Neglect of Mental Health in Schools: a Serious Issue
The problem of mental health in schools is one which has been long overlooked.
There are three apparent reasons behind this:
First, there is an obvious lack of awareness about mental health problems in schools. According to the National Survey on Drug Use and Health, 60% of people who have a mental health concern or mental illness don’t receive any form of treatment for their condition.
Cases of depression in children are often dismissed as mood swings, and signs of agitation and anger are shrugged off by labeling them as ‘teen rage’ or ‘just a phase’.
Here is the second reason, mental illness carries a social stigma. Believe it or not, parents are afraid of seeking help from a licensed mental health counselor fearing their child will be labeled ‘crazy’.
Lastly, some schools don’t have the resources, infrastructure or the training needed to proactively detect and help students who run the risk of developing a serious mental health issue.
Here are some alarming statistics on the state of mental health in schools across America.
- National Alliance on Mental Illness reports that one in every five children in the age group 13-18 suffers from a mental health condition. The same is true for every, one in seven children aged 2 to 8.
- NAMI also reports mental health issues to be one of the leading causes of students dropping out of school. 37% of students with a mental health condition age 14 and older drop out of school—the highest dropout rate of any disability group!
- As per another report by Centers for Disease Control and Prevention (CDC), 6.8% of children aged 3-17 years in the US were diagnosed with Attention-deficit/hyperactivity disorder (ADHD). 3% of them were found to be suffering from anxiety, while another 2.1% were diagnosed with depression.
History of Mental Health Issues in Schools
Schools, children, and parents have all been casualties in the growing epidemic of mental health illness in schools.
Children and teachers have paid for with their lives while parents have watched in sheer agony and horror as gun violence and self-harm have become a frequent occurrence.
Here are some major incidents in schools across the US that can be attributed to mental health issues.
Parkland, Florida (2018) – Nikolas Cruz lost his father at the age of 6 and had trouble in school while growing up. He was diagnosed developmentally delayed in 2002 and then with anger issues and ADHD in 2013. After being institutionalized for two years in 2014, he moved to Marjory Stoneman Douglas High School in 2016. Allegedly, he tried to harm himself twice, but an investigation by Florida Department of Children and Families closed the case by stating “he had a very low risk of self-harm but suffers from depression, ADHD, and autism.”
After his mother’s death in November 2017, there were several reports and complaints about Nikolaas buying firearms. In Feb 2018, he opened fire in the school, killing 14 students and 3 staff members.
Montgomery, Ohio (2008) – Jessica Logan was a cyberbullying victim at school. She was allegedly abused by her classmates over a photo that she had shared with her boyfriend, who had forwarded it to hundreds of other high school students.
This had started a line of abuse, causing serious depression in her. This ended in Jessica Logan committing suicide in her closet in July 2008. After her parent’s relentless efforts to sue the state and school, House Bill 116 (also called the Jessica Logan Act) was signed by the Ohio state governor in 2012.
The act covered harassment, intimidation and cyberbullying into the existing anti-bullying law, and requires school districts to create prevention and protection policies against bullying
San Diego, California (2001) – Andy Williams, 15, reportedly injured 13 people and killed 2 in a mass shooting in San Diego, CA, in 2001. Upon his parents’ divorce, Andy moved to California with his father. There, he was a victim of constant bullying and abuse.
The events of his parents’ divorce and continuous bullying soon led him to depression and drug abuse; to the extent of him being suicidal. Even though tried to talk to a school counselor about it he was sent away. His mentions of him planning to “pull a Columbine” to his friends were also never reported to the administration.
All this boiled down to him open-firing on March 5, 2001 killing two and injuring many.
Columbine, Colorado (1999) – Eric Harris and Dylan Klebold walked into their school in Columbine with four guns and thirty homemade bombs. Before committing suicide, they had killed a teacher and 12 of their fellow students and wounded 24 others.
Mental health professionals who helped the FBI in their investigation found out that Klebold was clearly a victim of depression and showed suicidal tendencies, and that Harris exhibited psychopathic tendencies.
