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https://spark.adobe.com/sp/design/video/8884dfa5-8e44-451e-8d23-eb447bb50114

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Running extracurricular social activities for pupils has also been shown to help have a positive impact on students, by providing a space for them to work through their emotions and develop strategies to address their challenges.

If both pupils and teachers have more open discussions about mental health, issues will also be easier to identify early on, and this will help to build students’ knowledge and understanding of the subject.

http://theconversation.com/five-things-schools-can-do-to-help-pupils-mental-health-79376

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In the wake of the recent school shootings in the past academic year, the need for school counselors and mental health professionals has become more apparent.States and school leaders are seeking a number of solutions as they provide mental health services to students. Some are forming partnerships with local agencies or setting up school-based mental health clinics while others are looking to digital solutions. Some states are allowing school security funds to be used for hiring mental health professionals, while others are now mandating mental health education at schools. School leaders can explore all these options as they look at ways to increase school safety and help students become healthier and better able to focus on learning.
https://www.educationdive.com/news/finding-professionals-to-meet-students-mental-health-needs-may-prove-chall/527534/

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Schools offer an ideal context for prevention, intervention, positive development, and regular communication between school and families. School-employed professionals like school psychologists, school counselors, school social workers, and school nurses know the students, parents, and other staff, which contributes to accessibility of services.
They are specially trained in school system functioning and learning, as well as how students’ behavior and mental health impacts their ability to be successful in school.
https://www.nasponline.org/resources-and-publications/resources/mental-health/school-psychology-and-mental-health/school-based-mental-health-services

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NAMI has developed training programs that address child and youth mental health. The NAMI Parents & Teachers as Allies program is an in-service training program for school personnel.

Presentations for Students

NAMI Ending the Silence provides students with information on mental health conditions and how to ask for help if they see the signs in themselves or a friend. Through the free classroom presentation, students get to see the reality of living with a mental health condition.
https://www.nami.org/Learn-More/Public-Policy/Mental-Health-in-Schools

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Schools can address the mental health crisis among American youth by addressing and eliminating the misconceptions surrounding the epidemic. The purpose would be to make it easier for students to get professional assistance with their mental health. By lawmakers enforcing the proper education of mental health in schools and providing teachers with practical skills to address it, stigmatization can lessen in intensity.

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Children face mental health epidemic, say teachers

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More pupils are struggling with anxiety, depression and addictions but not receiving the help they need

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These problems continue today, they add, in the form of poor funding for research and services compared to other illnesses; structural forms of discrimination; and “widespread, inaccurate, and sensational media depictions that link mental illness with violence.” The fact that mental health care is not covered by insurance to the same extent as medical care, and the fact that mental health research is not funded to the same levels as medical research, are two clear indications that stigma targeted at mental illness continues to exist at the structural level. Psychological scientist Patrick W. Corrigan of the Illinois Institute of Technology  says that “The prejudice and discrimination of mental illness is as disabling as the illness itself.  It undermines people attaining their personal goals and dissuades them from pursuing effective treatments.”
https://www.psychologicalscience.org/news/releases/stigma-as-a-barrier-to-mental-health-care.html
The early treatment success rates for mental illnesses are 60 to 80 percent, well above the approximately 40 to 60 percent success rates for common surgical treatments for heart disease.
https://www.teachforamerica.org/top-stories/reducing-stigma-mental-illness-so-students-get-help-they-need
Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610943/

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that public policy, the law, and media remain our greatest resources to stimulate change and spur action,” Carter, Palpant Shimkets, and Bornemann write in their commentary. “We also need to build bridges to other fields that connect to mental health, such as public health, primary care, and education.”
https://www.psychologicalscience.org/news/releases/stigma-as-a-barrier-to-mental-health-care.html

Rep. Grace F. Napolitano's Mental Health in Schools Act is part of the solution. By providing increased federal funding for therapists and mental health services in our schools, this bill will help youth with preventable mental illnesses get access to the services they need.
https://napolitano.house.gov/issues/mental-health-schools-act

The Mental Health in Schools Act builds on a highly-effective program known as the Safe Schools/Healthy Students

program, which strengthens partnerships between local education and community
programs including (but not limited to) local primary health, juvenile justice and child welfare entities,

and provides funding to place on-site qualified mental health and substance use professionals in schools across the country to provide behavioral health services for students and their families at no charge.
https://www.thenationalcouncil.org/wp-content/uploads/2016/05/mental_health_schoolsFINAL531.pdf

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Whatever the questions we choose to ask about mental health, and there are many, two things are clear: the upsurge of illness in our young should be of huge concern to us all; and we need to look at better ways of addressing the causes rather than waiting to deal with the consequences.

