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Well-U (Employee Wellness) Depression Coaching & Self-Management program

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Well-U (Employee Wellness) Depression Coaching & Self-Management program

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How does the Depression Coaching & Self-Management program differ from Behavioral Health Partners, and which program is right for you? Take a look at the chart below, or call (585)275-6300 to speak with a program representative who will help you decide.

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How does the Depression Coaching & Self-Management program differ from Behavioral Health Partners, and which program is right for you? Take a look at the chart below, or call (585)275-6300 to speak with a program representative who will help you decide.

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Well-Being for Life & Learning-Training Tracks

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The Well-Being for Life and Learning offers three training tracks: one for student support staff, faculty and staff instructors, and athletic staff.

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Training Tracks - University Health Service

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5 Self-Discovery Tips Therapists Swear By

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5 Self-Discovery Tips Therapists Swear By

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5 Ways to Learn More About Yourself Without Going to Therapy

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 How to help college instructors with mental health struggles 

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 How to help college instructors with mental health struggles 

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How to help college instructors with mental health struggles

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The majority of college instructors say they are struggling with mental health issues, which may impact their ability to teach effectively.

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Crisis Text Line provides free, 24/7 support via text message. We're here for everything: anxiety, depression, suicide, school. Text HOME to 741741.

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8 Tips for Maintaining Mental Health During Nursing School

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8 Tips for Maintaining Mental Health During Nursing School

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Too many nurses prioritize career success over their own mental and physical health, without realizing that you need to take care of yourself first in order to be the best nurse you can be. Here are a few suggestions to help!
As a nursing student, you already know that nursing school is both a challenging and life-changing experience. Between balancing your family life, coursework, and clinical, there are some days where you feel like you're at the end of your rope. Knowing how to stay healthy in nursing school will help prepare you for a rewarding career. A significant number of nursing students nearing the end of their program experience physical health problems, extreme levels of fatigue, and burnout because of the pressure, stress, and long hours of studying and clinical rotations.

Making your mental health a priority is an important factor in your success as a nursing student and can help you develop great habits for staying healthy as a nurse. The following are eight tips you can take to help maintain good mental health throughout your nursing school experience.

Schedule Time for Self-Care

Self-care can be one of the most important things you do for yourself. As a nurse, you will be spending your life caring for others, but it is just as important to care for yourself. Being on your feet for hours during clinical rotations, running from patient to patient can wreak havoc on your physical health, so make sure to see your doctor for any unusual aches, pains, or symptoms that you might have.

It is also essential to take time to ground yourself. Practicing mindfulness techniques, such as deep breathing, meditation, yoga, or tai chi can give you the tools to calm your anxiety before an exam, relax after a long day at the hospital, and help you keep a clear head when you feel overwhelmed.

Nursing school can be very stressful, despite its many rewards. It might feel like you don't have enough hours in a day to do your schoolwork, learn your practical skills, study for certification exams, and practice self-care. However, you don't need to carve out hours a day - just 10 or 15 minutes a day to drink a cup of tea and read a newspaper, take a hot shower, meditate, or call a friend might be all you need to recharge and ground yourself.

Prioritize Good Sleep

As a student in nursing school, you likely have pulled a few all-nighters studying for exams. However, as a nurse, it is essential that you can think clearly, have good reflexes, and be able to make critical life and death decisions with very little time.

Sleep deprivation, a common occurrence in both students and nurses, can cause a multitude of problems, including poor eye-hand coordination, difficulty staying awake during the day, high blood pressure, heart disease, slower reflexes, increased irritability, and a lowered ability to think and react quickly. Sleep deprivation also increases anxiety and lowers your ability to cope with stressful situations.

While it is difficult to get a good night's sleep every night, try to make quality sleep a priority. Create a relaxing sleep routine in the evening to help you destress and unwind after a stressful day at school. In addition, avoiding caffeine and using television, computers, or your phone in the evening can help your body fall asleep quicker and have a more restful sleep.

Join a Study Group

Some of the best people to support you through your nursing program are other nursing students. In addition to the mental health benefits of socializing, you'll also be likely to learn more. After all, you're all in the same situation. Joining a study group can give you a group of like-minded peers that understand not only your coursework but also the stress of nursing school. Together, your group can prepare for exams, debrief after difficult clinical days, and cheer each other on as you achieve various milestones in your program.

Socialize with Friends Outside of Your Nursing Program

Just as it's important to make connections with peers who understand what you're going through, it's just as important to spend time away from everything related to nursing school. Your friends outside of your nursing program may not understand what day-to-day life is like for you, but that offers you an opportunity to have conversations that don't revolve around books, symptoms, or grades. Separating school from your outside life can help produce positive mental health outcomes for nurses.

During holidays and breaks from school, try to make a point to reconnect with neighbors and friends over dinner, on a trip, or even during an evening workout. Nursing school can sometimes feel isolating, especially if you feel like you're always too busy to go out with friends and have fun, but spending even a few hours during school break socializing with friends can be just what you need tend to your mental health and be ready to tackle another semester.

Find Time for Exercise

As a nurse, you might feel like you are constantly doing cardio exercises throughout your entire shift running from patient to patient. That might be true, but taking time in the evenings or on weekends to engage in exercise, you enjoy can help you combat stress, avoid burnout, and keep up your strength and endurance for those marathon work sessions.

Frequent exercise is important for increasing your flexibility, endurance, stamina, balance, coordination, and strength. In addition, it can help reduce depression, improve mood, decrease feelings of soreness and pain, and improve memory. Each of these important benefits will help you not only feel better but also be a more efficient and capable nurse!

Avoid Self-Medication with Drugs or Alcohol

One of the dark secrets of nursing is that research has found that there is a higher rate of addiction among nurses than in the general public. Alcohol, cocaine, and marijuana addiction are some of the most common forms of substance abuse in the nursing field. While some might say these substances provide stress relief, nurses know firsthand just how dangerous a substance abuse disorder can be.