Harris was described as “nice” by some kids, but his personal website revealed his dissatisfaction and hatred towards others.
What Causes Mental Health Issues in Schoolchildren?
Unlike physiological disorders and illnesses, mental health disorders don’t come with a specific set of causes. The best way to understand the causal factors behind mental health disorders is through the biopsychosocial model.
According to this model, it is the interaction of several factors that make an individual susceptible to mental illness.
The key factors are:
- Biological factors such as genetic makeup, biological processes, and heredity.
- Psychological factors such as one’s personality, emotional disturbances, and stress.
- Social factors such as early loss of a parent, bullying, lack of social support, health education and social care.
Biological factors include head trauma, change in levels of neurotransmitters in the brain, brain damage due to infection or intoxication, and physiological or hormonal changes that happen during puberty and menstruation.
Vitamin and mineral deficiency also adversely affect the mental health of an individual.
Certain personality types can be prone to a particular mental health concern or mental illness. For example, Neurotic personality aka neuroticism is often linked with depression and borderline personality can lead to suicidal behavior and self-harm.
Emotional disturbances caused due to an abnormal parent-child relationship can also result in mental illness. Unhealthy parental behavior such as not showing love and affection, unrealistic comparison with siblings, being overprotective can cause emotional stress in children.
Lack of interpersonal connection in schools is a key reason for psychological and emotional stress. Children who find it hard to make friends or take part in group activities are prone to psychological stress.
Other psychological factors which may cause mental ailments can be a result of physical, emotional or sexual abuse, guilt feelings about masturbation (especially in families with strict religious beliefs).
Social factors such as financial instability, parents’ unhealthy behaviors like alcoholism, gambling, and extramarital affairs, discrimination based on race or gender, political turmoils, peer pressure, failure in relationship, fear of abandonment could make an individual vulnerable to mental health concerns and mental illness.
Why is Mental Health Important in Schools?
Before we go on to highlight the importance of creating an awareness about mental health in schools, let’s first establish what is meant by the term ‘mental health’.
While people may believe that mental health is just the absence of a mental condition or disease, it is not true! The ability to cope and deal with stress in various adverse life situations is also an essential part of mental health.
A big part of a students’ time is spent at school where they are exposed to other individuals and environments. They may come across situations that would be difficult to deal with without proper training or guidance.
Still not convinced?
Here are more reasons why it is important to make people aware of mental health in schools.
- Correlation between mental health and success– Having good mental health development can lead a child to be successful in school and in life. Research shows that children who receive socio-emotional support and mental health guidance in schools and from outside often perform better in academics.
- Easier to monitor at school– Benefits of mental health services in schools are immense as children spend almost 6 hours a day at their school. Therefore, they are more likely to seek services available there. This makes the school the ideal place to offer prevention, intervention, and regular communication for their positive development.
- Guarantees student safety– Proper mental health services ensure children’s safety in schools. Mental health services include socio-emotional learning, ensuring mental wellness and resilience, and making positive connections with other students and adults. This plays an important role in making the children feel safe and empowered to report safety concerns.
- Equips schools in handling a crisis– In the aftermath of a crisis, mental health services in schools will be essential to identify children who need help and engage in crisis intervention or trauma counseling if required.
- Reduces risky behavior in children– Addressing mental health in schools also involves reducing risk behavior in children, which include smoking cigarettes, consuming alcohol, illicit drug use, self-harm and sexual risk behavior. Whole-school approaches like the Gatehouse project have shown significant results in reducing self-harm and other problematic behaviors in schools.
- Helps student-athletes cope with pressure– Although physical activity can improve mental health, it has been observed that high school students engaged in sports are more vulnerable to mental health concern and mental illness, possibly because they are always under pressure to perform. The stress from high expectations and criticism can lead to depression or anxiety, which can affect their performance.
How Can Schools Detect Mental Health Issues in Children?
Now that we have established the need for mental health in schools, there is a bigger question that is still unanswered.
