
for a mental health day is extraordinarily subjective. Just having a big test should not be
an immediate and singular consideration. Parents need to know their children and be able
to talk to them and recognize genuine need. Mental health days should be focused on rest,
not opportunities to cram in wellness activities. Also, mental health days are
opportunities for fun activities differing from the normal routine, and not the opportunity
to stare at a computer screen, a tablet, or a smart phone. Finally, these days are
opportunities for parents to have in-depth conversations with their children, find out
when they feel best, and doing so parents can help their children find ways to recover
their good feelings in times of stress.
Summary
The middle school was created and improved specifically to benefit the
development of early adolescents, to give them an easier transition from the nurturing
environment of childhood in elementary school to the emphatic focus of high school
upon academics and vocation. As schooling has evolved and society has evolved, so too
has concern for students’ health and well-being, including mental health. Originally,
student mental health problems, particularly those manifest in inability to learn or
discipline, were thought to be indicators of mental retardation. The rise of specialists
gave schools tools to deal with individual differences which eventually gave rise to
special education. In the early twentieth century, students, and people generally, with
mental problems were removed from the school and community setting. As time
progressed, so did the manner and method of treatment, evolving into the concept of

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education in the least restrictive environment and in the home school as much as possible.
As education takes place in the home school as much as possible, mental health services
increasingly are available in the home school. The closures, social isolation, and
interminable nature of the coronavirus pandemic; starting in late 2019 it is still with us;
led to anxiety, depression, and behavior changes in students, their teachers, and their
parents. Efforts have been ongoing to understand the effects of the coronavirus pandemic;
hence, the methodology of this study will be to examine the results of the Pennsylvania
Youth Survey in three middle schools in northern Dauphin County before and after the
pandemic, analyze that data, and discuss mental health conditions before and after the
pandemic’s onset with the guidance counselors of those middle schools. That analysis
will hopefully lead to a discussion of how mental health programs can be improved in
those schools, including possible sharing of services given the schools close proximity.

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Chapter III
Methodology
Middle schools originated as an alternative to junior high schools that were
perceived to perpetuate the high school focus solely upon content. Middle school was
intended to provide early adolescents undergoing puberty with a school climate
conducive to students’ development which recognized the importance of students’ selfesteem (StateUniversity, 2022). Fenwick (1987) foregrounded the need to teach middle

school students ideals which have been incorporated into character education programs.
Given the middle school focus upon early adolescent child development, identity
formation, and the travails of puberty, student mental health has arisen as a significant
concern. Indeed, even before the onset of the coronavirus pandemic, student mental
health was a significant concern in middle school and in high school students
(Commonwealth SAP Interagency Committee, 2004).
As evidenced in the literature review, government attempts to control the
coronavirus’ spread exacerbated depression and anxiety in both students and parents.
Understandably, neither the national nor state government had any experience dealing
with a respiratory virus that was highly transmissible. This led to school and business
closures. In Pennsylvania, when schools reopened most followed an infection protocol to
control spread which led to quarantines and closures, usually extending vacations. Most
school districts developed an online component. Online education was not as effective as
in-person schooling. Having students at home increased parents’ financial, personal, and
mental health challenges (Abidelli & Sueman, 2020).

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When students returned to school for the 2021-2022 school year, Vestal (2021)
reported widespread incidence of behaviors associated with anxiety and depression
appearing in schools. Many students lost parents or caregivers, and Vestal noted that the
pandemic’s only positive effect was that it obviated the stigma associated with mental
health. As has been done since 1989, in 2021, Pennsylvania schools administered the
Pennsylvania Youth Survey, PAYS, a biennial survey of students in sixth, eighth, tenth,
and twelfth grades. The survey addressed alcohol, tobacco, and drug use; antisocial
behavior; community and school climate and safety, social and emotional health; and
systemic, risk, and protective factors. The fall 2021 survey included a series of questions
specific to the time of the coronavirus pandemic and to online schooling.
Purpose
In the wake of the various measures taken to reduce the spread of the coronavirus;
including school closures, masking, and social distancing; the return to in-person
schooling brought new concerns. There was an immediate concern for learning loss as it
occurred in the only similar modern-era event, school closures due to flood damage in
New Orleans after Hurricane Katrina (Hill, 2020). However, educators, parents, and the
students themselves recognized that the coronavirus pandemic affected the whole
community, which was beset by greater mental health challenges, specifically increased
anxiety and behaviors associated with depression.
Schools employ measures to assess academic performance and level, including
curriculum-based and standardized assessments. The purpose of this study is to assess the
impact of the coronavirus pandemic upon the mental health of middle school students in
the three middle schools in northern Dauphin County, Pennsylvania.

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The measures used to assess mental health are a quantitative analysis of the
responses to the PAYS, and a qualitative analysis of interviews based on surveys with the
guidance counselors of the three middle schools.
Research Questions
The research questions for this mixed-methods study are as follows:
1. What mental health challenges does the PAYS survey reveal?
2. How do the mental health challenges revealed by the PAYS survey correlate
to the observations of guidance counselors?
3. As PAYS survey data and guidance counselors’ observations reveal, what are
the pandemic induced sources of middle school students’ mental health
challenges?
4. How can the schools and school personnel confront these challenges?
For question number one, PAYS survey reports for the three middle schools were
collected. Survey reports were analyzed using descriptive and inferential statistics. This
was possible as the PAYS grade report details specific responses for all items, some of
which are in a Likert-like scale. To assign numerical values to the possible responses for
statistical analysis, the most desirable responses were assigned the highest value. In the
case of several of the PAYS survey items, frequency and percentage were the measures
used. For question two, school guidance counselors’ interview transcripts were analyzed
for common themes and then compared to the PAYS survey data. Question three required
renewed scrutiny of PAYS survey data along with the guidance counselors’ experiences,
particularly the data which directly reports pandemic effects. Question four is guided by
the relationships revealed through statistical and qualitative analysis and is also

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speculative, dependent upon the guidance counselors’ and educators’ opinions. This
analysis will shed light on interventions which will help to improve student mental
health.
Setting and Participants
This study is composed of a quantitative analysis of PAYS data for sixth and
eighth grade students in the years 2019 and 2021 and the qualitative analysis of guidance
counselor interviews in the three middle schools in northern Dauphin County – Halifax
Area Middle School, Millersburg Area Middle School, and Upper Dauphin Area Middle
School. The three school districts; Halifax Area, Millersburg Area, and Upper Dauphin
Area; are very similar demographically. Their school populations are overwhelmingly
white, families are of average middle income, and the local employers consist of light
industries, retail, farming, and the local school districts. Many members of all three
communities; professionals, skilled tradesmen, technologists, and office and clerical
workers; commute to the county seat and state capital, Harrisburg (Upper Dauphin Area
School District, 2023; United States Census Bureau, 2023).
All three school district communities were greatly impacted by the Great
Recession, 2008 – 2012, and by the coronavirus pandemic which began in 2020 and
continues. In the Great Recession, local light industries, such as machine shops in
Millersburg, window and door manufacturing in Upper Dauphin Area, and plastics
manufacturing in Halifax, all suffered layoffs, as all three local school districts suffered
furloughs. In the case of most local school districts, this was a correction, as two school
districts had continued to replace employees as their student populations declined (Upper
Dauphin Area School District, 2023, United States Census Bureau, 2023). After the

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abrupt downturn engendered by the coronavirus’ onset, by the fall of 2020 hiring in all
the local light industries escalated, to the point where there were too few workers for the
open jobs, leading to starting wage increases of as much as thirty percent, 30%, in the
light industries. Unfortunately for the local school districts, many classified staff were
lost to the higher wage jobs in light industries, retail, and fast food (Upper Dauphin Area
School District, 2023).
The populations of the districts as of the most recent census were as follows:
Halifax Area, 7603; Millersburg Area, 6718; and Upper Dauphin Area, 9755
(Pennsylvania Department of Education, 2022b). 2020-2021 school district populations
were Halifax Area, 874; Millersburg Area, 726; and Upper Dauphin Area, 1041. Middle
school populations were 279 at Halifax Area, 177 at Millersburg Area, and 303 at Upper
Dauphin Area (Pennsylvania Department of Education, 2023).
Total population of the area has remained stable over time; however, school
district student populations have dropped because of increases in cyber charter school
enrollment, particularly at the onset of the pandemic, and a unique move-in population.
Millersburg Area still feels the cyber charter exodus most pronouncedly, losing over nine
percent, 9.31%, of its student population to cyber charter schools (Potutschnig, 2023);
whereas both Halifax and Upper Dauphin Area have managed to reclaim most of the
students driven into cyber charter schools at the pandemic’s onset. In the Upper Dauphin
Area over the course of the last thirty years the school district has lost twenty-nine
percent, 29%, of its student population, because Amish families have relocated to the
district, buying many of the local farms (Upper Dauphin Area School District, 2023). As

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of the last census, there were almost 1700 Upper Dauphin Area residents ages five
through seventeen – only 980 of those residents attended the public schools.
Halifax Area Middle School, grades five through eight, has a population of 279
students. Prior to the district’s closure of the Enders-Fisherville Elementary School,
grades Kindergarten – two, in June of 2019, the middle school grade span was six
through eight. Millersburg Area Middle School, grades six through eight, has 177
students. Upper Dauphin Area Middle School, grades five through eight, has a population
of 303 students (Pennsylvania Department of Education, 2023). During the six to nine
years all these northern Dauphin County children have been in school, and in their
lifetimes, their communities have undergone significant changes. Only the basic rural
bucolic character of the area has remained unchanged.
PAYS survey data was secured from the superintendents of the northern Dauphin
County school districts. PAYS survey data is anonymous; hence, no informed consent is
required. The researcher solicited and obtained informed consent from the middle school
guidance counselors.
Research Plan
As noted in the literature review, one of the aims of the middle school was
addressing what was referred to as “mental hygiene.” The concern for mental health was
engendered by societal evolution through the development of compulsory education,
public health, and advancements in the social sciences beginning in the early twentieth
century. The concern for mental health continues to the present and is evident in schoolbased programs like the Pennsylvania Student Assistance Program, SAP, the proliferation
of the Multi-Tiered Systems of Support, MTSS, and the ubiquity of school guidance

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programs at all levels of schooling. Nonetheless, as noted by Hoover and Bostic (2020),
comprehensive systems of mental health support are lacking in public schools because of
the divergent interests driving public education having no data-driven basis, because
mental health and educational systems have traditionally operated separately, because
mental health systems do not always financially integrate well with schools, and because
concern for school-based mental health is often unfortunately linked to emergencies. The
coronavirus pandemic was just such an emergency.
History revealed few clues as to what would result from the pandemic and its
related effects except learning loss, as evidenced in the aftermath of school destruction in
New Orleans from Hurricane Katrina. According to many researchers, children returning
to school for the 2021-2022 school year exhibited widespread anxiety and depression,
suicidal ideation, and increased bullying among adolescents. Repeatedly, in study after
study, researchers noted increases in depression, anxiety, and victimization. As noted by
Vestal (2021) and seminal to this study, the only positive effect of the pandemic was to
reduce the stigma associated with mental health and its treatment.
Spurred by comments from local educators, guidance counselors, and
administrators, this study was conceived to clarify the impact of the pandemic upon
students and to identify strategies educators could pursue to ameliorate that impact. To
assess the impact of the coronavirus pandemic upon the mental health of the students in
the three northern Dauphin County middle schools as students returned to school in 2021
for the school year, the researcher obtained the Pennsylvania Youth Survey results,
PAYS, for the three middle schools for analysis.

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PAYS solicited responses from sixth, eighth, tenth, and twelfth graders: this
research is focused upon the sixth and eighth graders. The PAYS documents also include
responses from previous years, so for the purpose of this study the focus is upon the
responses for sixth and eighth graders for the pre-pandemic year 2019 and the fall of
2021 in the pandemic’s wake, with particular attention to the responses of sixth graders in
2019 and eighth graders in 2021 as these students form a similar cohort. Due to the facts
that PAYS is anonymous, that survey numbers vary from 2019 to 2021, and that school
populations change from year to year, it is reasonable to say these students form a similar
cohort, but not the same cohort.
The survey items selected to shed light upon the pandemic’s effects describe
student commitment to school, neighborhood attachment, family dynamics, respect for
the moral order including religiosity or church attendance, bullying, depressive symptoms
including suicidal ideation, suicide attempts, self-harm, and amount of sleep. Also, the
2021 administration of the survey included specific questions about the impact of
COVID-19 and students’ responses to online learning. These items were analyzed
quantitatively. Many are framed using a Likert-like scale which was converted into a
mathematical model to calculate descriptive and inferential statistics, and other items
were evaluated according to frequency and percentage.
The PAYS survey is anonymous and as such often reveals information that
students did not divulge to their peers, parents, teachers, counselors, or administrators.
However, the PAYS survey only reflects the condition of all students: it is statistically
significant to a five percent, 5%, confidence level, because some students’ surveys were
discounted because those students have given misleading responses identified by

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strategically placed questions to validate answers, some students declined to participate,
and some students happened to be absent for all or part of the survey administration.
Therefore, this study also includes qualitative data obtained through interviews of the
guidance counselors in the three middle schools to validate and clarify the quantitative
data from PAYS. The guidance counselors have particular insights because they were the
adults to whom the students often came with their troubles. Guidance counselors were
interviewed, the interviews were guided by survey questions, the interviews were
recorded on an iPhone, the interview responses were rendered in transcripts by having the
iPhone recording transcribed directly through Microsoft Word and then edited and
compared to the recording, and transcripts were analyzed for common themes.
The research will most probably indicate a need for a more unified approach to
mental health in the schools. Although the schools all have SAP teams, MTSS plans, and
guidance counselors and social workers, it is most probable that any coherent plan will
include a combination of faculty and staff training to increase mental health awareness
and additional professional personnel trained to address student mental health.
Research Design, Methods, and Data Collection
Research Design
This research study followed a mixed-methods approach, a type of research study
combining both quantitative and qualitative data (Mertler, 2019). Quantitative data was
obtained from the fall 2021 administration results of the Pennsylvania Youth Survey,
PAYS, in the Halifax Area, Millersburg Area, and Upper Dauphin Area School Districts.
Qualitative data was obtained through a structured survey and interviews of the guidance

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counselors in the districts’ middle schools. The PAYs data was derived from the survey
administered anonymously. The survey questions asked of the guidance counselors aimed
to give their impressions to clarify and enlarge understanding of the student data.
This research design application was submitted to the Institutional Review Board
on July 26, 2022. On September 1, 2022, the researcher received a letter requesting
changes to the survey letter and the application. On September 2, 2022, the corrected
application was resubmitted, and the researcher received approval to proceed on
September 8, 2022. The approval letter can be found in the appendix (Appendix A).
Methods and Data Collection
Data collection took place according to the following timeline memorialized in
Table 1. The PAYS data was collected and analyzed and that analysis yielded data
groupings related to mental health and specific mental health data to be explored. The
initial reading and analysis evinced little difference in substance abuse data over the
years. In northern Dauphin County among early adolescents hard drug and prescription
drug abuse is extremely low. The drugs of choice are alcohol and nicotine, including
vaping nicotine, and none of those abusive practices showed any marked increases. As
the literature review identified anxiety, depression, and violence particularly, the PAYS
data was examined in the areas of “School Domain Risk Factor – Low Commitment to
School,” “Respect for the Moral Order” including “religiosity” or church attendance,
internet and social media bullying, attacking others, “Neighborhood Attachment,”
“Mental Health Concern and Suicide Risk” including sleep and grief, “COVID-19
Impacts,” and “Remote Learning Experiences and Perceptions.”

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Table 1
Data Collection Timeline
Research Questions
What mental health
challenges do the
PAYS surveys
reveal?