There have, of course, been many attempts to do just that. A growing number of schools have attempted to change their culture by instigating programmes aimed at improving resilience and self-esteem, by improving their pastoral and monitoring procedures or by introducing classes in happiness and well-being, but most are merely scratching at the surface.

We might not fully understand what has made so many of our young so vulnerable and lacking in confidence, but we can speculate that the focus on IQ and academic achievement above EQ and well-being, as well as the break-down of family, are obvious areas that have eroded confidence and left children without the inner resources to cope.

The need for more urgent and concerted action can no longer be ignored and, over recent months, a number of leading heads and school associations have spoken out about mental health, the impact of league tables, the increase in tutoring, the extent of depression among students and cyber-bullying, based in part on the findings of a survey of independent schools released in October.

A brave few have even acknowledged the problems existing in their own school communities, which is commendable and the first step to involving the whole school community in finding solutions.

However, the response from many other heads and governors, who have ignored the growing extent of children's mental health issues in their own schools for far too long, has been disingenuous at best.

In many schools, the problems are not new and while more money and resources are now being diverted to address mental health issues, a few still appear to care more about their academic results than the mental health and well-being of their students.

The boom in tutoring, for instance, which a number of heads are now ready to criticise, can be seen as an entirely understandable response by parents to the over-rigorous testing and entrance exams, often poorly communicated by schools by smoke and mirrors, and undertaken in such a way that shows little consideration for their impact on children and families involved.

Tutoring may well be a symptom of a system in free-fall and struggling to cope, but regardless, the causes of the growing mental health problems lie largely with the schools and it is the causes, not the symptoms, that need addressing.

For that to happen, whole school cultures will need to change, and sometimes, radically so.

A number of steps can be taken. First, schools must recognise that it is not competition and hard work that causes stress and mental health issues among their students, rather fear and anxiety.

Schools that have not been averse to using anxiety - however unwittingly - and fear of failure to drive performance, urgently need to review their practice and ethos.

As well, in the face of a largely unregulated and often hostile virtual world, students must be taught better coping strategies, both on-line and off, and have better support from appropriately trained staff (which means some teachers being trained in social media).

What students don't need as they navigate the often difficult years of adolescence is to be over-monitored and managed, but rather guided and supported by informed adults. More counsellors are urgently needed, and, in some instances, the ethos of schools needs to be changed.

The Government, of course, has to play its part through extra funding for the sector specifically to help tackle the issue of mental health, but it is schools that need to take a lead in protecting the well-being and mental health of their students.

Peter Tait, former headmaster of Sherborne Preparatory School

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'Causes of growing mental health problems sit largely within schools'

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Whatever the questions we choose to ask about mental health, and there are many, two things are clear: the upsurge of illness in our young should be of huge concern to us all; and we need to look at better ways of addressing the causes rather than waiting to deal with the consequences.

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Behavioral health has become a public health crisis. No other public health crises are as widespread or contribute as much to the burden of illness in the U.S. as do behavioral health disorders. By 2020, mental and substance use disorders will surpass all physical diseases worldwide as major causes of disability.

Around the world we are gradually winning public health battle after public health battle. The CDC list of "Ten Great Public Health Achievements, 2001-2010" includes significant improvements globally with respect to infant mortality, vaccine-preventable diseases, access to safe water & sanitation, malaria, HIV, tuberculosis, tropical diseases, tobacco, road safety, and response to pandemics.

Meanwhile, developed nations are leading the world with respect to a new generation of public health crises relating to physical health (chronic diseases, such as heart disease and diabetes) and behavioral health (mental illness & substance abuse). As noted above, by 2020, "mental and substance use disorders will surpass all physical diseases worldwide as major causes of disability."

The perspective of the public health establishment is that the behavioral health crisis must be met with increased funding for "public behavioral health services." From their perspective, we need massive new investments in treatment centers, counselors, therapists, psychologists and psychiatrists, community interventions, etc.