How to identify the signs of mental illness in children?
|PRIMARY SCHOOL STUDENTS||MIDDLE SCHOOL STUDENTS||HIGH SCHOOL STUDENTS|
|Behavior problems in preschool or daycare||Excessive fear and worries||Destructive behavior and damaging property|
|Hyperactivity in comparison to other students||Extreme hyperactivity||Withdrawal from family and friends|
|Trouble sleeping/Persistent nightmares||Sudden decrease in school performance||Writings or constant mention of harming oneself|
|Excessive fear, worry or crying||Loss of interest in friends and activities they earlier used to enjoy||Use or abuse of substances|
|Extreme disobedience or aggression||Loss of appetite||Engaging in risky behavior such as speeding in car/ bike, unprotected sexual interactions, vandalism|
|Excessive temper tantrums||Sudden increase in weight or showing extreme concern about weight gain||Signs of Depression: Person is often agitated and hostile, unexplained headaches or stomach aches, extreme sensitivity to criticism, difficulty in concentration, fatigue and lack of energy,lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide.|
|Frequent stomach aches or headaches with no physical explanation||Visible prolonged sadness||Signs of suicidal ideation: lack of personal care, tardiness, defiant behavior, giving away prized positions, previous history of suicide attempt, alcohol/drugs use or experimentation, frequent mention of taking one’s own life, recent stressful life events|
|Signs of depression: sadness, carelessness,over-apologetic self-blaming, feeling unimportant and lonely||Substance use or abuse|
|Signs of Suicidal Intention: reckless behavior, disobedience, extreme guilt, expression of hopelessness||Signs of Depression: sadness, carelessness, being over-apologetic, blaming oneself for everything, feeling unimportant and lonely|
|Signs of suicidal ideations: reckless behavior, disobedience, extreme guilt, expression of hopelessness|
Warning Signs Applicable for all Age Groups
Certain common signs can help in identifying mental health concerns or mental illness among children of all age groups
- Constant feeling of anxiousness
- Frequent tantrums or intensely irritable
- Loss of interest in hobbies or previously enjoyed activities; withdrawal from friends and family
- The person is usually lethargic
- Engaging in risky and destructive behavior
- Harming self or others
Signs that tell us that the person is being bullied: Making excuses to skip school, skipping meals or binge eating, frequent nightmares, feeling helpless or decreased self-esteem, self-destructive behaviors, sudden loss of friends or avoidance of social situations, declining grades and loss of interest in school work.
Signs that tell us that the person is bullying others: Being friends with bullies, increasingly aggressive, constant blaming others for their problems, not taking responsibility for their actions, competitive and worried about their reputation and popularity.
Signs that tell us that the person is suicidal: talking about wanting to die or to kill oneself, looking for a way to kill oneself, talking about feeling hopeless or having no purpose, talking about feeling trapped or being in unbearable pain, talking about being a burden to others, increasing the use of alcohol or drugs, acting anxious, agitated, or reckless, sleeping too little or too much, withdrawing or feeling isolated, showing rage or talking about seeking revenge and displaying extreme mood swings.
Signs that tell us that the person is suffering from anxiety disorder: feelings of apprehension or dread, watching for signs of danger, anticipating the worst, trouble in concentrating, feeling tense and jumpy, irritability and feeling like your mind’s gone blank.
Providing and managing services for mental health in schools could be a difficult task. Framework for Managing Problems Regarding Mental Health in Schools
Schools have to identify students at risk and provide mental health support to hundreds of students, which could be a difficult job without proper systems in place.
Framework to Manage Mental Health in Schools
The National Center on Safe Supportive Learning Environments suggests that a mental health program should provide services in schools at three levels:
- Universal – Promoting mental health among all students
- Selective Services – For students who have already been identified at risk for mental health concerns
- Indicated Services – For students who exhibit serious signs of a mental health illness
The goal of universal mental health programs is to help children and youth of all ages, with or without disabilities or mental challenges, to be mentally healthy and to teach them how to take care of their mental health. Whole-school programs can also help in early detection of mental health problems.
