Mental Health in Schools – The Ultimate Guide for School Administrators

• National Alliance on Mental Illness (NAMI) reports that one in every five children in the age group 13 to 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. Almost 37% of students with a mental health condition, of age 14 and older, drop out of school—the highest dropout rate of any disability group!

• As per another report by the Centers for Disease Control and Prevention (CDC), 6.8% of children in the 3–17 age group in the US were diagnosed with Attention-deficit/hyperactivity disorder (ADHD). About 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

What causes mental health issues in school children?

• 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.

• Financial instability

• Unhealthy parental behaviors like alcoholism, gambling, or extramarital affairs

• Discrimination based on race or gender

• Political turmoils

• Peer pressure

• Failure in relationship

• Fear of abandonment

Case studies

Why is mental health important in schools?

• Correlation between mental health and success: Having good mental health development can help a child to succeed 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 school. Therefore, they are more likely to seek services available there. This makes schools the ideal place to offer prevention and intervention services.

• 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 risky behavior in children, which include smoking, consuming alcohol, illicit drug use, self-harm, and risky sexual 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 concerns 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.

What are the roles of school-based personnel in providing mental health for schools?

Warning signs applicable for all age groups

• Making excuses to skip school

• Skipping meals or binge eating

• Frequent nightmares

• Feeling helpless or having a decreased self-esteem

• Self-destructive behaviors

• Sudden loss of friends or avoidance of social situations

• Declining grades and loss of interest in school work

• 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

• 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

• Feeling anxious, agitated, or reckless

• Sleeping too little or too much

• Withdrawing or feeling isolated

• Showing rage or talking about seeking revenge

• Displaying extreme mood swings

• 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

Framework to manage mental health in schools

• Assessment of every student’s mental health: Schools should make sure that each and every student is evaluated and checked for signs or symptoms of a mental problem.

• Collaboration with Parents and Teachers: Getting everyone on board is an important part of promoting mental health at schools. Feedback should be solicited from all stakeholders on what can be done to improve students’ mental health.

• Enrollment in Prevention and Promotion Programs: Schools should enroll in prevention and promotion programs designed to improve the condition of mental health in schools.

• School Health And Performance Evaluation system (SHAPE) helps schools in keeping the mental health assessments of the students up to date. It also helps schools find suitable screening tools and interventions for every mental health condition.

• Positive Behavior Interventions and Support (PBIS) helps schools build systems capacity for implementing a multi-tiered approach to social, emotional, and behavioral issues. The PBIS works toward improving social, emotional, and academic outcomes for all students, including students with disabilities and students from underrepresented groups.

Different intervention strategies

• Create a positive environment at school: Schools should observe areas in and around their campus and assess if the school environment is pleasant and friendly. After the assessment, they should make the necessary changes to keep the school comfortable and inviting for students.

• Promote social and emotional learning: Guide students to develop critical skills for life. Help children with recognizing and managing emotions, thinking about their feelings and controlling or regulating behavior. The Search Institute’s Developmental Assets and Character Counts! Program are great resources that schools can leverage.

• Practice mindfulness and yoga: Children experience stress as they face diverse situational challenges every day. Mindfulness, yoga, and relaxation can improve stress-coping abilities and reduce anxiety among students, thereby ensuring a better mental health in schools.

• Establish motivation initiatives for all students: Initiatives like the ‘student of the week’and/or ‘student of the month’ and Buddy (mentoring) program can motivate students to try harder and also help students develop competence.

• Develop School‐wide Behavior & Social Skills: PBIS is a social skill development program that aims to promote the emotional well-being of students. Project Achieve: Stop and Think Social Skills Project for Schools is another evidence-based model prevention program that provides early academic and behavioral interventions.

• Assess the Students’ Medical Records: Schools can use a detailed health and medical record to filter high-risk students and students with a prior history of mental illness into a focused intervention schedule.

• Train Teachers: As students spend more time with teachers in their early age, training teachers in identifying risky and abnormal behaviors in class can be very useful in early intervention for children vulnerable to mental illness.

• Increase Parent-Teacher Interaction: Including parents in the intervention process can be very effective. It would lead to a better evaluation of students’ mental health.

• Use Technology to Filter At-Risk Students: Schools should consider using 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.

• Encourage 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 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.

• Individual Treatment Using Evidence‐Based Therapeutic Approaches: Identified students can be given individual care and treatment using scientifically-proven treatment methods.

• Violence Reduction, Anger Management, & Peer Mediation:  Such intervention programs can help students cope with stressful situations in a positive manner and, in turn, reduce violence to a large extent. Winning Against Violent Environments (WAVE) is a mediation program wherein students learn and participate in conflict management techniques and become agents of change by taking skills, such as effective decision-making, communication, and problem-solving into the classroom and to the community.

• Substance Abuse Prevention: LifeSkills provides students with the skills and knowledge necessary to help them avoid the misuse/abuse of opioids and prescription drugs. This is effective in reducing the risks of alcohol, tobacco, drug abuse, and violence while supporting the social and emotional development of the students.

Better mental health can help reduce gun violence in schools

• Telling someone about a hypothetical shooting plan, either to find a partner in crime or just for attention

• Showing antisocial traits or engaging in violence

• Exhibiting lack of remorse

How to deal with the after effects of a school shooting?

• Protect survivors from further physical or psychological harm

• Identify and provide support for the most-distressed students

• Return to school and familiar routines

• Facilitate communication among families, students, and community agencies

• Educate those affected about the expectable psychological responses, basic coping tools

• Ask for people’s concerns and try to address those immediately

• Refer to locally available support mechanisms or to trained clinicians, as appropriate

Listen, Protect, Connect (LPC): An evidence-informed model

• Maintaining a balanced level of emotions and reactions with students,

• Engaging students in periodic safety drills to remind them of how to stay safe,

• Expressing positive thoughts to encourage students to look at the future with hope, and

• Thinking out loud with students to help them cope with day-to-day challenges.

• Dead/missing family members, schoolmates or friends

• Fear for their lives after witnessing the death of another person

• Being injured in the attack

• Loss of home, pet, or a relocation

• Past traumatic experiences or losses

• Past history of post-traumatic stress disorder (PTSD), anxiety or mood disorders, coupled with any of the above

Conclusion