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In High School, the Kids Are Not All Right

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In High School, the Kids Are Not All Right

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I lost my first student to suicide not long ago. The student was no longer in my class at the time, nor even at the school, but I was flooded with the expected surge of feelings: overwhelming sadness, periodic despair, compulsive frame-by-frame replays of our every interaction. I felt the loss deeply. It was unspeakably tragic-for the student's friends and family, for me, and for the world I'd hoped the student would help shape.

I was haunted, too-I still am-by the fear of a similar tragedy among my raw-nerved and anxious students. And the recent spike in teenage suicides in my area has underscored this fear sharply.

Based on my observations, the lives of the high school students I teach are hemmed in everywhere by social pressures and expectations: high-stakes testing, the looming shadow of college admissions, the fiercely competitive school system, the painful process of figuring out who you are, and the ubiquitous desire for peer acceptance. Add to this the unseen pressures-fractured or fragmented home lives, emotional or physical violence and abuse, struggles with substance use, legal problems, and the wide range of issues borne by the many immigrant communities across the country-and it makes for a period of unsustainable emotional distress. In recent weeks the constant pressure has meant dealing with student depression almost daily, and helping support those who I feel might be toeing the line of self-harm.

There are plenty of resources for dealing with student mental health issues, of course-though most of them are geared either toward college kids or, more tragically, toward elementary and middle school-aged children. The sources that do offer strategies tailored for high school students tend to be either excessively academic or so general as to be useless. Reviewing my notes from my joint credential and master's program, I find inconsistency and a frustrating lack of clarity. The strategies include things like teaching positive management strategies and promoting emotional competency, or educating staff on mental health issues and encourage social supports.

As a practicing teacher, I don't find that very helpful. And in my day-to-day work life, I see two common-and mostly inadequate-mental health strategies deployed to help high schoolers who look like they might be struggling: First, take some time, and second, get caught up. Even if the advice is phrased differently, it's usually a variation on the same theme. Students are advised to take the adolescent equivalent of a personal day, and then complete their work accordingly. I'm not pointing fingers. I've done it myself.

In my case, frustration drove me to seek some better answers. In a series of recent conversations with the mental health professionals I trust, with colleagues who have a long history of putting students' mental well-being first-and of course with students-I've assembled a list of strategies for classroom teachers to implement that might help not just treat the symptoms but also address the underlying issues.

5 Strategies for Promoting High Schoolers' Mental Well-Being

1. Ask "How are you doing?"-and mean it. For the past six years, I've stood at the door and welcomed my high school students in with a handshake and a variant of that question. If I sense any problems, I might ask "Really?" or "You sure?" I think it's reassuring to students to know that an adult in their life cares about their well-being, and the research strongly supports that position.

Student responses, even if they don't answer honestly, can reveal volumes about their actual mental and emotional status. In my class, as students complete the warm-up, I go to my roster and note which students seemed upset or otherwise off.

Over the course of an average month, I think it's a good goal to seek out one substantial check-in with every student, no matter how they seem to be doing. The teacher will have made a meaningful one-on-one contact, and the student will know that the teacher has their well-being at heart. Furthermore, it's easy and cheap in terms of time invested, but can yield important insights.

2. Set office hours. This is a policy I've borrowed from some of the best teachers I've worked with: Set formal office hours and use them to meet with students about more than just academic concerns. For example, I'll try and meet with each of my students once per semester at some point outside of class time and use the conversation to learn more about who they are, what their academic goals are, and whatever other concerns they have. More often than not, these conversations move into more meaningful territory-most of my students just want or need someone to talk to. The primary objection is that this costs a great deal of time, and I agree. It's time intensive, but I think it's worth it.

3. Remember your Maslow. It seems trite to point this out, but in the midst of all the testing and the grading, we need to remind ourselves that mental health trumps academic performance every time. Students who don't feel grounded or safe or healthy cannot do their best work. Instead of constructing a classroom environment that operates at 100 percent difficulty all the time, consider alternate models that allow students to feel supported and competent first-and then consciously and explicitly ratchet up the difficulty and complexity as appropriate. I try to practice a type of curricular minimalism: lots of guided and independent low-stakes practice, culminating in a manageable set of summative exercises.