The Hippocratic Oath exhorted doctors to "first do no harm." In order to scale back the accelerating public health crisis stemming from mental health and substance abuse issues, I propose that public health officials first reflect on the role of government-managed secondary education in causing our epidemic of mental illness and substance abuse.

Stated so bluntly, my thesis is controversial. But it is not controversial that lifelong substance abuse (see here, here, and here) and mental illness typically start in adolescence. As the National Institute of Mental Health notes, "Mental disorders are really the chronic diseases of the young." The appropriateness of focusing on adolescent years is not controversial.

There are those who regard behavioral health as strictly a matter of genetics. That said, the Center for Disease Control has firmly stated the role of "school connectedness" in preventing adolescent dysfunction:
School connectedness was found to be the strongest protective factor for both boys and girls to decrease substance use, school absenteeism, early sexual initiation, violence, and risk of unintentional injury (e.g., drinking and driving, not wearing seat belts). In this same study, school connectedness was second in importance, after family connectedness, as a protective factor against emotional distress, disordered eating, and suicidal ideation and attempts.

The data above is taken from a study of 36,000 teens.

Researchers are only now discovering just how deeply these connections go. For instance, a 2007 article in the Journal of Adolescent Health discovered a direct connection between early teen experiences and mental health. They surveyed a cohort of almost 3,000 teens at grade 8, grade 10, and one year after graduation:

Overall, young people's experiences of early secondary school and their relationships at school continue to predict their moods, their substance use in later years, and their likelihood of completing secondary school. Students with good school and good social connectedness are less likely to experience subsequent mental health issues and be involved in health risk behaviors, and are more likely to have good educational outcomes.

In a world in which an estimated one third of teens are on prescription medication, and almost half of those are on psychiatric drugs ( ADHD, anti-depressent, anti-psychotics, and anti-anxiety), it is important for more parents to realize that school may be a causal factor with respect to their child's depression.

Another cohort study of 2,000 teens states bluntly in its report title: " School Connectedness Is an Underemphasized Parameter in Adolescent Mental Health."It explicitly suggests that a lack of school connectedness is a causal factor in mental health issues.

School connectedness also predicted depressive symptoms 1 year later for both boys and girls, anxiety symptoms for girls, and general functioning for boys, even after controlling for prior symptoms. . . . Results suggest a stronger than previously reported association with school connectedness and adolescent depressive symptoms in particular and a predictive link from school connectedness to future mental health problems.

Pharmaceutical companies invest significant marketing dollars into persuading parents and health care practitioners that depression is a biochemical disorder to be corrected by pharmaceuticals. But what if a significant portion of adolescent dysfunction and mental illness is actively caused by a child's feeling of disconnection from the school community?

A recent dissertation on schools and depression summarizes the scale of the issue:

Depression is a debilitating condition that is increasingly recognized among youth, especially adolescents. Nearly a third of adolescents experience a depressive episode by age 19 and an increasing number of youth experience depressed mood, subsyndromal symptoms, and minor depression. The prevalence of depression is particularly high among female, racial minority and sexual minority youth. . . . major depression and subthreshold depressive symptoms often first appear during the adolescent years. Rates of depression steadily increase from ages 12 to 15. Based on retrospective studies of depressed adults and prospective studies of youth, major depression is most likely to emerge during the mid-adolescent years (ages 13-15). Prospective studies that follow the same children over time reveal a dramatic increase in the prevalence of major depressive episodes after age 11 and again after age 15, with a flattening of rates in young adulthood.

Moreover, the importance of school connectedness extends to suicide as well:

The protective associations of higher school connectedness for suicidality in adolescents after accounting for the presence of depressive symptoms suggests that enhancing school connectedness may be a useful universal strategy for preventing suicidal behaviours in adolescents.

There is growing mainstream recognition that "school connectedness" is a significant risk factor for adolescent dysfunction, including substance abuse, mental illness, and suicide. Certainly "family connectedness" is also important. But as Judith Rich Harris showed twenty years ago, for adolescents peers are much more important an influence on behavior than are parents. In prominent surveys, "School connectedness" includes

I feel close to people at this school.

I am happy to be at this school.

I feel like I am part of this school.

The teachers at this school treat students fairly.

I feel safe in my school.