There are many reasons for this, including the high levels of stress that nurses face on the job, long working hours, increased pain in the body, grief and trauma after the death of a patient, and feeling overwhelmed by high patient loads or unfavorable working conditions. To avoid falling into the trap of alcohol or drug addiction, it is essential to avoid self-medicating for anxiety, depression, or pain. If you are suffering from mental illness or physical pain, seek help so that you can be properly treated.

Nourish Your Body

As a college student, there are likely days where you have gotten home after a long day of class and work and realize that you haven't had a full meal all day. When this continues, your body will begin showing signs of malnourishment, including poor concentration, increased anxiety and depression, difficulty sleeping, fatigue, confusion, irritability, difficulties regulating your blood sugar, and slowing metabolism.

Eating healthy meals is important for maintaining both your physical and your mental health. Try to eat a healthy meal before class and again before your work shift. Your school's cafeteria likely has options for on-the-go meals, such as fruit, yogurt, salads, or sandwiches. When you meet with your study group, consider meeting in the cafeteria or at a local cafe where you can all enjoy a healthy meal while studying. Finally, pack granola bars, fruits, pretzels, whole-grain crackers, or cottage cheese in your bag to snack on throughout the day to avoid blood sugar crashes.

Seek Professional Help for Grief and Trauma Care

Quality mental healthcare for nurses helps improve our healthcare industry as a whole. As a nursing student, you might have your first real experience with caring for a dying person. It might be a child who fought cancer for years or it could be a new mother who died during childbirth. Regardless, facing death and traumatic situations might cause you to feel grief unexpectedly, and in some cases, you might develop signs of post-traumatic stress disorder.

It is essential to seek professional help for coping with trauma and grief associated with nursing. There is no shame in talking with a therapist after a stressful situation at work. Some nurses even continue with weekly or monthly counseling appointments to help combat stress and feelings of burnout and to have a safe outlet to decompress and avoid bringing stress home.

It's likely that you are well on your way to a long and successful nursing career. With these eight tips, you will be better able to cope with the stresses of nursing, balance your school, work, and home life, and maintain or improve your mental and physical well-being.

Ready to jump-start your nursing career? Get certified or recertified in ACLS, PALS, or BLS online with eMedCert. Visit our website or contact us today.

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8 Tips for Maintaining Mental Health During Nursing School | eMedCert Blog

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Many nurses prioritize career success over mental health, without realizing the need to take care of yourself first to be the best nurse you can be.

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Mental Health & Wellness for Nursing Students

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Mental Health & Wellness for Nursing Students

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Attending nursing school can be an incredibly rewarding and worthwhile experience. However, it also often comes with a high amount of mental stress. From trying to choose the nursing program that's right for you and navigating the admissions process to getting good grades both in clinicals and the classroom, there's a lot to deal with.

Given all the demands of nursing school (and the profession as a whole), nursing students can be prone to more mental health challenges than the average college student. In this guide, you'll learn about the unique mental health struggles nursing students like you may encounter and discover outside resources and self-care strategies that can help you overcome them. By knowing about the risks while you're in nursing school, you'll reduce your chances of experiencing burnout now and when you start your career.

Common Mental Health Challenges for Nursing Students

Some of the major mental health challenges that nursing students face include stress, anxiety, and depression. Plus, the stress of nursing school can exacerbate already existing challenges, including substance use disorders, eating disorders, and mood disorders.

Most nursing students and nurses experience burnout at some point in their career. According to the American Hospital Association, the term "burnout" was added to the World Health Organization's International Classification of Diseases (ICD) in 2019. The ICD characterizes burnout as "chronic workplace stress that has not been successfully managed." Burnout includes:

Experiencing energy depletion or exhaustion

Increased feelings of job-related cynicism

A sense of lack of accomplishment or futility

When burnout was added to the ICD, approximately one-third of all nurses suffered from this condition. By 2021, a national survey by the American Nurses Association reported that 62 percent of U.S. nurses reported symptoms related to burnout. Here's what to watch for-and what to do.

Stress

Stress for nursing students typically includes academic stress, emotional stress, and relationship stress. Academic stress is particularly acute in accelerated nursing degree programs; while these programs are great for entering the field quickly (especially following a career change), the demands are intense. If you notice yourself spending a lot of time studying with limited improvement in comprehension or retention, that could be a sign you're experiencing intense academic stress.

Relationships and emotional well-being are affected by stress as well, particularly as you learn to balance your studies, new responsibilities, time with your loved ones, and time for yourself. If you're increasingly disconnected from friends or family, consistently turning down invitations, or feel that your emotions are muted, you may be on the cusp of severe burnout and should reach out for support.

Anxiety

Nursing school is a huge responsibility. Students find themselves under a lot of pressure-plus they know that the challenges will continue and the responsibilities will increase once they start their nursing career. In its purest form anxiety helps you, signaling that something important is happening and that you need to focus. However, anxiety can quickly spiral out of control and distract you. If you experience racing thoughts (even after your test or after the day's clinicals are over), are unable to calm down after doing deep breathing or using other relaxation tools, or constantly feel like a "deer in headlights," that may signal that your anxiety is getting in the way. Learning to manage these issues while you're a student is an excellent way to get yourself on the right track once you earn your degree.

Depression

Studies show that approximately one-third of nursing students worldwide suffer from depression. As a nurse, forming friendly relationships with patients bolsters good clinical care. However patients don't always get better; the feelings of futility that may accompany a patient relapse or death are a pathway toward burnout or depression. If you experience a depressed mood more days than not over two weeks or longer, have a lack of interest in your usual activities, and experience changes in sleeping or eating patterns or energy levels, it's time to consult a provider to screen for depression.

Other possible issues

When stress, anxiety, or depression feel like too much to handle, many people resort to more drastic means of coping, such as using dangerous substances, developing an eating disorder, or even turning to compulsive behaviors like shopping. The American Nurses Association indicates that 10%-14% of RNs in the US may have a problem with substance or alcohol use and, based on a smaller study group sample, as many as 5% of nurses may struggle with an eating disorder. While a little retail therapy may not seem like a bad thing, when used as a coping mechanism it can have negative effects on you, your family, and your finances.

