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More than two hours of homework may be counterproductive, research suggests.

A Stanford education researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.   "Our findings on the effects of homework challenge the traditional assumption that homework is inherently good," wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .   The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students' views on homework.   Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.   Students in these schools average about 3.1 hours of homework each night.   "The findings address how current homework practices in privileged, high-performing schools sustain students' advantage in competitive climates yet hinder learning, full engagement and well-being," Pope wrote.   Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.   Their study found that too much homework is associated with:   • Greater stress : 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.   • Reductions in health : In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.   • Less time for friends, family and extracurricular pursuits : Both the survey data and student responses indicate that spending too much time on homework meant that students were "not meeting their developmental needs or cultivating other critical life skills," according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.   A balancing act   The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.   Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as "pointless" or "mindless" in order to keep their grades up.   "This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points," said Pope, who is also a co-founder of Challenge Success , a nonprofit organization affiliated with the GSE that conducts research and works with schools and parents to improve students' educational experiences..   Pope said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.   "Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development," wrote Pope.   High-performing paradox   In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. "Young people are spending more time alone," they wrote, "which means less time for family and fewer opportunities to engage in their communities."   Student perspectives   The researchers say that while their open-ended or "self-reporting" methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for "typical adolescent complaining" – it was important to learn firsthand what the students believe.   The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Clifton B. Parker is a writer at the Stanford News Service .

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Is it time to get rid of homework? Mental health experts weigh in.

It's no secret that kids hate homework. And as students grapple with an ongoing pandemic that has had a wide range of mental health impacts, is it time schools start listening to their pleas about workloads?

Some teachers are turning to social media to take a stand against homework. 

Tiktok user @misguided.teacher says he doesn't assign it because the "whole premise of homework is flawed."

For starters, he says, he can't grade work on "even playing fields" when students' home environments can be vastly different.

"Even students who go home to a peaceful house, do they really want to spend their time on busy work? Because typically that's what a lot of homework is, it's busy work," he says in the video that has garnered 1.6 million likes. "You only get one year to be 7, you only got one year to be 10, you only get one year to be 16, 18."

Mental health experts agree heavy workloads have the potential do more harm than good for students, especially when taking into account the impacts of the pandemic. But they also say the answer may not be to eliminate homework altogether.

Emmy Kang, mental health counselor at Humantold , says studies have shown heavy workloads can be "detrimental" for students and cause a "big impact on their mental, physical and emotional health."

"More than half of students say that homework is their primary source of stress, and we know what stress can do on our bodies," she says, adding that staying up late to finish assignments also leads to disrupted sleep and exhaustion.

Cynthia Catchings, a licensed clinical social worker and therapist at Talkspace , says heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression. 

And for all the distress homework  can cause, it's not as useful as many may think, says Dr. Nicholas Kardaras, a psychologist and CEO of Omega Recovery treatment center.

"The research shows that there's really limited benefit of homework for elementary age students, that really the school work should be contained in the classroom," he says.

For older students, Kang says, homework benefits plateau at about two hours per night. 

"Most students, especially at these high achieving schools, they're doing a minimum of three hours, and it's taking away time from their friends, from their families, their extracurricular activities. And these are all very important things for a person's mental and emotional health."

Catchings, who also taught third to 12th graders for 12 years, says she's seen the positive effects of a no-homework policy while working with students abroad.

"Not having homework was something that I always admired from the French students (and) the French schools, because that was helping the students to really have the time off and really disconnect from school," she says.

The answer may not be to eliminate homework completely but to be more mindful of the type of work students take home, suggests Kang, who was a high school teacher for 10 years.

"I don't think (we) should scrap homework; I think we should scrap meaningless, purposeless busy work-type homework. That's something that needs to be scrapped entirely," she says, encouraging teachers to be thoughtful and consider the amount of time it would take for students to complete assignments.

The pandemic made the conversation around homework more crucial 

Mindfulness surrounding homework is especially important in the context of the past two years. Many students will be struggling with mental health issues that were brought on or worsened by the pandemic , making heavy workloads even harder to balance.

"COVID was just a disaster in terms of the lack of structure. Everything just deteriorated," Kardaras says, pointing to an increase in cognitive issues and decrease in attention spans among students. "School acts as an anchor for a lot of children, as a stabilizing force, and that disappeared."

But even if students transition back to the structure of in-person classes, Kardaras suspects students may still struggle after two school years of shifted schedules and disrupted sleeping habits.

"We've seen adults struggling to go back to in-person work environments from remote work environments. That effect is amplified with children because children have less resources to be able to cope with those transitions than adults do," he explains.

'Get organized' ahead of back-to-school

In order to make the transition back to in-person school easier, Kang encourages students to "get good sleep, exercise regularly (and) eat a healthy diet."

To help manage workloads, she suggests students "get organized."

"There's so much mental clutter up there when you're disorganized. ... Sitting down and planning out their study schedules can really help manage their time," she says.

Breaking up assignments can also make things easier to tackle.

"I know that heavy workloads can be stressful, but if you sit down and you break down that studying into smaller chunks, they're much more manageable."

If workloads are still too much, Kang encourages students to advocate for themselves.

"They should tell their teachers when a homework assignment just took too much time or if it was too difficult for them to do on their own," she says. "It's good to speak up and ask those questions. Respectfully, of course, because these are your teachers. But still, I think sometimes teachers themselves need this feedback from their students."

More: Some teachers let their students sleep in class. Here's what mental health experts say.

More: Some parents are slipping young kids in for the COVID-19 vaccine, but doctors discourage the move as 'risky'

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Health Hazards of Homework

March 18, 2014 | Julie Greicius Pediatrics .

A new study by the Stanford Graduate School of Education and colleagues found that students in high-performing schools who did excessive hours of homework “experienced greater behavioral engagement in school but also more academic stress, physical health problems, and lack of balance in their lives.”

Those health problems ranged from stress, headaches, exhaustion, sleep deprivation, weight loss and stomach problems, to psycho-social effects like dropping activities, not seeing friends or family, and not pursuing hobbies they enjoy.

In the Stanford Report story about the research, Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of the  study published in the  Journal of Experimental Education , says, “Our findings on the effects of homework challenge the traditional assumption that homework is inherently good.”

The study was based on survey data from a sample of 4,317 students from 10 high-performing high schools in California communities in which median household income exceeded $90,000. Of the students surveyed, homework volume averaged about 3.1 hours each night.

“It is time to re-evaluate how the school environment is preparing our high school student for today’s workplace,” says Neville Golden, MD , chief of adolescent medicine at Stanford Medicine Children’s Health and a professor at the School of Medicine. “This landmark study shows that excessive homework is counterproductive, leading to sleep deprivation, school stress and other health problems. Parents can best support their children in these demanding academic environments by advocating for them through direct communication with teachers and school administrators about homework load.”

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Barriers Associated with the Implementation of Homework in Youth Mental Health Treatment and Potential Mobile Health Solutions

Brian e. bunnell.

1 Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

2 Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA

Lynne S. Nemeth

3 Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Leslie A. Lenert

Nikolaos kazantzis.

4 Cognitive Behavior Therapy Research Unit and School of Psychological Sciences, Monash University, Clayton, VIC, Australia

Esther Deblinger

5 Child Abuse Research Education & Service (CARES) Institute, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA

Kristen A. Higgins

Kenneth j. ruggiero.

6 Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, USA

Author Contributions

Associated Data

Background:.

Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via m Health solutions.

Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n =21) and youth TF-CBT patients ages 8–17 ( n =15) and their caregivers ( n =12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential m Health solutions to those barriers.

The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for m Health solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities).

Conclusions:

This study adds to the literature on homework barriers and potential m Health solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.

Introduction

Homework, or between-session practice of skills learned during therapy, is one of the most integral, yet underutilized components of high-quality, evidence-based mental health care ( Kazantzis & Deane, 1999 ). Homework activities (e.g., self-monitoring, relaxation, exposure, parent behavior management) are assigned by providers in-session and completed by patients between sessions with the goal of “practicing” therapeutic skills in the environment where they will be most needed ( Kazantzis, Deane, Ronan, & L’Abate, 2005 ). There are numerous benefits to the implementation of homework during mental health treatment ( Kazantzis et al., 2016 ; Kazantzis, Deane, & Ronan, 2004 ). Homework enables the generalization of skills and behaviors learned during therapy, facilitates treatment processes, provides continuity between sessions, allows providers to better grasp patients’ learning, and strengthens that learning, leading to improved maintenance of treatment gains ( Hudson & Kendall, 2002 ; Scheel, Hanson, & Razzhavaikina, 2004 ). Meta-analytic and systematic reviews have shown that homework use by providers and adherence by patients predict increased treatment engagement, decreased treatment dropout, and medium-to-large effects on improvements in clinical outcomes for use (Cohen’s d =.48–.77) and adherence ( d =.45–.54) ( Hudson & Kendall, 2002 ; Kazantzis, Deane, & Ronan, 2000 ; Kazantzis & Lampropoulos, 2002 ; Kazantzis, Whittington, & Dattilio, 2010 ; Mausbach, Moore, Roesch, Cardenas, & Patterson, 2010 ; Scheel et al., 2004 ; Sukhodolsky, Kassinove, & Gorman, 2004 ). Simply put, 68% vs . 32% of patients can be expected to improve when therapy involves homework ( Kazantzis et al., 2010 ).

Despite its many benefits, homework is implemented with variable effectiveness in mental health treatment. Only 68% of general mental health providers and ~55% of family providers report using homework “often” to “almost always” ( Dattilio, Kazantzis, Shinkfield, & Carr, 2011 ; Kazantzis, Lampropoulos, & Deane, 2005 ). Further, providers report using homework in an average of 57% of sessions, although this rate is higher for CBT practitioners (66%) vs . non-CBT practitioners (48%). Moreover, only 25% of providers report using expert recommended systematic procedures for recommending homework (i.e., specifying frequency, duration, and location; writing down homework assignments for patients) ( Kazantzis & Deane, 1999 ). A national survey revealed that 93% or general mental health providers estimate rates of patient adherence to homework to be low to moderate ( Kazantzis, Lampropoulos, et al., 2005 ), and research studies report low to moderate rates of youth/caregiver adherence during treatment (i.e., ~39–63%; ( Berkovits, O’Brien, Carter, & Eyberg, 2010 ; Clarke et al., 1992 ; Danko, Brown, Van Schoick, & Budd, 2016 ; Dattilio et al., 2011 ; Gaynor, Lawrence, & Nelson-Gray, 2006 ; Helbig & Fehm, 2004 ; Lyon & Budd, 2010 ; Simons et al., 2012 ).

Numerous barriers to the successful implementation of homework during mental health treatment have largely been suggested by experts in the field, rather than specifically measured ( Dattilio et al., 2011 ), and have generally been classified as occurring on the provider-, patient-, task-, and environmental-level ( Kazantzis & Shinkfield, 2007 ). Provider-level barriers can relate to the therapeutic relationship and the degree to which a collaborative approach is used, provider beliefs about homework and the patient’s adherence, and providers’ ability to effectively design homework tasks ( Callan et al., 2012 ; Coon, Rabinowitz, Thompson, & Gallagher-Thompson, 2005 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Kazantzis & Shinkfield, 2007 ). Patient-level barriers can include patient avoidance and symptomatology, negative beliefs toward the task, not understanding the rationale or how to do the task, forgetting, and beliefs about their ability to complete homework tasks. ( Bru, Solholm, & Idsoe, 2013 ; Callan et al., 2012 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ; Kazantzis & Shinkfield, 2007 ; Leahy, 2002 ). Relatedly, core beliefs central to the patients’ psychopathology can be activated during homework–thereby triggering withdrawal and avoidance patterns ( Kazantzis & Shinkfield, 2007 ). Task-level barriers include poor match between tasks and therapy goals, tasks that are perceived as vague or unclear, tasks that are perceived as too difficult or demanding in terms of time or effort, tasks being viewed as boring, and general aversiveness of the idea of completing homework ( Bru et al., 2013 ; Callan et al., 2012 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ). Environmental factors have been noted to include practical obstacles, lack of family/caregiver support, dysfunctional home environments, lack of time due to busy schedules, and lack of reward or reinforcement ( Callan et al., 2012 ; Dattilio et al., 2011 ; Hudson & Kendall, 2005 ).

The advancement and ubiquitousness of technologies such as m Health resources (e.g., mobile- and web-based apps) provide a tremendous opportunity to overcome barriers to homework use and adherence and resultantly, improve the quality of mental health treatment. m Health solutions to improve access and quality of care, have been widely investigated, are effective in facilitating behavior change, practical, desired by patients and providers, and available at low cost ( Amstadter, Broman-Fulks, Zinzow, Ruggiero, & Cercone, 2009 ; Boschen & Casey, 2008 ; Donker et al., 2013 ; Ehrenreich, Righter, Rocke, Dixon, & Himelhoch, 2011 ; Hanson et al., 2014 ; Heron & Smyth, 2010 ; Krebs & Duncan, 2015 ; Luxton, McCann, Bush, Mishkind, & Reger, 2011 ; Ruggiero, Saunders, Davidson, Cook, & Hanson, 2017 ). Existing m Health resources include features that can support homework implementation (e.g., voice and SMS reminders and feedback, self-monitoring and assessment, and modules and activities that can be used to facilitate between-session practice; Bakker, Kazantzis, Rickwood, & Rickard, 2016 ; Tang & Kreindler, 2017 ), but these resources were not designed with the express intention of addressing barriers to homework implementation, particularly for youth and family patient populations.

The extant literature on barriers to homework implementation is limited in that it is largely based on expert recommendations. Therefore, the first aim of this study was to explore provider, youth, and caregiver patient perspectives on barriers to the successful implementation of homework during youth mental health treatment. Further, m Health solutions to those barriers have not been explored, especially for youth and family patients. Thus, the second and third aims of this study were to obtain suggestions for m Health solutions to homework barriers and explore perceptions on the benefits and challenges associated with those m Health solutions.