So how do universal programs really help in increasing mental health awareness?
- Assessment of every student’s mental health – Universal programs make sure that each and every student is evaluated and checked for any signs or symptoms of a mental problem
- Collaborate with Parents and Teachers – Getting everyone on board is an important part of promoting mental health at schools. Talk about what can be done to help students be mentally healthy
- Enrolling in Prevention and Promotion Programs – Schools should enroll in some prevention and promotion programs designed to improve the condition of mental health in schools
Here are two such programs which have been providing services to promote positive mental health in schools:
- School Health And Performance Evaluation system (SHAPE) helps schools by keeping the mental health assessments of the students up to date. It also finds suitable screening tools and interventions for each student’s requirements
- Positive Behavior Interventions and Support (PBIS) helps schools build systems capacity for implementing a multi-tiered approach to social, emotional and behavioral issues. PBIS works toward improving social, emotional and academic outcomes for all students, including students with disabilities and students from underrepresented groups
Different Intervention Strategies
As a first step, schools can consider implementing a universal intervention program that provides resources and tools to proactively create a positive environment and also create an awareness about the importance of mental health in schools. Here are some examples of universal intervention programs that schools can easily adopt.
- Create Positive Environment at School – Schools should observe areas in and around their campus and assess if the school environment is pleasant and friendly. Necessary changes should be made to make school more comfortable and inviting for students
- Promote Social and Emotional Learning – Students should be guided to develop and critical skills for life. Children should be helped with recognizing and managing emotions, thinking about their feelings and controlling or regulating behavior
- Practicing Mindfulness and Yoga – Children experience stress to varying degrees in school as they face different situational challenges every day. Mindfulness, yoga, and relaxation can improve the stress coping abilities and reduce anxiety among students, thereby ensuring a better mental health in schools.
John P Salerno, a Research Training Coordinator at the University of Miami, reviewed several universal intervention programs and concluded that universal intervention programs have shown good results as far as awareness and prevention of mental health problems are concerned. However, apart from prevention measures, schools also need to take proactive measures to identify and help students at risk.
In such cases, selective and indicative interventions are critical.
- Assessing the students’ medical records– A detailed health and medical record can be used to filter high-risk students and students with a prior history of mental illness to a focused intervention schedule
- Training teachers – as students spend more time with teachers in their early ages, training teachers in identifying risky and abnormal behaviors in class can be very useful in early intervention of children vulnerable to mental illness
- Increasing parent-teacher interaction – Including parents in the process of intervention can be very effective. It would lead to better evaluation of students’ mental health
- Using technology to filter at-risk students – Schools should consider using the help of technology to monitor any suspicious or indicative activity online. For example, SysCloud’s cloud-based monitoring service allows schools to monitor students who are at risk of self-harm or violent behavior by monitoring online content such as emails, documents, and chats.
- Encouraging sports and arts – In recent studies, it has been found that engaging in sports can have a positive impact on improving mental health in schools. According to an article published by BeBrainFit.com, arts in any form such as music, drama, painting, etc., can help in relieving stress. Schools can encourage these high-risk students to engage in sports and arts in order to channel their energy, creativity, and concentration into something productive, which can increase their self-esteem and in turn improve their mental health.
Schools are grappling with multi-dimensional challenges in providing a safe and holistic learning space for children and young adults. The emotional roller coaster that children and adolescents go through, as they navigate a competitive world, takes a toll on their mental health.
Unfortunately, incidents of self-harm, cyber-bullying, and violent behavior such as gun violence have almost become a routine affair. The after effects of such incidents go beyond the loss of lives and leaves a permanent scar in the minds of all the survivors.
Even the First Lady has outlined her mission to promote the well-being of children. Melania Trump’s Be Best initiative is aimed at highlighting major issues facing children today and encourage a positive social, emotional, and physical habits.
The only way schools can fight back is to take a proactive approach to managing mental health in their schools. The solution lies in creating a system that includes infrastructure, people, process and technology to help students cope with the challenges and give them the support needed to become productive citizens.