Clearly relationships to peers and educators are key variables here. Guess what? Human relationships are important to adolescents.

Meanwhile, a Gallup poll finds that only 44 percent of high school students feel engaged at school. Beyond a "smoking gun," this is an obvious catastrophe. For decades pop culture has been celebrating teen loathing of school: Alice Cooper, "School's Out," Pink Floyd, "Another Brick in the Wall," or as Rolling Stone describes Mogwai's "I Love You, I'm Going to Blow Up Your School,"

And what better way to show that special someone how much you care? For seven minutes the Scottish noise-rock monks of Mogwai ride a slow fuse from somber restraint to explosive chaos, adding their own unique contribution to rock's rich canon of school-as-murderous-hellhole songs - from Hüsker Dü's "Guns At My School" to the Dead Milkman's "Violent School" to the Boomtown Rats' school-shooting lament "I Don't Like Mondays."

Sometimes I wonder what planet public health researchers live on. Haven't they noticed that school is hell?

Here we find the key problem: Academic research is generated by individuals who underwent a self-selection process. Those who found school tolerable are more likely to continue formal education. Some eventually become degreed experts with the authority to dictate to others what education should look like. Meanwhile, most who find school a living hell leave and never look back.

Although I was a straight A student who got into Harvard, to this day I regard my secondary school years as the most boring and cruel years of my life. I was completely sympathetic then and now to those who hate school - many of whom self-medicated to address the boredom and cruelty (often thereby starting on the path to substance abuse) and/or were horribly depressed.

What if the institution of school itself is only appropriate for a fraction of our population? Perhaps those 44% who are engaged according to Gallup? What if school was actively harmful for most of the rest? Not just, "bummer" harmful, but contributing to lifelong substance abuse and mental illness harmful?

In Mind, Modernity, and Madness, Liah Greenfeld argues that reforming education is the only real solution we have to addressing the mental health epidemic. While she acknowledges there are genetic and familial factors that may predispose one to mental illness, the fact that rates of mental illness increase as nations transition from traditional cultures to modern cultures, and continue to increase with prosperity, is evidence that a cultural variable is essential to explain the growing prevalence of mental illness. Because some believe that the increased prevalence of mental illness may be a reporting artifact, note the increased prevalence of teen suicide in the modern world: rates in the U.S. are up about 3x since 1950. An astute student of Durkheim, she recommends greater urgency in addressing the growing anomie in the modern world that has resulted in higher rates of suicide, substance abuse, and mental illness.

What does "school connectedness" and "identity formation" have to do with public schools "causing" mental illness? By and large, there is little evidence that private schools are much better. Indeed, while Catholic students at Catholic schools are at a lower risk of suicide than the population as a whole, non-Catholic students at Catholic schools faced a 2-4 x higher risk of suicide. Private religious schools might actually be more dangerous if there is a mismatch.

Is it possible to create better schools, or should we simply accept that a growing percentage of our population will be depressed, try to counsel alienated teens from suicide and substance abuse, and accept the associated health care costs anticipated by the public health establishment?

I've spent most of my life creating small private and charter schools where teens who were previously miserable become happy and well. I've worked with dozens of teens who had been depressed, suicidal, and medicated with various pharmaceuticals become happy and well without "medication." Let's hear from a teen who was suicidal but is no longer thanks to a change in school environment,

I walk through the hallways of the public middle school on my way to the bathroom. I stop in the center of hallway staring ahead at the overwhelming endless hallway, no one in sight. clenching my fists I look around panicky around the solid brick white wall. No sign of anyone or anything living anywhere. I scratch my fingernails hard on the plastered wall. not making a dent. I do this several times until the tips of my fingers look like the tops of roses. I then start hitting my head then slamming my body against the wall still hitting my head trying to get out . . .

A backpack of melancholy weighs down on my shoulders so I free the questions inside with my thoughts: Why did I have to be depressed?, Why couldn't I learn like everyone else?, Why did I have to be scared? . . . I figured something was wrong with me. Just an idiot with issues, too stupid to learn and too ungrateful to be happy. All I could ever do was make my parents and the people around me worry. I was angry at myself, I was angry that I couldn't learn or be happy. If all I could do was make my parents worried I was just a waste of time to them. I didn't deserve to live I wanted to hurt myself. . . .