Types of Data to
Collect
Quantitative

How do the mental
health challenges
revealed by the PAYs
survey correlate to
the observations of
guidance counselors?

Qualitative

As PAYS survey data
and guidance
counselors
observations reveal,
what are the
pandemic induced
sources of middle
school students’
mental health
challenges?

Quantitative

How can the schools
and school personnel
confront these
challenges?

Qualitative

Data Sources
Data will be collected
from the Pennsylvania
Youth Survey results
from 2021 for the sixth
and eighth grade
students in the Halifax,
Millersburg, and Upper
Dauphin Area Middle
Schools.
Using data from the
quantitative analysis,
compare that data to
the qualitative analysis
of guidance counselor
observations from
interviews.
The results of the
analysis shall indicate
areas of concern and
also eliminate those
areas not statistically
significant.

The results of the
analysis will be
compared to
information found in
the literature review to
suggest courses of
action.

Timeline for Collecting
Data
By December 5, 2022 –
secure all data reports.
Read and analyze data
reports and scrutinize
those items particular to
mental health. February
15, 2023, using the
Statistical Program for
the Social Sciences,
SPSS, run an analysis.
In the February 9-28,
2023, interview the
schools’ guidance
counselors. Analyze
interview data for themes.
Compare themes to
statistics.
In March 1 – 27, 2023
analyze, using qualitative
and quantitative data
pinpoint sources of
students’ mental health
challenges.

In April 1 – 15, 2023, the
results of the analysis will
be compared to
information found in the
literature review.
Results will be shared
with the superintendents,
principals, and guidance
counselors for their
comments and
recommendations.

Many of the PAYS survey questions asked respondents to classify their response
according to degrees; hence, these questions were analyzed mathematically for

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descriptive and inferential statistics as they are framed in a Likert-like scale. For
example, the first item in “School Domain Risk Factor – Low Commitment to School”
was the following question: “How important do you think the things that you are learning
in school are going to be for your later life?” The possible answers were as follows:
“Very Important, Quite Important, Fairly Important, Slightly Important, and Not at All
Important.” The results are documented in Table 2, 3, 4, and 5.
As the most desirable answer was “Very Important,” that answer was assigned a
value of five, 5. The other answers were then assigned descending values, as follows:
“Quite Important,” four, 4, “Fairly Important,” three, 3, “Slightly Important,” two, 2, and
“Not at All Important,” one, 1. The researcher then constructed a frequency table for each
school and all students. To arrive at descriptive statistics, in the case of the sample table
which follows the number of responses was multiplied by the value noted above; hence,
the formula would be “nRating.” The resulting numbers were added and then divided by
the number of respondents to calculate the arithmetic mean.
Table 2 documents the Halifax Area Middle School results. A significant drop in
mean score occurred from 2019 to 2021 in both grades. Also, a significant drop occurred
in the similar cohort of respondents, those respondents who were sixth grade students in
2019 and those who were respondents in eighth grade in 2021. As there is no accounting
for students moving into the school district or those moving out in the PAYS data, we
must only assume that the groups are similar, not alike. However, there is a significant
difference in the means of the two groups. Also, the 2019 sixth grade respondents’ mode
was “Very Important;” whereas the 2021 eighth grade respondents’ distribution is
bimodal, split between “Very Important” and “Fairly Important.”

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MENTAL HEALTH
Table 2

School Domain Risk Factor – Low Commitment to School - “How important do you think
the things that you are learning in school are going to be for your later life?”
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Very Important

5

38 (190)

18 (90)

20 (100)

17 (85)

38 (190)

17 (85)

Quite Important
Fairly
Important
Slightly
Important

4

12 (48)

19 (76)

15 (60)

15 (60)

12 (48)

15 (60)

3

12 (36)

15 (45)

14 (42)

17 (51)

12 (36)

17 (51)

2

3 (6)

9 (18)

2 (4)

12 (24)

3 (6)

12 (24)

Not at all

1

0

3 (3)

2 (2)

3 (3)

0

3 (3)

65 (280)

64 (232)

53 (208)

65 (223)

65 (280)

65 (223)

4.3

3.63

3.92

3.43

4.3

3.43

Total - N
Mean

Note. The abbreviation HAMS is Halifax Area Middle School.
Table 3 documents the results for respondents in grades six and eight for the years
2019 and 2021 at the Millersburg Area Middle School. The results show a significant
difference between sixth grade and eighth grade means; however, that difference is
present in 2019, 2021, and in the cohort. The majority of the sixth grade respondents
considered school either “very” or “quite” important, which is reflected in the means and
the modes. Eighth grade respondents’ means indicate they viewed school as only “fairly
important;” however, the 2021 mode is “slightly important.” The cohort modes then show
a decline over two years from the sixth grade high of “fairly important” to the eighth
grade low of “slightly important.”

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MENTAL HEALTH
Table 3

School Domain Risk Factor – Low Commitment to School - “How important do you think
the things that you are learning in school are going to be for your later life?”
Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Very Important

5

17 (85)

10 (50)

16 (80)

10 (50)

17 (85)

10 (50)

Quite Important
Fairly
Important
Slightly
Important

4

12 (48)

13 (52)

9 (36)

7 (28)

12 (48)

7 (28)

3

7 (21)

17 (51)

11 (33)

15 (45)

7 (21)

15 (45)

2

5 (10)

10 (20)

5 (10)

17 (34)

5 (10)

17 (34)

Not at all

1

0

2 (2)

1 (1)

5 (5)

0

5 (5)

Total

41 (164)

62 (175)

42 (160)

54 (162)

41 (164)

54 (162)

Mean

4

2.82

3.81

3

4

3

Note. The abbreviation MAMS is Millersburg Area Middle School.
Table 4 documents the results for respondents in grades six and eight for the years
2019 and 2021 at the Upper Dauphin Area Middle School. Between sixth grade
respondent groups, there is a significant decline in the means from 2019 to 2021 and in
the size of the mode, although the majority of students still consider schooling important.
Eighth grade respondents means also show a decline; however, the decline of the mode is
more striking, from “very important” to “fairly important.” In the 2019-2021 cohort,
there is both a significant decline in means and in mode, although the size of the mode is
much smaller and the numbers reflect a more normal distribution.

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MENTAL HEALTH
Table 4

School Domain Risk Factor – Low Commitment to School - “How important do you think
the things that you are learning in school are going to be for your later life?”
Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Very Important

5

55 (275)

26 (130)

23 (115)

6 (30)

55 (275)

6 (30)

Quite Important
Fairly
Important
Slightly
Important

4

8 (32)

18 (72)

10 (40)

19 (76)

8 (32)

19 (76)

3

6 (18)

22 (66)

16 (48)

23 (69)

6 (18)

23 (69)

2

4 (8)

9 (18)

10 (20)

12 (24)

4 (8)

12 (24)

Not al all

1

1 (1)

5 (5)

6 (6)

3 (3)

1 (1)

3 (3)

Total

74 (334)

80 (291)

65 (229)

63 (202)

74 (334)

63 (202)

Mean

4.51

3.64

3.5

3.2

4.51

3.2

Note. The abbreviation UDAMS is Upper Dauphin Area Middle School.
Table 5 documents the results for all northern Dauphin County sixth and eight
grade respondents. For all respondents in northern Dauphin County middle schools the
mean response value for sixth graders in 2019 was 4.32, between “Very Important, and
Quite Important,” indicating it is reasonable to infer that those students placed a high
value upon their schooling’s future importance. The impact of the coronavirus pandemic
can be inferred from the .59 decline in mean and size of the mode from 2019 to 2021 for
sixth graders. Among eighth grade respondents there is a less significant decline in mean;
however, the distribution of scores is more normal in 2021. Of importance are the values
and difference for the cohort noted, the class of 2025 cohort: many of the sixth graders of
2019 grew into the eighth graders of 2021, and the mean value for schooling importance
declined from a very high 4.32 to 3.24, a judgment to the low side of “Quite Important

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MENTAL HEALTH
and Fairly Important.” An argument can certainly be made that this significant decline
can be attributed to maturation, which is reasonable; however, this is a judgment to
reserve for the next chapter.
Table 5

School Domain Risk Factor – Low Commitment to School - “How important do you think
the things that you are learning in school are going to be for your later life?”
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Very Important

5

110 (550)

54 (270)

59 (295)

33 (165)

110 (550)

33 (165)

Quite Important
Fairly
Important
Slightly
Important

4

32 (128)

50 (200)

34 (136)

41 (164)

32 (128)

41 (164)

3

25 (75)

54 (162)

41 (123)

55 (165)

25 (75)

55 (165)

2

12 (24)

28 (56)

17 (34)

41 (82)

12 (24)

41 (82)

Not al all

1

1 (1)

10 (10)

9 (9)

11 (11)

1 (1)

11 (11)

Total

180 (778)

196 (698)

160 (597)

181 (587)

180 (778)

181 (587)

Mean

4.32

3.56

3.73

3.24

4.32

3.24

Many of the questions referring to suicidal ideation, self-harm, and the impact of
COVID-19 were “Yes/No” questions. For these items, the responses are quantified as
percentages. For example, a table of those items, Table 6, is displayed as follows: the
2021 PAYS survey included a series of questions specific to COVID-19. Respondents
were asked to “select all of the following that you experienced.” These were the
responses, numbered:
1. I or someone in my family was sick with COVID-19 or COVID-19 symptoms.
2. A family member or friend close to me died from COVIID-19.

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63

3. One or more people living in my home lost their job.
4. I felt more anxious, nervous, worried, or angry than usual.
5. I felt more relaxed, comfortable, or rested than usual.
6. People in my home were arguing or physically fighting more than usual.
7. My family ate more meals together than usual.
8. My family shared more quality time together than usual (such as playing games,
exercising, talking, watching movies/tv).
9. I learned a new hobby or skill (such as cooking, crafts, gardening, physical
activities, outdoor activities, puzzles, new language).
10. I played more online games with others than usual.
Table 6 reflects some grim realities. First, over sixty percent of sixth and eighth
grade students, 61.3% and 63.2% respectively, in the three middle schools either
contracted the virus or a member of their family did. Second, slightly more than eleven
percent, 11.3%, of sixth graders and about ten percent, 9.8%, of eighth graders suffered a
death in their family or immediate circle. More than a quarter of the students responding
in each grade, 27.5 % in sixth grade and 29.9% in eighth grade, reported greater feelings
of anxiety, nervousness, worry, and anger.
Conversely, respondents reported some impressions that would be considered
positive. About eighteen percent of respondents, 18.3% in sixth grade and 17.8% reported
they felt more relaxed, comfortable, or rested than before. Although more than nine
percent, 9.9% in sixth grade and 9.2% in eighth grade, reported more arguing in their
households, a quarter or more of the respondents, 27.5% of sixth graders and 24.7% of
eighth graders, reported eating more family meals together and over forty percent, 42.2%

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MENTAL HEALTH
of sixth graders and 42.5% of eighth graders, reported spending more quality time

together with their families. Also, around half of respondents, 50.7% of sixth graders and
46.5% of eighth graders, reported learning a new skill.
Table 6
COVID – 19 Impacts
Response

HAMS

MAMS

UDAMS

Total

6

8

6

8

6

8

6

8

%

%

%

%

%

%

%

%

1. Ill

66%

60%

54.1%

67.3%

61.8%

62.9%

61.3%

63.2%

2. Death

12%

10%

2.7%

9.6%

16.4%

9.7%

11.3%

9.8%

3. Job loss

4%

6.7%

10.8%

3.8%

14.5%

9.7%

9.9%

6.9%

4. Feelings

26%

26.7%

35.1%

26.9%

23.6%

35.5%

27.5%

29.9%

5. Relaxed

12%

18.3%

13.5%

13.5%

27.3%

21%

18.3%

17.8%

6. More

8%

6.7%

10.8%

5.8%

10.9%

14.5%

9.9%

9.2%

7. Meals

24%

26.7%

24.3%

25%

32.7%

22.6%

27.5%

24.7%

8. Together

44%

41.7%

45.9

44.2%

38.2%

41.9%

42.2%

42.5%

9. New

50%

41.7%

45.9%

40.4%

54.5%

56.5%

50.7%

46.5%

10. Online

42%

45%

43.2%

46.2%

49.1%

46.8%

45.1%

46%

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.
Like the inferences gained from statistical analysis of the items in a Likert-like
scale, from the percentages we can make certain inferences as well. The purpose of the
guidance counselor interviews is to clarify and enlarge upon these inferences. Hence,
after obtaining permission through the school district and building leadership, the
guidance counselors were contacted and informed consent was secured.
The guidance counselors were given the interview questions in advance – the interview
questions are appended (Appendix B). Interviews were then scheduled and conducted as
scheduled. The interviews were recorded on an iPhone. The interview responses were

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65

rendered in transcripts by having the iPhone recording transcribed directly through
Microsoft Word and then edited and compared to the recording. Thereafter, the
interviews were qualitatively analyzed for themes utilizing the coding regimen described
by Saldana (2013). Like the PAYS survey items, the structured interview questions
focused upon anxiety, depression, violence including self-harm, bullying, problems at
home, attitudes toward school, and attitudes toward online learning. The guidance
counselors did not have hard numbers available. Their responses were based upon their
experiences with students.
As noted, at minimum the researcher expects that additional training in mental
health will be required of the professional and classified staffs of the school districts. This
type of training will probably be achievable without greatly increased costs for the
training itself; however, expenses will be incurred in finding ways to make time for the
employees to train. This will undoubtedly require the use of substitute teachers, substitute
paraprofessionals, and other classified staff substitutes which are already in short supply.
As to needs for professional staff, the literature review indicated that what students need
most is the listening ear of a caring trained professional, meaning a guidance counselor or
social worker. Although the districts do employ guidance counselors and social workers,
more may be needed. These professionals could conceivably be shared, as the districts
already share some services and staff.
Validity
As noted in Mertler (2019), the quality of action research depends upon its rigor,
and rigor is dependent upon accuracy and reliability, which are determined through the
researcher’s efforts to assess bias to assure the research does not parrot the researcher’s

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66

intent (144). First, PAYS offered the researcher a repeated cycle of assessments of most
of the items surveyed. Due to the extensive mathematical analysis employed in this study,
the researcher limited the analysis to 2019 and 2021 – pre-pandemic and pandemic, since
the pandemic was not extinguished by the fall of 2021. The exceptions to the repeated
cycle were as follows: previous PAYS surveys did not include a question on the impact
of COVID-19 or a question about online learning.
Second, to ensure engagement and persistent observation, the middle school
guidance counselors were given the opportunity to review the interview transcripts and
were also given the opportunity to offer feedback reflecting upon what they had said in
the interview. The middle school principals were also given the opportunity to review the
preliminary data and the interview transcripts.
Third, to demonstrate experience with the process, the researcher noted his
experience in action research, having conducted a study on elementary school student
writing in 2007 when the researcher was a student in the Bucknell University program
leading to the Pennsylvania Letter of Eligibility. Also, the researcher conducted an action
research study as part of the selection process for middle school mathematics textbooks
in 2009 - 2010 when the researcher was employed as the Assistant Superintendent of the
Waynesboro Area School District. Finally, the researcher has the advice and direction of
two seasoned school superintendents; David Hatfield, Ed.D., of the Halifax Area School
District, the researcher’s external advisor, and David Foley, Ed.D., of the Knoch School
District, who is also the professor in charge of the researcher’s study.
Triangulation of the data was achieved through multiple data sources, both
quantitative data from the PAYS survey, qualitative data from the guidance counselor

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67

interviews, member checking through guidance counselor reviews of their interview
transcripts, and reflections of the middle school principals involved. The member
checking and reflections qualified as significant debriefing.
Limitations
PAYS is an anonymous survey, and it is not disaggregated by race or gender;
therefore, the researcher cannot make any assumptions regarding effects particular to
gender or race. As noted previously, PAYS items concerning COVID-19 effects and
online learning have no precursor in previous surveys – that data stands alone.
The PAYS survey is also reflective of the condition of the students in the three
school districts. Not all students participated in the survey – it was elective, and some
students were absent for the whole or part of the survey. That stated, the confidence
interval for the total number of survey items and total number of surveys was high. Also,
PAYS included five validity checks so only honest surveys are counted.
All of the educators, guidance counselors and principals, have continuous
experience with the coronavirus pandemic having been employed in education
throughout; however, one of the guidance counselors is new to her position as are two of
the principals. Nevertheless, those “new” individuals experienced the effects of the
pandemic in their previous positions, and their viewpoints are balanced by individuals in
their schools in complementary positions.
Finally, although the researcher has considerable experience in education, the
researcher was only a consultant at the time of the pandemic to the present. Nonetheless,
the researcher has had considerable contact with those involved, and, like all of them, has
had the experience of living through the coronavirus pandemic.