Institutional Review Board approval was obtained prior to enrolling any participants in the study. The approach for this study was based on the constructivist grounded theory, which acknowledges the researcher’s prior knowledge and influence in the process and supports and guides conceptual framework development to understand interrelations between constructs ( Charmaz, 2006 ). This qualitative study used a thematic analysis of semi-structured interviews in a sample of nationally certified trainers in Trauma-Focused Cognitive Behavioral Therapy (TFCBT; Cohen, Mannarino, & Deblinger, 2017 ), youth who had engaged in TF-CBT, and their caregivers. The initial goal was to conduct interviews with 15–20 interviewees in each group to achieve theoretical saturation (i.e., no new information was derived), consistent with a prior study by members of the research team which used similar semi-structured interviews with national TF-CBT trainers ( Hanson et al., 2014 ), and recommendations by Morse (2000) given the relatively narrow scope and clear nature of the study. Interviews were conducted until interviewers and the study lead determined that no new pertinent information was being obtained.

Participants

National trainers..

Twenty-one national trainers in TF-CBT were interviewed. National trainers are mental health providers who completed a 15-month TF-CBT Train-the-Trainer program led by the TF-CBT developers. Trainers work extensively with numerous community mental health providers to problem-solve common barriers to clinical practice and thus, provide a unique perspective on the barriers to successful homework implementation and possible m Health solutions to those barriers. An e-mail invitation was sent to a list of approved TF-CBT trainers. Twenty-four trainers responded to this e-mail, 22 of whom agreed to participate in an interview, one of whom was unreachable after initial scheduling. Interviews were completed with a total of 21 trainers, who received a $25 gift card in compensation for their time.

Trainers had been treating children for an average of 23.29 years ( SD =8.80) and had been training providers for an average of 14.95 years ( SD =8.98). In the year prior to the interview, they led an average of 17 provider trainings ( SD =21.67) and trained roughly 345 providers ( SD =339.90). All trainers were licensed, and the majority were Clinical Psychologists (47.6%) and Social Workers (33.3%). The average age of trainers was 47.48 years ( SD =13.63) and the majority were female (71.4%), white (95.2%), and non-Hispanic/Latino (85.7%; see Table 1 ).

Trainer Demographics

Twelve families were interviewed for this study. Families were included if they had one or more youth between the ages of 8 and 17 years-of-age and a caregiver who had engaged in at least four sessions for TF-CBT. These criteria were chosen because TF-CBT is typically recommended for youth between the ages of 8 and 17 years-of-age and it was estimated that four sessions would have likely allowed for adequate time for patients to have received homework assignments, consistent with the authors’ experience and prior TF-CBT literature ( Deblinger, Pollio, & Dorsey, 2016 ; Scheeringa, Weems, Cohen, Amaya-Jackson, & Guthrie, 2011 ). Families were recruited via advertisements online and at local community mental health clinics, and from a participant pool from a prior study ( Davidson et al., 2019 ). Twenty-nine families initially expressed interest in participating in the study. Six families were ineligible because they had not received TF-CBT and contact was lost with six families after their initial contact. Seventeen families were scheduled for an interview, five of which were unreachable after initially being scheduled, and interviews were completed with 12 families. Written informed consent from caregivers and assent from youth above the age of 15 were obtained in-person for four families and via a telemedicine-based teleconsent platform (i.e., https://musc.doxy.me ) for eight families. Families received a $30 gift card in compensation for their time.

A total of 15 youth who had engaged in TF-CBT, and their caregivers ( n =12; three families had two youth who had received treatment) were interviewed. Six youth were still in treatment at the time of their interview and nine had finished treatment an average of 49 weeks ( SD =42.32) prior to the interview. The average age of youth was 13.20 years ( SD =3.19), roughly half were female (53.3%), the majority were white (80%), and all were non-Hispanic/Latino. The average age of caregivers was 44.83 years ( SD =7.90), 66.7% were female, and all were White and non-Hispanic/Latino. Youth and caregivers rated their comfort with technology, in general, on a 10-point Likert scale (i.e., 1–10) with higher scores representing higher levels of comfort. Youth reported being very comfortable with technology (M=9.62, SD =1.12), as did their caregivers (M=7.83, SD =2.63; see Table 2 ).

Family Demographics

Trauma-Focused Cognitive Behavioral Therapy

TF-CBT is a well-established and widely disseminated mental health treatment ( Cohen et al., 2017 ; Deblinger, Mannarino, Cohen, Runyon, & Steer, 2011 ; Silverman et al., 2008 ; Wethington et al., 2008 ). It is a conjoint youth-caregiver mental health treatment typically conducted over ~12, 90-minute sessions that address nine major treatment components (i.e., P sychoeducation; P arenting Skills; R elaxation Skills; A ffective Expression and Modulation Skills; C ognitive Coping and Processing Skills; T rauma Narration and Processing; I n Vivo Exposure; C onjoint Child Parent Activities; and E nhancing Future Safety and Development). TF-CBT also addresses a broad range of symptom domains including trauma- and stress-related disorders, disruptive behavior disorders/behaviors, depression/depressive symptoms, and anxiety disorders ( Cohen et al., 2017 ). TF-CBT was chosen as a model treatment for this study because of its broad symptom focus, inclusion of treatment components used in a variety of youth mental health treatments, and involvement of youth and their caregivers, offering potential to improve the applicability of the study’s results to a range of youth mental health treatment approaches.

Procedures for Data Collection

Interviews were conducted via telephone for trainers, and either in-person or via telephone for families based on their preference. A postdoctoral fellow and masters-level research assistant conducted the interviews, which were audio-recorded and transcribed using a professional transcription service. Interviews included three major components. The first component included demographic questions. The second included a brief orientation to the goal of the study, which was to develop a new technology-based resource to help providers and patients during the implementation of homework during mental health treatment. The third component included questions that aimed to assess perspectives on barriers to homework implementation, elicit suggestions for m Health solutions to those barriers, and examine perceptions on the benefits and challenges associated with m Health solutions to homework barriers. The average duration of interviews was 41 minutes for trainers and 37 minutes for families. See Supplementary Materials for complete interviews.

Data Analysis

Transcribed interviews were coded using NVivo qualitative analysis software. NVivo was used to identify common themes (nodes) as they related to (1) patient-, provider-, task-, and environmental-barriers to homework implementation, (2) suggestions for m Health solutions to homework barriers, and (3) benefits and challenges associated with m Health homework solutions. Initial and secondary coding passes were conducted to identify and refine theme classifications as they emerged and impose a data-derived hierarchy to the nodes identified. Focused coding was used to refine the coding and ensure that data were coded completely with minimal redundancy ( Miles & Huberman, 1994 ). Themes were initially proposed by the first author and reviewed by an expert in qualitative and mixed methods research (the second author) and an internationally recognized expert in the implementation of homework and related barriers during CBT (the fourth author). Divergent perspectives on theme descriptions ( n =2) and classifications ( n =1) were compared until agreement was reached.

Results are organized by the main topics explored in this study, including: 1) barriers to the successful implementation of homework, coded on provider, patient, task, and environmental levels; 2) potential m Health solutions to those homework barriers; and 3) perceived benefits and challenges of those potential m Health solutions. Results within each of these topics are presented first from the perspectives of trainers and second from the perspectives of families.

Barriers to the Successful Implementation of Homework

Trainer perspectives..

As displayed in Table 3 , trainers identified several barriers to homework implementation on the provider-, patient-, task-, and environmental-level.

Trainer Perspectives on Homework Barriers

Provider-Level Barriers.

Many trainers felt that providers tend to have difficulty engaging patients in assigned tasks, leading some providers to become discouraged by low levels of engagement. As stated by one trainer,

“I think they recognize that [homework assignments] do have value, but in terms of what I feel, a lot of clinicians are not having success with families completing homework, so it’s diminishing the sense of value…something they’ve tried to put into place and they are not feeling there’s any success in it.”

Trainers also noted that many providers do not see homework as an integral part of therapy. One trainer commented,

“I think there are a lot of concrete barriers, but to me probably the biggest barrier will be the–I think that still to this day [providers] like to think that therapy happens in that one hour.”

Other interrelated difficulties faced by providers related to their capacity to effectively and consistently develop, assess, and assign meaningful and patient-centered homework exercises.

As stated by one trainer,

“I see a lot of that just shooting from the hip, kind of off the cuff, ‘let’s do this,’ but yet, it’s not backed by anything concrete or tangible…I think probably one of the biggest pieces again is the failure on the clinician’s part to follow that up and too often review it at the end of the session.”

Another said,

“I think clinicians don’t always appreciate how hard it is to actually do homework that requires you to make some behavioral change.”

Barriers also related to providers’ time and resources for implementing homework, as conveyed by one trainer’s comment,

“I mean, these people…every minute of every day is filled up with doing, billing, writing, charting, going to meetings, getting supervision, and seeing patients, and then they go home exhausted.”

Patient-Level Barriers.

Many trainers stated that, similar to some providers, patients often do not see homework as an important part of therapy. Put by one trainer,

“I think that some [patients] just feel that coming to the session is enough and that should resolve everything, and that you know, doing homework is just kind of an extra thing…I don’t really need to do it to benefit from the therapy.”

Perhaps relatedly, trainers also noted that patients generally forget to do homework assignments, and often forget why, how, when, and where assignments should be done.

Task-Level Barriers.

Task-level barriers noted by trainers included assignments not always aligning with patient values or treatment goals and that the term ‘homework’ being aversive to patients of all ages. One trainer commented,

“I think it has to be something that [patients] see the value in. And again, we go back to that engagement and them trusting you as well as you explaining to them why this could be helpful…If it didn’t help, we need to change it.”

Another trainer laughed while stating,

“when we use the word homework, we might as well just throw a stink bomb in the room.”

Environmental-Level Barriers.

Finally, on the environmental-level, many trainers suggested that patients’ home lives are busy and chaotic, leaving little-to-no time for homework.

Explained by one trainer,

“I think that for parents…they have many other things in their life; work, parenting, partnerships that they are working on, just day to day chores or things that they have to do in terms of their family or other responsibilities. So, [homework] often feels like, I think for families, to add another thing…it just feels like a lot.”

Associated barriers included limited caregiver involvement and reinforcement for completing homework assignments. One trainer commented,

“So, let’s not forget that the parents need to be encouraged and checked on to make sure the kid is doing it. They have to work at it – It’s not going to just happen. So, helping the parents to see that they’re going to need to work to make sure the kids do it, because again, the kids would rather eat ice-cream than do the work. I mean change is hard.”

Another stated,

“I would say, lack of reinforcement for homework, so maybe for getting what you assign for homework and not reviewing it or the kiddo or the family learning pretty quickly, you know, why do it, because there’s not a lot of support around it. You know, if [patients] don’t get reinforced, whether tangibly or verbally, they may not continue that.”

Family Perspectives.

Families identified several barriers to homework implementation on the patient-, task-, and environmental-level which were similar to many of those noted by national trainers (see Table 4 ).

Family Perspectives on Homework Barriers

Families believed that patients often avoid homework as a result of their symptoms. In other words, the patient’s unhelpful coping strategies are being triggered.

One caregiver commented,

“Sometimes people don’t even want to dig into their feelings even to do the assignment either, you know. It stirs up things. You know, when you’re dealing with feelings, sometimes you don’t want to experience that feeling…you shut down. You don’t want to feel that at that time.”

“When you already have a child that has ADHD or behavior problems, it’s hard to get them motivated and to get them to do these exercises at home.”

Families also felt that patients simply forget to complete homework or bring it to their next session. One child stated,

“That’s my problem, she’ll give me homework, we met once a week, basically, and I would forget it because I’ve got a lot going on, and when I come in and she’s like, ‘Did you do your homework,’ I’m like, ‘Oh man’.”

Similar to trainers, families felt that patients often forget why, how, when and where assignments should be done. As stated by one caregiver,

“I think sometimes it can also be just, like maybe not fully understanding what is being asked of them to do. I know the therapist will ask them in the office, ‘do you understand?’ and of course the kids always go, ‘yes I do, can I go home now’?”

With respect to task-level barriers, most families viewed homework assignments as boring. General consensus from families was that patients–particularly youth– would more often than not just rather be doing something more interesting.

On the environmental level, all families noted that the home-life of patients is busy and chaotic, leaving little perceived time for homework. Everyday responsibilities such as schoolwork, employment, household chores, and familial responsibilities often take precedence. One caregiver stated,

“Well I think it sounds good in the office and then you get home and you just get quite busy and it gets pushed aside.”

Another commented,

“But I know what he’s saying…sometimes seven-and-a-half hours at school and then sometimes his therapy would be an hour-and-a-half. And thank goodness, his teacher was so flexible that on days he has therapy he did not have homework [for school], but he was just so emotionally and physically drained. When he got home, all he wanted to do was just rest or play. Because that’s the therapy, it can be just exhausting.”

Families also believed that that there is often a lack of reinforcement for completing homework assignments.

m Health Solutions to Homework Barriers

Trainer suggestions..

Trainers provided several suggestions for m Health solutions to homework barriers ( Table 5 ). Most trainers felt that reminders and schedules to help patients remember to complete homework assignments would be a crucial feature. One trainer suggested, “Maybe some kind of reminder feature, something that would kind of record into their daily calendars that they use, or an alarm, or something like a daily reminder…set to the times they are most likely to do the homework.”

Trainer Suggestions for m Health Solutions to Homework Barriers

Trainers also suggested including reports or activity summaries of homework completion along with behavior and symptom tracking tools. One trainer thoughtfully commented, “If the homework app can somehow help to provide some data on the actual implementation of certain skills during the week that would be very valuable because I think the constructive feedback and the positive feedback that’s offered by therapists about performance of those skills between sessions can be really valuable.”

Trainers suggested including a variety of interactive, fun, and rewarding activities that engage children and caregivers. For example, one trainer stated,

“I think the more interactive you can make it between parent and child and the more of a game you can make it…kids are more likely to do that and to kind of use those skills.” All trainers ( n =21) felt that a text message-based system for reminding patients to complete homework assignments would be beneficial.

Family Suggestions.

Families suggested that the main function of the resource should serve to provide reminders (e.g., text messages or push notifications) for patients to complete homework assignments as well as instructions for how and when they should be completed. Another common suggestion was to include a reward system within the resource to reinforce engagement with homework assignments. Some suggestions for this reward system included coins, experience points, levels, and customizable avatar characters. One child thoughtfully related,

“there could be a digital reward system like stars or gems or something. Then it could be redeemed or something in the therapist’s office. Like I remember it was a while ago, I remember my therapist said if I was able to do something that I was having trouble with, we would have like brownies or something the next visit.”

