A mental health day is a day when a student stays home to rest or deal with stress, anxiety or low mood, and the school counts the absence as excused, just as it would for a fever. The debate is whether schools should treat a day off for the mind in the same way as a day off for the body.
The idea is new. Until 2019, Oregon schools had to excuse absences only for physical illness. That year, after a campaign led by students, the state let pupils take up to five excused absences for mental or behavioral health in any three-month period. Utah had passed a similar law the year before.1 By 2022 at least 12 states, including Illinois, Virginia, California and Washington, accepted mental health as a valid reason to miss school.2
Supporters point to a crisis. In 2023, 39.7% of US high school students said they felt persistently sad or hopeless, and 20.4% had seriously considered suicide in the past year.3 In 2021 three leading groups of children's doctors and hospitals declared a “National State of Emergency in Children's Mental Health.”5 Worldwide, the World Health Organization says “one in seven 10-19-year-olds experiences a mental disorder.”6
The Oregon campaign was also about honesty. Haily Hardcastle, an 18-year-old who helped push the bill, asked: “Why should we encourage lying to our parents and teachers?” Chloe Wilson, 14, died by suicide in February 2018 after being bullied, and had often pretended to be sick to avoid school. Her mother, Roxanne, said: “Because she lied to get her absences excused, we didn't get to have those mental health conversations.”1
Critics worry about attendance. In the 2022-23 school year, 13.4 million US students, or 27.7%, were chronically absent, missing about a month of school.11 One study found that 10 absences in 9th grade lower the chance of graduating on time by 2%.12 Some psychologists also warn that for children with serious anxiety, staying home can make the anxiety worse.16 Others ask who decides. In Connecticut, a parent's documented permission is enough for a student to take one of two mental health wellness days a year.9
Other countries face the same tension. In 2023 England's Department for Education told schools they need not ask for medical evidence for short absences linked to mental health, while still expecting them “to work to ensure regular attendance for every child.”20 In Japan, a record 353,970 elementary and junior high students missed 30 or more days of school in 2024.22
The main fault lines are clear. Does a day off help a struggling student recover, or teach them to avoid what scares them? Do these laws cut stigma, or label ordinary stress as illness? And would the money and attention be better spent on counselors? There is little evidence either way: a 2020 review found no research specifically examining policies like these.13
Key terms
Excused absence
A day off school that the school accepts as legitimate, such as illness, so the student is not marked as truant.
Chronic absenteeism
Missing at least 10% of the school year for any reason, excused or not. That is about a month of school.
School refusal
When a child feels such strong fear or distress about school that they cannot make themselves go. Also called school avoidance.
Behavioral health
A broad term covering mental health and behaviors that affect wellbeing, such as anxiety, depression and substance use.
Stigma
Negative attitudes that make people ashamed to admit a problem or ask for help, often a barrier to mental health care.
Early intervention
Spotting a problem and offering help at an early stage, before it becomes more serious and harder to treat.
School connectedness
A student's sense that adults and classmates at school care about them and their learning.
Prevalence inflation
The idea, proposed by researchers in 2023, that mental health awareness may lead some people to see ordinary distress as a disorder.
Pros and cons at a glance
Pro: give them mental health days
Con: keep the usual rules
Pro arguments
Con arguments
Key clashes
Most debates on mental health days are won or lost on these four questions.
1Does a day off help, or feed avoidance?
Both sides agree anxiety is real. They disagree about what a day at home does to it.
Pro saysFor a student at breaking point, a day of rest, talking and seeing a professional can stop a crisis growing.16
Con saysFor anxious students, staying home brings short-term relief but can make returning harder and the fear stronger.1618
2Should mental illness be treated like physical illness?
A question of fairness and of how we see mental health.
Pro saysDepression and anxiety are among the leading causes of illness in teenagers. Excusing only physical illness sends the wrong message.6
Con saysA fever is easy to see; feeling low is not. Without a clear test, the label can stretch to ordinary stress.18
3How much does a missed day really cost?
Both sides use attendance data and read it differently.
Pro saysMental health problems already keep students out of school. A few capped, honest days are a small price for spotting them early.13
Con saysEvery absence adds up, and chronic absence is already at record levels in many places.1112
4Days off, or more support in school?
Even supporters agree a day off is not treatment.