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68

Summary
At the onset of the coronavirus pandemic, school closures were widely employed
to stem virus transmission. Those closures persisted throughout the 2020-2021 school
year, dependent upon infection rates. It was almost uniformly recognized that learning
loss would occur and engender the need for remediation. However, no one expected the
impact upon children’s and parents’ mental health arising from the upheavals of the
coronavirus pandemic, including the rapid transition to online learning, the subsequent
school re-openings and closures, and the debates over masking.
This mixed-methods research study, through a quantitative examination of PAYS
data and a qualitative examination of the impressions of middle school guidance
counselors’ interview data, determined the mental health challenges confronting the sixth
and eighth grade students of the three middle schools in northern Dauphin County;
Halifax Area Middle School, Millersburg Area Middle School, and Upper Dauphin Area
Middle School; the correlation between the anonymous PAYS data and the observations
of the middle school guidance counselors; and the pandemic induced sources of the
middle school students’ mental health challenges. This research study concluded with an
analysis and recommendations for the school districts to confront student mental health
challenges.
The data analysis in the next chapter indicated the areas of correlation suggesting
strategies to help students understand the resulting effects of the coronavirus pandemic.
Along with in-school remediation, the strategies constituted a path forward for the
schools and the districts.

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MENTAL HEALTH
Chapter Four
Data Analysis and Results
The impetus behind this study was diagnostic. Upon the upheaval in public life,

and specifically education, a wide swath of interest arose to discern just what effects the
coronavirus pandemic had upon individuals, communities, and society in general. In the
case of education, it was accepted that learning loss had occurred, and subsequent studies
attempted to evaluate the depth and breadth of that learning loss, which has been
measured with some certitude through standardized and curriculum-based assessments.
As schools returned to full-time in-person status, unfortunately it became evident that
there had occurred a considerable increase in mental health symptoms, particularly
depression and anxiety. There were no standardized tests to assess mental health effects;
however, the Pennsylvania Youth Survey, PAYS, for the fall of 2021 included survey
items that sought to assess the pandemic’s impact. Throughout the 2021-2022 school
year, students beset school guidance counselors continually with troubles indicating
increased depression and anxiety. Hence, this study was developed to identify what
happened during the coronavirus pandemic and as it subsided, and to recommend a
course of action to decrease and treat the pandemic’s mental health effects.
Data Analysis
For this mixed-methods study, quantitative data was assembled from the results of
PAYS administered in the fall of 2021 at the three middle schools in northern Dauphin
County; Halifax Area, Millersburg Area, and Upper Dauphin Area Middle Schools; and
qualitative data was analyzed from the interviews of the three middle school guidance
counselors. As many educators and counselors had remarked at length about the mental

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70

health effects of the pandemic dislocation, the PAYS analysis focused on those items
possibly impacting student mental health. The interview questions asked of guidance
counselors reflect that same focus on mental health.
PAYS results were solicited from the superintendents of the three school districts.
The narrative reports were then analyzed, and the data reports were printed and collated.
The PAYS narrative reports called out concerns for student mental health; however, the
researcher’s interest was in the strength of the data and its progression from prepandemic to pandemic periods. The researcher hypothesized that more could be learned
from the examination statistically of the student responses, particularly of the student
respondents who had been sixth graders during the 2019 administration of the survey and
had become, at least in part, respondents as eighth graders during the 2021 survey
administration. PAYS included questions that framed answers in Likert-like scales that
could be assigned numerical values and then analyzed using descriptive and inferential
statistics. PAYS also included questions that were answered with simple
positive/negative responses, and these were assessed for the strength of the response
indicated by frequency.
After obtaining consent from their supervisors, the three middle school guidance
counselors’ consent was obtained to proceed with their inclusion in the study. Given the
counselors’ workload and time constraints, the counselors were given the survey
questions in advance. The counselors were consulted for interview scheduling, interviews
were scheduled, and completed. The interviews were recorded on the researcher’s
personal iPhone SE. The interviews were then transcribed directly from the phone into
Microsoft Word installed on a 2017 build 21.5” iMac running Ventura 13.3.1(a). The

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71

transcriptions were edited to correct mistakes common when a computer program tries to
mimic the nuances of the human voice. The corrected transcripts were then emailed to the
guidance counselors for their feedback. Subsequently, summaries of the three interviews
were emailed to the guidance counselors, school principals, and the district
superintendents for their feedback.
The guidance counselors’ interview responses were analyzed according to the
regimen documented by Saldana (2013). The interview responses were printed with wide
margins for notetaking. The first analytical reading produced an underlined text. The
second analytical reading produced an annotated text. The notations indicated the
strength or lack thereof in response to the item queried which Saldana characterizes as
“Magnitude Coding,” under “Grammatical Methods” (59). The questions themselves
reflected what the researcher wished to investigate. Similarities and differences among
the schools were noted.
Limitations
This mixed-methods study is limited to the effects of the coronavirus pandemic
upon middle school students’ mental health. Throughout the analysis, the researcher
noted various effects possibly associated with the pandemic which could have earlier
antecedents and other causes. These will be discussed further in Chapter Five. It is worth
reiterating that PAYS is not disaggregated demographically. Chapter Two, Review of the
Literature, indicated some possible pandemic effects particular to adolescent females.
This study, neither of quantitative nor qualitative data, addressed gender. PAYS included
items to judge respondents’ veracity; however, PAYS does not measure respondents’
ability to make distinctions required to answer questions requiring response on the Likert-

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72

like scale. Undoubtedly, high school seniors who have taken the survey three times have
a better idea of how to respond to the Likert-like scale most truthfully.
Results
Data was analyzed according to the study’s research questions. The study sought
to answer the four research questions, as follows:
1. What mental health challenges do the PAYS surveys reveal?
2. How do the mental health challenges revealed by the PAYS survey correlate
to the observations of guidance counselors?
3. As PAYS survey data and guidance counselors observations reveal, what are
the pandemic induced sources of middle school students’ mental health
challenges?
4. How can the schools and school personnel confront these challenges?
For question number one, PAYS reports for the three middle schools were collected.
Survey reports were analyzed using descriptive and inferential statistics. This was
possible as the PAYS grade report details specific responses for all items, some of which
are in a Likert-like scale. For questions two through four, school guidance counselors
were interviewed. Question three required renewed scrutiny of PAYS survey data,
particularly the data which directly reported pandemic effects, and question four was
guided by the relationships revealed through statistical analysis and was also speculative,
dependent upon the guidance counselors’ opinions.
Question one was “what mental health challenges do the PAYS surveys reveal?
A reading of the PAYS reports identified the items to analyze, the most obvious being
items concerning depressive symptoms, suicide risk and self-harm, and COVID impact.

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73

Of the other items, those related to hard drug and prescription drug use were insignificant
in the populations. Among the populations, the drugs of choice were nicotine, ingested
through smoking or vaping, and alcohol. Again, among the middle school populations
this drug use was not significant. The items that may have impacted self-worth and could
be reflective of respondent mental health were commitment to school, respect for the
moral order and religiosity or church attendance, bullying particularly through texts or
social media, neighborhood attachment, and family conflict. Given that all students were
originally thrust into virtual schooling when schools were closed at the pandemic’s onset,
attendant upon covid impact is a group of questions regarding online learning.
There were four items devoted to depressive symptoms:
1. In the past twelve months, have you felt sad or depressed most days, even if
you felt OK sometimes?
2. Sometimes I think that life is not worth it.
3. At times I think I am no good at all.
4. All in all, I am inclined to think that I am a failure.
Students were to respond either with the emphatic negative, NO!, the negative, no, the
affirmative, yes, or the emphatic affirmative, YES! (25). These Likert-like items may be
scored as follows: as the most desirable response would be the emphatic negative, that
was assigned four points. Therefore, the items have the following point scale: NO! = 4,
no = 3, yes = 2, and YES! = 1. Frequency tables for these items are appended (Appendix
C). Table 7 indicates the mean response for each question. Although there is some
variation, means are all positive.

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Table 7
Depressive Symptoms Mean Values by Question
SADNESS
2019

2021

School

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

HAMS

3.15

2.98

3

3.27

3.15

3.27

MAMS

2.81

2.66

3.07

2.71

2.81

2.71

UDAMS

2.9

2.49

2.93

2.82

2.9

2.82

ALL

2.98

2.7

3

2.95

2.98

2.95

LIFE
2019

2021

School

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

HAMS

3.43

3.26

3.2

3.57

3.43

3.57

MAMS

3.32

2.88

3.36

3.19

3.32

3.19

UDAMS

3.28

2.85

3.21

3.03

3.28

3.03

ALL

3.35

3.03

3.14

3.27

3.35

3.27

NO GOOD
2019

2021

School

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

HAMS

3.11

2.89

2.96

3.4

3.11

3.4

MAMS

2.87

2.65

3.12

2.91

2.87

2.91

UDAMS

2.92

2.68

2.87

2.85

2.92

2.85

ALL

2.98

2.74

2.97

3.06

2.98

3.06

FAILURE
2019

2021

School

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

HAMS

3.42

3.03

3.2

3.59

3.42

3.59

MAMS

3.32

3.04

3.37

3.07

3.32

3.07

UDAMS

3.27

3.01

3.1

3.16

3.27

3.16

ALL

3.34

3.04

3.2

3.29

3.34

3.29

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper

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Dauphin Area Middle School. The abbreviations used for the questions are as follows:

SADNESS, In the past twelve months, have you felt sad or depressed most days, even if
you felt OK sometimes? LIFE, Sometimes I think that life is not worth it; NO GOOD, At
times I think I am no good at all; and FAILURE, All in all, I am inclined to think that I
am a failure.
As reflected in Table 8, the fact that all means are positive does not mean that
there is no significant population with depressive symptoms. Table 8 shows the
percentage and number of the total of all respondents by grade level total who responded
in the negative, exhibiting symptoms of depression, and the numbers are alarming.
Table 8
Percentage, Number and Total of Negative Respondents by Year and Grade Level
2019
Question

2021

Grade 6

Grade 8

Grade 6

Grade 8

33% (59/176)

42% (84/198)

31.6% (49/155)

35% (62/177)

LIFE

18.75% (23/176)

34.7% (68/196)

26.6% (41/154)

21.35% (38/178)

NO GOOD

32.77% (58/177)

44.72% (89/199)

35.9% (56/156)

32.02% (57/178)

FAILURE

15.82% (28/177)

30.93% (60/194)

25.32% (39/154)

18.54% (33/178)

SADNESS

Note. The abbreviations used for the questions are as follows: SADNESS, In the past
twelve months, have you felt sad or depressed most days, even if you felt OK sometimes?
LIFE, Sometimes I think that life is not worth it; NO GOOD, At times I think I am no
good at all; and FAILURE, All in all, I am inclined to think that I am a failure.
The information in Tables 7 and 8 indicates that depressive symptoms were
present in middle school students in all schools in significant numbers both before and

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after the pandemic and that a significant number of students expressed negative
responses; therefore, they were exhibiting depressive symptoms.
PAYS included six items addressing suicide risk, as follows:
1. Did you ever feel so sad or hopeless almost every day for two weeks or more
in a row that you stopped doing some usual activities?
2. Did you ever seriously consider attempting suicide?
3. Did you make a plan about how you would attempt suicide?
4. How many times did you actually attempt suicide?
5. If you attempted suicide during the past 12 months, did any attempt result in
an injury, poisoning, or overdose that had to be treated by a doctor or nurse?
6. How many times in the past 12 months have you done anything to harm
yourself (such as cutting, scraping, burning) as a way to relieve difficult
feelings or to communicate emotions that may be difficult to express verbally?
(pp. 48-49)
Table 9 summarizes the number of respondents who demonstrated continued
sadness, the number of respondents who contemplated suicide, and the number of
respondents who planned suicide. Middle school populations were 279 at Halifax Area,
177 at Millersburg Area, and 303 at Upper Dauphin Area. PAYS was only administered
to sixth and eighth graders meaning the actual numbers of students exhibiting both
depressive symptoms and suicidal ideations were higher. The total northern Dauphin
County 2021 middle school population was 759: the sixth and eighth grade total was 463.
Of those students, a maximum number of 417 responded. In the fall of 2021, 89 felt
sadness or hopelessness, 51 contemplated suicide, and 41 planned suicide. Like

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symptoms of depression, suicidal ideations were present in the both the 2019 and 2021
student populations. In small middle schools in rural settings, these numbers are
remarkable.
Table 9
Summary of Items 1-3
2019

2021

Question

Grade 6

Grade 8

Grade 6

Grade 8

Sadness

16.6% (20/120)

27.5% (41/149)

25.8% (39/151)

27.7% (50/180)

Considered

10.16% (13/128)

21.38% (31/145)

15.44% (23/149)

15.6% (28/180)

Planned

9.37% (12/128)

18.62% (27/145)

12.75% (19/149)

12.22% (22/180)

Note. Abbreviations refer to questions as follows: “Hopeless” is “Did you ever feel so sad
or hopeless almost every day for two weeks or more in a row that you stopped doing
some usual activities?” “Considered” is “Did you ever seriously consider attempting
suicide?” “Planned” is “Did you make a plan about how you would attempt suicide?”
Table 10 documents question number four, “How many times did you actually
attempt suicide?” Again, in the small rural communities studied herein, the numbers were
remarkable. Perhaps most alarming was the number of respondents who made repeated
attempts. From pre-pandemic 2019 to 2021, the number of individuals attempting suicide
six or more times doubled. Within the similar cohort, sixth graders in 2019 becoming
eighth graders in 2021, there was a similar increase. Tragically, one Millersburg Area
student succeeded in her attempt in 2021. Also, though some may view the percentages
as low, no educator or parent would consider the percentages and numbers anything less
than shocking.

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Table 10
Number of Suicide Attempts

Number
0
1
2 or 3
4 or 5
6 or more
Total
% attempted

2019
Grade 6
116
5
5
0
1
127
8.66%

All Respondents
2021
Grade 8
Grade 6
130
135
5
8
10
3
1
1
2
4
148
151
12.16%
10.60%

Grade 8
168
3
6
1
2
180
6.60%

Note. % attempted refers to the number of individuals that attempted suicide, not the
number of attempts.
Table 11 documents the numbers of suicide attempts resulting in the need for
medical attention, a measure of the serious nature of the attempts.
Table 11
Number of Attempts Resulting in Injury Requiring Medical Intervention
All Respondents

No attempt
Yes
No

2019
Grade 6
96
3
27

Grade 8
113
6
29

2021
Grade 6
101
2
46

Grade 8
144
5
27

Cohort
Grade 6
96
3
27

Grade 8
144
5
27

Note. A “Yes” response indicates the need for medical attention from a doctor or nurse.