Families also recommended that the resource include interactive and fun activities. The most common suggestion was to “gamify” homework assignments to make them more fun and interesting to patients. For example, a caregiver noted,

“I think that if you are able to play a game or level up after you did your activity…I don’t think you would have a problem with them doing the activity. They would be so excited to be able to play the game.”

Families providers also recommended reports and activity summaries so that progress could be tracked and reported to providers to be reviewed during the next treatment session ( Table 6 ). All families ( n =12) felt that a text message-based system for reminding patients to complete homework assignments would be beneficial.

Family Suggestions for m Health Solutions to Homework Barriers

Benefits and Challenges of m Health Solutions to Homework Barriers

The majority of trainers responded that an m Health solution to homework barriers would increase provider use of ( n =20; 95.2%) and family adherence to ( n =21; 100%) homework during mental health treatment. The majority of trainers also responded that such a resource would positively affect the therapeutic relationship ( n =15; 71.4%), increase treatment efficiency ( n =18; 85.7%), and improve treatment effectiveness ( n =18; 85.7%). Neutral responses were provided by all trainers who did not respond affirmatively to these questions (i.e., no negative responses were provided). Trainers also commented on the potential clinical utility of an m Health homework resource in that it would help providers with tracking and assigning homework and patients with skill development while promoting high levels of engagement in youth patients. Access, comfort with technology, and convenience were also noted benefits (See Table 7 ). One trainer commented,

Trainer Perspectives on Benefits and Challenges relating to m Health Solutions to Homework Barriers No. of Trainers

“I feel like so many people now enjoy so much more doing things on electronics and so definitely in sessions with kids I’m often recommending having a clinician use apps…sometimes technology is the way to really hook families in and engage them.”

“You know everybody has a phone and if we can have some apps where…I mean it’s so exciting to me what you are talking about. I can’t think of a better idea, I really can’t. I mean people always have their phones on them even if you are really, really poor, people tend to have a phone.”

Challenges identified by trainers centered around confidentiality, access and comfort with technology, and potential negative impacts on the therapeutic process. For example, one trainer stated,

“I do not know if people worry about if somebody else saw the app and wondered, ‘oh you are in therapy, oh what happened to you?’ So, some things around privacy issues and confidentiality, but those will be pretty easy to fix.”

The majority of families believed that the an m Health homework resource would make practicing therapy skills at home more fun or interesting ( n =11; 91.7%), would help families practice skills more often ( n =12; 100%), would positively affect the therapeutic relationship ( n =12; 100%), and would improve treatment effectiveness ( n =11; 91.7%). Neutral responses were provided by all families who did not respond affirmatively to these questions (i.e., no negative responses were provided). Families also suggested that an m Health homework resource would have excellent clinical utility, helping to improve communication between providers and families, make treatment and homework more rewarding, encourage more engagement from youth One caregiver commented,

“I think it would encourage the kids to get [homework] done even before the parents. The kids would want to do it on the phone, they love messing with phones.”

“I think by having the reminders, as well as having something there that’s interactive for the kids and the caregivers both. I think it would be a huge help.”

Similar to trainers, challenges noted by families related to confidentiality and some families not having access to the technology or the internet. Additional family perspectives on benefits and challenges are provided in Table 8 .

Family Perspectives on Benefits and Challenges relating to m Health Solutions to Homework Barriers

The aims of this study were to assess barriers to the successful implementation of homework during youth mental health treatment, obtain suggestions for m Health solutions to those barriers, and explore perceptions on the benefits and challenges associated with m Health solutions to homework barriers through semi-structured qualitative interviews with relevant stakeholders. National trainers in TF-CBT provided a unique perspective on the common challenges met by mental health providers and their patients as well as potential solutions to those challenges, particularly given their extensive experience problem-solving common clinical challenges with community mental health providers. Interviews with youth TF-CBT patients and their caregivers provided important perspectives from those most affected by homework barriers in mental health treatment.

Perspectives on Barriers to the Successful Implementation of Homework

Trainer and family perspectives on the various barriers to the successful implementation of homework during mental health treatment aligned well with the heuristic proposed by Kazantzis and Shinkfield (2007) , which classifies barriers as occurring on the provider-, patient-, task-, and environmental-levels. Most of the provider-level barriers noted by trainers were consistent with expert recommendations from the research literature, such as providers’ beliefs relating to homework and patient engagement in homework ( Coon et al., 2005 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ), difficulty designing homework activities and individualizing them to specific patients ( Kazantzis & Shinkfield, 2007 ), forgetting about homework and running out of time during the session ( Friedberg & Mcclure, 2005 ), difficulty with consistency and not wanting to put too many demands on patients ( Coon et al., 2005 ), and difficulty effectively assessing patient barriers ( Kazantzis & Shinkfield, 2007 ). Experts have proposed a model for practice that directly addresses many of these provider-level barriers by proposing an ideal process for facilitating engagement in homework ( Kazantzis, MacEwan, & Dattilio, 2005 ).

Trainer and family perspectives on the most common patient-level homework barriers were similar and were also consistent with the extant literature. These included patients’ avoidance or symptoms ( Coon et al., 2005 ; Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ; Hudson & Kendall, 2005 ; Leahy, 2002 ), forgetting to complete assignments ( Coon et al., 2005 ; Hudson & Kendall, 2005 ), not understanding when, where, or how to do assignments or the rationale ( Dattilio et al., 2011 ; Friedberg & Mcclure, 2005 ; Garland & Scott, 2002 ), and beliefs about homework tasks and their ability to complete them ( Dattilio et al., 2011 ; Kazantzis & Shinkfield, 2007 ). Interestingly, whereas the most commonly endorsed patient-level barrier by trainers was patients not seeing homework as an integral part of therapy or important, the most commonly endorsed barriers by families included avoidance or symptoms, forgetfulness, and lack of understanding about assignments, reflecting differing views on the more significant barriers faced by patients. This discrepancy in the trainers/providers vs . families’ perspectives regarding between session assignments suggests the importance of therapists’ focusing more time on explaining assignments, discussing potential challenges, emphasizing the benefits of completing assignments in overcoming symptoms/difficulties and ultimately inspiring follow through.

Task-level barriers reported by both trainers and families included assignments not aligning with patient values or treatment goals ( Coon et al., 2005 ; Dattilio et al., 2011 ; Hudson & Kendall, 2005 ). Many trainers reported that the word “homework” is an aversive term to patients, particularly to youth patients. Perhaps relatedly, many families reported that children view homework assignments are boring. Negative associations with homework may be addressed by referring to “homework” as practice assignments, experiments, exercises, or action plans, as recommended by a recent Beck Institute blog post by Drs. Judith Beck and Francine Broder ( Beck & Broder, 2016 ).

Finally, environment-level barriers noted by trainers and families included the home lives of patients being busy and chaotic – leaving little time to complete homework assignments; a lack of caregiver involvement in the case of youth; and a lack of reward or reinforcement for completing homework assignments, all of which have been previously noted ( Bru et al., 2013 ; Coon et al., 2005 ; Dattilio et al., 2011 ; Kazantzis & Shinkfield, 2007 ). In sum, trainer and family perspectives on barriers to the successful implementation of homework were largely consistent with those suggested by experts. Further, there was a general agreement between trainers and families with respect to those barriers. It is important to note the interrelatedness of several barriers within various levels. For example, patients not understanding the importance of homework or seeing it as an integral part of therapy could very much reflect a mismatch in alliance, tasks needed to achieve therapy goals, or a poor therapist rationale and opportunity for client feedback and discussion. Further, a patient’s understanding of the rationale for homework might be dependent on the provider’s skill in its explanation.

Trainers and families provided numerous suggestions for m Health solutions to homework barriers. These functionality and content suggestions included: reminders and schedules to overcome barriers to forgetting; behavior and symptom tracking and reports or activity summaries to assist providers in assessing homework completion; a variety of homework activities to choose from to help providers struggling with developing activities; resources for caregivers to improve caregiver support; and an integrated reward system to make completing homework rewarding and reinforcing for patients. Other suggested features related more to user interface and user experience. For example, interviewees felt that the m Health resource should allow easy navigation to relevant resources; include clear instructions via video, text, and audio to help patients understand and remember how to do assignments; include interactive and fun activities to help make the assignments less boring and less like “homework;” and be patient-centered and developmentally appropriate. Trainers and families also felt that a text message-based system for reminding patients to complete homework assignments would be beneficial, indicating that this approach would provide a good alternative to a purely app-based resource.

As outlined in recent reviews, there are several studies on m Health resources that include the functionality and content features suggested in this study and can also be used to facilitate homework implementation ( Bakker et al., 2016 ; Tang & Kreindler, 2017 ). For example, a number of m Health resources can be used for self-monitoring and symptom tracking, and many have engaging activities that can be used to support between-session learning and skill development in the areas of relaxation, cognitive therapy, imaginal exposure, and parent behavioral management ( Bunnell et al., 2019 ; Jungbluth & Shirk, 2013 ; Kristjánsdóttir et al., 2013 ; Newman, Przeworski, Consoli, & Barr Taylor, 2014 ; Reger et al., 2013 ; Shapiro et al., 2010 ; Whiteside, Ale, Vickers Douglas, Tiede, & Dammann, 2014 ). SMS- and app-based reminders and feedback on progress can also be used to encourage continued engagement in skills practice ( Aguilera & Muñoz, 2011 ; Harrison et al., 2011 ; Reger et al., 2013 ; Wiederhold, Boyd, Sulea, Gaggioli, & Riva, 2014 ). However, as stated previously, most of these resources were not designed with the express intention of addressing barriers to homework implementation, particularly for youth and family patient populations, leaving room for future work in this area.

Trainers and families expressed very positive views on m Health solutions to homework barriers. Trainers felt that m Health would increase provider use and family adherence to homework, positively affect the therapeutic relationship, and increase treatment efficiency and effectiveness. Families felt that it would make practicing therapy skills at home more fun or interesting, help families practice skills more often, positively affect the therapeutic relationship, and improve treatment effectiveness. A potential benefit commonly noted by trainers and families was a high likelihood that youth would engage with the resource given their generally strong interest in technology, and that this would help to reinforce the practice of skills learned during therapy. A particular benefit noted was increased access to helpful resources between-sessions. Trainers and families expressed concerns about issues relating to confidentiality. While they did not view this as a fatal flaw of the resource, they suggested implementing appropriate safeguards to protect patient privacy and clearly explaining data protection to encourage use.

Limitations

There are several limitations to this study. Regarding generalizability of results, the selection of trainers and families interviewed was based on experience with TF-CBT, a specific treatment protocol for childhood trauma. Although interview questions were kept general during interviews, referring to mental health treatment rather than solely to TF-CBT, the views expressed by interviewees may relate more to TF-CBT than other child mental health treatments. However, a strength of this research is that TF-CBT has a broad symptom focus (e.g., PTSD, anxiety, depression, anger, disruptive behavior) and includes treatment components used in numerous youth mental health treatments (e.g., psychoeducation, relaxation, cognitive coping, affective modulation, exposure), which suggests that results would be applicable to a range of child mental health treatments. Additionally, national trainers in TF-CBT have consistent exposure to working closely with community mental health providers and regularly help them to problem-solve common barriers in clinical practice. This added insight into difficulties experienced by numerous mental health providers rather than asking individual providers about their experience. This is a strength of this study but also a potential limitation as not directly measured, thus an assumption. The views of trainers may not be completely representative of the every-day challenges to homework implementation experienced by community mental health providers. Given the small samples size and lack of diversity, the results should be interpreted with caution as they may not reflect the experiences or views of therapists and patients who utilize homework across different treatment approaches, therapy settings, and populations.

With respect to interview questions and results, they tended to focus on barriers and challenges and provided less of an opportunity for trainers and family members to share factors that may have led to successes with homework assignments. Such information could also importantly support the development and presentation of m health solutions by therapists. Relatedly, families were asked about barriers faced by youth and caregivers, and not by providers, which would have provided interesting data on family perspectives on providers’ limitations. Although comfort with technology in general was assessed in youth and caregivers, it was not specified as comfort with m Health, and ratings were not collected from trainers. As such, a potential limitation of this study is that participants’ comfort specifically with mHealth was unknown. Furthermore, this study focused specifically on m Health without a comparison to other low-tech solutions, which might have resulted in inflated levels of interest in m health solutions to homework barriers. A final limitation is that interviews were coded by the first author, and there is potential for variability in coding that was not accounted for (i.e., the same themes might have been classified in different ways). Despite this limitation, themes were reviewed and by an internationally recognized expert in the implementation of homework and related barriers during CBT (the fourth author) and compared until agreement was reached, supporting the derived themes.

Conclusions

This study provides important new information on barriers to the successful implementation of homework during youth mental health treatment, based on perspectives of providers, youth, and caregivers with that treatment experience. This study adds to the literature on these barriers, which has been based largely on recommendations from experts in the field. The results of this study aligned well with this literature, providing additional support for these recommendations. Valuable insights on potential m Health solutions to these homework barriers were also provided. These data are being used to inform the development of an m Health resource that aims to address homework barriers in hopes of improving provider use and patient adherence to homework during youth mental health treatment, with the ultimate goal of improving the quality of care received by patients in community mental health settings.

Supplementary Material

10608_2020_10090_moesm1_esm, acknowledgments.

Compliance with Ethical Standards

Funding. Dr. Bunnell was supported by the National Institute of Mental Health (grant numbers F32 MH108250 and K23 MH118482).

Disclosure of Potential Conflicts of Interest

Conflict of Interest. The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

Statement of Human Rights.

Ethics approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board at the Medical University of South Carolina (Pro00047774) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement on the Welfare of Animals

Ethical approval. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Associations of time spent on homework or studying with nocturnal sleep behavior and depression symptoms in adolescents from Singapore

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Does Homework Cause Stress? Exploring the Impact on Students’ Mental Health

How much homework is too much?