Substance use can increase when you are consistently stressed. Many people end a day with a declaration of, "I need a drink!" If you notice that you drink or use substances more days than not, rely on substances or alcohol to wind down after classes or exams, rush through assignments so you can start drinking, or feel you wouldn't know how to cope without alcohol or substances, consider reaching out for support.

Eating disorders are prevalent; many people have complex relationships with food that are exacerbated by stress. Some may use food to relieve stress, provide emotional comfort, or gain a sense of control. If you are repeatedly eating more than you intended or are having a tough time branching out from a few "safe" foods, discuss what's happening with a healthcare provider.

Compulsive shopping may not be a formal diagnosis, but during periods of high stress you might turn to shopping for the quick dopamine hit that comes with getting something shiny and new. If you notice that you're having trouble financially because of your discretionary spending, buying things you don't need, or have a tough time resisting scrolling your favorite websites for new purchases, seek assistance from a mental health professional.

Importance of Self-Care and Managing Symptoms

Self-care has become a mental health buzzword in the last decade, and for good reason: Healthcare professionals must learn to put on their own oxygen masks before assisting others. However, self-care is more than pedicures and cupcakes; it's a deliberate, long-term practice to both help you feel better in the moment and have a better day tomorrow. These guidelines will help you learn to care for yourself during nursing school and beyond.

Live a healthy lifestyle.

It's the key to keeping stress under control and avoiding burnout.

Sleep: When you're stressed you might think of rest as optional, however rest and sleep are the most important ways to help your body and mind. Your body is going to find a way to get the rest it needs, either by you prioritizing regular sleep or by your body crashing under the strain of your exhaustion.

Exercise: Resting your body is important, and moving it is important, too. However, finding time for exercise can be difficult. Can you walk to classes instead of driving? Ride your bike to meet friends instead of taking a rideshare? Lift weights while listening to virtual lectures? These strategies will remain helpful once you're working in the nursing field.

Healthy diet: Eating a variety of nutritious foods is crucial to overall health. Treats are fine, but if you notice yourself relying on less nutrient-dense foods, take-out, or even skipping meals, stop and think about how to prepare healthy meals ahead of time. Band together with friends to do a meal swap-have each person make an entree, then divide it among the group so everyone gets a portion of each dish. It's a great way to share the labor and try some new foods!

Find activities that ground you.

When you feel like your thoughts are going a thousand miles an hour, it's important to know which activities help ground you. Brainstorm quick activities you can do daily and bigger undertakings that you might do once a month. Start with ideas like these:

Journaling is a great way to reflect on your thoughts and emotions. Consider which type of journaling feels most helpful, whether it's using an app on your phone, a small paper journal that you keep with you, or a fancier journal that provides a sense of ritual when you write.

Many students have heard of mindfulness, yet they mistakenly think that knowing about it yields the same benefits as practicing it. Lots of apps are available to help you start small, such as with a two-minute mindfulness session, and then build from there.

Physical activity provides a great way to stay connected socially and get some exercise. Intermural sports leagues allow you to meet new people and practice working as a team.

Take breaks.

Be intentional about carving out time for yourself; mental rest can be as important as physical rest. After a break you'll be refreshed and ready to take on a new challenge.

Learn good time-management and organization skills.

This might not seem like self-care, but it absolutely is because of the impact on your stress level and anxiety. While sorting through a backlog of emails will take longer today, after you've done it you'll save yourself time and decrease the risk of losing a message or missing an important deadline. Ask yourself, "What can I do today that will make tomorrow 15% easier for me?" Then do it!

Signs You Might Need Help & Where to Go for Support

During nursing school, you or your loved ones may notice symptoms of a more serious issue, such as panic attacks, poor sleep, change in appetite, feelings of helplessness or emptiness, withdrawing from social interactions, trouble concentrating, or thoughts of self-harm. It's common to try to white-knuckle through these challenges, thinking "as soon as I pass this test, things will get better." Remind yourself, though, that that's not necessary or healthy. Help is available.

Get Help Through Counseling or Therapy

Most schools have free counseling resources for students. Sessions may be designed for short-term support, but your clinician will let you know if longer-term care would be helpful. Remember, therapy is most effective when utilized both as maintenance (like changing your car's oil) and if you experience a major challenge. As a nurse caring for others, you may need a roster of people who are in the business of caring for you. Here is a great resource to help you find the right mental health professional.

Seek Medical Help for Your Depression or Anxiety if Needed

Therapy is a fantastic, evidence-based tool for managing mental health challenges. However in some cases it works best in tandem with medication. Typically we don't hesitate to take medication for migraines or high blood pressure, so why would we hesitate to take medication for mental health needs?

Reach Out to Family and Friends

Sometimes it's easiest to reach out to someone you trust and ask them to walk through a rough patch with you. You might also be surprised at the perspective someone close to you might be able to provide on the challenges you face. Leaning on those who love and know you best, is part of life, and helps to deepen your community and relationships at the same time. Their support will help you feel less alone as you navigate hard times.

Take Advantage of Additional Resources

If you are struggling, these resources can provide the help you need:

National Suicide Prevention Lifeline: 800-273-8255

National Eating Disorders Association Helpline: 800-931-2237

Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline: 800-662-4357

SAMHSA Disaster Distress Helpline: 800-985-5990

American Nurses Association Suicide and Resilience Support

Expert Q&A

Heather ONeal, APRN, CN-M, IBCLC is an Advanced Practice Nurse Practitioner, Certified Nurse Midwife, and Internationally Board-Certified Lactation Consultant), professional podcaster, author, and clinical faculty at West Virginia University School of Nursing. Heather hosts and manages Breastfeeding for Busy Moms, an international online education and support community for lactating parents. She also cohosts the Milk Minute Podcast, an inclusive evidence-based podcast for lactating parents and their partners all over the world.

Q: What should a prospective student know before going into this field?

A: You should know how to advocate for yourself and safeguard your time. You need to set boundaries for your work-life from the onset and learn to not feel guilty about saying no to extra shifts. The guilt you feel for neglecting yourself and your family will far outweigh the guilt of leaving your work-family to deal with disaster. There will ALWAYS be a fire to put out at work and it is not solely your responsibility to keep that ship afloat. The first rule of nursing is to take care of yourself first.