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Perhaps the most telling statistic in terms of numbers is the increase in self-harm after the
onset of the pandemic and the number of respondents indicating an escalating frequency
of self-harm. Table 12 shows the frequency of self-harm. The number of sixth graders
harming themselves more than doubled from 2019 to 2021. The number of eighth graders
from 2019 to 2021 declined somewhat; however, multiple instances increased. Finally,
the increase in the number of attempts in the Grade 6, 2019 – Grade 8, 2021 cohort is
dramatic, from 11 total attempts to 28, including fifteen respondents who reported
multiple instances.
Table 12
Instances of Self-Harm; Cutting, Scraping, Burning
All
Respondents
Number
0
1 or 2
3 to 5
6 to 9
10 to 19
20 to 39
40 or more

2019
Grade 6
120
9
2
0
0
0
0

Grade 8
117
20
3
3
2
0
6

2021
Grade 6
120
14
5
3
0
3
1

Grade 8
147
11
7
1
4
3
2

Cohort
Grade 6
120
9
2
0
0
0
0

Grade 8
147
11
7
1
4
3
2

Note. Under “Number,” a zero indicates the number of individuals who did not harm
themselves; whereas the increasing numbers indicate the number of times the respondents
harmed themselves.
Finally, PAYS framed the questions specific to the effects of COVID-19 in the
following format, eliciting positive and negative, Yes/NO, answers.

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1. I or someone in my family was sick with COVID-19 or COVID-19 symptoms.
2. A family member or friend close to me died from COVIID-19.
3. One or more people living in my home lost their job.
4. I felt more anxious, nervous, worried, or angry than usual.
5. I felt more relaxed, comfortable, or rested than usual.
6. People in my home were arguing or physically fighting more than usual.
7. My family ate more meals together than usual.
8. My family shared more quality time together than usual (such as playing games,
exercising, talking, watching movies/tv).
9. I learned a new hobby or skill (such as cooking, crafts, gardening, physical
activities, outdoor activities, puzzles, new language).
10. I played more online games with others than usual. (51)
As noted in Chapter Three, Table 6, over sixty percent of sixth and eighth grade
students, 61.3% and 63.2% respectively, in the three middle schools either contracted the
coronavirus or a member of their family did. Slightly more than eleven percent, 11.3%, of
sixth graders and about ten percent, 9.8%, of eighth graders suffered a death in their
family or immediate circle. More than a quarter of the students responding in each grade,
27.5 % in sixth grade and 29.9% in eighth grade, reported greater feelings of anxiety,
nervousness, worry, and anger.
Conversely, respondents reported some impressions that would be considered
positive. About eighteen percent of respondents, 18.3% in sixth grade and 17.8% reported
they felt more relaxed, comfortable, or rested than before. Although more than nine
percent, 9.9% in sixth grade and 9.2% in eighth grade, reported more arguing in their

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households, a quarter or more of the respondents, 27.5% of sixth graders and 24.7% of
eighth graders, reported eating more family meals together and over forty percent, 42.2%
of sixth graders and 42.5% of eighth graders, reported spending more quality time
together with their families. Also, around half of respondents, 50.7% of sixth graders and
46.5% of eighth graders, reported learning a new skill. Given the nature of the pandemic,
its closures and restrictions, almost half of respondents in both grades reported playing
more online games – 45.1% for sixth graders and 46% for eighth graders.
The increased amount of time online undoubtedly had an impact upon students,
although no PAYS questions measured the aggregate effect. However, given that so
much pandemic instruction was delivered online, PAYS did pose questions about online
learning, including its quality. Toward the end of the 2021 PAYS questionnaire,
respondents were asked to answer “No!,” an emphatic no, “no,” “yes,” and “Yes!,” an
emphatic yes, to this question: “My learning improved when my classes were taught
online due to COVID-19.” Table 13 memorializes the results for all respondents. The
mode being 3 for sixth graders, 33 respondents, and 4 for eighth graders, 52 respondents,
and the frequency of negative responses being 63 for sixth graders and 73 for eighth
graders, indicated that a great majority of respondents recognized the failings of online
learning; however, there was a minority that showed a preference for online learning and
a small group that preferred it. Undoubtedly, the lack of teacher preparedness for online
education exacerbated by the hasty response to the coronavirus which engendered school
closings somewhat explains respondents’ disdain for online learning; however, what
explains the preference? There were no PAYS items to fully explain these results.

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Table 13
My Learning Improved Online
All
Respondents
Grade 6
Response Rating
No!
4
no
3
yes
2
Yes!
1
Total
Mean

n (nRating)
30 (120)
33 (99)
13 (26)
3 (3)
79 (248)
3.14

Grade 8
n
(nRating)
52 (208)
21 (63)
13 (26)
8 (8)
94 (305)
3.27

Note. A comparison of all means indicated that most students knew their learning did not
improve online.
The review of the PAYS items addressing depressive symptoms, suicide risk and
self-harm, and COVID impact indicate that the mental health effects most closely related
specifically to the coronavirus pandemic were increased anxiety and the number of
suicide attempts and instances of self-harm.
The second research question was “how do mental health challenges revealed by
PAYS correlate to the observations of the guidance counselors?” To reiterate in part, the
guidance counselors were interviewed, interview questions are appended, the interviews
transcribed, and then analyzed in part according to the process memorialized by Saldana
(2013). The interview responses were printed with wide margins for notetaking. The first
analytical reading produced an underlined text. The second analytical reading produced
an annotated text. The notations indicated the strength or lack thereof in response to the
item queried which Saldana characterizes as “Magnitude Coding, under “Grammatical
Methods” (59).

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Two of the three guidance counselors reported increases in student self-harm. The
third stated that there was no increase; however, neither did it decrease. All noted a
significant increase in reports of depression; one indicated it more than doubled. Two of
the three reported increases in students reporting suicidal ideations; one noted the district
changed its policies in response to the increase and a student suicide. The third guidance
counselor again reported a static condition – there were reports of suicidal ideations, but
no more than previously seen. All counselors reported cyberbullying as a problem, with
two noting significant increases. All counselors also noted an increase of in-school
bullying.
None of the guidance counselors reported increases in either in-school or out-ofschool violent attacks. The school which had experienced a student suicide reported an
increase in grieving behavior and grief counseling; however, the other two schools did
not report any increases. This is worth noting because the PAYS questions on the effects
of COVID-19 asked how many students had experienced the death of a household
member or someone with whom they were close, and the responses were 11.3% of all
sixth graders and 9.8% of eighth graders.
Student attitudes toward school varied; however, one counselor stated that many
students were happy to return to in-person schooling. All three reported students were
happy to see their peers in-person. When schools first returned on a limited basis during
the 2020-2021 school year, all the counselors agreed that there was heightened anxiety
specific to the coronavirus transmission. Finally, all three noted that they had students
who in the face of academic or social difficulties will advocate for cyber schooling to
solve their problems. Having experienced online education, some students resorted to

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withdrawing to cyber schooling as an option, although they knew they would not learn as
much as they would in school. The counselors saw it as an escape for those in trouble,
and two of the counselors noted that this sentiment was symptomatic of a lack of coping
skills. The counselors characterized this as an increased social anxiety.
Therefore, congruent to the PAYS indicators of increased anxiety and self-harm,
the guidance counselors also reported the same conditions. It is worthwhile to note that
the magnitude of the guidance counselors’ responses, which were emphatic, do not match
the magnitude or lack thereof documented in PAYS, which indicated depressive
symptoms and suicidal ideations as being an ongoing condition.
The third research question asked, “as PAYS data and guidance counselors
observations reveal, what are the pandemic induced sources of middle school students’
mental health challenges?” Certainly fear of contracting the coronavirus, passing it to
other persons in one’s household, and the incidence of household deaths were causes of
anxiety given the numbers of students and immediate household members who
contracted the disease and the number who unfortunately died. Additionally, all the
guidance counselors indicated increased cyber bullying, in-school bullying, and students
stating the option of withdrawing into cyber schooling.
Examining PAYS items regarding “Commitment to School,” the importance of
school to later life as memorialized in Tables 2-5 in Chapter Three, do not indicate
dissatisfaction with school as significant. Sixth graders from all schools felt school was
important to later life, and the distribution of their scores was skewed positively. Eighth
graders showed a significant drop in that feeling; however, they still saw school as
important, and the distribution of their scores bore more resemblance to the normal curve.

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Therefore, the drop in eighth grade scores may be attributable to the eighth graders’
school experience, having become cynical, or realistic with age.
An examination of the items assessing moral order (Appendix E) indicated little
amiss. Most respondents understand stealing, lying, cheating in school, and violence are
all wrong. One item identified that may have had significance was religiosity, church
attendance (Appendix F). Although there was variation, church attendance markedly
declined; however, it might be irresponsible to consider this as many traditional
denominational churches turned to online services during the pandemic, which could
account for the decline.
As noted in Chapter Three, Table 6, over forty percent of all respondents reported
spending more quality time with their families. The guidance counselors noted this factor
as being positive in most cases but problematic given what they knew about some of
those families. Most respondents reported there was little negative insulting behaviors in
their immediate families and that their families did not engage in serious arguments.
None of the groups of respondents showed a marked lack of neighborhood attachment.
Except for a dour minority, respondents showed satisfaction with their living conditions.
A minority of students in all three schools reported that they sometimes hated
being in school. Unfortunately, as PAYS does not disaggregate by gender, we have no
idea whether these were disaffected boys or girls. Also, there was a minority of students
that felt school was not interesting or worth the effort. A further examination of the tables
on depressive symptoms and suicide and self-harm indicated that there was again a
minority of individuals expressing negative feelings. Those who attempted suicide and
engaged in self-harm notwithstanding, there appeared a consistent minority expressing

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these negative feelings. Finally, the group that experienced bullying was a static group,
mostly, with one exception: the number of students who felt bullied at home doubled
between 2019 and 2021, perhaps a corollary to spending more time at home.
Unfortunately, neither PAYS nor the guidance counselors reported that these troubled
students might be the same population.
Therefore, given the focus of this research study, the identified pandemic induced
source of mental health challenges is survey-measured heightened anxiety confirmed by
guidance counselors’ observations. As a high percentage of survey respondents
experienced coronavirus infection, and some deaths, in their households, this trauma
undoubtedly influenced this heightened anxiety. Incidence of self-harm also rose in
intensity, measured by the number of respondents who engaged in multiple suicide
attempts.
The fourth research question was “how can the schools and school personnel
confront these challenges?” Given that bullying and cyber-bullying, depressive
symptoms, suicidal ideations, and instances of self-harm were evident in the population
prior to the pandemic and that the pandemic appears to have dramatically increased
anxiety in the population, the reasonable strategy to address these challenges would be
increased awareness about mental health through mandatory redundant educational
strategies and trainings presented to the whole student body and all staff and faculty.
Awareness in the communities should be promoted through social media, district
websites, and yearly mailings. As the pandemic has reduced the stigma associated with
mental health, schools and communities need to claim the advantage and promote good
mental health and dealing with depression and anxiety.

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Undoubtedly, the three districts should examine staffing. The state staffing
recommendation is one guidance counselor for every 250 students, and it would be wise
for the districts to follow this guideline, if not seek to employ additional counselors. It is
worthwhile to note, that guidance counselors at all levels are often responsible for
administering the state’s standardized high stakes tests – the Pennsylvania State System
of Assessments, PSSA, and the subject area Keystone Tests. These tests require about a
month, twenty school days, of guidance counselors’ attention, days not devoted to
counseling students. If possible, and it may not be, there should be some mechanism in
place to give students access to counselors during testing.
The districts also maintain social workers. Each district should have at least one
social worker, and it would be reasonable to expect the districts to employ and share at
least one more social worker; however, two may be preferrable. Finally, given the
magnitude of respondents self-reporting suicidal ideations including planning and
attempting suicide, it would be ideal if the districts through the guidance counselors had
the opportunity to offer psychological and psychiatric referrals to those students who
needed and requested referrals and whose parents were agreeable. Although there is
access to counseling through the school’s Student Assistance Teams, having more ready
access to psychologists and psychiatrists may be beneficial.
Triangulation
Triangulation of data was achieved through the following process: the research
study utilized two primary sources of data – the PAYS data and the guidance counselors’
interviews. The guidance counselors’ interviews validated and clarified the PAYS data.
The PAYS data in turn validated and provided additional understanding of the guidance

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counselors’ interviews. Member checking occurred through transcription of the
interviews. The transcripts were then emailed to the three guidance counselors for their
review. All three attested to the accuracy of their transcripts. The researcher then
synthesized a summary sheet, including preliminary findings, and sent that to the
guidance counselors, their middle school principals, and the three district
superintendents; thereby completing the process of member checking and triangulation.
Discussion
As noted, the PAYS data was solicited from the school district’s superintendents.
The PAYS profiles of the three districts provided information; however, of particular
interest were the data report numbers catalogued in the documents titled All Questions by
Grade Report. The data from the most pertinent questions were then recorded in
Microsoft Excel in the form of tables by school and collectively, as needed. Those items
in a Likert-like scale were then assigned values to compute descriptive statistics.
Notably, Likert-like scale data were always positive. Also, data from
positive/negative questions was also positive, except for online learning. There were
minorities answering all items negatively which possibly indicated those individuals
experienced mental duress, including severe symptoms of depression and anxiety
resulting in suicidal ideations and repeated suicide attempts in the worst cases.
The guidance counselors’ interviews were analyzed, and the results compared to
the PAYS data. Perhaps because of their sensitive nature and the direct connection to
their students, the guidance counselors’ impressions were emphatic. However, given the
severity of the conditions represented by the negative responses, the strength of the
guidance professionals’ reactions is understandable.

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The coronavirus pandemic created heightened anxiety amongst the middle school
populations, having an impact upon students’ mental health. However, as will be
discussed in the next chapter, the data analysis revealed additional factors that may be
influencing middle school students’ mental health.
Summary
Again, the purpose of the study was to assess the impact of the coronavirus
pandemic upon middle school students’ mental health in the three small middle schools
of northern Dauphin County. Originally, the researcher had supposed that the pandemic
had had a noticeable effect on numerous negative behaviors and exaggerated those
behaviors. However, PAYS results indicated increased anxiety among the population and
increased instances of self-harm, particularly among the respondents in the Grade 6, 2019
– Grade 8, 2021 cohort. The middle school guidance counselors’ interviews indicated
significant increases in anxiety and the magnitude of that anxiety. PAYS results did not
indicate great increases in many symptoms of depression or some suicidal ideations;
however, PAYS results indicated a significant minority having negative feelings. This
research study could not identify if the respondents of those groups were the same
individuals or not. Ultimately, the study identified the pandemic induced source of mental
health challenges as the survey-measured heightened anxiety confirmed by guidance
counselors’ observations. That heightened anxiety probably exacerbated student
responses to bullying, cyber-bullying, depressive symptoms, and suicidal ideations, and
this may have driven the increase in self-harm.
In the final chapter, the researcher will present a series of conclusions resultant
from the study, a discussion of the limitations of the study, and several recommendations

MENTAL HEALTH
for future research. As was the case, and is the case, with studies of this kind, its focus
was to answer its research questions. Throughout that process several additional
questions arose concerning relationships within the data which were unclear to the
researcher but could certainly provide fertile and important directions for future study.