Homework has become a matter of concern for educators, parents, and researchers due to its potential effects on students’ stress levels. It’s no secret students often find themselves grappling with high levels of stress and anxiety throughout their academic careers, so understanding the extent to which homework affects those stress levels is important. 

By delving into the latest research and understanding the underlying factors at play, we hope to curate insights for educators, parents, and students who are wondering whether homework causing stress in their lives?

The Link Between Homework and Stress: What the Research Says

Over the years, numerous studies investigated the relationship between homework and stress levels in students. 

One study published in the Journal of Experimental Education found that students who reported spending more than two hours per night on homework experienced higher stress levels and physical health issues . Those same students reported over three hours of homework a night on average.

This study, conducted by Stanford lecturer Denise Pope, has been heavily cited throughout the years, with WebMD producing the below video on the topic– part of their special report series on teens and stress : 

Additional studies published by Sleep Health Journal found that long hours on homework on may be a risk factor for depression , suggesting that reducing workload outside of class may benefit sleep and mental fitness .

Homework’s Potential Impact on Mental Health and Well-being

Homework-induced stress on students can involve both psychological and physiological side effects. 

1. Potential Psychological Effects of Homework-Induced Stress:

• Anxiety: The pressure to perform well academically and meet homework expectations can lead to heightened levels of anxiety in students. Constant worry about completing assignments on time and achieving high grades can be overwhelming.

• Sleep Disturbances : Homework-related stress can disrupt students’ sleep patterns, leading to sleep anxiety or sleep deprivation, both of which can negatively impact cognitive function and emotional regulation.

• Reduced Motivation: Excessive homework demands could drain students’ motivation, causing them to feel fatigued and disengaged from their studies. Reduced motivation may lead to a lack of interest in learning, hindering students’ overall academic performance.

2. Potential Physiological Effects of Homework-Induced Stress:

• Impaired Immune Function: Prolonged stress could weaken the immune system, making students more susceptible to illnesses and infections.

• Disrupted Hormonal Balance : The body’s stress response triggers the release of hormones like cortisol, which, when chronically elevated due to stress, can disrupt the delicate hormonal balance and lead to various health issues.

• Gastrointestinal Disturbances: Stress has been known to affect the gastrointestinal system, leading to symptoms such as stomachaches, nausea, and other digestive problems.

• Cardiovascular Impact: The increased heart rate and elevated blood pressure associated with stress can strain the cardiovascular system, potentially increasing the risk of heart-related issues in the long run.

• Brain impact: Prolonged exposure to stress hormones may impact the brain’s functioning , affecting memory, concentration, and other cognitive abilities.

The Benefits of Homework

It’s important to note that homework also offers many benefits that contribute to students’ academic growth and development, such as: 

• Development of Time Management Skills: Completing homework within specified deadlines encourages students to manage their time efficiently. This valuable skill extends beyond academics and becomes essential in various aspects of life.

• Preparation for Future Challenges : Homework helps prepare students for future academic challenges and responsibilities. It fosters a sense of discipline and responsibility, qualities that are crucial for success in higher education and professional life.

• Enhanced Problem-Solving Abilities: Homework often presents students with challenging problems to solve. Tackling these problems independently nurtures critical thinking and problem-solving skills.

While homework can foster discipline, time management, and self-directed learning, the middle ground may be to  strike a balance that promotes both academic growth and mental well-being .

How Much Homework Should Teachers Assign?

As a general guideline, educators suggest assigning a workload that allows students to grasp concepts effectively without overwhelming them . Quality over quantity is key, ensuring that homework assignments are purposeful, relevant, and targeted towards specific objectives. 

Advice for Students: How to balance Homework and Well-being

Finding a balance between academic responsibilities and well-being is crucial for students. Here are some practical tips and techniques to help manage homework-related stress and foster a healthier approach to learning:

• Effective Time Management : Encourage students to create a structured study schedule that allocates sufficient time for homework, breaks, and other activities. Prioritizing tasks and setting realistic goals can prevent last-minute rushes and reduce the feeling of being overwhelmed.

• Break Tasks into Smaller Chunks : Large assignments can be daunting and may contribute to stress. Students should break such tasks into smaller, manageable parts. This approach not only makes the workload seem less intimidating but also provides a sense of accomplishment as each section is completed.

• Find a Distraction-Free Zone : Establish a designated study area that is free from distractions like smartphones, television, or social media. This setting will improve focus and productivity, reducing time needed to complete homework.

• Be Active : Regular exercise is known to reduce stress and enhance mood. Encourage students to incorporate physical activity into their daily routine, whether it’s going for a walk, playing a sport, or doing yoga.

• Practice Mindfulness and Relaxation Techniques : Encourage students to engage in mindfulness practices, such as deep breathing exercises or meditation, to alleviate stress and improve concentration. Taking short breaks to relax and clear the mind can enhance overall well-being and cognitive performance.

• Seek Support : Teachers, parents, and school counselors play an essential role in supporting students. Create an open and supportive environment where students feel comfortable expressing their concerns and seeking help when needed.

How Healium is Helping in Schools

Stress is caused by so many factors and not just the amount of work students are taking home.  Our company created a virtual reality stress management solution… a mental fitness tool called “Healium” that’s teaching students how to learn to self-regulate their stress and downshift in a drugless way. Schools implementing Healium have seen improvements from supporting dysregulated students and ADHD challenges to empowering students with body awareness and learning to self-regulate stress . Here’s one of their stories. 

By providing students with the tools they need to self-manage stress and anxiety, we represent a forward-looking approach to education that prioritizes the holistic development of every student. 

To learn more about how Healium works, watch the video below.

About the Author

Sarah Hill , a former interactive TV news journalist at NBC, ABC, and CBS affiliates in Missouri, gained recognition for pioneering interactive news broadcasting using Google Hangouts. She is now the CEO of Healium, the world’s first biometrically powered immersive media channel, helping those with stress, anxiety, insomnia, and other struggles through biofeedback storytelling. With patents, clinical validation, and over seven million views, she has reshaped the landscape of immersive media.

Homework as a Mental Health Concern It's time for an in depth discussion about homework as a major concern for those pursuing mental health in schools. So many problems between kids and their families, the home and school, and students and teachers arise from conflicts over homework. The topic is a long standing concern for mental health practitioners, especially those who work in schools. Over the years, we have tried to emphasize the idea that schools need to ensure that homework is designed as "motivated practice," and parents need to avoid turning homework into a battleground. These views are embedded in many of the Center documents. At this time, we hope you will join in a discussion of what problems you see arising related to homework and what you recommend as ways to deal with such problems, what positive homework practices you know about, and so forth. Read the material that follows, and then, let us hear from you on this topic. Contact: [email protected] ######################### As one stimulus, here's a piece by Sharon Cromwell from Education World prepared for teachers " The Homework Dilemma: How Much Should Parents Get Involved? " http://www.education-world.com/a_curr/curr053.shtml . What can teachers do to help parents help their children with homework? Just what kind of parental involvement -- and how much involvement -- truly helps children with their homework? The most useful stance parents can take, many experts agree, is to be somewhat but not overly involved in homework. The emphasis needs to be on parents' helping children do their homework themselves -- not on doing it for them. In an Instructor magazine article, How to Make Parents Your Homework Partner s, study-skills consultant Judy Dodge maintains that involving students in homework is largely the teacher's job, yet parents can help by "creating a home environment that's conducive to kids getting their homework done." Children who spend more time on homework, on average, do better academically than children who don't, and the academic benefits of homework increase in the upper grades, according to Helping Your Child With Homework , a handbook by the Office of Education Research and Improvement in the U.S. Department of Education. The handbook offers ideas for helping children finish homework assignments successfully and answers questions that parents and people who care for elementary and junior high school students often ask about homework. One of the Goals 2000 goals involves the parent/school relationship. The goal reads, "Every school will promote partnerships that will increase parental involvement and participation in promoting the social, emotional, and academic growth of children." Teachers can pursue the goal, in part, by communicating to parents their reasons for assigning homework. For example, the handbook states, homework can help children to review and practice what they have learned; prepare for the next day's class; use resources, such as libraries and reference materials; investigate topics more fully than time allows in the classroom. Parents can help children excel at homework by setting a regular time; choosing a place; removing distractions; having supplies and resources on hand; monitoring assignments; and providing guidance. The handbook cautions against actually doing the homework for a child, but talking about the assignment so the child can figure out what needs to be done is OK. And reviewing a completed assignment with a child can also be helpful. The kind of help that works best depends, of course, partly on the child's age. Elementary school students who are doing homework for the first time may need more direct involvement than older students. HOMEWORK "TIPS" Specific methods have been developed for encouraging the optimal parental involvement in homework. TIPS (Teachers Involve Parents in Schoolwork) Interactive Homework process was designed by researchers at Johns Hopkins University and teachers in Maryland, Virginia, and the District of Columbia to meet parents' and teachers' needs, says the Phi Delta Kappa Research Bulletin . The September 1997 bulletin reported the effects of TIPS-Language Arts on middle-grade students' writing skills, language arts report card grades, and attitudes toward TIPS as well as parents' reactions to interactive homework. TIPS interactive homework assignments involve students in demonstrating or discussing homework with a family member. Parents are asked to monitor, interact, and support their children. They are not required to read or direct the students' assignments because that is the students' responsibility. All TIPS homework has a section for home-to-school communication where parents indicate their interaction with the student about the homework. The goals of the TIPS process are for parents to gain knowledge about their children's school work, students to gain mastery in academic subjects by enhancing school lessons at home, and teachers to have an understanding of the parental contribution to student learning. "TIPS" RESULTS Nearly all parents involved in the TIPS program said TIPS provided them with information about what their children were studying in school. About 90 percent of the parents wanted the school to continue TIPS the following year. More than 80 percent of the families liked the TIPS process (44 percent a lot; 36% a little). TIPS activities were better than regular homework, according to 60 percent of the students who participated. About 70 percent wanted the school to use TIPS the next year. According to Phi Delta Kappa Research Bulletin , more family involvement helped students' writing skills increase, even when prior writing skills were taken into account. And completing more TIPS assignments improved students' language arts grades on report cards, even after prior report card grades and attendance were taken into account. Of the eight teachers involved, six liked the TIPS process and intended to go on using it without help or supplies from the researchers. Furthermore, seven of the eight teachers said TIPS "helps families see what their children are learning in class." OTHER TIPS In "How to Make Parents Your Homework Partners," Judy Dodge suggests that teachers begin giving parent workshops to provide practical tips for "winning the homework battle." At the workshop, teachers should focus on three key study skills: Organizational skills -- Help put students in control of work and to feel sure that they can master what they need to learn and do. Parents can, for example, help students find a "steady study spot" with the materials they need at hand. Time-management skills -- Enable students to complete work without feeling too much pressure and to have free time. By working with students to set a definite study time, for example, parents can help with time management. Active study strategies -- Help students to achieve better outcomes from studying. Parents suggest, for instance, that students write questions they think will be on a test and then recite their answers out loud. Related Resources Homework Without Tears by Lee Canter and Lee Hauser (Perennial Library, 1987). A down-to-earth book by well-known experts suggests how to deal with specific homework problems. Megaskills: How Families Can Help Children Succeed in School and Beyond by Dorothy Rich (Houghton Mifflin Company, 1992). Families can help children develop skills that nurture success in and out of school. "Helping Your Student Get the Most Out of Homework" by the National PTA and the National Education Association (1995). This booklet for teachers to use with students is sold in packages of 25 through the National PTA. The Catalog item is #B307. Call 312-549-3253 or write National PTA Orders, 135 South LaSalle Street, Dept. 1860, Chicago, IL 60674-1860. Related Sites A cornucopia of homework help is available for children who use a computer or whose parents are willing to help them get started online. The following LINKS include Internet sites that can be used for reference, research, and overall resources for both homework and schoolwork. Dr. Internet. The Dr. Internet Web site, part of the Internet Public Library, helps students with science and math homework or projects. It includes a science project resource guide Help With Homework. His extensive listing of Internet links is divided into Language Art Links, Science Links, Social Studies Links, Homework Help, Kids Education, and Universities. If students know what they are looking for, the site could be invaluable. Kidz-Net... Links to places where you can get help with homework. An array of homework help links is offered here, from Ask Dr. Math (which provides answers to math questions) to Roget's Thesaurus and the White House. Surfing the Net With Kids: Got Questions? Links to people -- such as teachers, librarians, experts, authors, and other students -- who will help students with questions about homework. Barbara J. Feldman put together the links. Kidsurfer: For Kids and Teens The site, from the National Children's Coalition, includes a Homework/Reference section for many subjects, including science, geography, music, history, and language arts. Homework: Parents' Work, Kid's Work, or School Work? A quick search of this title in the Education Week Archives and you'll find an article presenting a parent's viewpoint on helping children with homework. @#@#@#@@# As another stimulus for the discussion, here is an excerpt from our online continuing education module Enhancing Classroom Approaches for Addressing Barriers to Learning ( https://smhp.psych.ucla.edu ) Turning Homework into Motivated Practice Most of us have had the experience of wanting to be good at something such as playing a musical instrument or participating in a sport. What we found out was that becoming good at it meant a great deal of practice, and the practicing often was not very much fun. In the face of this fact, many of us turned to other pursuits. In some cases, individuals were compelled by their parents to labor on, and many of these sufferers grew to dislike the activity. (A few, of course, commend their parents for pushing them, but be assured these are a small minority. Ask your friends who were compelled to practice the piano.) Becoming good at reading, mathematics, writing, and other academic pursuits requires practice outside the classroom. This, of course, is called homework. Properly designed, homework can benefit students. Inappropriately designed homework, however, can lead to avoidance, parent-child conflicts, teacher reproval, and student dislike of various arenas of learning. Well-designed homework involves assignments that emphasize motivated practice. As with all learning processes that engage students, motivated practice requires designing activities that the student perceives as worthwhile and doable with an appropriate amount of effort. In effect, the intent is to personalize in-class practice and homework. This does not mean every student has a different practice activity. Teachers quickly learn what their students find engaging and can provide three or four practice options that will be effective for most students in a class. The idea of motivated practice is not without its critics. I don't doubt that students would prefer an approach to homework that emphasized motivated practice. But �� that's not preparing them properly for the real world. People need to work even when it isn't fun, and most of the time work isn't fun. Also, if a person wants to be good at something, they need to practice it day in and day out, and that's not fun! In the end, won't all this emphasis on motivation spoil people so that they won't want to work unless it's personally relevant and interesting? We believe that a great deal of learning and practice activities can be enjoyable. But even if they are not, they can be motivating if they are viewed as worthwhile and experienced as satisfying. At the same time, we do recognize that there are many things people have to do in their lives that will not be viewed and experienced in a positive way. How we all learn to put up with such circumstances is an interesting question, but one for which psychologists have yet to find a satisfactory answer. It is doubtful, however, that people have to experience the learning and practice of basic knowledge and skills as drudgery in order to learn to tolerate boring situations. Also in response to critics of motivated practice, there is the reality that many students do not master what they have been learning because they do not pursue the necessary practice activities. Thus, at least for such individuals, it seems essential to facilitate motivated practice. Minimally, facilitating motivated practice requires establishing a variety of task options that are potentially challenging -- neither too easy nor too hard. However, as we have stressed, the processes by which tasks are chosen must lead to perceptions on the part of the learner that practice activities, task outcomes, or both are worthwhile -- especially as potential sources of personal satisfaction. The examples in the following exhibit illustrate ways in which activities can be varied to provide for motivated learning and practice. Because most people have experienced a variety of reading and writing activities, the focus here is on other types of activity. Students can be encouraged to pursue such activity with classsmates and/or family members. Friends with common interests can provide positive models and support that can enhance productivity and even creativity. Research on motivation indicates that one of the most powerful factors keeping a person on a task is the expectation of feeling some sense of satisfaction when the task is completed. For example, task persistence results from the expectation that one will feel smart or competent while performing the task or at least will feel that way after the skill is mastered. Within some limits, the stronger the sense of potential outcome satisfaction, the more likely practice will be pursued even when the practice activities are rather dull. The weaker the sense of potential outcome satisfaction, the more the practice activities themselves need to be positively motivating. Exhibit � Homework and Motivated Practice Learning and practicing by (1) doing using movement and manipulation of objects to explore a topic (e.g., using coins to learn to add and subtract) dramatization of events (e.g., historical, current) role playing and simulations (e.g., learning about democratic vs. autocratic government by trying different models in class; learning about contemporary life and finances by living on a budget) actual interactions (e.g., learning about human psychology through analysis of daily behavior) applied activities (e.g., school newspapers, film and video productions, band, sports) actual work experience (e.g., on-the-job learning) (2) listening reading to students (e.g., to enhance their valuing of literature) audio media (e.g., tapes, records, and radio presentations of music, stories, events) listening games and activities (e.g., Simon Says; imitating rhymes, rhythms, and animal sounds) analyzing actual oral material (e.g., learning to detect details and ideas in advertisements or propaganda presented on radio or television, learning to identify feelings and motives underlying statements of others) (3) looking directly observing experts, role models, and demonstrations visual media visual games and activities (e.g., puzzles, reproducing designs, map activities) analyzing actual visual material (e.g., learning to find and identify ideas observed in daily events) (4) asking information gathering (e.g., investigative reporting, interviewing, and opinion sampling at school and in the community) brainstorming answers to current problems and puzzling questions inquiry learning (e.g., learning social studies and science by identifying puzzling questions, formulating hypotheses, gathering and interpreting information, generalizing answers, and raising new questions) question-and-answer games and activities (e.g., twenty questions, provocative and confrontational questions) questioning everyday events (e.g., learning about a topic by asking people about how it effects their lives) O.K. That's should be enough to get you going. What's your take on all this? What do you think we all should be telling teachers and parents about homework? Let us hear from you ( [email protected] ). Back to Hot Topic Home Page Hot Topic Home Page --> Table of Contents Home Page Search Send Us Email School Mental Health Project-UCLA Center for Mental Health in Schools WebMaster: Perry Nelson ([email protected])