4. Consider what matters. I have often spoken with both past and current colleagues about makeup work. Many are of the belief that if a student misses an assignment, they should be-and often must be-responsible for timely completion upon their return. Others tend to recommend a gardener's approach, pruning the material to its most vital branch. More specifically, when a student is out, it's important for teachers to consider what work, what skills, and what benchmarks are actually important for outcomes.

When a colleague suggested to me that not all assignments matter, and those that do matter don't all matter the same, I balked-but there's plenty of wisdom in the idea. When a student falls behind, consider dropping assignments or editing down the work and, most importantly, explain to the student why that exception is being made. They will appreciate the clarity and the empathy, and most respond by working with greater discipline toward more manageable outcomes in the future.

5. Use the professionals. The best attempts of teachers pale in comparison to the support, resources, and guidance of professionals. I cannot advocate enough for teachers and all school staff to get to know your on-site school psychologists or mental health counselors (if you are so lucky), or to find those very important names and numbers immediately. Every mental health professional I've met in education has impressed me with their sensitivity, care, and ability to identify underlying issues well beyond my knowledge, and they explain the connection between a student's case history and my observations in a way that is both useful and crystal clear. Although teachers tend to try to be self-sufficient and eschew asking for help from those outside the classroom, we aren't mental health professionals-and this sort of assistance is necessary.

And don't forget to talk to someone yourself. This last strategy emphasizes self-care. I've seen teachers look just as punch-drunk as students, sometimes suffering from the same anxiousness and depression. It's important that teachers make an effort to talk to someone else-especially since the old truism that each classroom is its own kingdom is generally still true. A teacher who is burdened with the trials and tribulations of their hundred-plus students-and their own struggles to boot-won't have the headspace to be a humane, observant, and effective shepherd.

Whether it's in small doses with a spouse or significant other, structured sessions with a therapist, or even informational conversations with colleagues, getting those feelings and thoughts out of your head will make you more capable of responding to the needs of others.

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In High School, the Kids Are Not All Right | Edutopia

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I lost my first student to suicide not long ago. The student was no longer in my class at the time, nor even at the school, but I was flooded with the expected surge of feelings: overwhelming sadness, periodic despair, compulsive frame-by-frame replays of our every interaction. I felt the loss deeply.

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The Hidden Mental Health Crisis in America’s Schools: Millions of Kids Not Receiving Services They Need

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The Hidden Mental Health Crisis in America’s Schools: Millions of Kids Not Receiving Services They Need

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Millions of American students suffer from mental health problems, and only a fraction are receiving necessary treatment, warns a brief from the American Institutes for Research.

And the prevalence of mental health problems appears to be growing. Sixty-two percent of college students reported feeling "overwhelming anxiety" over the previous year in 2016, up from 50 percent just five years prior. More alarming still, hospitalizations for mood disorders among children ages 17 and under leaped by 68 percent between 1997 and 2011.

Building largely on government data, including a blockbuster 2013 analysis from the Centers for Disease Control and Prevention, the brief observes that up to 20 percent of Americans under the age of 18 suffer from mental, behavioral, or emotional disorders. (That translates to approximately 15 million children across the country, according to 2010 U.S. Census figures.) The most common disorders include ADHD, depression, conduct problems, autism, substance abuse, and Tourette's syndrome.

Yet estimates show that almost half of all children with those emotional or psychological conditions don't receive either medication or psychological services, and only 7.4 percent of adolescents report visiting with a mental health professional over the course of a year. Since the onset of these problems can be difficult to detect, and millions of families lack health insurance, children must often rely on mental health resources provided by their schools.

"Schools sometimes serve as the de facto mental health system for children in the United States," write authors Elizabeth Freeman and Kimberly Kendziora.

The report recommends that schools develop "multilevel, evidence-based interventions" to reverse the tide of young adults - particularly those living in poverty - struggling with depression, anxiety, and a host of other ailments.