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MENTAL HEALTH
Chapter Five
Conclusions and Recommendations
The impetus for this research was to understand the effects the coronavirus
pandemic had upon the mental health of middle school students in the three middle
schools of northern Dauphin County. The researcher utilized the results of the 2021
Pennsylvania Youth Survey, PAYS, and interviews with the middle school guidance
counselors verified through member checking; then summarized those three interviews
and distributed that summary to the guidance counselors, the middle school principals,
and the school district superintendents. All agreed with the summary.
As noted, the impact of the pandemic upon students’ academic skills was
quantifiable through curriculum-based assessments and standardized tests. The impact

upon students’ mental health was less discernable. Through analysis of PAYS, a student
self-reporting tool, and guidance counselor interviews, the researcher hypothesized that
an assessment of the coronavirus pandemic’s impact upon student mental health could be
ascertained, as well as a strategy for remediating that impact.
Given the necessity of anonymity for this study, the conclusions drawn were
general. PAYS data was anonymous, and neither race nor gender were disaggregated in
PAYS data. Likewise, in interviewing the guidance counselors, the researcher did not
request names of students, race, or gender. Overall, the guidance counselors’ impressions
were validated through PAYS data and vice versa. However, it is worthwhile to note that
the guidance counselors’ impressions were more emphatic because of the intensity of the
reports they received. This explained the minor disparity between some of the guidance
counselors’ reports and students’ self-reports.

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The research did determine that the coronavirus pandemic had an effect upon
middle school students’ mental health. Data noted in Chapter Three and Four taken from
Table 6 indicated that 61.3% of sixth graders and 63.2% of eighth graders either fell ill
with COVID-19 or a member of their immediate family contracted the virus. Moreover,
11.3% of sixth graders and 9.8% of eighth graders experienced a death in their immediate
family or circle of acquaintances. These shocks to impressionable minds were reflected in
increased anxiety experienced by 27.5% of sixth graders and 29.9% of eighth graders.
The guidance counselors reported that students stated they worried about catching the
virus and about bringing it home to their family members.
Although depressive symptoms were prevalent in middle school students in 2019
and 2021 in fairly equal proportions, as noted in Chapter Four in Tables 8 and 9, Table 9
also indicated a significant increase of symptoms among the students in the 2019 – 2021
cohort who were sixth graders in 2019 and then eighth graders in 2021. In that group
chronic sadness increased both in numbers, 20 in 2019 and 50 in 2021, and percentage,
16.6% in 2019 and 27.7% in 2021. The numbers considering and planning suicide also
increased significantly: those who considered suicide in 2019 numbered 13 or 10.16%
which grew to 28 in number, 15.6% in 2021, and those who planned suicide in 2019
numbered 12 or 9.37% which grew to 22 in number, 12.22% in 2021. The number of
individuals who reported multiple suicide attempts also increased in the 2019 – 2021
cohort, as did the number of attempts requiring medical intervention.
As noted in Chapter Four, Table 12, the most alarming numbers revealed through
PAYS data were the numbers of students engaging in self-harm and repeated suicide
attempts, six or more. The number of instances of self-harm increased dramatically both

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in number and frequency. This may have reflected the intensity of emotion the guidance
counselors witnessed. Also, among the members of the 2019 – 2021 cohort, the number
of individuals harming themselves increased from 11 in 2019 to 28 in 2021. Therefore,
although the total population of respondents reporting experiencing depressive symptoms
both in 2019 and 2021 was similar, the marked effect upon the 2019 – 2021 cohort
indicated the impact of the coronavirus pandemic.
The guidance counselors’ impressions testified to this conclusion. Although they
did not cite numbers, the counselors indicated the increase in self-harm, the increase in
depressive symptoms, and the increase in suicidal ideations reported to them.
Undoubtedly, the guidance counselors were also dramatically moved because these were
students they knew well: to a casual observer reading the percentages, the impacts may
have seemed slight; however, to the guidance counselors these were numbers of real
students they saw daily.
To reiterate, these are general conclusions supported by survey responses and the
impressions of guidance counselors. No matter how much students trust their counselors,
adults in school, it is doubtful that students report everything to the adults. This was
easily reflected in the number of students whose suicide attempts resulted in needed
medical attention. Over the course of time, the guidance counselors only knew of one
suicide attempt for certain – the one that succeeded.
Certainly, the coronavirus pandemic aggravated depressive symptoms and spurred
increased suicidal ideations among the respondents. However, it must be noted that
students experienced symptoms of depression and suicidal ideations before the pandemic.
Once again, this research study focused upon the effects of the pandemic; however, there

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were other causes of early adolescent malaise. Although most students showed a
commitment to school, gave their best efforts, valued learning, found schoolwork

meaningful and interesting, and enjoyed school, there was a persistent minority that took
the opposite view. Of note was that among the 2019 - 2021 cohort of respondents the
number responding negatively increased significantly over the years, and there is no
evidence tying this directly to the pandemic. It is possible that the increase could be due
to maturation, the cynicism that comes with age, the increased perception of academic
failure, or the reality of actual academic failure attributable to the increasing difficulty of
academics.
The guidance counselors indicated an increase in bullying; however, the numbers
did not dramatically increase as noted in Table 14. Table 14 summarizes the locations of
bullying and the instances. However, there were more individuals reporting bullying as
evinced in the difference of the 2019 and 2021 totals.
Table 14
Answers to the question, “Where were you bullied?”
All Respondents
2019

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n, %

n, %

n, %

n, %

n, %

n, %

I was not bullied
On school
property

86, 60.1%

83, 44.4%

105, 61.4%

130, 63.4%

86, 60.1%

130, 63.4%

37, 25.9%

64, 34.2%

32, 18.7%

39, 19%

37, 25.9%

39, 19%

At a school event

2, 1.4%

10, 5.3%

3, 1.7%

2, .97%

2, 1.4%

2, .97%

Going to or from

4, 2.8%

9, 4.8%

6, 3.5%

7, 3.4%

4, 2.8%

7, 3.4%

In the community

6, 4.2%

13, 6.9%

8, 4.7%

10, 4.9%

6, 4.2%

10, 4.9%

At home

8, 5.6%

8, 4.3%

17, 9.9%

17, 8.3%

8, 5.6%

17, 8.3%

143

187

171

205

143

205

Response

Total

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MENTAL HEALTH
Note. This table is for all respondents. Appendix D represents the tables for the three
schools and for all respondents. n is equal to the number of respondents, and % is the
percentage of the total.
The guidance counselors also reported more students complaining about cyber
bullying. Although the numbers shown in Table 15 for all respondents indicated no
increase in percentage, the numbers indicate a significant number of victims; hence, a
significant number of possible complaints.
Table 15
Instances of Cyber Bullying
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n

n

n

n

n

n

No!

4

89

80

86

104

89

104

no

3

22

37

35

44

22

44

yes

2

19

30

22

25

19

25

Yes!

1

5

10

11

8

5

8

135

157

154

181

135

181

24/135

40/157

33/154

33/181

24/135

33/181

17.80%

25.50%

21.40%

18.23%

17.80%

18.23%

Total
n/Total
Percent
yes

Note. The question posed was, “during the past twelve months, have you been bullied
through texting and/or social media?” This table is for all respondents. Appendix D
represents the tables for the three schools and for all respondents.
a

In “All Respondents,” Percent yes is the percentage of the total respondents responding

positively to the question.

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96

Again, it was noted there was a significant minority having negative experiences,
and neither the PAYS data nor the guidance counselors’ interviews could possibly
indicate any overlap in these groups.
As noted in Appendix E, the pandemic had no effect upon the PAYS criteria for
moral order. Student respondents overwhelmingly understood that stealing, lying,
cheating, and violence were wrong; however, in all categories there was a small minority
who approved, if slightly. The pandemic also had a negligible effect upon church
attendance, noted in Appendix H, which had been declining for years; however, it was
noted that mainline churches took worship online due to safety concerns, whereas many
evangelical churches held in-person services throughout the pandemic.
Appendix G documented respondents’ neighborhood attachment, which was also
unchanged by the pandemic. Most respondents were satisfied with their circumstances;
however, there was again a minority who were not. Appendix H displayed the number of
respondents who experienced family conflict, and there was also no marked increase in
those experiencing distress like yelling or arguing. However, there were significant
minorities who experienced family problems. To recur to Table 14, there was an increase
in bullying reported at home both from 2019 to 2021 and within the cohort, which may
be attributable to the quality of the home life. However, this increase could also be
attributable to respondents spending more time at home. Although more time at home
with family may have had positive effects for some students, the guidance counselors had
expressed reservations and indicated that there were some homes of suspect quality. Salt
et al. (2021) corroborated the guidance counselors’ impressions that abuse and
mistreatment increased.

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MENTAL HEALTH

Whether it be bullying or academic failure, the guidance counselors all noted that
when faced with adversity students showed an increased inclination to escape into online
schooling. Because of the pandemic necessitated retreat into online schooling, the
guidance counselors indicated that students found withdrawing from school into a cyber
school or their districts’ online programs more acceptable, despite the fact that they knew
they learned less online. Table 16 reflects this.
Table 16
Question: My learning improved when classes were taught online due to COVID-19.
All
Respondents
Grade 6
Response

Rating

n (nRating)

Grade 8
n
(nRating)

No!

4

30 (120)

52 (208)

no

3

33 (99)

21 (63)

yes

2

13 (26)

13 (26)

Yes!

1

3 (3)

8 (8)

Total

79 (248)

94 (305)

Mean

3.14

3.27

Note. This question applies only to 2021.
Again, there was a minority that preferred schooling online for what the guidance
counselors characterized as frivolous reasons. Students expressed that they didn’t want to
get out of bed, or get dressed, or that they wanted to go online just because they could do
so. The students’ escape did not produce increased achievement or learning. Data noted
in Chapter Three, Table 6 documented that during the pandemic almost fifty percent of
all students spent more time online playing online games. Undoubtedly, the fact that
during the pandemic parents saw their children online so much more made online
education a more acceptable alternative, even though the guidance counselors all

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MENTAL HEALTH
expressed that parents knew their children would not learn as well online. Guidance

counselors expressed that many parents bowed to their children’s demands to go to online
schooling simply to stop their children’s complaining.
Ultimately, this research study found that in all the middle schools among all the
respondents there was a persistent minority; one of the guidance counselors called them
the “negative” minority. These students thought they were failures, were depressed,
expressed suicidal ideations, disliked their homelives, experienced distress in the home,
and many sought to escape into an alternative they plainly knew was not good for them.
Unfortunately, this research study cannot answer the question of who these students were.
Because of the anonymity of the study, it is impossible to determine if this minority is the
same group with similar characteristics or individuals distributed among the populations.
Another negative trait some of these individuals may share is sleep deprivation. Table 17
documents the amount of sleep respondents self-reported. There is a significant minority
that may be sleep deprived which could aggravate depressive symptoms.
Table 17
Amount of Sleep Nightly
All Respondents
2019

Cohort

2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

<4

7

15

7

15

7

15

5

5

13

6

15

5

15

6

7

22

13

26

7

26

7

21

33

19

42

21

42

8

43

46

54

62

43

62

9

33

13

37

16

33

16

10+

10

7

11

4

10

4

Total
Percentage 6 or
less

126

149

145

180

126

180

15%

33.56%

17.93%

31.11%

15%

31.10%

Hours per night

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99

Recurring to Chapter Two, Review of the Literature, the researcher must note that
this minority observed having depressive symptoms and suicidal ideations was described
by Hazen et al. (2010) who noted that 12% of children and adolescents suffer from a
psychiatric malady impairing their function, 14% have suicidal ideations, and 7%
attempted suicide (p.1). Reisz (2013) noted that low socioeconomic status can aggravate
these conditions. For the three school districts in 2020, census poverty among five-to
seventeen-year-old children was 8.9% for Halifax Area, 13.66% for Millersburg Area,
and 13.68% for Upper Dauphin Area (PDE, June 17, 2023). Given these data and
numbers, one may be disposed to consider the mental duress evinced in the northern
Dauphin County middle school students to be normal; however, to those who know these
young people, this type of conclusion is unacceptable and fails to recognize the students’
needs.
Fiscal Implications
The pandemic and subsequent reporting have removed some of the stigma of
mental illness; therefore, the three middle schools and the three districts need to seize the
opportunity to take measures to improve mental health awareness and educate students,
staff, faculty, and the community to the importance of good mental health. This should be
done through social media, print media, district websites, and outreach. Also, all three
districts have access to the same Student Assistance Program providers, intermediate unit
resources, online trainings, and in-service time which can be used to provide ongoing
redundant training. There is no reason not to do so. The cost of services should be
minimal. Students and teachers already have time built into their schedules; however,
support staff do not. There would be a cost for substitute staff to free regular employees

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100

to train. Hopefully, the districts will start the new year with enough substitutes on their
rosters. It would not be unreasonable to require each district to devote twenty days of
substitute time which would allow substitutes to rotate through district buildings to spell
regular employees. The cost estimate would be $4000 per district.
As noted previously, the shocking size of the number of students needing
intervention must engender action from the school districts. Undoubtedly, the most
effective way to counsel students is to have more adults available to do so. Kamenetz
(2022) refers to this as “healing by listening” (288). The redundant mental health
training will serve to make more adults able counselors; however, there is no substitute
for trained guidance counselors. Given the districts’ average salaries and benefits costs, if
each district were to hire an additional counselor the cost would be an estimated
$140,000 with benefits. Also, all three districts have social workers, but two districts
share a social worker. Having three discrete social workers and an additional shared
social worker would be helpful. Depending upon how this was contracted, the cost would
be $150,000. All the districts already budget training, and they already budget substitutes.
Personnel additions would be the biggest upfront expenses; however, these could easily
be one-time costs as all three districts’ enrollments are contracting, so the districts may be
able to pay for these additional personnel over time through attrition, as teachers retire
and are not replaced. Although it is highly unlikely that the three districts could come to
agreement to share some administrators, the districts may be able to save money by
employing one curriculum director for the three districts.

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101

Limitations
It cannot be overstated that this research is a study of the coronavirus pandemic’s
effect upon middle school student mental health. In the course of the data analysis, the
researcher found that depressive symptoms and suicidal ideations had been present in
these middle school populations for years. As the researcher was a superintendent from
almost the beginning of the Pennsylvania Youth Survey, PAYS, the researcher had access
to the earliest data, and the researcher noted that from the start of the survey there has
been a concern for cyber bullying. Cyber bullying takes place online. When the
researcher was an assistant principal and principal before PAYS in the early part of the
twenty-first century, reports came to the office of cyber bullying through an early form of
social media – Myspace. After the advent of PAYS, there is a steady escalation of reports
of cyber bullying through social media and increases in depressive symptoms and
suicidal ideations. This research study did not seek to investigate the link between social
media and mental health. Concomitant to the rise of social media is its platform, the
cellular phone, which has evolved into a handheld computer, the power of which cannot
be understated. This study did not seek to investigate the link between cellular phone
usage and mental health.
Due to the anonymity employed in the study, the researcher could not investigate
any of the pandemic’s effects particular to race or gender. Also, anonymity made it
impossible to determine if the members of the minorities showing mental health effects
were the same individuals. As the study was limited to PAYS, the researcher did not
investigate some of the possible effects noted in the guidance counselor’s interviews,

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102

such as the effect upon additional family dynamics, the effect of the pandemic upon
siblings, and effects upon student resilience.
The researcher did not attempt to determine the effect of the backlash against
masking, although all the guidance counselors witnessed it as did the researcher. There
were no PAYS questions specifically about parents or other adults’ attitudes toward
masking, and the impact of those attitudes upon students. However, it was witnessed by
all that there was an extremely vocal minority that refused to wear masks, put signs on
their lawns, showed up at school board meetings, intimidated school board members, and
sought to demonize masking. An unfortunate byproduct of this was the alienation of that
vocal minority from the majority of the school community, including the students. Given
the measures the schools took which teachers and students followed only to have their
actions vilified by some, the resulting animosity is understandable.
Future Research
Over time there will be an increasing amount of research devoted to the
coronavirus pandemic, its impact upon student academics, its impact upon mental health,
and remediation strategies meant to ameliorate the academic effects and mental health
effects of extended school closures. Kamenetz (2022) refers to this period as a “stolen
year,” which is the title of her book. Approximately 45% of Northern Dauphin County
middle school students spent more time online. Kamenetz notes that the effect of
increased screen time may aggravate symptoms in those predisposed to anxiety and
depression and that “screen use after dark can disrupt sleep, and poor sleep can contribute
to mental health problems” (273). The effect of this screen time must be studied.