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Education scholar Denise Pope has found that too much homework has negative effects on student well-being and behavioral engagement. (Image credit: L.A. Cicero)

A Stanford researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.

“Our findings on the effects of homework challenge the traditional assumption that homework is inherently good,” wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .

The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students’ views on homework.

Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.

Students in these schools average about 3.1 hours of homework each night.

“The findings address how current homework practices in privileged, high-performing schools sustain students’ advantage in competitive climates yet hinder learning, full engagement and well-being,” Pope wrote.

Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.

Their study found that too much homework is associated with:

* Greater stress: 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.

* Reductions in health: In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.

* Less time for friends, family and extracurricular pursuits: Both the survey data and student responses indicate that spending too much time on homework meant that students were “not meeting their developmental needs or cultivating other critical life skills,” according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.

A balancing act

The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.

Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as “pointless” or “mindless” in order to keep their grades up.

“This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points,” Pope said.

She said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.

“Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development,” wrote Pope.

High-performing paradox

In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. “Young people are spending more time alone,” they wrote, “which means less time for family and fewer opportunities to engage in their communities.”

Student perspectives

The researchers say that while their open-ended or “self-reporting” methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for “typical adolescent complaining” – it was important to learn firsthand what the students believe.

The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

Media Contacts

Denise Pope, Stanford Graduate School of Education: (650) 725-7412, [email protected] Clifton B. Parker, Stanford News Service: (650) 725-0224, [email protected]

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Data and Statistics on Children’s Mental Health

Mental health is an important part of children’s overall health and well-being. Mental health includes children’s mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. 1 Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children’s Health, to describe the presence of positive indicators of children’s mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider.  The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

• Affection (97.0%), resilience (87.9%), positivity (98.7%) and curiosity (93.9%) among children ages 3-5 years 2
• Curiosity (93.0%), persistence (84.2%), and self-control (73.8%) among children ages 6-11 years 2
• Curiosity (86.5 %), persistence (84.7%), and self-control (79.8%) among children ages 12-17 years 2

Facts about mental disorders in U.S. children

• ADHD 9.8% (approximately 6.0 million) 2
• Anxiety 9.4% (approximately 5.8 million) 2
• Behavior problems 8.9% (approximately 5.5 million) 2
• Depression 4.4% (approximately 2.7 million) 2
• Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%). 3
• For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%). 3
• For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%). 3
• “Ever having been diagnosed with either anxiety or depression” among children aged 6–17 years increased from 5.4% in 2003 to 8% in 2007 and to 8.4% in 2011–2012. 4
• “Ever having been diagnosed with anxiety” increased from 5.5% in 2007 to 6.4% in 2011–2012. 4
• “Ever having been diagnosed with depression” did not change between 2007 (4.7%) and 2011-2012 (4.9%). 4
• For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:
• 15.1% had a major depressive episode. 2
• 36.7% had persistent feelings of sadness or hopelessness. 2
• 4.1% had a substance use disorder. 2
• 1.6% had an alcohol use disorder. 2
• 3.2% had an illicit drug use disorder. 2
• 18.8% seriously considered attempting suicide. 2
• 15.7% made a suicide plan. 2
• 8.9% attempted suicide. 2
• 2.5% made a suicide attempt requiring medical treatment. 2

Learn more about high-risk substance use among youth . Learn more about suicide .

• Nearly 8 in 10 children (78.1%) with depression received treatment. 3
• 6 in 10 children (59.3%) with anxiety received treatment. 3
• More than 5 in 10 children (53.5%) with behavior disorders received treatment. 3
• 1 in 6 U.S. children aged 2–8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder. 5
• Diagnoses of ADHD, anxiety, and depression become are more common with increased age. 3
• Behavior problems are more common among children aged 6–11 years than younger or older children. 3

• Among children aged 2-8 years, boys were more likely than girls to have a mental, behavioral, or developmental disorder. 5
• Among children living below 100% of the federal poverty level, more than 1 in 5 (22%) had a mental, behavioral, or developmental disorder. 5
• Age and poverty level affected the likelihood of children receiving treatment for anxiety, depression, or behavior problems. 3
• Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%). 6
• Racial/ethnic discrimination was almost seven times as common among children with three other ACEs compared to those with no other ACEs. 6

Note : The estimates reported on this page are based on parent report, using nationally representative surveys. This method has several limitations. It is not known to what extent children receive these diagnoses accurately. Estimates based on parent-reported diagnoses may match those based on medical records, 7  but some children may also have mental disorders that have not been diagnosed, or receive diagnoses that may not be the best fit for their symptoms. Limited information on measuring children’s mental health nationally is available 2 .

Read more about children’s mental health from a community study .

Access to mental health treatment

Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders. 7 Access to providers who can offer services, including screening, referrals, and treatment, varies by location. CDC is working to learn more about access to behavioral health services and supports for children and their families.

View information by state describing the rates of different types of providers who can offer behavioral health services providers by county.

Read a recent report describing shortages of services, barriers to treatment, and how integration of behavioral health care with pediatric primary care could address the issues.

Read a policy brief on potential ways to increase access to mental health services for children in rural areas

What is It and Why is It Important?

Data sources for mental health and related conditions

There are many different datasets which include information on children’s mental health and related conditions for children living in the United States.

Healthy People 2030 Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade, including children’s mental health and well-being.

National Survey of Family Growth (NSFG) NSFG gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health.

National Health and Nutrition Examination Survey (NHANES) NHANES assesses health and nutritional status through interviews and physical examinations, and includes conditions, symptoms, and concerns associated with mental health and substance abuse, as well as the use and need for mental health services.

National Health Interview Survey (NHIS) NHIS collects data on children’s mental health, mental disorders, such as ADHD, autism spectrum disorder, depression and anxiety problems, and use and need for mental health services.

National Survey of Children’s Health (NSCH) NSCH examines the health of children, with emphasis on well-being, including medical homes, family interactions, the health of parents, school and after-school experiences, and safe neighborhoods. This survey was redesigned in 2016.

For previous versions of this survey, see also: National Survey of Children’s Health (NSCH 2003, 2007, 2011-12) National Survey of Children with Special Healthcare Needs (NS-CSHCN 2001, 2005-6, 2009-10)

National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA) NS-DATA collects information about children, 2-15 years old in 2011-2012, who had ever been diagnosed with ADHD and/or Tourette syndrome (TS), with the goal of better understanding diagnostic practices, level of impairment, and treatments for this group of children.

National Survey on Drug Use and Health (NSDUH) NSDUH, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides national- and state-level data on the use of tobacco, alcohol, and illicit drugs (including non-medical use of prescription drugs), as well as data on mental health in the United States.

National Vital Statistics System (NVSS) NVSS contains vital statistics from the official records of live births, deaths, causes of death, marriages, divorces, and annulment recorded by states and independent registration areas

National Youth Tobacco Survey (NYTS) NYTS is a nationally representative school-based survey on tobacco use by public school students enrolled in grades 6-12.

School Associated Violent Death Study (SAVD) SAVD plays an important role in monitoring trends related to school-associated violent deaths (including suicide), identifying the factors that increase the risk, and assessing the effects of prevention efforts.

School Health Policies and Programs Study (SHPPS) SHPPS is a national survey assessing school health policies and practices at the state, district, school, and classroom levels. Collected data includes mental health and social service policies.

Web-based Injury Statistics Query and Reporting System (WISQARS) WISQARS is an interactive database system that provides customized reports of injury-related data.

Youth Risk Behavior Surveillance System (YRBSS) The YRBSS monitors health-risk behaviors, including tobacco use, substance abuse, unintentional injuries and violence, sexual behaviors that contribute to unintended pregnancy, and sexually transmitted diseases.

• Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children – United States, 2005—2011. MMWR 2013;62(Suppl; May 16, 2013):1-35. [ Read summary ]
• Bitsko RH, Claussen AH, Lichtstein J, Black LJ, Everett Jones S, Danielson MD, Hoenig JM, Davis Jack SP, Brody DJ, Gyawali S, Maenner MM, Warner M, Holland KM, Perou R, Crosby AE, Blumberg SJ, Avenevoli S, Kaminski JW, Ghandour RM. Surveillance of Children’s Mental Health – United States, 2013 – 2019 MMWR, , 2022 / 71(Suppl-2);1–42. [Read article]
• Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics , 2018. Published online before print  October 12, 2018 [ Read summary ]
• Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup J. Epidemiology and impact of healthcare provider diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics . Published online before print April 24, 2018 [ Read summary ]
• Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2–8 years — United States, 2016. MMWR , 2018;67(5):1377-1383. [ Read article ]
• Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022. [ Read summary ]
• US Department of Health and Human Services Health Resources and Services Administration & Maternal and Child Health Bureau. Mental health: A report of the Surgeon General . Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999. [ Read report ]

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How Homework Is Destroying Teens’ Health

Jessica Amabile '24 , Staff Writer March 25, 2022

“[Students] average about 3.1 hours of homework each night,” according to an article published by Stanford .  Teens across the country come home from school, exhausted from a long day, only to do more schoolwork.  They sit at their computers, working on homework assignments for hours on end.  To say the relentless amount of work they have to do is overwhelming would be an understatement.  The sheer amount of homework given has many negative impacts on teenagers.

Students have had homework for decades, but in more recent years it has become increasingly more demanding.  Multiple studies have shown that students average about three hours of homework per night.  The Atlantic mentioned that students now have twice as much homework as students did in the 1990s.  This is extremely detrimental to teens’ mental health and levels of stress.  Students have a lot to do after school, such as spending time with family, extracurricular activities, taking care of siblings or other family members, hanging out with friends, or all of the above.  Having to juggle all of this as well as hours on end of homework is unreasonable because teenagers already have enough to think or worry about.   

According to a student- run survey conducted in Cherry Hill West, students reported that they received the most homework in math, history, and language arts classes.  They receive anywhere from 1 to 4 or more hours of homework every day, but only about 22.7% somewhat or strongly agree that it helps them learn.  Of the students who participated, 63.6% think schools should continue to give out homework sometimes, while 27.3% said they should not give out homework at all.  In an open-ended response section, students had a lot to say.  One student wrote, “I think we should get homework to practice work if we are seen struggling, or didn’t finish work in class. But if we get homework, I think it just shows that the teacher needs more time to teach and instead of speeding up, gives us more work.”  Another added,  “Homework is important to learn the material. However, too much may lead to the student not learning that much, or it may become stressful to do homework everyday.”  Others wrote, “The work I get in chemistry doesn’t help me learn at all if anything it confuses me more,” and “I think math is the only class I could use homework as that helps me learn while world language is supposed to help me learn but feels more like a time waste.”   A student admitted, “I think homework is beneficial for students but the amount of homework teachers give us each day is very overwhelming and puts a lot of stress on kids. I always have my work done but all of the homework I have really changes my emotions and it effects me.”  Another pointed out, “you are at school for most of your day waking up before the sun and still after all of that they send you home each day with work you need to do before the next day. Does that really make sense[?]”