Q: Have you noticed a shift in discourse or reduction of stigma regarding mental health care among nursing students?

A: As a clinical instructor at WVU, I have absolutely noticed a change in students' willingness to discuss mental health struggles or advocate for what they need. I invite the students to take mental health breaks throughout long clinical days in order to build resilience for the long game. Students are very open to talking about their therapists and even establishing care with a therapist even when they aren't in crisis.

Q: What are the impacts of mental health challenges that you observe as an instructor in a nursing student's performance?

A: Working in a hospital environment is as much of a mental game as a physical game. The hours are long, and it can be grueling on your body, but it's your mind that helps you maintain your efficacy as a care provider. Often, when a student is struggling with a mental health crisis, the progression can look like waning attention to physical appearance and hygiene, then increased social isolation during clinical rotations, then only being able to put in the bare minimum to assignments, and in some extreme instances, I've seen the worst cases develop into incidents of cheating or academic dishonesty. Unattended mental health crises seem to typically follow that trajectory, and I try to intervene early when I observe any of these behaviors.

Q: If a nurse needs help, what should that person's first plan of action be?

A: Many hospitals have a peer support team that is free and provides support for nurses in crisis as it relates to work issues, such as the death of a patient, medication error, or workplace to name a few. That is an excellent place to start for nurses as well as students, because it allows you to talk with someone who has walked in your shoes. If someone is uncomfortable speaking with peers or the mental health crisis that is not directly related to their job, they often have access to several free visits through an Employee Assistance Program (EAP) or Student Counseling Center if they are still completing their studies. Many EAP and SCC programs will even offer couple's counseling and will offer referrals to resources in the community for ongoing care.

Q: What are some of the best ways for nurses to implement self-care practices into their training and ultimately their careers?

A: Decide what's important to you early on and choose a nursing job that can build around your non-negotiables. For example, if you are the kind of person that needs consistency in an exercise routine at the same time every day you might want to consider an 8-hour nursing job instead of a 12-hour nursing job. When you work three 12-hour shift the days of the week will often change and your body will be completely exhausted during and after those three days. It makes sticking to a workout routine extremely difficult - especially when you have a family as well.

You Are Not Alone

You don't have to suffer in silence. If you're struggling with your mental health, mobilize the available resources as quickly as you can. We think of healthcare workers as heroes, but that doesn't mean they don't need support, connection, and help. Learning how to ask for help, set appropriate boundaries, and tune in to your own needs, particularly during times of stress, are all skills that will help you succeed in your nursing career.

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Mental Health Wellness for Nursing Students

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Learn about self-care strategies and find outside resources for overcoming mental health challenges during nursing school.

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24/7, confidential crisis support for Veterans and their loved ones. Contact the Veterans Crisis Line: Dial 988 then Press 1, chat online, or text 838255.

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LGBTQ youth suicide facts and information

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More than 700 000 people die by suicide every year. For each suicide, there are likely more than 20 suicide attempts.

Suicide occurs throughout life. It was the fourth leading cause of death among 15-29-year-olds globally in 2019.

Suicide occurs in all regions of the world. In fact, 77% of global suicides happen in low- and middle-income countries.

While the link between suicide and mental disorders (in particular, depression and alcohol use disorders) and a previous suicide attempt is well established, particularly in high-income settings, many suicides happen impulsively in moments of crisis. Further risk factors include experience of loss, loneliness, discrimination, a relationship break-up, financial problems, chronic pain and illness, violence, abuse, and conflict or other humanitarian emergencies.

Suicides and suicide attempts have a ripple effect that impacts on families, friends, colleagues, communities and societies.

Suicides are preventable. Much can be done to prevent suicide at individual, community and national levels.

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Every year close to 800 000 people die as a result of suicide. This is one death every 40 seconds. Beyond this, suicide has a ripple effect that impacts on societies, communities, friends and families who have lost a loved one to suicide. So, yes, suicide really is a serious public health problem.

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Suicide is a serious public health problem that can have lasting harmful effects on individuals, families, and communities. There are many factors that contribute to suicide. The goal of suicide prevention is to reduce factors that increase risk and increase factors that promote resilience.

48,000
Suicide is a leading cause of death in the United States. It was responsible for over 48,000 deaths in 2021.

12.3 Million
In 2021, an estimated 12.3 million adults seriously thought about suicide, 3.5 million made a plan, and 1.7 million attempted suicide.

2.6% Higher
Provisional 2022 data show that suicide deaths increased by 2.6% between 2021-2022. Click here to access provisional data.

Contact the 988 Suicide and Crisis Lifeline if you are experiencing mental health-related distress or are worried about a loved one who may need crisis support.

Connect with a trained crisis counselor. 988 is confidential, free, and available 24/7/365.

Visit the 988 Suicide and Crisis Lifeline for more information at 988lifeline.org .

Connect with the Veterans Crisis Line to reach caring, qualified responders with the Department of Veterans Affairs:

Suicide prevention is everyone's business. You can #BeThere and #BeThe1To help a friend, loved one, or coworker. Everyone can learn the warning signs and how to get help.

Everyone-adults, teens, and even children, experiences stress. Learning healthy ways to cope with stress and getting the right care and support can help reduce stressful feelings and symptoms. Find tips for parents, kids and teens, and school personnel.

To receive email updates about this topic, enter your email address:

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Suicide is a serious public health problem that has lasting harmful effects on individuals, families, and communities. Many factors contribute to suicide, but suicide is preventable.

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The Suicide Prevention Resource Center at the University of Oklahoma Health Sciences Center is supported by a grant from the U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), under Grant No. 1H79SM083028-03

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National Institute of Mental Health (NIMH)

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Learn about suicide prevention, including helpline numbers, warning signs, risk factors, treatments and therapies, and resources for more information.

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American Foundation for Suicide Prevention

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Learn about suicide, how you can help prevent it, and resources for those affected, from the American Foundation for Suicide Prevention. Our mission: save lives and bring hope to those affected by suicide

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Understanding the issues concerning suicide and mental health is an important way to take part in suicide prevention, help others in crisis, and change the conversation around suicide.