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103

Undoubtedly, there must be future research devoted to the effect of the cellular
telephone on mental health and the effect of social media upon mental health.
Unfortunately, these genies have escaped the bottle. Nonetheless, research may unveil
ways to limit or sanitize cellular telephone use and remove the fangs of social media.
There seems to be a bipartisan political consensus coalescing around the necessity to
regulate social media; however, as of this writing no one has answered the question,
“How?” satisfactorily.
There must also be research attendant upon the publicizing and education about
mental health to continually reduce the stigma surrounding it. It is common knowledge
that the junior United States Senator from Pennsylvania, John Fetterman, voluntarily
committed himself to Walter Reed National Military Medical Center for treatment of
depression and underwent that treatment for six weeks. Senator Fetterman received
considerable support from colleagues across the political spectrum; however, some
partisans chose to attack him on specious grounds, mostly having to do with him being
paid for not working. This type of shallow reaction should become moribund, and the
foregrounding of the importance of mental health treatment will hopefully lead to greater
acceptance of sick leave for that treatment.
Increased awareness of mental health’s importance should engender a push to
train more mental health professionals as well as raising awareness among the general
population. Kamenetz noted that “in 2019 there were just 8300 practicing child and
adolescent psychiatrists in the United States for an estimated fifteen million children and
adolescents who could have used their help” (276).

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104

There must be greater research analyzing and defining resilience and how it may
be promoted among students. Students need to be more involved in their own
development; however, it was the general belief of the guidance counselors that students
needed adults to guide them. The counselors felt that the main reason cyber schools and
online schooling generally produced poorer results was because students in middle school
were unable to self-regulate.
Finally, there must be greater study of the effectiveness of online learning. For
older, self-directed learners, rigorous online learning works; however, children are
generally not self-directed. There must be increased scrutiny of cyber schooling and
school district online programs to gauge both achievement and mental health effects.
Summary
This research study showed that the coronavirus pandemic had a demonstrated
effect upon student mental health. As the middle school was originally organized to better
serve early adolescents’ social and emotional development as well as academics, this
study indicated the necessity for greater emphasis upon mental health. Good mental
health must be taught in an age-appropriate fashion to students. They must be aware of
the symptoms of depression and be willing to approach the adults in their lives with their
feelings and concerns. Students, staff, teachers, and administrators must receive ongoing
redundant training in mental health to foreground its importance. This emphasis and
training are possible in all the school districts of northern Dauphin County. Early
adolescence is a time of change, and puberty can be confounding and confusing for many
students. Schools can help to cushion the blows through education and assuring that
caring personnel are in place who daily interact with students.

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Although this research study did not address the effects of social media and the
cellular telephone, the two have a decided effect upon the lives of early adolescents. The
school district and personnel must offer understanding to counterbalance the malignant
influences channeled through the cellular telephones from social media, particularly
hypercritical views of body image and personal taste. Schools and personnel must also
promote personal interactions between students and students and adults, without
electronic devices. Too often electronic devices, cellular telephones particularly, have
replaced personal interaction, conversation.
Schools and districts must reach out to the community and promote mental health
awareness, for students and adults alike. Schools and districts must reach out to parents
through school events, social media, websites, and mailings to improve not only mental
health awareness but also trust. Parents and families must recognize that schools intend to
help and will work with parents to help children succeed. An important component of this
is promoting parents’ understanding that their children’s teachers and principals have no
magical powers of cognition – they don’t know everything a child does every day, they
don’t see every interaction children have with each other, and there are many things they
do not know unless the children or their parents tell them.
All reasonable people must do what they can to honor the views of others;
however, during the coronavirus pandemic the actions of a vocal minority opposed to
masking and other strategies to combat the virus harmed community unity, cheapening
the actions of the schools to limit the spread of the coronavirus and keep students and
their families healthy and keep students in school. The actions of that minority need to be
portrayed for what they were. Probably, that vocal minority will not change; therefore,

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106

the majority must find a way to move on and respect the better angels of human nature,
agreeing to politely disagree.
As horrible as the pandemic was in its toll of sickness, death, and effects on
mental health, it is incumbent upon those who have passed through its crucible to learn
from the experience and to do better. Schools, districts, communities, states, and the
nation can regroup. The greatest task is to raise awareness and educate, and this is within
our power.

107

MENTAL HEALTH
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Salt, E., Wiggins, A. T., Cooper, G. L., Benner, K., Adkins, B. W., Hazelbaker, K., &
Rayens, M. K. (2021). A comparison of child abuse and neglect encounters before
and after school closings due to SARS-Cov-2. Child Abuse and Neglect, 118, 1-7.
https://doi.org/ 10.1016/j.chiabu.2021.105132
Smith, P. K. & Brain, P. (2000). Bullying in schools: Lessons from two decades of
research. Aggressive Behavior, 26(1), 1-9. https://doi.org/10.1002/(SICI)/10982337(2000)26:1<1::AID-AB1>3.0CO;2-7
StateUniversity.com. (2022). Middle schools: The Emergence of Middle Schools, Growth
and Maturation of the Middle School Movement.
https://education.stateuniversity.com/pages/2229/Middle-Schools.html

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114

Styx, L. (2022). States are now accepting “mental health day” as a valid reason for
missing school. Mental Health News. https://www.verywellmind.com/thegrowing-acceptance-of-mental-health-days-for-students-5199076
United States Census Bureau. (2023a). 2012-2016 ACS 5-year estimates.
https://www.census.gov/programs-surveys/acs/technical-documentation/tableand-geography-changes/2016/5-year.html
United States Census Bureau. (2023b). Economic surveys: All sectors: County business
patterns, including zip code business patterns, by legal form of organization and
employer.
https://data.census.gov/table?q=Dauphin+County,+Pennsylvania+Business+and+
Economy&tid=CBP2020.CB2000CBP
Upper Dauphin Area School District. (2023). [Unpublished raw data of the local school
district census].
Vestal, C. (2021). COVID harmed kids’ mental health—and schools are feeling it.
Stateline. https://www.pewtrusts.org/en/research-andanalysis/blogs/stateline/2021/11/08/covid-harmed-kids-mental-health-andschools-are-feeling-it
Walters, G. D., Renell, L., & Kremser, J. (2021). Social and psychological effects of the
covid-19 pandemic on middle-school students: Attendance options and changes
over time. School Psychology, 36(5), 277-284.
https://doi.org/10.1037/spq0000438

115

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Appendices

116

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Appendix A
Institutional Review Board Approval

Institutional Review Board
250 University Avenue
California, PA 15419
instreviewboard@calu.edu
Melissa Sovak, Ph.D.

Dear Evan,
Please consider this email as official notification that your proposal
titled “The Coronavirus Pandemic's Impact on Middle School
Students' Mental Health” (Proposal #PW22-009) has been approved
by the Pennsylvania Western University Institutional Review Board as
submitted.
The effective date of approval is 09/08/2022 and the expiration date is
09/07/2023. These dates must appear on the consent form.
Please note that Federal Policy requires that you notify the IRB
promptly regarding any of the following:
(1) Any additions or changes in procedures you might wish for your
study (additions or changes must be approved by the IRB before they
are implemented)
(2) Any events that affect the safety or well-being of subjects
(3) Any modifications of your study or other responses that are
necessitated by any events reported in (2).
(4) To continue your research beyond the approval expiration date of
09/07/2023, you must file additional information to be considered for
continuing review. Please contact instreviewboard@calu.edu

MENTAL HEALTH

Please notify the Board when data collection is complete.
Regards,
Melissa Sovak, PhD.
Chair, Institutional Review Board

117

118

MENTAL HEALTH
Appendix B
Guidance Counselor Survey

All these questions pertain to the 21-22 school year. Most follow-ups request the counselor
compare 21-22 to the pre-pandemic year. Please remember to speak generally and avoid specific
cases.
1. How many students did you, teachers, or administrators identify as risks for self-harm?
Or were already harming themselves?
a. How do these numbers compare to the pre-pandemic year?
2. How many students were identified, self-identified or spotted by adults, as being
depressed?
a. How do these numbers compare to the pre-pandemic year?
3. How many students were identified as having suicidal ideations?
a. How do these numbers compare to the pre-pandemic year?
4. How many students reported bullying out of school?
a. How do these numbers compare to the pre-pandemic year?
5. How many students reported bullying in school?
a. How do these numbers compare to the pre-pandemic year?
6. How many students reported getting attacked at school? In the community?
a. How do these numbers compare to the pre-pandemic year?
7. How many students reported attacking another person in school? Or in the community?
a. How do these numbers compare to the pre-pandemic year?
8. How many students reported problems at home?
a. How do these numbers compare to the pre-pandemic year?
9. How many students required grief counseling?
a. How do these numbers compare to the pre-pandemic year?
10. How many students expressed dissatisfaction with school?
a. How do these numbers compare to the pre-pandemic year?

MENTAL HEALTH
11. How many students expressed worrisome thoughts specifically tied to COVID 19?
a. How do these numbers compare to the pre-pandemic year?
12. How many students reported they preferred online learning?
a. How do these numbers compare to the pre-pandemic year?
b. Generally, what were their reasons?

119

120

MENTAL HEALTH
Appendix C
Depressive Symptoms Statistics Tables
Table C1.
Have you felt depressed or sad most days?
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

30 (120)

23 (92)

34 (136)

No!

4

32 (128)

no

3

16 (48)

16 (48)

12 (36)

15 (45)

16 (48)

15 (45)

yes

2

12 (24)

9 (18)

11 (22)

11 (22)

12 (24)

11 (22)

Yes!

1

5 (5)

11 (11)

6 (6)

3 (3)

5 (5)

3 (3)

Total

65 (205)

66 (197)

52 (156)

63 (206)

65 (205)

63 (206)

Mean

3.15

2.98

3

3.27

3.15

3.27

Rating

MAMS
2019

Response

32 (128)

34 (136)

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

14 (56)

17 (68)

17 (68)

20 (80)

14 (56)

20 (80)

no

3

8 (24)

12 (36)

12 (36)

9 (27)

8 (24)

9 (27)

yes

2

9 (18)

8 (16)

10 (20)

11 (22)

9 (18)

11 (22)

Yes!

1

6 (6)

13 (13)

2 (2)

12 (12)

6 (6)

12 (12)

Total

37 (104)

50 (133)

41 (126)

52 (141)

37 (104)

52 (141)

Mean

2.81

2.66

3.07

2.71

2.81

2.71

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

27 (108)

26 (104)

26 (104)

21 (84)

27 (108)

21 (84)

no

3

20 (60)

13 (39)

16 (48)

16 (48)

20 (60)

16 (48)

yes

2

20 (40)

18 (36)

10 (20)

18 (36)

20 (40)

18 (36)

Yes!

1

7 (7)

25 (25)

10 (10)

7 (7)

7 (7)

7 (7)

Total

74 (215)

82 (204

62 (182)

62 (175)

74 (215)

62 (175)

Mean

2.9

2.49

2.93

2.82

2.9

2.82

121

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

73 (292)

73 (292)

66 (264)

75 (300)

73 (292)

75 (300)

no

3

44 (132)

41 (123)

40 (120)

40 (120)

44 (132)

40 (120)

yes

2

41 (82)

35 (70)

31 (62)

40 (80)

41 (82)

40 (80)

Yes!

1

18 (18)

49 (49)

18 (18)

22 (22)

18 (18)

22 (22)

Total

176 (524)

198 (534)

155 (464)

177 (522)

176 (524)

177

Mean

2.98

2.7

3

2.95

2.98

2.95

% yes, Yes!

33%

42%

31.60%

35%

33%

35%

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.
a

In “All Respondents,” %yes, Yes! is the percentage of the total respondents responding

positively to the question.

122

MENTAL HEALTH
Table C2.
Sometimes I think that life is not worth it.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

40 (160)

31 (124)

45 (180)

No!

4

40 (160)

no

3

15 (45)

8 (24)

5 (15)

11 (33)

15 (45)

11 (33)

yes

2

8 (16)

11 (22)

9 (18)

5 (10)

8 (16)

5 (10)

Yes!

1

2 (2)

6 (6)

6 (6)

2 (2)

2 (2)

2 (2)

Total

65 (223)

65 (212)

51 (163)

63 (225)

65 (223)

63 (225)

Mean

3.43

3.26

3.2

3.57

3.43

3.57

Rating

MAMS
2019

Response

40 (160)

45 (180)

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

23 (92)

22 (88)

25 (100)

27 (108)

23 (92)

27 (108)

no

3

7 (21)

10 (30)

10 (30)

14 (42)

7 (21)

14 (42)

yes

2

4 (8)

10 (20)

4 (8)

7 (14)

4 (8)

7 (14)

Yes!

1

3 (3)

9 (9)

3 (3)

5 (5)

3 (3)

5 (5)

Total

37 (123)

51 (147)

42 (141)

53 (169)

37 (123)

53 (169)

Mean

3.32

2.88

3.36

3.19

3.32

3.19

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

42 (168)

37 (141)

28 (112)

26 (104)

42 (168)

26 (104)

no

3

16 (48)

11 (33)

14 (52)

17 (51)

16 (48)

17 (51)

yes

2

11 (22)

22 (44)

13 (26)

14 (28)

11 (22)

14 (28)

Yes!

1

5 (5)

10 (10)

6 (6)

5 (5)

5 (5)

5 (5)

Total

74 (243)

80 (228)

61 (196)

62 (188)

74 (243)

62 (188)

Mean

3.28

2.85

3.21

3.03

3.28

3.03

123

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

105 (420)

99 (396)

84 (336)

98 (392)

105 (420)

98 (392)

no

3

38 (114)

29 (87)

29 (87)

42 (126)

38 (114)

42 (126)

yes

2

23 (46)

43 (86)

26 (52)

26 (52)

23 (46)

26 (52)

Yes!

1

10 (10)

25 (25)

15 (15)

12 (12)

10 (10)

12 (12)

Total

176 (590)

196 (594)

154 (490)

178 (582)

176 (590)

178 (582)

Mean

3.35

3.03

3.14

3.27

3.35

3.27

18.75%

34.70%

26.60%

21.35%

18.75%

21.35%

% yes, Yes!

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.
a

In “All Respondents,” %yes, Yes! is the percentage of the total respondents responding

positively to the question.

124

MENTAL HEALTH
Table C3.
At times, I think I am no good at all.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

32 (128)

25 (100)

39 (156)

No!

4

31 (124)

no

3

15 (45)

7 (21)

7 (21)

12 (36)

15 (45)

12 (36)

yes

2

14 (28)

15 (30)

13 (26)

10 (20)

14 (28)

10 (20)

Yes!

1

5 (5)

12 (12)

7 (7)

2 (2)

5 (5)

2 (2)

Total

65 (202)

66 (191)

52 (154)

63 (214)

65 (202)

63 (214)

Mean

3.11

2.89

2.96

3.4

3.11

3.4

Rating

MAMS
2019

Response

31 (124)

39 (156)

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

16 (64)

16 (64)

22 (88)

24 (96)

16 (64)

24 (96)

no

3

7 (21)

13 (39)

9 (27)

9 (27)

7 (21)

9 (27)

yes

2

9 (18)

10 (20)

5 (10)

11 (22)

9 (18)

11 (22)

Yes!