As an article from Healthline mentioned, “Researchers asked students whether they experienced physical symptoms of stress… More than 80 percent of students reported having at least one stress-related symptom in the past month, and 44 percent said they had experienced three or more symptoms.”  If school is causing students physical symptoms of stress, it needs to re-evaluate whether or not homework is beneficial to students, especially teenagers.  Students aren’t learning anything if they have hours of “busy work” every night, so much so that it gives them symptoms of stress, such as headaches, weight loss, sleep deprivation, and so on.  The continuous hours of work are doing nothing but harming students mentally and physically.

The mental effects of homework can be harmful as well.  Mental health issues are often ignored, even when schools can be the root of the problem.  An article from USA Today contained a quote from a licensed therapist and social worker named Cynthia Catchings, which reads, “ heavy workloads can also cause serious mental health problems in the long run, like anxiety and depression.”  Mental health problems are not beneficial in any way to education.  In fact, it makes it more difficult for students to focus and learn.  

Some studies have suggested that students should receive less homework.  To an extent, homework can help students in certain areas, such as math.  However, too much has detrimental impacts on their mental and physical health.  Emmy Kang, a mental health counselor, has a suggestion.  She mentioned, “I don’t think (we) should scrap homework; I think we should scrap meaningless, purposeless busy work-type homework. That’s something that needs to be scrapped entirely,” she says, encouraging teachers to be thoughtful and consider the amount of time it would take for students to complete assignments,” according to USA Today .  Students don’t have much control over the homework they receive, but if enough people could explain to teachers the negative impacts it has on them, they might be convinced.  Teachers need to realize that their students have other classes and other assignments to do.  While this may not work for everything, it would at least be a start, which would be beneficial to students.

The sole purpose of schools is to educate children and young adults to help them later on in life.  However, school curriculums have gone too far if hours of homework for each class are seen as necessary and beneficial to learning.  Many studies have shown that homework has harmful effects on students, so how does it make sense to keep assigning it?  At this rate, the amount of time spent on homework will increase in years to come, along with the effects of poor mental and physical health.  Currently, students do an average of 3 hours of homework, according to the Washington Post, and the estimated amount of teenagers suffering from at least one mental illness is 1 in 5, as Polaris Teen Center stated.  This is already bad enough–it’s worrisome to think it could get much worse.  Homework is not more important than physical or mental health, by any standards.

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• Open access
• Published: 27 June 2023

The relationship between homeworking during COVID-19 and both, mental health, and productivity: a systematic review

• Charlotte E. Hall 1 , 2 , 3 ,
• Louise Davidson 2 , 4 ,
• Samantha K. Brooks 1 , 3 ,
• Neil Greenberg 1 , 3 &
• Dale Weston 2  

BMC Psychology volume  11 , Article number:  188 ( 2023 ) Cite this article

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As of March 2020, the UK public were instructed to work from home where possible and as a result, nearly half of those in employment did so during the following month. Pre-pandemic, around 5% of workers chose to work from home; it was often seen as advantageous, for example due to eliminating commuting time and increasing flexibility. However, homeworking also had negative connotations, for example, blurred boundaries between work and home life due to a sense of constant connectivity to the workplace. Understanding the psychological impact of working from home in an enforced and prolonged manner due to the COVID-19 pandemic is important. Therefore, this review sought to establish the relationship between working from home, mental health, and productivity.

In January 2022, literature searches were conducted across four electronic databases: Medline, Embase, PsycInfo and Web of Science. In February 2022 grey literature searches were conducted using Google Advanced Search, NHS Evidence; Gov.uk Publications and the British Library directory of online doctoral theses. Published and unpublished literature which collected data after March 2020, included participants who experienced working from home for at least some of their working hours, and detailed the association in terms of mental health or productivity were included.

In total 6,906 citations were screened and 25 papers from electronic databases were included. Grey literature searching resulted in two additional papers. Therefore, 27 studies were included in this review. Findings suggest the association between homeworking and both, mental health and productivity varies considerably, suggesting a complex relationship, with many factors (e.g., demographics, occupation) having an influence on the relationship.

We found that there was no clear consensus as to the association between working from home and mental health or productivity. However, there are indications that those who start homeworking for the first time during a pandemic are at risk of poor productivity, as are those who experience poor mental health. Suggestions for future research are suggested.

Peer Review reports

Within the UK, the COVID-19 pandemic led to several behavioural interventions being implemented by the government with the aim to reduce transmission of the virus. As of March 2020, the public were instructed to work from home and as a result, nearly half of those in employment did so during April 2020 [ 1 ]. As of January 2022, 36% of workers still reported homeworking at least once in the last seven days [ 2 ]. Pre-pandemic, only around 5% of workers chose to work from home [ 3 ] and findings on the impact of doing so is inconsistent. For some, homeworking was seen as a positive way of overcoming issues (e.g., decreasing commuting time [ 4 ]). However, homeworking also had negative connotations, for example, blurred boundaries between work and home life due to a sense of constant connectivity to the workplace [ 5 ]. Considering the potential disadvantages of homeworking pre-pandemic, understanding the psychological effect of enforced and prolonged working from home due to the COVID-19 pandemic is important.

Unsurprisingly, since the onset of the pandemic, the association between working from home and various aspects of health have been the subject of much research. Literature reviews, including papers from pre-pandemic, have reported mixed findings. For example, a rapid review conducted by Oakman (2020), contained 23 studies published between 2008 and 2020, explored the link between working from home and mental and physical health. For mental health specifically, the relationship was reported to be complex with many conflicting findings (e.g., increased stress and increased well-being; [ 6 ]). Varied findings have also been reported by a systematic review conducted by Lunde (2022) which sought to establish the relationship between working from home and employee health (examined outcomes included: general health, pain, well-being, stress, exhaustion and burnout, satisfaction, life and leisure) using studies published between 2010 to 2020 [ 7 ].

A scoping review focused on more current pandemic related research was conducted by Elbaz (2022) and aimed to establish the association between telework (i.e., a working arrangement that allows individuals to engage in work activities through information and communication technologies from outside the main work location [ 8 ]) and work-life balance using studies published between January 2020 and December 2021. 42 papers were included, and the review concluded that teleworking resulted in a mixed relationship. However, the link between teleworking and psychological health was typically more negative than positive [ 8 ].

Thus, the purpose of this review is to establish if there is an association between working from home and both, mental health, and productivity; specifically, for those who experienced working from home during the COVID-19 pandemic. This systematic review seeks to, first, contribute to the evidence base by being the first review to collate findings from published and grey literature research originating from economically developed countries (as indicated by membership of the Organisation for Economic Co-operation and Development; OECD) into the link between working from home and both, mental health, and productivity during the COVID-19 pandemic. Second, to establish risk or resilience (as defined as positive adaptation in response to adversity [ 9 ]) factors that make an individual more likely to adapt well to homeworking during a pandemic. Third, to provide findings and conclusions that can be used to establish implications and future research suggestions for improving the experience of homeworking for those doing so during a future public health emergency.

This systematic review is designed in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 10 ]. This results in the method section describing and explaining the process of criteria selection, use of information sources, the search strategy, study selection, data collection, quality assessment and the analytical method used during the review.

Eligibility criteria

The development of inclusion and exclusion criteria for the current review was iterative and developed alongside literature familiarisation, preliminary database searches, and research team meetings. The final inclusion and exclusion criteria for the current systematic review can be found in Table 1 .

Information sources

Electronic database searches.

Search terms were created in relation to population/context, intervention, and outcome of the research question, as recommended by Cochrane’s Handbook for Systematic Reviews [ 11 ]. Terms were developed a priori from current literature and developed iteratively by the research team using preliminary searches to ensure a manageable and focused scope of investigation.

The final search was conducted on the 25 th of January 2022 across the following databases:

Ovid®SP MEDLINE.® 1946 to January 18, 2022

Ovid.®SP Embase 1974 to 2022 January 14

Ovid.®SP APA PsycINFO 1806 to January Week 2 2022

Web of Science™ Core Collection

The final search involved two strings of terms: firstly, those relating to homeworking, and secondly, psychological terms encompassing mental health, resilience, and productivity. Where possible, databased controlled vocabulary was used. Free text terms remained consistent across all four searches, only differing on database specific truncation and use of punctuation. Free text terms were searched within titles and abstracts on Medline, Embase and APA PsychINFO. Free text terms were searched within title, abstract, author keywords and Keywords Plus in Web of Science Core Collection. All searches were limited to 2020 – current, to only capture data related to working from home during the COVID-19 pandemic. Full search strategies for all databases, including filters and limits used can be found in Supplemental Table 1 .

Grey literature searches

The following sources were searched on the 1 st of February 2022: Google Advanced Search, NHS Evidence; Gov.uk Publications; and the British Library directory of online doctoral theses (EThOS).

The following search was used for the Google Advanced Search, NHS evidence, and EthOS. For the Google Advanced Search, the results were ordered by most relevant, and the first 20 pages (totalling 200 hits) were screened. The NHS search was limited to primary research only.

(“work from home” OR “telework” OR “homework”)

(“mental health” OR “productivity” OR “resilience”)

The remaining searches were kept relatively simple due to small numbers of papers available shown during preliminary searches. Gov.uk Publication searches were limited to: ‘research’ or ‘statistics’ or ‘policy papers and consultations’, including the terms “homework”, “telework”, or “work from home”. Office for National Statistics searches were “homework”, “telework” or “work from home”. Full search strategies for all registers and websites, including filters and limits used can be found in Supplemental Table 2 .

Study selection

Results of the literature searches were downloaded to EndNote X9 reference management software (Thomson Reuters, New York, United States (US)). Initial screening was carried out for all titles and abstracts against the inclusion and exclusion criteria by one author (CEH). Each study was categorised into one of the following groups: “include”, “exclude” or “unsure”. A 10% check of excluded papers (~ 400 records) was carried out by a second reviewer (LD), any papers marked as potentially relevant by LD were then rescreened by CEH. Both of the “include” and “unsure” categories then were subject to full text screening. To provide robustness to the review process, 10% of the papers were also full text screened by a second reviewer (LD). When there were disagreements between reviewers (i.e., on 3/12 papers), a third reviewer (SKB) was used, and the majority decision taken. Articles were then categorised into “include” or “exclude”. A PRIMSA flowchart of the screening process is presented in Fig.  1 .

PRISMA flow diagram

Data extraction and synthesis

Data was extracted using a data extraction spreadsheet by one author (CEH). Article data and information extracted included: authors; title; type of document (e.g., publication, governmental report); publication year; publication origin; aims and hypotheses; size of sample; sample demographics and characteristics; variables of interest examined, outcome measures; key findings, limitations, and recommendations. Extraction of this data allowed for study characteristics (e.g., date of publication, country of origin, sample characteristics, outcome measures) to be reported alongside key findings, whilst considering reported study limitations and recommendations/implications suggested by the authors. A 20% check of extracted data relating to key findings was carried out by LD, no discrepancies found between reviewers. Narrative synthesis was used to collate findings from the retained papers [ 12 ]. Research findings were firstly grouped by variables examined (e.g., productivity or mental health focused), and a narrative was synthesised.

Quality assessment

The Mixed Methods Appraisal tool [ 13 ] was used to appraise the quality of included studies based on the information provided in the papers. This tool was chosen due to its ability to appraise both qualitative and quantitative studies whilst also accounting for the differences between types of study. Many reviews have used this tool for quality assessment, for example [ 14 , 15 , 16 ]. Papers were checked for suitability using the following screening questions: “Are there clear research questions?”; “Do the collected data allow to address the research questions?”. Each study was then assessed using five questions relevant to the methodological approach used within the paper [ 13 ]. One author carried out the quality appraisal (CEH).

In total 6,906 search results were extracted from electronic databases. Post duplication screening, 4,233 papers remained for title and abstract screening. 119 papers were sought for retrieval, one paper [ 17 ] was deemed potentially relevant to the review, but after exhausting all means of accessing the full text the paper had to be excluded from the review. Following title and abstract screening, 118 full texts were screened, and 25 studies were retained as they aligned with the inclusion criteria. Two additional studies were included as a result of grey literature searches. Therefore, 27 studies were included in this review (refer to Fig.  1 for flow diagram).

Study characteristics

Date of publication.

No papers included in this review were published prior to 2020, as per the exclusion criteria. Only one paper was published in 2020 [ 18 ], 25 papers were published in 2021 [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], and one paper was published in 2022 [ 44 ].

Country of origin

Data extracted relating to the location of the first authors institution at the time of publication was extracted to display geographical spread of the papers retained within this review. As per the inclusion criterion, all paper origins are from OECD countries. The location of papers is relatively varied, with four papers originating from each of the USA [ 21 , 28 , 30 , 43 ], the UK [ 19 , 39 , 40 , 42 ] and Japan [ 32 , 33 , 34 , 38 ]. Three papers originated from Turkey [ 26 , 27 , 37 ], and Italy [ 18 , 22 , 24 ]. Two papers originated from Columbia [ 23 , 35 ]. The remaining papers originated from Canada [ 31 ], Germany [ 44 ], Luxembourg [ 36 ], the Netherlands [ 41 ], Portugal [ 20 ], Spain [ 25 ] and Sweden [ 29 ].

Study design

The majority of the retained papers used similar methodological approaches to collect data; 24 out of 27 of the papers used online surveys [ 18 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. It is necessary to note that, three of these papers used additional qualitative elements in their surveys [ 39 , 40 , 42 ], and four surveys collected data at multiple time points [ 36 , 38 , 41 , 44 ]. Of the remaining three papers, two used secondary data analysis [ 26 , 44 ], and one paper [ 19 ] used semi-structed interviews to collect data.

