If we’ve spent any time together in the past few weeks, I’ve almost certainly complained about how annoying I find the New York City public school calendar. Whoever designed it must have been playing a practical joke on parents. Truly. It is maximally inconvenient. The kids had this Tuesday off for Election Day, Thursday is a half day for parent-teacher conferences, and next Wednesday is closed for Veterans Day. Add in my daughter being home sick and my son’s various doctor’s appointments related to getting glasses for the first time, and you can imagine that my children have effectively not been in school.
Against the backdrop of how much my children have been home, I was surprised (and a bit dismayed) when my patient, a high schooler named Ben, told me he’d missed school because he needed a mental health day. He had been up late studying for a test and still felt unprepared, so he turned off his alarm. His plan was to use the day to study more and take the exam a day late.
Ben is hardly the first kid in my practice to tell me some version of this story, and I struggle to get on board with it. We already have mental health days built into the school calendar. They’re called weekends, holidays, and vacations. Taking additional days off whenever they feel overwhelmed is neither appropriate nor acceptable.
The main problem is that these things that we’re calling “mental health days” are really episodes of school avoidance. Think about the circumstances in which kids ask to skip school: They slept poorly and are worried about being tired in class. They had a fight with a friend and don’t want to face the conflict. They feel unprepared for a test and are worried about doing poorly. They’re overwhelmed by homework. The phrase “mental health day” makes staying home sound like a proactive therapeutic intervention, but avoidance is anything but.
Avoidance provides immediate relief at the expense of long-term wellbeing. It sets up a negative reinforcement cycle. A child anticipates something stressful at school. They stay home and feel better. Feeling better makes them more likely to avoid school the next time. Meanwhile, the underlying stressor remains unresolved and looms even larger, so the anxiety is maintained and perhaps made worse. The relief they feel after staying home shouldn’t be mistaken for evidence that staying home was good for their mental health. Feeling better in the moment is very different from actually getting better. The kid who stays home never learns that they can tolerate doing poorly on a test. They don’t learn how to navigate conflicts with friends, or that they can function reasonably well after a bad night’s sleep.
Ultimately, school shouldn’t be optional. Children and families should treat attendance as non-negotiable, not as a choice made day to day based on how a kid feels. Kids shouldn’t think they need to be well rested, confident, and happy to participate in essential parts of life. If they stay home whenever they feel stressed, they come to believe they can’t handle stressful situations, that failure is intolerable, and that avoiding discomfort is better than managing it. Approaching challenges despite discomfort helps kids build coping skills, problem-solving skills, resilience, and confidence.
Parents can take their kids’ distress seriously without allowing avoidance. They can help kids define exactly what they’re worried about and make a concrete plan for managing it. When the distress is persistent or impairing, they can connect their kids with support or treatment.
Of course, there are legitimate reasons to miss school that have to do with mental health: acute psychiatric crises, unsafe situations like violence or bullying, and clinically indicated absences that are part of a treatment plan. Some children also have significant school avoidance, and for them, a gradual return-to-school plan tends to be more appropriate than insisting on full attendance right away. But these situations need to be distinguished from ordinary anxiety, frustration, and tiredness.
Stressed-out kids don’t need more time away from the demands of school. They need opportunities to confront challenges, paired with support to manage them. The best mental health days are the ones when children build their capacity to function in the face of discomfort.
I regret missing this so much!
Reminder to read (or listen to) AYF!