1

6 (6)

12 (12)

6 (6)

9 (9)

6 (6)

9 (9)

Total

38 (109)

51 (135)

42 (131)

53 (154)

38 (109)

53 (154)

Mean

2.87

2.65

3.12

2.91

2.87

2.91

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

25 (100)

30 (120)

26 (104)

21 (84)

25 (100)

21 (84)

no

3

25 (75)

12 (36)

11 (33)

16 (48)

25 (75)

16 (48)

yes

2

17 (34)

24 (48)

16 (32)

20 (40)

17 (34)

20 (40)

Yes!

1

7 (7)

16 (16)

9 (9)

5 (5)

7 (7)

5 (5)

Total

74 (216)

82 (220)

62 (178)

62 (177)

74 (216)

62 (177)

Mean

2.92

2.68

2.87

2.85

2.92

2.85

125

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

72 (288)

78 (312)

73 (292)

84 (336)

72 (288)

84 (336)

no

3

47 (141)

32 (96)

27 (81)

37 (111)

47 (141)

37 (111)

yes

2

40 (80)

49 (98)

34 (68)

41 (82)

40 (80)

41 (82)

Yes!

1

18 (18)

40 (40)

22 (22)

16 (16)

18 (18)

16 (16)

Total

177 (527)

199 (546)

156 (463)

178 (545)

177 (527)

178 (545)

Mean

2.98

2.74

2.97

3.06

2.98

3.06

32.77%

44.72%

35.90%

32.02%

32.77%

32.02%

% yes, Yes!

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.
a

In “All Respondents,” %yes, Yes! is the percentage of the total respondents responding

positively to the question.

126

MENTAL HEALTH
Table C4.
All in all, I am inclined to think I am a failure.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

35 (140)

30 (120)

44 (176)

No!

4

40 (160)

no

3

18 (52)

9 (27)

5 (15)

14 (42)

18 (52)

14 (42)

yes

2

6 (12)

11 (22)

12 (24)

3 (6)

6 (12)

3 (6)

Yes!

1

2 (2)

11 (11)

4 (4)

2 (2)

2 (2)

2 (2)

Total

66 (226)

66 (200)

51 (163)

63 (226)

66 (226)

63 (226)

Mean

3.42

3.03

3.2

3.59

3.42

3.59

Rating

MAMS
2019

Response

40 (160)

44 (176)

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

24 (96)

24 (96)

23 (92)

27 (108)

24 (96)

27 (108)

no

3

6 (18)

11 (33)

11 (33)

11 (33)

6 (18)

11 (33)

yes

2

4 (8)

10 (20)

6 (12)

7 (14)

4 (8)

7 (14)

Yes!

1

4 (4)

6 (6)

1 (1)

8 (8)

4 (4)

8 (8)

Total

38 (126)

51 (155)

41 (138)

53 (163)

38 (126)

53 (163)

Mean

3.32

3.04

3.37

3.07

3.32

3.07

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

37 (148(

36 (144)

30 (120)

28 (112)

37 (148(

28 (112)

no

3

24 (72)

19 (57)

16 (48)

21 (63)

24 (72)

21 (63)

yes

2

7 (14)

13 (34)

8 (16)

8 (16)

7 (14)

8 (16)

Yes!

1

5 (5)

9 (9)

8 (8)

5 (5)

5 (5)

5 (5)

Total

73 (239)

81 (244)

62 (192

62 (196)

73 (239)

62 (196)

Mean

3.27

3.01

3.1

3.16

3.27

3.16

127

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

101 (404)

95 (380)

83 (332)

99 (396)

101 (404)

99 (396)

no

3

48 (142)

39 (116)

32 (96)

46 (138)

48 (142)

46 (138)

yes

2

17 (34)

34 (68)

26 (52)

18 (36)

17 (34)

18 (36)

Yes!

1

11 (11)

26 (26)

13 (13)

15 (15)

11 (11)

15 (15)

Total

177 (591)

194 (590)

154 (493)

178 (585)

177 (591)

178 (585)

Mean

3.34

3.04

3.2

3.29

3.34

3.29

15.82%

30.93%

25.32%

18.54%

15.82%

18.54%

% yes, Yes!

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.
a

In “All Respondents,” %yes, Yes! is the percentage of the total respondents responding

positively to the question.

128

MENTAL HEALTH
Appendix D
Bullying Statistics Tables
Table D1
Internet and Social Media Bullying
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

46 (184)

38 (152)

37 (148)

40 (160)

46 (184)

40 (160)

no

3

6 (18)

16 (48)

6 (18)

12 (36)

6 (18)

12 (36)

yes

2

9 (18)

10 (20)

5 (10)

9 (18)

9 (18)

9 (18)

Yes!

1

3 (3)

3 (3)

3 (3)

3 (3)

3 (3)

3 (3)

Total

64 (223)

67 (223)

51 (179)

64 (217)

64 (223)

64 (217)

Mean

3.48

3.33

3.51

3.39

3.48

3.39

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

14 (56)

19 (76)

21 (84)

31 (124)

14 (56)

31 (124)

no

3

4 (12)

8 (24)

11 (33)

15 (45)

4 (12)

15 (45)

yes

2

4 (8)

8 (16)

5 (10)

6 (12)

4 (8)

6 (12)

Yes!

1

1 (1)

0

2 (2)

1 (1)

1 (1)

1 (1)

Total

23 (77)

35 (116)

39 (129)

53 (182)

23 (77)

53 (182)

Mean

3.35

3.31

3.31

3.43

3.35

3.43

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

29 (116)

23 (92)

28 (112)

33 (132)

29 (116)

33 (132)

no

3

12 (36)

13 (39)

18 (54)

17 (51)

12 (36)

17 (51)

yes

2

6 (12)

12 (24)

12 (24)

10 (20)

6 (12)

10 (20)

Yes!

1

1 (1)

7 (7)

6 (6)

4 (4)

1 (1)

4 (4)

Total

48 (165)

55 (162)

64 (196)

64 (207)

48 (165)

64 (207)

Mean

3.44

2.94

3.06

3.23

3.44

3.23

129

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

89 (356)

80 (320)

86 (344)

104 (416)

89 (356)

104 (416)

no

3

22 (66)

37 (111)

35 (105)

44 (132)

22 (66)

44 (132)

yes

2

19 (38)

30 (60)

22 (44)

25 (50)

19 (38)

25 (50)

Yes!

1

5 (5)

10 (10)

11 (11)

8 (8)

5 (5)

8 (8)

Total

135 (465)

157 (501)

154 (504)

181 (606)

135 (465)

181 (606)

Mean

3.44

3.19

3.27

3.35

3.44

3.35

Note. The question asked was as follows: “During the last 12 months, have you been
bullied through texting and social media?” The abbreviations used for the schools are as
follows: HAMS is Halifax Area Middle School, MAMS is Millersburg Area Middle
School, and UDAMS is Upper Dauphin Area Middle School.

130

MENTAL HEALTH
Table D2.
Where were you bullied?
HAMS
2019
Grade 6
Response

Cohort
2021

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n, %

n, %

n, %

n, %

n, %

n, %

I was not bullied.

37, 54%

36, 43%

31, 56.4%

44, 55.7%

37, 54%

44, 55.7%

On school property

22, 32%

28, 33.7%

15, 27.3%

18, 22.8%

22, 32%

18, 22.8%

At a school event

0

5, 4%

2, 3.6%

2, 2.5%

0

2, 2.5%

Going to or from

1, 1.4%

5, 4%

0

3, 3.8%

1, 1.4%

3, 3.8%

In the community

4, 5.9%

3, 3.6%

2, 3.6%

5, 6.3%

4, 5.9%

5, 6.3%

At home

4, 5.9%

6, 7.2%

5, 9.1%

7, 8.8%

4, 5.9%

7, 8.8%

68

83

55

79

68

79

Total

MAMS
2019

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n, %

n, %

n, %

n, %

n, %

n, %

I was not bullied.

13, 52%

23, 56%

30, 68.2%

44, 80%

13, 52%

44, 80%

On school property

6, 24%

10, 24.4%

5, 11.4%

7, 12.7%

6, 24%

7, 12.7%

At a school event

1, 4%

1, 2.4%

1, 2.3%

0

1, 4%

0

Going to or from

0

1, 2.4%

4.60%

0

0

0

In the community

2, 8%

2, 4.9%

0

1, 1.8%

2, 8%

1, 1.8%

At home

3, 12%

4, 9.8%

6, 13.6%

3, 5.4%

3, 12%

3, 5.4%

25

41

44

55

25

55

Response

Total

UDAMS
2019

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n, %

n, %

n, %

n, %

n, %

n, %

I was not bullied.

36, 72%

24, 33.8%

44, 61.1%

42, 59.1

36, 72%

42, 59.1%

On school property

9, 18%

26, 36.6%

12, 16.7%

14, 19.7

9, 18%

14, 19.7%

At a school event

1, 2%

4, 5.6%

0

0

1, 2%

0

Going to or from

3, 6%

3, 4.2%

4, 5.6%

4, 5.6%

3, 6%

4, 5.6%

In the community

0

8, 11.3%

6, 8.3%

4, 5.6%

0

4, 5.6%

1, 2%

6, 8.4%

6, 8.3%

7, 9.9%

1, 2%

7, 9.9%

50

71

72

71

50

71

Response

At home
Total

131

MENTAL HEALTH
All Respondents
2019

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n, %

n, %

n, %

n, %

n, %

n, %

I was not bullied.
On school
property

86, 60.1%

83, 44.4%

105, 61.4%

130, 63.4%

86, 60.1%

130, 63.4%

37, 25.9%

64, 34.2%

32, 18.7%

39, 19%

37, 25.9%

39, 19%

At a school event

2, 1.4%

10, 5.3%

3, 1.7%

2, .97%

2, 1.4%

2, .97%

Going to or from

4, 2.8%

9, 4.8%

6, 3.5%

7, 3.4%

4, 2.8%

7, 3.4%

In the community

6, 4.2%

13, 6.9%

8, 4.7%

10, 4.9%

6, 4.2%

10, 4.9%

At home

8, 5.6%

8, 4.3%

17, 9.9%

17, 8.3%

8, 5.6%

17, 8.3%

143

187

171

205

143

205

Response

Total

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

132

MENTAL HEALTH
Appendix E
Moral Order Statistics Tables
Table E1.

I think it is okay to take something without asking as long as you get away with it.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

52 (208)

45 (180)

41 (164)

49 (196)

52 (208)

49 (196)

no

3

6 (18)

19 (57)

8 (24)

10 (30)

6 (18)

10 (30)

yes

2

0

2 (4)

1 (2)

0

0

0

Yes!

1

0

0

0

0

0

0

Total

58 (226)

49 (241)

50 (190)

59 (226)

58 (226)

59 (226)

Mean

3.89

3.77

3.8

3.83

3.89

3.83

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

30 (120)

30 (120)

30 (120)

32 (128)

30 (120)

49 (196)

no

3

6 (18)

18 (54)

8 (24)

18 (54)

6 (18)

10 (30)

yes

2

0

1 (2)

1 (2)

1 (2)

0

0

Yes!

1

0

0

0

0

0

0

Total

36 (138)

49 (176)

39 (146)

51 (184)

36 (138)

59 (226)

Mean

3.83

3.59

3.74

3.61

3.83

3.83

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

65 (260)

61 (244)

47 (188)

42 (168)

65 (260)

42 (168)

no

3

7 (21)

20 (60)

11 (33)

17 (51)

7 (21)

17 (51)

yes

2

1 (2)

2 (4)

2 (4)

2 (4)

1 (2)

2 (4)

Yes!

1

0

0

1 (1)

0

0

0

Total

73 (283)

83 (308)

61 (226)

61 (223)

73 (283)

61 (223)

Mean

3.88

3.71

3.7

3.66

3.88

3.66

133

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

147 (588)

136 (544)

118 (472)

123 (492)

147 (588)

123 (492)

no

3

19 (57)

57 (171)

27 (81)

45 (135)

19 (57)

45 (135)

yes

2

1 (2)

5 (10)

4 (2)

3 (6)

1 (2)

3 (6)

Yes!

1

0

0

1 (1)

0

0

0

Total

167 (647)

198 (725)

150 (556)

171 (627)

167 (647)

171 (627)

Mean

3.87

3.66

3.71

3.67

3.87

3.67

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

134

MENTAL HEALTH
Table E2.
It is alright to beat people up if they start the fight.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

35 (140)

26 (104)

26 (104)

35 (140)

35 (140)

35 (140)

no

3

13 (39)

15 (45)

17 (51)

12 (36)

13 (39)

12 (36)

yes

2

5 (10)

14 (28)

6 (12)

9 (18)

5 (10)

9 (18)

Yes!

1

4 (4)

11 (11)

1 (1)

2 (2)

4 (4)

2 (2)

Total

57 (193)

66 (188)

50 (168)

58 (196)

57 (193)

58 (196)

Mean

3.39

2.85

3.36

3.38

3.39

3.38

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

17 (68)

14 (56)

23 (92)

11 (44)

17 (68)

11 (44)

no

3

10 (30)

14 (42)

9 (27)

21 (63)

10 (30)

21 (63)

yes

2

5 (10)

11 (22)

4 (8)

14 (28)

5 (10)

14 (28)

Yes!

1

2 (2)

9 (9)

3 (3)

4 (4)

2 (2)

4 (4)

Total

34 (110)

48 (129)

39 (130)

50 (139)

34 (110)

50 (139)

Mean

3.23

2.69

3.33

2.78

3.23

2.78

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

43 (172)

17 (68)

23 (92)

27 (108)

43 (172)

27 (108)

no

3

17 (51)

28 (84)

17 (51)

13 (39)

17 (51)

13 (39)

yes

2

10 (20)

26 (52)

12 (24)

15 (30)

10 (20)

15 (30)

Yes!

1

3 (3)

12 (12)

9 (9)

6 (6)

3 (3)

6 (6)

Total

73 (246)

83 (216)

61 (176)

61 (183)

73 (246)

61 (183)

Mean

3.37

2.6

2.88

3

3.37

3

135

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

95 (380)

57 (228)

72 (288)

73 (292)

95 (380)

73 (292)

no

3

40 (120)

57 (171)

43 (129)

46 (138)

40 (120)

46 (138)

yes

2

20 (40)

51 (102)

22 (44)

38 (76)

20 (40)

38 (76)

Yes!

1

9 (9)

32 (32)

13 (13)

12 (12)

9 (9)

12 (12)

Total

164 (549)

197 (533)

150 (474)

169 (518)

164 (549)

169 (518)

Mean

3.35

2.71

3.16

3.06

3.35

3.06

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

136

MENTAL HEALTH
Table E3.
I think sometimes it's OK to cheat at school.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

47 (188)

34 (136)

39 (156)

44 (176)

47 (188)

44 (176)

no

3

10 (30)

19 (57)

10 (30)

15 (45)

10 (30)

15 (45)

yes

2

1 (2)

11 (22)

1 (2)

0

1 (2)

0

Yes!

1

0

1 (2)

0

0

0

0

Total

58 (220)

65 (217)

50 (188)

59 (221)

58 (220)

59 (221)

Mean

3.79

3.34

3.76

3.75

3.79

3.75

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

26 (104)

24 (96)

31 (124)

26 (109)

26 (104)

26 (109)

no

3

8 (24)

18 (54)

8 (24)

19 (57)

8 (24)

19 (57)

yes

2

1 (2)

7 (14)

0

6 (12)

1 (2)

6 (12)

Yes!

1

0

0

0

0

0

0

Total

35 (130)

49 (164)

39 (148)

51 (178)

35 (130)

51 (178)

Mean

3.71

3.35

3.79

3.49

3.71

3.49

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

51 (204)

43 (172)

34 (136)

37 (148)

51 (204)

37 (148)

no

3

15 (45)

29 (87)

21 (63)

15 (45)

15 (45)

15 (45)

yes

2

3 (6)

10 (20)

5 (10)

9 (18)

3 (6)

9 (18)

Yes!