Variables examined and measures

Of the 27 papers, 13 focused specifically on mental health outcomes [ 22 , 24 , 25 , 26 , 28 , 29 , 33 , 34 , 36 , 37 , 41 , 42 , 43 ], six on productivity outcomes [ 20 , 21 , 23 , 27 , 31 , 32 ], and eight included both mental health and productivity outcomes [ 18 , 19 , 30 , 35 , 38 , 39 , 40 , 44 ]. All measures used varied across studies with many being unvalidated. Table 2 shows more in-depth details about variable measures.

Study sample

There was substantial variation in the sample characteristics across the included papers. Sample size varied highly between papers, ranging from n  = 32 [ 19 ] to n  = 20,395 [ 34 ]. In relation to job role, many papers included participants from difference sectors and occupations within their study [ 19 , 21 , 22 , 23 , 25 , 27 , 28 , 31 , 32 , 33 , 37 , 38 , 39 , 41 , 43 , 44 ], two included a representative participant group [ 26 , 36 ], some targeted specific occupations or groups (e.g., Alumni from the Portuguese AESE Business School [ 20 ]; Italian professionals [ 24 ]; university staff [ 29 , 42 ]; behaviour analysists [ 30 ]; administrative workers [ 18 ]) and, some did not provide information on job role but focused on home working populations [ 34 , 35 , 40 ]. Table 3 displays extracted data in relation to sample size and characteristics including location and job role details.

Quality appraisal

Overall quality of papers varied across the 27 that were retained, with an average score of 62%. The MMAT quality scores as a percentage can be found in Table 2 . The included papers within this systematic review varied in quality. Many were cross-sectional, quantitative in methodology, and recruited participants using snowball or opportunistic sampling. This resulted in some unclear sample characteristics (e.g., not knowing where a percentage of participants were from), and uncertainty as to how often the sample were working from home. Only three of the retained papers within this review used qualitative research elements, and there was no common method for measuring mental health, or productivity across homeworking research.

To allow comparisons across and between research, findings relating to mental health and productivity will be separated and reported on separately in the following section.

• Mental health

This following section details outcomes relating to mental health and synthesises the following outcomes from 21 papers: ‘depression’ [ 20 , 22 , 33 , 37 , 42 ]; ‘anxiety’ [ 20 , 22 , 33 , 37 , 42 ]; ‘stress’ (including work stress) [ 18 , 22 , 28 , 29 , 35 , 37 , 38 ]; ‘psychological distress’ [ 24 , 34 , 41 ]; wellbeing [ 36 ] (including ‘subjective wellbeing’ [ 24 ], ‘psychological wellbeing’ [ 25 ]; ‘mental wellbeing’ [ 26 , 42 , 43 ]); ‘health’ [ 29 ]; ‘burnout’ [ 28 , 30 , 44 ]; and general ‘mental health’ [ 39 , 40 ]. Table 2 provides additional information on how these outcomes are measured, and it is necessary to note that there are overlap in how outcomes are described (i.e., ‘mental wellbeing’, ‘psychological wellbeing’, ‘health’, and ‘psychological distress’ were all measured using the same questionnaire).

The findings in relation to mental health varied across the retained papers. Many of the papers reported a negative relationship between homeworking and mental health and wellbeing [ 19 , 24 , 25 , 26 , 29 , 30 , 33 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 44 ]. For example, one paper established that the transition to homeworking during the pandemic increased psychological strain due to increased work intensification, poor adaptation to new ways of working, and online presenteeism [ 19 ]. Another paper reported that out of those who continued to work during the COVID-19 pandemic (i.e., not furloughed, or unemployed), teleworkers experienced less self-perceived wellbeing than those who continued working at their pre-COVID-19 workplace [ 25 ].

Some of the retained papers concluded a mixed findings in relation to home working and mental health. For example, despite a main finding that working from home during the COVID-19 pandemic results in lower levels of well-being, Schifano et al., also concluded that when the sample only includes those who switched to homeworking from office working, there is a small fall in anxiety levels when moving to working from home [ 36 ]. Additionally, Taylor et al., reports that around 40 per cent believe that their mental health had worsened either a lot or a little since working from home, compared to around 30 per cent that believed their mental health had improved [ 39 ]. Similarly, Moretti et al., reports that around 40 per cent of participants declared a reduced stress level since they have worked remotely, around 30 per cent reported an unchanged level, and one-third of participants experienced increased stress [ 18 ].

Homeworking was found to have no association with burnout by one retained paper [ 30 ]. Shimura et al., provides evidence that remote work does decrease psychological and physical stress responses when controlling for confounding factors such as job stressors, social support, and sleep status [ 38 ]. Working from home was also considered to be better for wellbeing in comparison to being furloughed or unemployed [ 25 , 36 ].

Factors affecting mental health when homeworking

Demographics.

When considering age, findings were mixed. One paper reported being older [ 36 ] resulted in poorer mental health outcomes. Additionally, another paper focused on stress and burnout specifically reported that being a young male [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], an older male (55 +) or a middle aged or older woman (45 +) resulted in increased stress, and being a middle-aged man [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] increased burnout [ 28 ].

Being female was reported to result in increases of depression, anxiety, and stress [ 37 ]. Females were also reported to experience two or more new physical or mental health issues were provided in comparison to male workers [ 43 ]. In this study, nine types of physical issues were assessed, these included, but are not limited to, musculoskeletal discomfort or injury, headaches or migraines, cardiovascular issues. Eight types of mental health issues were assessed, these included, but are not limited to, anxiety or nervousness, mental stress, rumination or worry, depression, sadness, or feeling blue [ 43 ].

Those considered better-educated were reported to have worsened mental health outcomes [ 36 ]. Those working in the field of “education and research” judged their telework experience to be much worse than participants working in other fields (e.g., ‘IT and telecommunication’, ‘Public administration and law enforcement agencies’, ‘Health and social services’ and ‘Legal and administrative services’) and were less willing to replicate the telework experience, there were also higher levels of stress and anxiety apparent [ 22 ].

Living arrangements

Living and working in a home which is considered crowded or confined resulted in poorer mental health [ 33 , 36 ]. Having a larger house and living with a partner, or with one or two housemates, was also found to be protective of mental health [ 22 ].

Results are mixed in relation to working in a household that includes children. On one hand, having young children in the home was considered to have a negative link to wellbeing, supposedly related to increased demands [ 36 ]. Whereas other research reported having infants (less than two years old) or toddlers (two to five years of age) at home as protective of wellbeing but were also associated with more mental health issues [ 43 ]. These conflicting findings were reasoned to be due to working parents being able to spend more time at home with their children, resulting in better mental wellbeing. However, due to work-life strain caused by increased demands and lack of support (i.e., from babysitters) during working hours there is an increase in new physical and mental issues apparent [ 43 ].

Isolation or loneliness

Spending more time remote working was considered to increase perceptions of isolation, and isolation and psychological distress were reported to mutually affect each other over time [ 41 ]. Additionally, having frequent contacts with work colleagues was considered protective factors of mental health [ 22 ].

Homeworking preference

Workers who preferred to work from home experienced less psychological distress with increasing telecommuting frequency, while those who preferred not to telecommute experienced more psychological distress with increasing telecommuting frequency [ 34 ].

Length of time homeworking

The association between working from home and mental health and wellbeing was found to differ depending on frequency and length of time home working [ 26 , 29 , 33 , 44 ].

One paper found working from home for a short duration was considered no different on mental well-being in comparison to those always working at the employer’s premises [ 26 ]. Niu et al., found that there was initially no difference in the mental health between workers who continued working in the office and those who switched to telework, but participants who teleworked for a longer period showed more severe anxiety and depression in comparison to those who teleworked for a short period. [ 33 ]. Similarly, those working from home for a high percentage of their weekly hours reported more negative psychological symptoms than employees who work from home for less hours [ 44 ], and higher ratings of stress were also reported in those working from home several times per week in comparison to those who worked from home less than once per month [ 29 ].

• Productivity

This following section details outcomes relating to productivity and synthesises the following outcomes from 14 papers: ‘productivity’[ 18 , 21 , 27 , 30 , 31 , 32 , 35 , 40 ], ‘performance’ [ 23 , 39 ], ‘percieved productivity’ [ 20 ], ‘level of work ability’ [ 44 ], ‘presenteeism’ [ 38 ]. Table 2 provides additional information on how these outcomes are measured.

The findings in relation to productivity varied across the retained papers. Some of the retained papers concluded a negative relationship between home working and productivity [ 19 , 30 , 32 , 40 ]. For example, Adisa (2021) found that the transition to home working from office-based work caused increased work intensification, online presenteeism and employment insecurity – which resulted in psychological strain and poor levels of work engagement [ 19 ]. Similarly, increased work intensity (e.g., receiving more information from teams and engaging in more planning activities) due to working from home also resulted in decreased worker productivity [ 30 ]. Morikawa et al., concludes that productivity whilst working from home was about 60–70% of the productivity at business premises, and was especially low for employees and firms that started homeworking after the onset of the COVID pandemic [ 32 ]. A UK-wide survey of office workers (including telecom, local government, financial services and civil service staff) who were working from home during the COVID-19 pandemic reported that since the onset of homeworking, 30% reported of workers that it is now more difficult to meet targets, and they had concerns of underperforming [ 39 ].

Some studies concluded that working from home was in fact no different in comparison to office working in terms of productivity [ 23 ]. This was reported for those who worked at home pre-COVID-19 and tended to practice working from home frequently [ 32 ]. Additionally, other research concluded that 90% of new teleworkers reported being at least as productive (i.e., accomplishing at least as much work per hour at home) as they were previously in their usual place of work [ 31 ].

Moretti et al., reported that working at home resulted in productivity decreasing in 39.2% and an increasing in 29.4% of participants [ 18 ]. However, Guler et al., established that participants who worked from home were more relaxed, more efficient, and they produced better quality work [ 27 ]. Despite reported increased or no change to levels of productivity, some research studies did find that those working from home were reporting longer working hours [ 21 , 27 ].

Factors affecting productivity when homeworking

Two papers reported that males were less productive than females when working from home [ 20 , 21 ]. Those who are older and have higher levels of income are also more likely to be productive when homeworking [ 21 ], as were those who are unmarried with no children [ 31 ]. Those who are highly educated, high wage employees, long distance commuters, tended to exhibit a relatively small reduction in productivity [ 32 ]. Having an appropiate workspace was also associated with higher levels of productivity [ 21 ].

In terms of occupation, “scientists” were most likely to have the highest level of productivity, in comparison to “engineering and architecture,” “computer sciences and mathematics” and “healthcare and social services.” [ 21 ]. Other research also supported that those who work in in information and communications industry only displayed a relatively small reduction in productivity [ 32 ]. Higher levels of productivity in were also apparent in public administration (41%) as well as in health care and social assistance (45%). In contrast, the corresponding percentage was lower in goods-producing industries (31%) and educational services (25%) [ 31 ].

Mental health and productivity

A few of the retained studies looked at the interaction between mental health and productivity whilst homeworking [ 21 , 27 , 35 ]. In a sample of staff that had been working from home for more than 6 months, it was reported that they were less stressed, more efficient, and had better quality of work during working from home period according to self-report data [ 27 ]. Other research reported that having an appropiate workspace, and better mental health was also associated with higher levels of productivity [ 21 ]. Stress was also found to lessen the positive association between working remotely on productivity and engagement [ 35 ].

This systematic literature review sought to 1) explore the association between working from home and both, mental health, and productivity, and 2) establish potential risk factors. Literature searches encompassed both peer previewed published literature and grey literature, 27 papers were retained post screening and included within this review. The results established that relationship between homeworking and both, mental health and productivity varies considerably, suggesting a complex association with many mediating and moderating factors.

Prior to the COVID-19 pandemic and the introduction of enforced and prolonged homeworking, working from home was often considered advantageous. Research often concluded that homeworking had multiple advantages [ 4 , 45 , 46 , 47 ]. There were also potential concerns reported with homeworking [ 45 , 48 ], for example in relation constant connectivity to the workplace [ 5 ], but these were not considered to outweigh the benefits [ 48 ]. This review revealed conflicting findings, with the majority of the research suggesting a negative or mixed link to mental health, which is supported by current literature [ 6 ].

This suggests that homeworking as a choice is considered largely beneficial (i.e., as shown by research prior to the pandemic), but when homeworking is instead mandatory there is potential that it may have a more negative association for certain individuals and occupations over others.

The relationship between working from home and productivity was also mixed, in that some papers found that home workers could be more productive, whereas others found the opposite. However, most studies reviewed show that homeworking for both new starters (e.g., has only worked from home) and those transitioning to homeworking for the first time, were particularly likely to report low levels of productivity along with concerns about meeting targets. There was also consistency amongst reviewed papers that homeworkers who reported better mental health (e.g., were less stressed) were more productive which is consistent with previous research showing an inverse relationship between stress levels and productivity [ 49 , 50 ]. Taken together, findings from the current review suggest that prolonged homeworking can negatively affect mental health, and in turn, lower levels of mental health can negatively affect productivity. Therefore, there should be a focus on maintaining and mitigating workers mental health when they are asked to work from home for a prolonged period.

Feelings of isolation or loneliness in homeworkers were also considered to have a consistent link to poorer mental health. This finding is well supported as the negative association isolation and loneliness have on mental health is widely reported across research (e.g., [ 51 , 52 ], and as demonstrated in an overview of systematic reviews [ 53 ]). The ability to create a shared sense of social identity with colleagues, which is protective of workplace stress [ 54 ] and burnout [ 55 ], may be hindered by homeworking [ 56 ] which can result in feelings of isolation or loneliness. This finding suggests that opportunities for social integration should be promoted by managers and team leaders. For example, through team meetings, in person events, or where possible, office working days.

As the findings relating to both mental health and productivity were varied, examination of factors which have potential to affect this relationship were explored. Personal and practical factors such as, being female, older in age, living and working in a crowded or confined home, or having young children at home were consistently associated with worsened mental health. Literature also concludes, being female, older in age, a highly educated high wage earner, being unmarried with no children, or someone with an active advantage towards homeworking (e.g., long distance commuters), and an appropiate workspace were associated with higher levels of productivity. These findings highlight the importance of considering practical factors that could be targeted by potential interventions (e.g., exploring how to manage work and having children at home, having an appropriately sized workspace, and managing overcrowded housing situations) as well as tailoring interventions to suit the target demographic (e.g., by considering gender, age, and occupation).