Yet in-school supports are already overstretched. Although the National Association of School Psychologists recommend a ratio of no more than 700 students per school psychologist when comprehensive mental health services are being provided, the ratio across American schools in 2014-15 was estimated to be nearly twice that. Teachers, already responsible for academic achievement and classroom management, typically receive little training in dealing with mental health problems.

That's why schools need to lead the way in collecting mental health information among students and family and developing working relationships with local doctors, hospitals, and mental health agencies, according to the brief.

The authors recommend that school leaders use one of a number of free tools to develop surveys for both parents and school staff, inquiring about the most common mental health problems students experience and the availability of community-based services to address them. Next, leaders can develop school-level mental health plans that specify which interventions (support groups, youth mentoring, outpatient treatment) are most needed and how to target them.

"Partnerships between schools and community mental/behavioral health professionals offer students and families an extended network of services that are easily accessible," the authors write. "When programs are able to identify and address student mental and behavioral challenges early, students are more likely to gain resiliency skills and be successful in school and life while the threat of later harm is reduced."

That harm is both real and severe. Children with mental health problems are vastly more likely to develop substance abuse problems, become involved in criminal activity, and drop out of school. Among Americans ages 10 to 24, suicide is the third-leading cause of death.

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The Hidden Mental Health Crisis in America's Schools: Millions of Kids Not Receiving Services They Need

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Millions of American students suffer from mental health problems, and only a fraction are receiving necessary treatment, warns a brief from the American Institutes for Research. And the prevalence of mental health problems appears to be growing. Sixty-two percent of college students reported feeling "overwhelming anxiety" over the previous year in 2016, up from 50 [...]

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Here's How Schools Can Support Students' Mental Health

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Here's How Schools Can Support Students' Mental Health

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About one in five children in the United States shows signs of a mental health disorder - anything from ADHD to eating disorders to suicide.

And yet, as we've been reporting this month, many schools aren't prepared to work with these students. Often, there's been too little training in recognizing the problems, the staff who are trained are overworked, and there just isn't enough money.

When there are enough people to handle the job, how should all the different roles fit together?

Many experts point to one model. It's got a bureaucratic name - the "multi-tiered system of supports" - but when you picture it, just imagine an upside-down pyramid, or maybe a funnel. It starts with support for everyone and moves on to more and more specialized help.
The Village
Here, everyone in the school has a part to play. The collective mission is broad: Create a school environment of general well-being, and a climate where mental health isn't stigmatized.

It takes a lot of planning - with big decisions often coming from the top. Just askAmanda Aiken.

She is now the Senior Director of Schools at New Orleans College Prep, a charter school network. But before that she was a principal at one of their schools, Lawrence D. Crocker College Prep.

In that role, she made a point to stand outside her New Orleans school every morning. When the buses drove in, she was at each door. Other staff were stationed at the front and back entrances.

Every student, from preschool to eighth grade, shook at least two hands before they even get inside the building.

Every student, every day?

Sometimes, Aiken conceded, it was a hug rather than a handshake.

"They hear a lot of good-mornings and a lot of how-are-you-doings," says Aiken. "I require that human touch."

Now her successor carries on that tradition.

But Aiken wasn't just being nice. It was strategic.

Many students at Crocker, part of a charter school network, have a higher risk for mental health problems. Most students receive free or reduced-price lunches, and Aiken estimates as many as 70 percent have experienced some form of trauma in the last two years: violence in their neighborhoods, family troubles, the daily stress of living in poverty.

"We need to make sure what we're doing is not retraumatizing," she says. "I see the principal as the leader in setting the tone and the culture of how school will support students and families."

That starts in the morning, but extends far beyond. Crocker is a "trauma-informed" school, which means all staff are trained on how to work with, and identify, students who have gone through trauma.

It also means they have a focus on structure, so students know what to expect. They also have a social-emotional curriculum, yoga after school and a focus on keeping suspension rates low through restorative justice.

"They aren't going to be prepared for college if they're suffering," Aiken says.

As principal, she tried to prevent crises, rather than addressing them as they come up.