1

0

0

1 (1)

0

0

0

Total

69 (255)

82 (279)

61 (210)

61 (211)

69 (255)

61 (211)

Mean

3.7

3.4

3.44

3.46

3.7

3.46

137

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

124 (496)

101(404)

104 (416)

107 (428)

124 (496)

107 (428)

no

3

33 (99)

66 (198)

39 (116)

49 (147)

33 (99)

49 (147)

yes

2

5 (10)

28 (56)

6 (12)

15 (30)

5 (10)

15 (30)

Yes!

1

0

1 (1)

1 (1)

0

0

0

Total

162 (605)

196 (659)

150 (545)

171 (605)

162 (605)

171 (605)

Mean

3.73

3.36

3.63

3.54

3.73

3.54

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

138

MENTAL HEALTH
Table E4.

It is important to be honest with your parents, even if they become upset or you get
punished.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

34 (136)

18 (72)

22 (88)

17 (68)

34 (136)

17 (68)

yes

3

12 (36)

21 (63)

10 (30)

19 (57)

12 (36)

19 (57)

no

2

2 (4)

7 (14)

2 (4)

4 (8)

2 (4)

4 (8)

No!

1

10 (10)

19 (19)

16 (16)

19 (19)

10 (10)

19 (19)

Total

58 (186)

65 (168)

50 (138)

59 (152)

58 (186)

59 (152)

Mean

3.21

2.58

2.76

2.58

3.21

2.58

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

20 (80)

20 (80)

22 (88)

18 (72)

20 (80)

18 (72)

yes

3

8 (24)

21 (63)

13 (39)

17 (51)

8 (24)

17 (51)

no

2

1 (2)

2 (4)

0

4 (8)

1 (2)

4 (8)

No!

1

3 (3)

5 (5)

4 (4)

9 (9)

3 (3)

9 (9)

Total

32 (111)

48 (152)

39 (131)

48 (140)

32 (111)

48 (140)

Mean

3.47

3.17

3.36

2.97

3.47

2.97

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

45 (180)

42 (168)

30 (120)

33 (132)

45 (180)

33 (132)

yes

3

13 (39)

35 (105)

14 (42)

15 (45)

13 (39)

15 (45)

no

2

3 (6)

2 (4)

6 (12)

6 (12)

3 (6)

6 (12)

No!

1

9 (9)

3 (3)

10 (10)

7 (7)

9 (9)

7 (7)

Total

70 (234)

82 (280)

60 (184)

61 (196)

70 (234)

61 (196)

Mean

3.34

3.41

3.07

3.21

3.34

3.21

139

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

99 (396)

80 (320)

74 (296)

68 (272)

99 (396)

68 (272)

yes

3

33 (99)

77 (231)

37 (111)

51 (153)

33 (99)

51 (153)

no

2

6 (12)

11 (22)

8 (16)

14 (28)

6 (12)

14 (28)

No!

1

22 (22)

27 (27)

30 (30)

35 (35)

22 (22)

35 (35)

Total

160

195 (600)

149 (453)

168 (488)

160

168 (488)

Mean

3.31

3.08

3.04

2.9

3.31

2.9

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

140

MENTAL HEALTH
Appendix F
Religiosity Statistics Table
How often do you attend religious services or activities?
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Weekly, plus

4

26 (104)

32 (128)

15 (60)

19 (76)

26 (104)

19 (76)

1-2 a month

3

10 (30)

9 (27)

7 (21)

9 (27)

10 (30)

9 (27)

Rarely

2

15 (30)

11 (22)

11 (22)

17 (34)

15 (30)

17 (34)

Never

1

11 (11)

13 (13)

18 (18)

17 (17)

11 (11)

17 (17)

Total

62 (175)

65 (190)

51 (121)

62 (154)

62 (175)

62 (154)

Mean

2.82

2.92

2.37

2.48

2.82

2.48

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Weekly, plus

4

13 (52)

19 (76)

7 (28)

15 (60)

13 (52)

15 (60)

1-2 a month

3

7 (21)

8 (24)

5 (15)

6 (18)

7 (21)

6 (18)

Rarely

2

7 (14)

12 (24)

17 (34)

15 (30)

7 (14)

15 (30)

Never

1

8 (8)

12 (12)

11 (11)

17 (17)

8 (8)

17 (17)

Total

35 (95)

51 (136)

40 (88)

53 (125)

35 (95)

53 (125)

Mean

2.71

2.67

2.2

2.36

2.71

2.36

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Weekly, plus

4

15 (60)

29 (116)

19 (76)

16 (64)

15 (60)

16 (64)

1-2 a month

3

9 (27)

7 (21)

8 (24)

5 (15)

9 (27)

5 (15)

Rarely

2

17 (34)

32 (64)

18 (36)

24 (48)

17 (34)

24 (48)

Never

1

28 (28)

14 (14)

16 (16)

17 (17)

28 (28)

17 (17)

Total

69 (149)

82 (215)

61 (152)

62 (144)

69 (149)

62 (144)

Mean

2.16

2.62

2.49

2.32

2.16

2.32

141

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Weekly, plus

4

54 (216)

80 (320)

41(164)

50 (200)

54 (216)

50 (200)

1-2 a month

3

26 (78)

24 (72)

20 (60)

20 (60)

26 (78)

20 (60)

Rarely

2

39 (78)

55 (110)

46 (92)

56 (112)

39 (78)

56 (112)

Never

1

47 (47)

39 (39)

45 (45)

51 (51)

47 (47)

51 (51)

Total

166 (419)

198 (541)

152 (361)

177 (423)

166 (419)

177 (423)

Mean

2.52

2.73

2.37

2.39

2.52

2.39

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

142

MENTAL HEALTH
Appendix G
Neighborhood Attachment Tables
Table G1.
I like my neighborhood.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

25 (100)

18 (72)

24 (96)

20 (80)

25 (100)

20 (80)

yes

3

23 (69)

32 (96)

19 (57)

32 (96)

23 (69)

32 (96)

no

2

10 (20)

7 (14)

4 (8)

10 (20)

10 (20)

10 (20)

No!

1

3 (3)

7 (7)

5 (5)

2 (2)

3 (3)

2 (2)

Total

61 (192)

64 (199)

52 (166)

64 (198)

61 (192)

64 (198)

Mean

3.15

3.11

3.19

3.09

3.15

3.09

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

11 (44)

15 (60)

14 (56)

16 (64)

11 (44)

16 (64)

yes

3

17 (51)

28 (54)

18 (54)

26 (78)

17 (51)

26 (78)

no

2

4 (8)

4 (8)

4 (8)

7 (14)

4 (8)

7 (14)

No!

1

5 (5)

4 (4)

1 (1)

4 (4)

5 (5)

4 (4)

Total

37 (108)

37 (126)

37 (119)

53 (160)

37 (108)

53 (160)

Mean

2.92

2.47

3.21

3.02

2.92

3.02

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

31 (124)

24 (96)

31 (124)

16 (64)

31 (124)

16 (64)

yes

3

35 (105)

34 (102)

15 (45)

31 (93)

35 (105)

31 (93)

no

2

6 (12)

15 (30)

6 (12)

11 (22)

6 (12)

11 (22)

No!

1

0

4 (4)

6 (6)

3 (3)

0

3 (3)

Total

72 (241)

77 (232)

58 (181)

61 (182)

72 (241)

61 (182)

Mean

3.35

3.01

3.22

2.98

3.35

2.98

143

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

Yes!

4

67 (268)

56 (224)

69 (276)

52 (208)

67 (268)

52 (208)

yes

3

75 (225)

94 (282)

52 (156)

89 (267)

75 (225)

89 (267)

no

2

20 (40)

26 (52)

14 (28)

28 (56)

20 (40)

28 (56)

No!

1

8 (8)

15 (15)

12 (12)

9 (9)

8 (8)

9 (9)

Total

170 (521)

191 (573)

147 (472)

178 (540)

170 (521)

178 (540)

Mean

3.06

3

3.21

3.03

3.06

3.03

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

144

MENTAL HEALTH
Table G2.
I'd like to get out of my neighborhood.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

29 (116)

25 (100)

29 (116)

27 (108)

29 (116)

27 (108)

no

3

15 (45)

24 (72)

12 (36)

26 (78)

15 (45)

26 (78)

yes

2

7 (14)

8 (16)

8 (16)

9 (18)

7 (14)

9 (18)

Yes!

1

7 (7)

7 (7)

2 (2)

2 (2)

7 (7)

2 (2)

Total

58 (182)

63 (195)

51 (170)

64 (206)

58 (182)

64 (206)

Mean

3.14

3.09

3.33

3.22

3.14

3.22

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

13 (52)

14 (56)

17 (68)

24 (96)

13 (52)

24 (96)

no

3

14 (42)

23 (69)

12 (36)

19 (57)

14 (42)

19 (57)

yes

2

7 (14)

9 (18)

4 (8)

6 (12)

7 (14)

6 (12)

Yes!

1

3 (3)

6 (6)

3 (3)

4 (4)

3 (3)

4 (4)

Total

37 (111)

52 (149

36 (115)

53 (169)

37 (111)

53 (169)

Mean

3

2.86

3.19

3.19

3

3.19

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

30 (120)

30 (120)

29 (116)

23 (92)

30 (120)

23 (92)

no

3

27 (81)

19 (57)

14 (42)

21 (63)

27 (81)

21 (63)

yes

2

10 (20)

17 (34)

7 (14)

13 (26)

10 (20)

13 (26)

Yes!

1

5 (5)

11 (11)

8 (8)

4 (4)

5 (5)

4 (4)

Total

72 (226)

77 (222)

58 (180)

61 (185)

72 (226)

61 (185)

Mean

3.14

2.88

3.1

3.03

3.14

3.03

145

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

72 (288)

69 (276)

75 (300)

74 (296)

72 (288)

74 (296)

no

3

56 (168)

66 (198)

38 (114)

66 (193)

56 (168)

66 (193)

yes

2

24 (48)

34 (68)

19 (38)

28 (56)

24 (48)

28 (56)

Yes!

1

15 (15)

24 (24)

13 (13)

10 (10)

15 (15)

10 (10)

Total

167 (519)

193 (566)

145 (465)

178 (555)

167 (519)

178 (555)

Mean

3.11

2.93

3.21

3.12

3.11

3.12

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

146

MENTAL HEALTH
Appendix H
Family Conflict Statistics Tables
Table H1.
People in my family have serious arguments.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

36 (144)

27 (108)

31 (124)

34 (136)

36 (144)

34 (136)

no

3

15 (45)

21 (63)

13 (39)

23 (69)

15 (45)

23 (69)

yes

2

2 (4)

9 (18)

6 (12)

5 (10)

2 (4)

5 (10)

Yes!

1

4 (4)

7 (7)

0

2 (2)

4 (4)

2 (2)

Total

57 (197)

64 (196)

50 (175)

64 (217)

57 (197)

64 (217)

Mean

3.46

3.06

3.5

3.39

3.46

3.39

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

13 (52)

25 (100)

16 (64)

21 (84)

13 (52)

21 (84)

no

3

16 (48)

12 (36)

18 (54)

21 (63)

16 (48)

21 (63)

yes

2

7 (14)

6 (12)

4 (8)

10 (20)

7 (14)

10 (20)

Yes!

1

2 (2)

8 (8)

1 (1)

1 (1)

2 (2)

1 (1)

Total

38 (116)

51 (156)

39 (127)

53 (168)

38 (116)

53 (168)

Mean

3.05

3.06

3.26

3.17

3.05

3.17

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

22 (88)

23 (92)

17 (68)

30 (120)

22 (88)

30 (120)

no

3

35 (105)

25 (75)

25 (75)

19 (57)

35 (105)

19 (57)

yes

2

9 (18)

18 (36)

12 (24)

9 (18)

9 (18)

9 (18)

Yes!

1

4 (4)

9 (9)

6 (6)

4 (4)

4 (4)

4 (4)

Total

68 (215)

75 (212)

60 (173)

62 (199)

68 (215)

62 (199)

Mean

3.16

2.83

2.88

3.21

3.16

3.21

147

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

71 (284)

75 (300)

64 (256)

85 (340)

71 (284)

85 (340)

no

3

66 (198)

58 (174)

56 (168)

63 (189)

66 (198)

63 (189)

yes

2

18 (36)

33 (66)

22 (44)

24 (48)

18 (36)

24 (48)

Yes!

1

15 (15)

24 (24)

7 (7)

7 (7)

15 (15)

7 (7)

Total

170 (533)

190 (564)

149 (475)

179 (584)

170 (533)

179 (584)

Mean

3.13

2.96

3.19

3.26

3.13

3.26

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

148

MENTAL HEALTH
Table H2.
People in my family often insult or yell at each other.
Rating

HAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

25 (100)

21 (84)

18 (72)

30 (120)

25 (100)

30 (120)

no

3

23 (69)

21 (63)

22 (66)

21 (63)

23 (69)

21 (63)

yes

2

6 (12)

10 (20)

9 (18)

10 (20)

6 (12)

10 (20)

Yes!

1

3 (3)

11 (11)

1 (1)

2 (2)

3 (3)

2 (2)

Total

57 (184)

63 (178)

50 (157)

63 (205)

57 (184)

63 (205)

Mean

3.23

2.82

3.14

3.25

3.23

3.25

Rating

MAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

11 (44)

14 (56)

18 (72)

18 (72)

11 (44)

18 (72)

no

3

16 (48)

20 (60)

14 (42)

26 (78)

16 (48)

26 (78)

yes

2

7 (14)

9 (18)

5 (10)

4 (8)

7 (14)

4 (8)

Yes!

1

4 (4)

8 (8)

2 (2)

5 (5)

4 (4)

5 (5)

Total

38 (110)

51 (142)

39 (126)

53 (163)

38 (110)

53 (163)

Mean

2.89

2.78

3.23

3.07

2.89

3.07

Rating

UDAMS
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6
2019

Grade 8
2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

17 (68)

21 (84)

19 (76)

20 (80)

17 (68)

20 (80)

no

3

33 (99)

32 (96)

22 (66)

23 (69)

33 (99)

23 (69)

yes

2

13 (26)

13 (26)

9 (18)

18 (36)

13 (26)

18 (36)

Yes!

1

6 (6)

12 (12)

9 (9)

2 (2)

6 (6)

2 (2)

Total

69 (199)

78 (218)

60 (169)

63 (187)

69 (199)

63 (187)

Mean

2.88

2.78

2.82

2.96

2.88

2.96

149

MENTAL HEALTH
Rating

All Respondents
2019

Response

Cohort
2021

Grade 6

Grade 8

Grade 6

Grade 8

Grade 6 2019

Grade 8 2021

n (nRating)

n (nRating)

n(nRating)

n (nRating)

n(nRating)

n(nRating)

No!

4

53 (212)

56 (224)

55 (220)

68 (272)

53 (212)

68 (272)

no

3

72 (216)

73 (219)

58 (174)

70 (210)

72 (216)

70 (210)

yes

2

26 (52)

32 (64)

23 (46)

32 (64)

26 (52)

32 (64)

Yes!

1

13 (13)

31 (31)

12 (12)

9 (9)

13 (13)

9 (9)

Total

164 (493)

192 (538)

148 (452)

179 (560)

164 (493)

179 (560)

Mean

3

2.8

3.05

3.13

3

3.13

Note. The abbreviations used for the schools are as follows: HAMS is Halifax Area
Middle School, MAMS is Millersburg Area Middle School, and UDAMS is Upper
Dauphin Area Middle School.

MENTAL HEALTH

150