Limitations

Limitations for the current review these can be split into retained paper limitations and review process limitations. In terms of retained paper limitations, quality screening established that the retained papers varied in quality. Many were cross-sectional (only four studies within the current review collected data from multiple time points), quantitative in methodology, and recruited participants using snowball or opportunistic sampling. This resulted in some unclear sample characteristics (e.g., not knowing where a percentage of participants were from), and uncertainty as to how often the sample were working from home. These elements limit the generalisability of the findings, and this should be considered when conclusions are drawn from this data.

For this review specifically there are a number of limitations to consider. Firstly, limiting the search to English only may have resulted in the exclusion of potentially relevant papers. Secondly, this review did not seek to collate findings from studies which only directly compared those who had to work from home during the pandemic vs. those who could not, or did not, work from home, which could have potentially provided clearer results. However, where papers provided comparisons (e.g., [ 25 , 36 ]) they were extracted and presented in the results. Thirdly, current literature has established that working throughout the pandemic can be negatively related to mental health [ 57 , 58 , 59 ], which makes it difficult to disentangle the impact of working from home specifically. However, in the current review, three papers indicated that homeworking has potential to be negatively linked to mental health when carried out, or continued, for a long period of time (in comparison to hybrid working or working from home for a short period). This could possibly be due to the previously reported benefits of homeworking (e.g., flexibility, eradicating commuting time, and work life balance) no longer feeling advantageous when constantly working from home. This is an area that requires more research and is discussed in more detail in the following section.

Implications and future research

The current review found that working from home is neither positively or negative related to mental health or productivity, suggesting that a one size fits all approach to tackling the mitigation and management of workers mental health and productivity whilst they work from home is not suitable nor fit for purpose. However, there are indications that those who start homeworking for the first time during a pandemic are at risk of poor productivity, as are those who experience poor mental health. This suggests that employers should aim to help those who are new to home working, for example through training or mentoring programs. Additionally, those at risk of having poor mental health should be more closely monitored and provided with early support to ensure productivity.

The varied nature of the findings also calls for more in-depth research into why homeworking has such wide-ranging effect on individuals, and what factors have potential to mitigate and moderate this relationship. Due to the wide-ranging findings, it may be sensible to focus on specific occupational contexts and qualitatively explore barriers and facilitators to working from home to provide in depth rich data. Such work is currently underway as a PhD project focused on response organisations that worked from home during the COVID-19 pandemic conducted by the first author of the current review.

Considering the impact of working from home for different durations is also important, as the current review establishes that three papers indicated that homeworking has potential to be negatively associated with mental health when carried out, or continued, for a long period of time. Further empirical research is needed to provide more detail into, this finding along with examination into the factors that could impact this relationship (e.g., isolation, pre-existing mental health concerns). Resilience factors and characteristics associated with growth and flourishing whilst working from home should also be the subject of future research.

Methodologically, future research should seek to employ qualitative or mixed method designs to collect more in-depth and complete data in relation to the psychological effect of homeworking. Additionally, there should be a focus on using similar research measures when adding to the homeworking evidence base, as this would allow for research finding to be accurately compared. Similar suggestions were reported in a recent rapid review [ 60 ].

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

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Acknowledgements

This study was funded by the National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency, King’s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care. For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising.

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CEH, DW, SKB and NG conceptualised the review, created aims and established inclusion criteria. CEH, LD and SKB conducted the database searches and all screening in accordance with the inclusion criteria. CEH conducted quality appraisal of included papers. CEH carried out the analysis, and CEH drafted the initial manuscript; all authors provided critical revision of intellectual content. All authors reviewed and approved the final manuscript.

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Supplemental Table 1. Search Strategy. Supplemental Information Table 2. Grey literature Searches.

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Hall, C.E., Davidson, L., Brooks, S.K. et al. The relationship between homeworking during COVID-19 and both, mental health, and productivity: a systematic review. BMC Psychol 11 , 188 (2023). https://doi.org/10.1186/s40359-023-01221-3

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According to Sierra’s Homework Policy recommendation, students shouldn’t get more than ten minutes of homework every night and a maximum of fifty minutes of homework per term. While this recommendation is not binding or absolute, it mostly serves as a conceptual guide for teachers and tutors alike. Spending this amount of time on homework every night after a hectic day at school is not in any way fun for students, no matter the age or class. No student enjoys doing homework, especially when it has become a daily routine, and now that homework score is calculated as part of their cumulative score for the term. To ease the homework burden, students can ask for help at 123 Homework service and get it at an affordable price.

Whether homework can lead to or cause depression is an age-long question, and this article aims to explain the ‘if’ and ‘how’ too much homework can cause depression.

Studies have shown that the more time spent on homework means that students are not meeting their developmental needs or imbibing other critical life skills. While focusing on their homework, students are likely to forgo other activities such as participating in hobbies, seeing friends and family, and having meaningful and heart-to-heart conversations with people. Homework steals all the attention and spare time. Eventually, it puts students on the path of social reclusiveness, which would sooner or later tell on their mental and emotional balance.

Also, when a group of Harvard Health researchers asked students whether they experience any physical symptoms of stress like exhaustion, sleep deprivation, headache, weight loss, and stomach ache, over two-thirds of the participating students claim that they cope with anxiety thanks to their use of drugs, alcohol, and marijuana.

A Stanford University study showed that homework affects students’ physical and mental health because at least 56% of students attribute homework to be their primary source of stress. According to the study, too much homework is also a leading cause of weight loss, headache, sleep deprivation, and poor eating habits.

As beneficial as homework is to the students’ academic development, the fact remains that an additional two hours spent on homework after spending around 8 hours in school is too much and could lead to a massive mental breakdown.

Even though research has shown that homework can lead to depression, that doesn’t take away the fact that assignment is the only way to ensure and ascertain that students fully understood what they have learned in class; however, the question remains, is two hours on homework every night not too much?

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Spirituality

The mental health of the "spiritual but not religious", surprisingly, people who identify as spiritual tend to have worse mental health..

Posted August 27, 2024 | Reviewed by Michelle Quirk

• Many people today report having a spiritual life while disavowing any particular religious practice.
• Research shows that being spiritual but not religious significantly predicts mental distress.
• Modes of evaluation that commend a spiritual life without due reflection should be regarded with caution.

There is a long tradition of wondering about the mental health implications of religious practice. The psychiatrist and psychoanalyst Carl Jung famously claimed to have seen almost no practicing Catholics in decades of clinical practice. Others have failed to replicate this result, but the idea that religious practice has some meaningful impact on mental health persists.

For Jung, speaking in 1939, the world could be divided into two categories: those who practiced a religion (which for Europeans of Jung's era primarily included Catholicism, Protestantism, and Judaism) and those who did not. Any serious contemporary consideration of this question, however, would need to introduce a third category. Many people today reject "organized religion," but do not quite identify as secular either. They report having a spiritual life while disavowing any particular religious practice. They are, in a phrase, " spiritual but not religious ."

This fact introduces a new question for psychology: What are the mental health benefits of this spiritual attitude? One might reasonably suppose that they are positive. After all, many people who take this attitude engage in practices that are widely held to be beneficial to mental health, such as meditation , even if they do not accept the background theology of Buddhism or other major religions that encourage meditative practices. This spiritual orientation is also a part of 12-step programs that encourage individuals to find their own "higher power," outside the bounds of traditional religious belief. So, one might think that this kind of spiritual orientation to the world is associated with positive mental health.

Mixed Research Results

The empirical literature on this question, however, is decidedly more mixed. Consider an important 2013 study in the British Journal of Psychiatry . The authors consider data from approximately 7,400 individuals in England. Of these, most identify as either religious or as non-religious and non-spiritual, but about a fifth (19 percent) identify as spiritual but not religious. The prevalence of mental disorders in the first two groups (the religious and the non-religious non-spiritual) is roughly the same, but the spiritual but not religious are different: Among other things, they are significantly more likely to have phobias, anxiety , and neurotic disorders generally. In short, being spiritual but not religious is a significant predictor of mental distress, compared to the general population.

This correlation between spirituality without religiosity ought to give us pause, in part because it is confirmed by subsequent studies. For example, one more recent study (Vittengl, 2018) finds that people who are more spiritual than they are religious are at greater risk for the development of depressive disorders. As I said, all this is very puzzling. What explains these somewhat dispiriting findings? And what lessons should we draw from it?

Three Caveats

To begin with, we should note three caveats or complications.

First, as the authors emphasize, these findings say nothing about cause and effect. It could be that spiritual practices outside of traditional religion are a cause of mental distress. Or it equally well could be that people in mental distress seek out spiritual but non-religious practices. Or it could be that these two phenomena—being spiritual but not religious and experiencing mental distress—are common effects of some shared cause.

Second, many people do not seek their spiritual orientation, in the first place, because of its mental health benefits. People who are drawn to spirituality while rejecting traditional religious frameworks are in the first place pursuing their own spiritual values, rather than seeking mental health. So these correlations should not, on their own, lead anyone to doubt their own spiritual convictions.

Third, as all of the authors discussed above acknowledge, these correlations remain very poorly understood. This is partly because we are stuck in a dichotomous way of thinking about spirituality—on which people are religious or not religious—that the introduction of a third category remains something of a novelty. Furthermore, this third category remains poorly understood, in part because "spirituality" itself admits so many different understandings.

With those qualifications in place, however, I think these correlations ought to be better known and recognized by practicing clinicians. Many clinicians will see the development of a spiritual life in a client, outside the bounds of traditional religion, as a sign of psychological growth. And, indeed, it is often that. But it is, at the same time, something of a risk factor for many mental health disorders, and so is not exactly an unalloyed good.

Here as elsewhere, there are few unambiguous goods in therapy , and what may be good for one person may be concerning in another. Modes of evaluation that commend a spiritual life, without due reflection on the role and structures involved in that life, should be regarded with some caution. The empirical evidence, such as it is, suggests that being "spiritual but not religious" is a more ambivalent state than it is usually taken to be.

King M, Marston L, McManus S, Brugha T, Meltzer H, Bebbington P (2013) Religion, spirituality and mental health: results from a national study of English households. British Journal of Psychiatry . 202(1):68–73.

Vittengl JR (2018) A lonely search?: Risk for depression when spirituality exceeds religiosity. Journal of Nervous and Mental Disease 206:386–389.

John T. Maier, Ph.D., MSW , is a psychotherapist in private practice in Cambridge, Massachusetts.

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Teens are spending nearly 5 hours daily on social media. Here are the mental health outcomes

Forty-one percent of teens with the highest social media use rate their overall mental health as poor or very poor

Vol. 55 No. 3 Print version: page 80

• Social Media and Internet

Percentage of teens with the highest social media use who rate their overall mental health as poor or very poor , compared with 23% of those with the lowest use. For example, 10% of the highest use group expressed suicidal intent or self-harm in the past 12 months compared with 5% of the lowest use group, and 17% of the highest users expressed poor body image compared with 6% of the lowest users.

Average number of hours a day that U.S. teens spend using seven popular social media apps, with YouTube , TikTok , and Instagram accounting for 87% of their social media time. Specifically, 37% of teens say they spend 5 or more hours a day, 14% spend 4 to less than 5 hours a day, 26% spend 2 to less than 4 hours a day, and 23% spend less than 2 hours a day on these three apps.

[ Related: Potential risks of content, features, and functions: The science of how social media affects youth ]

Percentage of the highest frequency social media users who report low parental monitoring and weak parental relationships who said they had poor or very poor mental health , compared with 25% of the highest frequency users who report high parental monitoring and strong parental relationships . Similarly, 22% of the highest users with poor parental relationships and monitoring expressed thoughts of suicide or self-harm compared with 2% of high users with strong parental relationships and monitoring.

Strong parental relationships and monitoring significantly cut the risk of mental health problems among teen social media users, even among those with significant screen time stats.

Rothwell, J. (October 27, 2023). Parenting mitigates social media-linked mental health issues . Gallup. Survey conducted between June 26–July 17, 2023, with responses by 6,643 parents living with children between ages 3 and 19, and 1,591 teens living with those parents. https://news.gallup.com/poll/513248/parenting-mitigates-social-media-linked-mental-health-issues.aspx .

Rothwell, J. (2023). How parenting and self-control mediate the link between social media use and mental health . https://ifstudies.org/ifs-admin/resources/briefs/ifs-gallup-parentingsocialmediascreentime-october2023-1.pdf .

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Mental Health Officers (Scotland) Report 2023

The Scottish Social Services Council (SSSC) today published the Mental Health Officers (Scotland) Report 2023. 

The Mental Health Officers (Scotland) Report 2023 presents information on: 

The number of practising MHOs in post at 5 December 2023, excluding long-term absentees.

MHO trainees, leavers, vacancies and staffing shortfalls.

Key characteristics of the MHO workforce (e.g. age) and the type of teams they work in.

The key points from this year’s MHO report are set out below.

• There were 729 active MHO posts in 2023, which is 22 more than the 707 in 2022.
• The number of individuals (headcount) working as an MHO rose from 670 in 2022 to 697 in 2023
• The overall hours estimated to be spent on MHO duties each week in 2023 was 13,149 the highest since 2016 when we started reporting this figure, the previous highest was in 2022 when it was 12,752.
• Between 2022 and 2023 there was a rise of 3.1% in the overall hours estimated to be spent on MHO duties each week.
• Active exclusive MHO posts rose by 17 (6.4%), and cover posts by 13 (28.9%) whereas there was a fall of 8 in non-exclusive posts (2.0%).
• Reported shortfall increased by 11.8% from 2,606 to 2,914 hours per week.
• Between December 2022 and December 2023, 98 staff left 100 MHO posts.

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Tables from The Mental Health Officers (Scotland) Report 2023

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The  Mental Health Officer time series data section of the data website can be found  here . This will be updated in September 2024 with the 2023 MHO data. This means the latest data can be viewed as part of the full time series data, some of which goes back to 2005.

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