Distance education during pandemic led to less care for mental ill health

Upper secondary school students were less likely to seek help for mental ill health when they were forced to study at home during the pandemic. A similar decrease was not seen for secondary school students aged 14–16 who remained in school. This has been shown in a new study at Uppsala University, based on data covering all of Sweden’s upper secondary school students between 2015–2021.

“We have examined usage rates in healthcare. A key question is whether the reduction we see reflects the fact that healthcare became less accessible during the pandemic, but everything points to an actual reduction in mental ill health,” notes Helena Svaleryd, Professor of Economics at Uppsala University.

From mid-March to mid-June 2020, Swedish upper secondary school students, especially those on theoretical programmes, were taught remotely. Over the same period, care for psychiatric conditions, particularly depression and anxiety, decreased by 4.4 percent in this group compared to secondary school students aged 14–16 who continued to attend school. This difference persisted for at least 21 months after schools reopened.

“This shows that Sweden managed to transition to distance education without negative consequences for the mental health of 14–16-year-old students,” continues Svaleryd.

The shift to distance education during the pandemic gave researchers an opportunity to investigate whether teaching methods and the study environment could affect mental health. In a new study, they conclude that there is no evidence that the decline in mental ill health care was due to a general reluctance to seek care. The researchers also saw a significant reduction in unplanned and emergency contact with healthcare.

“This suggests that the decrease is not due to reduced accessibility. If young people were not accessing healthcare through normal channels, such as school health services, we should be seeing that they are more likely to seek emergency or unplanned care. Instead, we are seeing the opposite,” continues Svaleryd.

Another reason could be the cancellation of the national exams, but they were also cancelled for 14–16-year-olds and there was no reduction in care for mental ill health. The study is unable to specify why distance education led to a reduction in psychiatric disorders, but the researchers suggest several possible explanations: reduced stress, more flexible schedules, reduced social pressure and a reduction in the perceived demands of academic performance.

Sweden stands out in terms of the level of care and medication for psychiatric conditions among young people when compared to our neighbouring countries, according to a previous study (Wesselhoeft et al 2020). There are no clear answers as to why this is. 

“This study shows that one contributing factor may be the school environment. More generally, research on how the school environment affects mental health seems warranted,” adds Svaleryd.

Björkegren, E., Svaleryd, H. and J. Vlachos, “Remote Instruction and Student Mental Health. Swedish Evidence from the Pandemic”, forthcoming in American Economic Journal: Economic Policy, https://www.aeaweb.org/articles?id=10.1257/pol.20220699