We Believe

Suicide is not inevitable for anyone. By starting the conversation, providing support, and directing help to those who need it, we can prevent suicides and save lives.

Evidence shows that providing support services, talking about suicide, reducing access to means of self-harm, and following up with loved ones are just some of the actions we can all take to help others.

By offering immediate counseling to everyone that may need it, local crisis centers provide invaluable support at critical times and connect individuals to local services.

Know the Risk Factors

Risk factors are characteristics that make it more likely that someone will consider, attempt, or die by suicide. They can't cause or predict a suicide attempt, but they're important to be aware of.

Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders, and certain personality disorders

Alcohol and other substance use disorders

Hopelessness

Impulsive and/or aggressive tendencies

History of trauma or abuse

Major physical illnesses

Previous suicide attempt(s)

Family history of suicide

Job or financial loss

Loss of relationship(s)

Easy access to lethal means

Local clusters of suicide

Lack of social support and sense of isolation

Stigma associated with asking for help

Lack of healthcare, especially mental health and substance abuse treatment

Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma

Exposure to others who have died by suicide (in real life or via the media and Internet)

Know the Warning Signs

Some warning signs may help you determine if a loved one is at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change. If you or someone you know exhibits any of these, seek help by calling the Lifeline.

Talking about wanting to die or to kill themselves

Looking for a way to kill themselves, like searching online or buying a gun

Talking about feeling hopeless or having no reason to live

Talking about feeling trapped or in unbearable pain

Talking about being a burden to others

Increasing the use of alcohol or drugs

Acting anxious or agitated; behaving recklessly

Sleeping too little or too much

Withdrawing or isolating themselves

Showing rage or talking about seeking revenge

Extreme mood swings

Get in touch

Call the Lifeline

Read Stories Of Hope & Recovery
Get stories from people who have been through a crisis and found hope.

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Understanding the issues concerning suicide and mental health is an important way to take part in suicide prevention, help others in crisis, and change the conversation around suicide. Suicide is not inevitable for anyone. By starting the conversation, providing support, and directing help to those who need it, we can prevent suicides and save lives.

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Three steps anyone can learn
to help prevent suicide.

The world is experiencing a global mental health crisis.

People across the age span need help.

QPR and Hope Squad® partner to prevent suicide
Read More

Free download of Paul Quinnett's book
Download PDF

We can all save lives

The QPR mission is to reduce suicidal behaviors and save lives by providing innovative, practical and proven suicide prevention training. The signs of crisis are all around us. We believe that quality education empowers all people, regardless of their background, to make a positive difference in the life of someone they know.

But professionals must do more...

Surveys show that most healthcare providers, including mental health professionals, do not receive specific or adequate training in how to help those at risk of suicide. Unless you are a psychiatrist, or an exception, the odds are you did not receive adequate and specific suicide intervention or treatment training as part of your professional academic experience.

Your patients assume that you are competent to help them or their loved ones survive a suicide crisis.

Are you? Check Now

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QPR Institute | Practical and Proven Suicide Prevention Training

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Question, persuade, refer: our mission is to reduce suicidal behaviors and save lives by providing innovative, practical and proven suicide prevention training.

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Eaton, Hunsaker, & Moon (2023). Improving Learning and Mental Health in the College Classroom

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Eaton, Hunsaker, & Moon (2023). Improving Learning and Mental Health in the College Classroom

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How teachers can help combat higher education's mental health crisis.

Mental health challenges on college campuses were a huge problem before COVID-19, and now they are even more pronounced. But while much has been written about higher education's mental health crisis, very little research focuses on the role played by those on campus whose influence on student well-being may well be greatest: teachers. Drawing from interviews with students and the scholarship of teaching and learning, this book helps correct the oversight, examining how faculty can-instead of adding to their own significant workloads or duplicating counselors' efforts-combat student stress through adjustments to the work they already do as teachers.

Improving Learning and Mental Health in the College Classroom provides practical tips that reduce unnecessary discouragement. It demonstrates how small improvements in teaching can have great impacts in the lives of students with mental health challenges, while simultaneously boosting learning for all students.

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Improving Learning and Mental Health in the College Classroom (Teaching and Learning in Higher Education)

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Amazon.com: Improving Learning and Mental Health in the College Classroom (Teaching and Learning in Higher Education): 9781952271809: Eaton, Robert, Hunsaker, Steven V., Moon, Bonnie: Books

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We're here to help. The CARE Network enables members of the University community to express their concern about a person, incident, or issue by submitting one of the following reports online: CARE Referral Bias-Related Incident Report COVID-19 Concern Report Making a referral or submitting a report initiates a review process and/or coordinated response involving the appropriate individuals, staff, and offices.

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Listening to your favorite music may have more health benefits than you realize. Here's how songs can reduce stress and help you heal.

It's not until we forget our headphones that we realize just how much we rely on music to help us through the day. Our favorite music seems capable of pumping us up before an important moment, calming us down when we're upset, and just about anything in between.

But is there actually a scientific explanation for this? As it turns out, yes!

Music has been widely studied and revered throughout human history for its ability to both entertain and heal. Countless experts have investigated how listening to music can potentially have therapeutic effects on a range of mental and physical health conditions, or just as a way to cope with everyday life.

Contemporary research suggests music has significant power to help reduce stress and anxiety, relieve pain, and improve focus among many more benefits.

Stress - the feeling of emotional tension, overwhelm, or feeling unable to cope - affects us mentally and physically.

Stress has a biological impact that causes your body to release specific hormones and chemicals that activate your brain in certain ways. For example, when we are highly stressed, our heart rate and blood pressure can go up, and our adrenal gland begins producing cortisol, also known as "the stress hormone."

Short term, cortisol can help us find the focus and energy we need to deal with a difficult situation, but when the body is exposed to excess cortisol for a prolonged period of time, it causes perpetual, exhausting states of fight, flight, or freeze. Ongoing or chronic stress can lead to developing an anxiety disorder, depression, chronic pain, and more.