"If you have everyone trained and take an 'it takes a village' approach, you can do a lot of preventative measures to reduce the risk significantly," says Aiken.

But, she adds, a healthy school environment isn't enough.

"Teachers are trained to teach. We have all taken a child psychology class, but we're not trained to work with kids with mental health needs," she says.

That's where other professionals come in.
The First Responders
When a student does show signs of trouble, one of the first steps is to talk with them. That conversation will dictate what happens next, but getting students to open up? It's easier said than done.

School social worker Ana Bonilla-Galdamez is a pro at that. Her office at Charles Barrett Elementary School in Alexandria, Va., is a testament to the different strategies she uses to unleash the gift of gab in even the most guarded of students.

There's a lot going on in there. First, there's her bookshelf, with titles like: Growing Good Kids, The Special Education Treatment Planner, Small Group Counseling.

And then there's everything else. She has a lot of board games: Candyland, Operation and her favorite, Uno. She also has art supplies, balls, a dollhouse and a sand box. A Superman doll sits in her chair, because even Superman has a weakness.

These are her tools. They help students open up, and they also help build the skills those kids will need throughout life, like managing emotions.

Although now at an elementary school, Bonilla-Galdamez spent most of her 20-year career at the high school level, working largely in what she describes as "crisis mode."

"We would think, 'Man, if we just had met this kid before,' " she says. A few years ago, a job opened up in the elementary school and she decided to apply.

"I thought, this is my chance to see where this starts," she says.

Early intervention for the child - and education for the parent - is key, she says. That's where the games in her office and the phone calls home come in.

"My job is to dig," she says, "For me to do that, I need to build the trust of the parent and the child."

She tells the story of the time a young mom came in, worried about her kindergarten son. He had been telling her he wanted to die. In her office, Bonilla-Galdamez let the boy choose whatever game he wanted. As he grew comfortable, she asked him about life at home.

"He had witnessed people being killed," she says. "He had witnessed a lot of violence."

What to do next all depends on what that child needs. That kindergartner might have ended up in a small group, working on coping skills or managing his emotions. But, in this case that wasn't the answer: She had also learned that the young boy had run out into traffic when he was upset.

"The threat was imminent, so I referred him to emergency services," says Bonilla-Galdamez. "Our environment isn't suited to clinical interventions."

At that point, Bonilla-Galdamez continued working with the family, but she also helped them connect to more specialized help, and the kindergartner moved on to the third level for more support.
Clinical Care
At this level, a doctor or therapist may get involved for the first time. Often, school plays a vital role in connecting the student to a clinic.

Vital, but not necessarily easy. When school psychologists Monique Leopold and Danielle Palmer refer students to a mental health clinic, they know that a lot of the time, the appointment never happens.

The two women have a handful of high-quality programs that they rely on for referrals near their schools - a network of public charter schools in the nation's capital called DC Prep. Sometimes though, families can't get an appointment for months. And when they do, with so many living in poverty, getting there is one more complication in already chaotic lives.

"It's not that [those families] don't love their kids, it's that they don't have the capacity," says Palmer.

And even when the students do get professional treatment or medication, sometimes prescriptions lapse before the child could be seen again.

"Triggers are brought from the community into school," says Leopold, "They go to school without what they need."

To try and meet those needs, DC Prep started a partnership with Children's National Health System. Now, a psychiatrist visits the schools once or twice each month.

"I told a family this morning, 'Listen, we have a doctor here,' " Leopold says, "and the mom's eyes lit up."

Lisa Cullins, one of those psychiatrists who visits, says school is a logical place for students to get clinical mental health care.

"At school, they're going to be there anyway. It's something they do everyday," she says. The partnership isn't just easy on families. It's also easier on her.

"To know our patients, we have to know their school setting," she says. "When I walk in, I have a comprehensive packet of information on how the child has been doing since the beginning of the year."

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Here's How Schools Can Support Students' Mental Health

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About one in five children in the United States shows signs of a mental health disorder - anything from ADHD to eating disorders to suicide. And yet, as we've been reporting this month, many schools aren't prepared to work with these students.