I stayed up all night in bed fearing the next day of school. I eventually did start talking to the school counselor about my problems. At first I would come in calmly and just talk to her. Then I started coming in every single day crying and more depressed than the day before. Sometimes I just came in asking to call my mom. I never told anyone that I wanted to commit suicide. Until the day I told my mom.

I fiddle with lock and push open the steel door to the inside of my small house. Immediately I drop my school bag near the the front door. Mom is still at work. Slowly walking to the kitchen I stare at the sharp kitchen knife tucked into the knife block. Slowly still walking toward it I carefully take out the knife and feel the blade across my finger. I endeavor to conceive how much it would hurt if I were to stab it into my chest. I pose the knife back in its place. i'm too afraid too and cowardly of the pain. I think of less brutal ways but all thoughts fail. . . .

There is nothing abstract about these issues for me. Sure we could add more counselors and medication. But simply changing schools, from a one-size-fits-all public school to one at which she was allowed to learn at her own pace in her own way, in a warm, supportive peer culture, eliminated the misery.

But our system creates unreasonable obstacles to the creation of such schools. Because of my experience creating small, personalized schools, I am intimately familiar with the obstacles to creating them. For instance, my current school, The Academy of Thought and Industry, with campuses in San Francisco, New York, and Austin is working to persuade accrediting organizations that students should be allowed to take advanced academic courses whenever they want rather than follow grade-level curricula. Even in the world of private schools, mainstream accreditation agencies tend to force mainstream expectations on schools.

Because I know it is possible to create schools that integrate emotional well-being with academic performance, if it was not so challenging to create such schools the demand would be great for them. If parents could choose schools at which their children were happy and well, they would do so. Indeed, in light of the high stakes associated with school connectedness, as recognized as the CDC, I go ballistic when I read about education researchers insulting the judgment of parents who choose to leave public schools, such as this summary of a famous 2006 paper by Judy Jackson May:

"Many parents base their school choice decision on factors that have nothing to do with the quality of education" (May, 2006, p. 28). In her study, parents reflected on positive feelings, which translated into smaller class sizes, teacher familiarity, one-on-one attention, and a sense of belonging. May refers to this construct as "the perception gap" - the positive expressions parents charter schools that are consistent more with their feelings rather than with achievement results, but are ultimately defined as "academic satisfaction."

She calls parents' decision to put their children in a school with " smaller class sizes, teacher familiarity, one-on-one attention, and a sense of belonging" a "perception gap"? I perceive I don't want my child to kill herself, and you call that a "perception gap" that has "nothing to do with the quality of education"? WTF?

I used to be optimistic about the charter school movement. Indeed, I co-created a charter school in rural New Mexico that was ranked the 36th best public high school in the U.S. (and ranked the best public high school in NM by K12.Niche.com in 2016). But federal control restricts charter school autonomy too much to address our public health crisis. In order to create fundamentally new kinds of schools, educators need freedom from all existing curricular constraints, licensing constraints, and testing constraints. As long as opportunities for "innovation" in education are constrained by the same constraints faced by public schools, innovators only have small parameters within which to innovate.

In order to develop robustly healthy personal identities in a world of anomie and constant change, adolescents will need to be embedded in new subcultures which have not yet been developed. Thus rather than new technology, new pedagogies, new evaluations, and so forth, the educational project of the future is the creation of new, deliberately developed teen subcultures that will support lifelong happiness and well-being.

Thus it is not so much that public schools per se are causing mental illness. But their existence and dominance are preventing the evolution of a better system much as the existence and dominance of the Soviet Union prevented the evolution of an innovative technology sector. We need an innovative humanities sector to address the behavioral health crisis coming our way. It must be based on radical freedom to create new systems of education and new subcultures of well-being.

What will they look like? We don't know. But if you'd like to explore ten school designs that are "eye-poppingly liberating to the pedagogical imagination" (in the words of the poet Fred Turner), please do so. And improve upon them. And allow them. Let's get started now.

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Are Public Schools Causing an Epidemic of Mental Illness?

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Behavioral health has become a public health crisis. No other public health crises are as widespread or contribute as much to the burden of illness in the U.S. as do behavioral health disorders. By 2020, mental and substance use disorders will surpass all physical diseases worldwide as major causes of disability.