Across time and space, music has had tremendous success as a tool for stress relief. While some types of music such as classical and ambient have long been studied for their calming effects, listening to your personal favorite music of any genre also has benefits.

A 2020 overview of research into music and stress suggests that listening to music can:

lower our heart rate and cortisol levels

release endorphins and improve our sense of well-being

distract us, reducing physical and emotional stress levels

reduce stress-related symptoms, whether used in a clinical environment or in daily life

Most investigations into music's health effects center on its ability to calm us down and relieve stress. In recent years, this research has expanded in exciting and surprising new directions.

Some recent findings include the following:

Reduced cortisol levels. A recent 2021 study showed that adults who listened to both personal and neutral selections of music, at home and in a laboratory environment, had significantly "reduced cortisol levels." This was found regardless of the music type.

Benefits in mental health treatments. An overview of 349 studies on music's usefulness as a mental health treatment for conditions including schizophrenia, bipolar disorder, and major depression, found that 68.5% of music-based interventions had positive results.

Reduced burnout. Music therapy also had significant benefit in preventing burnout in operating room staff. A 6-week showed that after having access to 30-minute music listening sessions each day at work for a month, staff reported decreased stress levels and less emotional exhaustion.

Helps you fall asleep. of respondents to a 2018 survey reported they use music (from multiple genres) to help them fall asleep, mostly because it relaxed them, and distracted them from daily stressors. People who used music less were more likely to have lower quality sleep.

Reduced depression. Music listening or music therapy reduced depression levels, according to a 2017 review, and was associated with increased confidence and motivation, especially in group settings.

Reduced anxiety in children. A 2021 review of articles from 2009 to 2019 showed that music significantly reduced anxiety for children leading up to and during medical procedures.

Helps people cope with the pandemic. A of over 5,600 people from 11 countries demonstrated that music has played a very important role during the COVID-19 pandemic in helping people cope during lockdown, and meet their well-being goals across culture, age, and gender lines.

Improved quality of life with Alzheimer's disease. Especially when tried in the form of personal playlists for relaxation, research showed that music interventions can have positive effects on the behavior and cognition of people with Alzheimer's disease, improving quality of life.

Meditation is an ancient tradition that is practiced in cultures all over the world and is an integral part of some religions and types of yoga. There are many types of mediation, and people use some types to help treat mental and physical health conditions.

shows that listening to "self-chosen, pleasant, familiar music" reduced pain in people with fibromyalgia.

According to a small-scale , listening to music in headphones while under local or general anesthesia can lower cortisol levels during surgery, and decrease post-op pain and stress.

Usually, meditation aims to focus, center, calm, or direct your attention. It can also help relax our bodies. So it can pair well with music for some people.

Often, music used for meditation has a slow tempo, which can reduce heart rate, and also lower anxiety and stress levels. Guided meditation involves music with a narrator or speaker that directs your energy flow and focus, or offers positive affirmations.

Music therapy is different from just listening to music, although listening is a big part of it!

Music therapists work with a variety of patients of all ages. Like other forms of therapy, including art therapy, music therapists plan individualized sessions to help you meet your goals.

Music therapy can include goal-oriented music listening, playing and composing music, and songwriting, among other activities. These kinds of "purposeful" interactions with music can help you work through emotions or issues that are bothering you, encourage positive feelings, and even assist with speech or physical therapy.

A study compared the effects of music therapy with a therapist versus music medicine (where music was played without a therapist) among people with cancer. Even though all music listening showed positive results, 77% of patients preferred music therapy sessions to just listening to music on their own.

Research shows that music can help relieve both chronic pain and post-operative pain:

How does it work? Scientists the effect may result from music actually shifting brain activity away from pain-related connectivity patterns, as well as creating positive emotions, and offering a distraction.

Music isn't just limited to helping with physical pain. Stress causes emotional and psychological pain as well, which music can help alleviate.

Maybe you've found yourself searching for "study playlists" on Spotify or YouTube. Well, it turns out there's a reason why millions of other people stream these playlists too!

Listening to music has been shown to improve focus on certain tasks, especially if the task is more complex. Music may also help sharpen our brain's ability to recall information and make connections.

In one recent experiment, participants were asked to press a button anytime the hand on a special clock started moving. The authors found that when people listened to their preferred background music while doing this "low-demanding sustained-attention task," their minds wandered less, and they were more focused, compared to those without music.

Anxiety, stress, and pain often hang out together. Music may be one way to help manage them and their troublemaking.

As some of the previously discussed research indicates, music can help reduce anxiety in both adults and children before and during medical procedures.

In one of over 950 critically ill patients, 30 minutes of music therapy a day was consistently associated with lower rates of anxiety and stress. Music's ability to decrease biological stress responses like heart rate and cortisol levels also helps tackle anxiety.

The sympathetic and parasympathetic parts of your central nervous system are involuntary or automatic, meaning they work without you having to think about them.

Doctors may refer to the parasympathetic side as "rest and digest," since it takes care of things when the body is at rest, while sympathetic is "fight or flight," in charge of the body in motion.

When we are thrown into a stressful situation, it's hard to calm back down and stay grounded. Deep breathing is one way to activate the parasympathetic nervous system to move back into "rest and digest."

One shows that some types of music may also be a way to reactivate the parasympathetic nervous system quicker following a period of increased heart rate, like after exercising.

lowered stress and anxiety

better mood

reduced pain

improved sleep

sharpened focus or memory

relaxing your body and helping with meditation

assistance with speech or physical therapy

fostering community and a sense of togetherness

Certain genres of lyric-less music, like classical and ambient, are historically the subject of most research studies into music and stress. While there's evidence that they can reduce stress and anxiety, that doesn't mean they're "better" than other genres of music.

For many of the studies mentioned in this article, music listening involved multiple genres or songs chosen by both the participants and the researchers. In fact, the American Music Therapy Association states that "All styles of music can be useful in effecting change in a client or patient's life."

We also use different kinds of music for different purposes. Since we all have special relationships with our favorite songs and genres, we can use those to invoke certain emotions and feelings unique to that relationship. For example:

Musicians, researchers, and music therapists have actually claimed to create "the most relaxing" song ever, called "Weightless." But you'll have to decide for yourself.

