Taiwanese high schools will begin offering mental health leave to students this month, to address rising rates of youth suicide and high levels of stress and depression.
Under the programme, high school students can apply for up to three days off each semester, taken as full or half days, without proof of need but with the permission of their parents. More than 40 schools have expressed interest in the trial run, according to the ministry of education.
The scheme is in response to rising concerns over mental health issues among young people in Taiwan. Between 2014 and 2022, the suicide rate among people aged 15 to 24 more than doubled, even as the overall rate declined.
But some Taiwanese authorities have been criticised over their response to the crisis, with advocates saying extreme academic pressure on students is a key driver of stress, anxiety and depression.
In 2022, a senior official at the ministry of health and welfare came under fire from youth advocacy groups after linking the increase in suicides to the “growing number of tall buildings in Taiwan”. His comments were in response to a question from UN experts about whether Taiwan authorities had looked into systemic factors such as academic pressure, and were widely criticised as dismissive of growing concerns about the impact this had on students in Taiwan and other east Asian countries.
In 2022 the Child Welfare League Foundation conducted a survey of students, finding that more than 12% reported “severe” levels of stress, and was more than twice as bad among senior high school students than juniors. Almost a quarter of high school students said they had experienced severe depression. The survey said the top three drivers of stress reported were schoolwork (77%), future prospects (67%) and interpersonal relationships (43%).
“I could easily get into the top three grades in my class in junior high school, but now my grades are not as good as they should be,” one high school student told the Observer, who also listed personal and family relationships and body image as sources of anxiety.
“This has made me very anxious, and I’ve begun to worry about whether or not I’ll be able to get into a university or something like that.”
The girl said her teacher had discussed mental health leave with the class, but she didn’t think many of her fellow students would take it up.
“I don’t think you can deal with an emotional or mental state by taking time off school. It’s just an escape,” she said.
“No one is going to take this kind of leave … Even if they do, they will just stay home and study. I think a lot of parents would be against this policy. They’re not high school students, so they don’t know how much pressure we’re under.”
Hsiao Chih-hsien, a psychologist at the National Sun Yat-sen University counselling and health unit, said the leave days were a good step in the right direction.
“Mental health leave has a certain degree of effectiveness. It allows students to relieve the urgent stresses of the moment and have sufficient buffer rest time to digest and cope with their discomfort,” Hsiao said.
Hsiao suggested the programme could also help improve social attitudes towards mental illness. “If mental discomfort is seen in a normalised manner,” Hsiao said, “students will be more courageous in seeking help.”
In 2018, polling found that more than 53% of people in Taiwan thought mental illness was stigmatised in their society. An 18-year-old Taipei student said he believed this would hold many young people back from using the leave, for “fear they will be treated as mentally or psychologically ill by their classmates”.
The high school pilot programme emulates initiatives already running at dozens of Taiwanese universities, offering up to five days of mental health leave.
The National Taiwan University student union said there were 1,686 applications for mental health leave last semester, accounting for 5% of the students. The proportion was higher among arts students, of whom 11% applied for leave.
“As there are days in each semester when students can take the leave without any supporting documents, it is very helpful and flexible for students who are unable to attend classes due to temporary psychological problems,” a spokesperson said.
The union said students were positive about the programme, but there were teething problems, including some professors deducting attendance points from students who take the leave days.
Government guidelines for the scheme advise universities to pay increased attention to students’ emotional wellbeing and ensure counselling and other services are available alongside the leave days.
“All teachers (including tutors and supervisors), professional counsellors, and relevant personnel in teaching and administrative units should pay attention to the physical and mental health of students, and should not cause discrimination or stigmatisation due to the use of physical and mental adjustment leave,” it said, urging that students instead be encouraged to seek help.
In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@samaritans.org or jo@samaritans.ie. In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counsellor. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org