What is mental health?
COVID-19 has already directly afflicted the lives of nearly 6 million people in the United States. The response to aid individuals afflicted with this illness has been emergent due to the threatening nature of COVID-19.
But what if there was another illness that affected 5 million people in the US for their entire lives, though symptoms were not always apparent? Instead, they were almost undetectable in some cases. Well, it seems like we would all be just as scared.
Unfortunately a condition like this does exist. According to the National Alliance on Mental Illness, it is estimated that one in five youth have a mental health condition or disorder, with half of mental health conditions developing by age 14.
A mental health disorder is a condition that disrupts a person’s mood, thought or behavior, often for a long period of time.
The growing crisis around student mental health, and the scarcity of available care, has long been a concern of many educators and health professionals. However, the previous responses to mental health in schools have been mostly reactive, and focusing on a crisis response rather than a comprehensive approach to helping students with their mental health needs. It is also important to recognize that untreated mental illness has a devastating impact on learning.
Currently, only 16 percent of all children receive any mental health services. However, of those receiving care, 70 to 80 percent receive that care in a school setting.
What is being done?
According to a 2014 study by the Center for Health and Health Care in Schools, students who receive positive behavioral health interventions see improvements on a range of behaviors related to academic achievement, including but not limited to letter grades or test scores.
Comprehensive programs generally provide substantive professional development for staff, including workshops and resources. These programs have social and emotional learning competencies integrated into the curriculum. Despite this evidence, comprehensive mental health programs are still only scattered across the country. Many resource-starved districts have cut or never staffed critical positions, namely school psychologists, weakening their school’s ability and capacity to properly address these challenges.
How can educators help promote positive mental health in the classroom?
In every school, there are people who could play a big role in identifying problems and helping students succeed. Teachers see students every day and could spot sudden changes. But teachers have almost no mental health training. Counselors can help but there just are not enough of them. On average, every counselor has nearly 500 students. School nurses are medical professionals; however, there is rarely more than one school nurse in one building. School psychologists have the most expertise to step in due to their specialized training; however, schools are not required to have one on staff.
The goal moving forward needs to be that all these roles work together to create an environment that supports a student with a mental health disorder. Beginning with parents, everyone helps create a safe, caring environment. In this systematic approach, everyone watches for warning signs in a child such as major changes in mood, headaches, slipping grades, and missing class. When those warning signs pop up, specialist staff counselors, nurses, or school psychologists step in.
Teachers and students should be provided with ways to recognize signs of developing mental health problems, and there should be opportunities around the awareness and management of mental health crises. Students themselves need to be empowered with information so that they will be able to get the help they need. Because children spend most of their day at school, it just makes sense to have mental health awareness and education become part of the curriculum.
Experts recommend beginning as early as kindergarten, with a focus on age appropriate instructional practices in areas like reducing stigma and obtaining and maintaining good mental health. At the kindergarten level, this also includes social and emotional learning, which allows kindergarten students to identify their emotions through labeling activities, drawing or painting pictures, and reading books. Furthermore, mental health disorder training should address the relationship between mental health, substance abuse, and other negative coping behaviors, as well as the negative impact of stigma and cultural attitudes toward mental illness.
How can we promote positive mental health in students?
Several states have either approved or have legislation in the works related to mental health education. New York was the first state to enact a law requiring mental health education in public schools. The state legislature allocated $1 million in 2018, and the state budget included $500,000 in 2019 to create the School Mental Health Resource and Training Center to support school efforts to comply with the new law.
A Virginia law requires mental health education in the 9th and 10th grades. A proposal for implementing the new law extends the mandate to include kindergarten through the 10th grade. The proposed standards are designed to be incorporated into existing standards for social and emotional health. They include age-appropriate instructional practices aimed at reducing stigma and teaching students how to obtain and maintain good mental health, understand mental health disorders, pick up on signs and symptoms of distress, and seek help. For example, at the 4th grade level, students will learn about healthy self-concepts, respecting differences, and how to understand and manage emotions related to loss, grief, and stress.
Some legislation to aid the mental health crisis in schools is aimed at addressing concerns about additional workloads and teacher training. The American School Counselor Association recommends a student to counselor ratio of 250 to 1, and as of 2019, only three states (New Hampshire, North Dakota and Vermont) are aligned with that threshold. However, there has been progress in that regard; a new Texas law requires teacher preparation institutions to include mental health instruction in their certification programs, and a Nevada bill created a grant program for districts to contract with social workers or other mental health professionals.
In Arizona, the State Board of Education recently approved an additional $20 million for schools to hire counselors, social workers, and police officers, and the Colorado School Counselor Corps has put $60 million into new hires and professional development since 2008.
What more can be done?
The efforts to aid the mental health crisis in schools in these particular states is a step in the right direction; however, there needs to be a standard set across the country when it comes to helping students with mental health. This means that there needs to be parallel legislation enacted in each state, coupled with a goal towards a more reasonable student to counselor ratio to ensure that students receive the proper mental health attention.
That impact on well-being may be magnified by another effect of school closures: Schools are “the de facto mental health system for many children and adolescents,” providing mental health services to 57 percent of adolescents who need care, according to the authors of a recent study published in JAMA Pediatrics. School closures may be especially disruptive for children from lower-income families, who are disproportionately likely to receive mental health services exclusively from schools.
Another JAMA study found a three-fold increase in adult depression during the pandemic, indicating a potential surge in mental health struggles for both students and teachers. Whether virtual or in-person, schools will be on the frontlines of this struggle: COVID-19 will have major repercussions for children’s and adolescents’ health and well-being. Timely action can help lessen the effects and improve long-term capacities for mental health services.
Sana Sami is a student at Loyola University Chicago School of Law and wrote this blog post as part of the Education Law Practicum.