Listening to your favorite music has more benefits than you realize. It's also safe, cost-effective, and widely available.

Music is certainly not a magical cure, nor is it a substitute for therapy, medication, surgery, or any other medical treatments. But music can be an important element of your well-being and self-care on a daily basis, as well as a helpful partner in dealing with more acute health conditions.

Music listening, therapy, and interventions have many benefits like:

Research into music's healing and stress-relieving properties is ongoing and sometimes with mixed results. But ultimately, perhaps the most important takeaway is: keep listening!

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how can listening to music reduce stress

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Can Listening to Music Reduce Stress? Research, Benefits, and Genres

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You can't explain it, but you know when you turn on your favorite tunes, it does something for you beyond soothing. Learn how listening to music reduces stress.

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Self-Compassion - Mindful University Project

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Seven years ago, Jean Twenge, a professor of psychology at San Diego State University and the author of Generations, predicted an impending mental health crisis for iGen, commonly known as Gen Z. Born from 1995 to roughly 2012, iGen includes current college and university students and those soon to arrive on campus. Twenge, who has spent her career researching generational trends, hypothesized that an increase in the use of smartphones and the concurrent ascent of social media were the leading cause of rising rates of depression, anxiety, and loneliness among teens. "The arrival of the smartphone has radically changed every aspect of teenagers' lives, from the nature of their social interactions to their mental health," Twenge wrote in a 2017 Atlantic article.

Many of her colleagues were skeptical back then, but recent data from the National Survey on Drug Use and Health backs up Twenge's claims: Between 2011 and 2021, the number of teens and young adults with clinical depression more than doubled. Between 2007 and 2019, the suicide rate for people in their early twenties rose by 41 percent. During the same time period, the suicide rate for ten- to fourteen-year-olds tripled overall and nearly quadrupled for girls. Screen time, especially on smartphones, simultaneously skyrocketed for teens and young adults, with social media use also soaring.

Twenge's most recent research indicates that smartphone and social media use are now having a detrimental effect on young adults' mental health. Heavy smartphone use (four-plus hours a day) negatively affects cognitive control and socio-emotional functioning, and social media content often normalizes self-harm and can damage young adults' self-esteem. Twenge says it's as if a "nuclear bomb" has been dropped on the lives of teens and young adults. Although she's quick to point out the cohort's overall commitment to social justice and their comfort with diversity, Twenge's research largely depicts a generation in crisis.

In the following conversation with Liberal Education, Twenge reflects on this generation's defining characteristics, the problems they face, and how understanding generational trends can help college and universities support their students.

Why do you call this cohort iGen rather than the more common moniker of Gen Z?
I call them iGen because they're the first generation to spend their entire adolescence in the age of the smartphone. Gen Z has become the accepted term, but I think it's better to use a label that relates to this generation's experiences.

IBM introduced the first smartphone in 1992, Apple debuted the first iPhone in 2007, and the majority of US citizens owned a smartphone by the end of 2012. That's right when the oldest iGeners were teenagers-they started spending a lot of time on their phones and online. Concurrently, social media use became prevalent. Simultaneously, how teenagers socialized completely changed. Rather than going to parties or hanging out with friends at the mall, they instead began to spend huge amounts of time online.

The early 2010s is also when teen depression rates started to rise, doubling between 2011 and 2019. When people discuss the current adolescent mental health crisis, they often say it's due to the
pandemic-but it started almost a decade before COVID hit. I contend that it relates to the change in how teens spend their time outside of school. More time online and less time exercising, sleeping, and hanging out with friends is a bad formula for mental health.
Broadly speaking, what are the defining characteristics of iGen?
Every generation has its strengths and weaknesses. For iGen, one of their biggest strengths is their desire to help others and contribute to society. In surveys of high school seniors, iGen is more likely than millennials [born between 1981 and 1996] and Gen X [born between 1965 and 1980] to say they want a job where they can directly help other people or contribute to society. Surveys of iGen college students have found that they're more likely than previous generations to prioritize helping people who are experiencing difficulties. They are also comfortable with diversity and assume that their schools and workplaces will include people from a variety of races, ethnicities, religions, gender identities, and sexual orientations.
What are the main challenges facing iGen?
Their very high rates of depression, anxiety, self-harm, and related issues are their biggest challenges. It's important to remember that depression isn't just about emotions-it also affects cognition. It affects how you think and how you view the world. Unlike the more optimistic millennials who preceded them, members of iGen tend to be pessimistic. Pessimism can lead to the desire to change things for the better, but it can also result in cynicism and apathy. Ultimately, this generational characteristic could create issues for society and the health of our democracy.
Besides smart phone and device usage, what's driving the change from millennials' overall optimism to iGen's overall pessimism?
Social media is also having an impact. Many studies have shown that social media posts that focus on negative emotions like anger are liked and shared more often. Negativity gets rewarded online.
We often hear about smartphone addictions. Is the term "addiction" appropriate in this context?
There are some ways in which it's an applicable term. It's noticeable how often people use the language of addiction when discussing their social media or smartphone use. While there's a difference between a substance addiction like alcoholism and a behavior addiction like gambling, both light up the dopamine pathway. That also happens with smartphone usage. It feels good when someone likes your post, but it's a problem when that feeling leads to a compulsive use of devices or an unhealthy reliance on virtual relationships.

(iStock)

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Gen Z is facing unprecedented struggles on campus and in life

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10 Ways to help someone having a panic attack

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10 Ways to help someone having a panic attack

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Shutterstock / Wondermind

Last month, I had my first panic attack in front of two of my closest friends and my dad. My heart rate skyrocketed, my chest went all stress ball, and I swore I wasn't getting enough oxygen. My body just didn't feel like my own, and if you told me I was slowly dying, I would've believed you. The worst of it didn't last too long, but I was drained, disoriented, and really fucking disturbed for the rest of the night (and, to be honest, I'm still anxious about it).