Pro saysMental health days work best alongside support, flagging struggling students early, as Illinois does.8
Con saysWith one counselor for every 372 students, the priority should be care in schools, not changing attendance rules.19
Around the world
The US: there is no national rule. By 2022 at least 12 states, from Oregon and Utah to Illinois, Virginia and Kentucky, accepted mental health as a reason for an excused absence.2 Their rules differ: Connecticut allows two days a year, while Nevada asks for a note from a mental or behavioral health professional.92
England: schools do not need medical evidence for short mental health absences, but must still work to get every child attending regularly.20 In 2024/25, 18.14% of pupil enrolments were persistently absent, up from 10.86% in 2018/19.21
Japan: a record 353,970 elementary and junior high students missed 30 or more days of school in 2024, the twelfth rise in a row.22
Worldwide: the WHO estimates that one in seven 10 to 19-year-olds has a mental disorder.6
Debate tip: comparing countries is useful evidence on both sides. Pro can point to the scale of the youth mental health problem everywhere; Con can point to rising absence in countries that have become more relaxed about staying home.
Discussion questions
For class or club discussion. There are no right answers; ask for reasons and evidence.
Should students get mental health days off school? Explain your answer using at least one argument from each side.
Is a day off for anxiety the same as a day off for the flu? What, if anything, makes them different?
Who should decide when a student takes a mental health day: the student, the parents, a doctor or the school?
If mental health days made attendance slightly worse but helped students feel heard, would that be a fair trade?
What could a school do on a hard day, other than sending a student home, to support their mental health?
Sources
Sarah Zimmerman, Associated Press, “New law in Oregon allows students to take ‘mental health days’,” Chicago Sun-Times, July 21, 2019. LinkNews report
CNBC, “74% of parents think schools should allow mental health days, these 12 states already do,” August 23, 2022, citing a survey by Verywell Mind and Parents. LinkNews report
Jorge V. Verlenden and others, “Mental Health and Suicide Risk Among High School Students and Protective Factors: Youth Risk Behavior Survey, United States, 2023,” MMWR Supplements 73(4), Centers for Disease Control and Prevention, October 10, 2024. LinkGovernment report
NPR, “The surgeon general's latest advisory highlights the youth mental health crisis,” interview with US Surgeon General Vivek Murthy, December 7, 2021 (via KUNC). LinkNews report
American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children's Hospital Association, “Declaration of a National Emergency in Child and Adolescent Mental Health,” November 2, 2021. LinkMedical associations
World Health Organization, “Mental health of adolescents,” fact sheet, September 1, 2025. LinkInternational body
Pew Research Center, “Most U.S. Teens See Anxiety and Depression as a Major Problem Among Their Peers,” February 20, 2019. LinkResearch center survey
Jonathan Franklin, NPR, “Kids in Illinois will soon be able to take 5 mental health days from school,” September 2, 2021 (via MPR News). LinkNews report
Connecticut State Department of Education, memo to superintendents on Mental Health Wellness Days under Public Act 21-46, January 24, 2022. LinkGovernment guidance
Dan Grossman, “Are mental health days working in schools?” Scripps News, May 23, 2023. LinkNews report
Attendance Works, press release on national chronic absence data for 2022-23, January 16, 2025. LinkResearch nonprofit
Jing Liu, Monica Lee and Seth Gershenson, “The Short- and Long-Run Impacts of Secondary School Absences,” EdWorkingPapers, May 2021. LinkAcademic research
Health Impact Project, The Pew Charitable Trusts, “Health Note: Excused Absences in Public Schools for Behavioral Health,” Colorado Senate Bill 20-014, 2020. LinkResearch nonprofit
Evie Blad, “What Educators Need to Know About the Intense Anxiety That Keeps Students Home From School,” Education Week, September 8, 2023. LinkNews report
Ann Dornfeld, “When anxious kids won't go to school, what should parents and schools do?” KUOW, July 22, 2019. LinkNews report
Zachary Payne, “What parents should know before letting kids skip school for mental health?” WILX, September 9, 2026. LinkNews report
Rachel Paula Abrahamson, TODAY, report on a former teacher's video about mental health days, January 24, 2026 (via NBC New York). LinkNews report
Lucy Foulkes and J. L. Andrews, “Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis,” New Ideas in Psychology 69, 2023. LinkPeer-reviewed research
American School Counselor Association, “Student-to-School-Counselor Ratio 2024-2025,” February 13, 2026. LinkProfessional association
Amy Walker, “Evidence not needed for short mental health absence, says DfE,” Schools Week, February 7, 2023. LinkNews report
Department for Education (England), “Pupil absence in schools in England: 2024/25,” March 26, 2026. LinkGovernment statistics
Nippon.com, “Absenteeism at Japanese Schools Rises Again,” Japan Data, on Ministry of Education figures for the 2024 school year. LinkNews report
Jennifer C. Kerr and Meghan Hoyer, Associated Press, “Data reveals how many U.S. students chronically miss school,” PBS NewsHour, June 8, 2016. LinkNews report
Kristiana Bolzman, “3 Challenges Resulting from Oregon's Student Mental Health Law,” Catalyst, Independent Institute. LinkOpinion, think tank
Arguments marked “Evidence needed” are waiting for a source before this guide goes live.