If you've never had one, a panic attack basically feels like a "surge of intense fear or intense discomfort" that peaks in minutes, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). These can come out of nowhere or be triggered by something you're scared of, per the DSM-5-TR. When it happened to me, I knew my health anxiety was the culprit. For other people, things like social anxiety might kick off an attack before they speak in public, or a fear of bugs might set one off when their apartment's pet cockroach comes out to play, explains clinical psychologist Terri Bacow, PhD, author of Goodbye, Anxiety: A Guided Journal for Overcoming Worry. This is all to say that panic attacks can be sparked by anything, and you might not even know the reason.

Panic attacks can make you sweaty, shaky, and dizzy and ramp up your heart rate. They can also cause shortness of breath, chest pain, tingling, numbing, and a choking kind of feeling. And all of that can come with an overwhelming fear of losing control or dying, per the DSM-5-TR.

Yeah, it's a pretty disturbing experience, but if you're trying to be there for someone having a panic attack, it might not always be obvious that it's happening. Sometimes people hyperventilate or look super unwell, but a lot of it is internal chaos, notes Dr. Bacow. During my attack, I was too scared to say anything at its peak. My friends said they noticed I was quieter than usual-that something was wrong-though they had no clue what was going down until I told them.

Whether you know someone who's prone to panic attacks or want to be prepared just in case, we spoke to mental health pros and people who've been there about how to handle these situations in the moment. So the next time you notice your partner or even a stranger sitting near you on a plane potentially experiencing a panic attack, you'll know exactly what to do.

How to help someone having a panic attack.

1. Try to confirm they're really having a panic attack.

Like we said, it's not always clear if your bestie or that lady in Target's frozen aisle is, in fact, panicking. They might look a little off or they could appear to be having a medical issue-and either of those things might be true.

So, one of the surest ways to figure out if someone is having a panic attack is to ask them. For example, if Target lady looks like she's hyperventilating, ask, "Do you think you're having a panic attack?" or just, "Are you OK?" would work, Dr. Bacow says.

It's very possible that they can't get the words out to confirm/deny or they might even say they're having a heart attack, Dr. Bacow notes. So, yeah, this isn't fail-proof. When it's unclear what's going on, you can ask them if they'd like you to call 911, or just do it to be safe. When in doubt, getting medical help is the safest option, says psychiatrist Shreya Maniar Nagula, MD.

2. Choose your words wisely.

Saying the wrong thing might make someone having a panic attack more anxious or annoyed. If you say, "Everything is fine," or, "You're OK," it can feel dismissive of their physical and mental experience, explains Dr. Bacow. And telling them to "calm down" isn't helpful because they might not know how to do it, says Dr. Maniar Nagula. "We would love to calm down, but saying the words does nothing," notes Julia, 32, who says she feels like she's suffocating when she's having a panic attack.

Instead, you should speak kindly (duh) and focus on validating words that encourage them to work through what they're feeling, says Dr. Bacow. "A sample script [might be], 'This will pass in a few minutes. Staying calm will make it go away faster, and I can help you ride this out,'" she suggests. You can also say things like, "I'm here with you," or, "You'll get through this," suggests Dr. Maniar Nagula. And, if you know them, remind them of the other panic attacks they survived as proof they'll get through this one, Dr. Maniar Nagula says.

3. Remain calm.

Staying chill in front of someone who isn't helps a lot, says Dr. Bacow. That's because how other people react rubs off on how we react (see: co-regulation). Like when, as little kids, our parents were scared of something so we got scared too, she explains. Basically, not freaking out helps reassure the person having a panic attack that things maybe aren't as terrifying as they seem (even if the panic attack is), she says. Emily T.* says her S.O. talks to her in a gentle and kind tone that feels soothing. If he was panicking or annoyed, it would probably make her even more anxious, she says.

4. Try to distract them.

The thing about panic attacks is that people can start freaking out over the physical stuff, like their heart pounding, chest hurting, and the choking sensation, often making those symptoms worse, says Dr. Bacow. So thinking about something not related to what a panic attack feels like gives their nervous system a chance to cool off, she says.

Maybe ask if they're up for counting backward from 100 by two, suggests Dr. Bacow. Or you can ask what they see around them, what they hear, or what they can touch to ground them, suggests Dr. Maniar Nagula. Whatever the exercise, the goal is to get them focused on what's happening around them instead of the chaos in their brain.

While distractions are great, you should also reassure them that you understand what they're going through and that you're taking it seriously. Again, we don't want anyone to feel like we're dismissing their very real experience, ya know?

5. Walk them through deep breathing.

Sometimes, deep breathing can ease people's chest tightness, fast heart rate, and shortness of breath when they're having a panic attack, which, in turn, helps them feel less anxious, says Dr. Maniar Nagula. So take long inhales and exhales with them or count to five each time they breathe in and out, she suggests. Doing it together lets them follow your lead when they're not sure how to do it themselves.

For example, when Julia is mid-panic attack, she and her husband do box breathing together: inhaling for four seconds, holding for four seconds, exhaling for four seconds, and holding for four seconds. That little exercise slows her breathing and her racing thoughts, she explains.

That said, if the person having a panic attack can't seem to breathe deeply and slowly with you and starts taking more shallow breaths, it could make them more panicked, says Dr. Bacow. When that happens, move on to another kind of distraction, like what's going on around them, she suggests.

6. Ask if you can touch them.

Though physical touch is great for some, others might feel more worked up by it, Dr. Maniar Nagula says. So, ask them if it's OK to touch their shoulder or arm to calm them, she suggests.

When you're in freakout mode, having another person hold your hand or rub your back can calm your stress response. It makes you feel like someone is there for you, says Dr. Maniar Nagula. For Julia, her husband will hold her tight, like being wrapped in a weighted blanket, she says.

How to help someone after a panic attack.

7. Ask them what they need.

Panic attacks are scary, so it's common for people to have residual feelings of anxiety when it's over, says Dr. Maniar Nagula. To guide them through the aftermath, the best thing you can do is ask them what they need-not everyone will want the same thing. When it looks like someone's symptoms are calming down, try something like, "Do you want water?" or "Do you want a hug?" or "Should we go get some food?" suggests Dr. Bacow. A simple, "What do you need right now?" may be helpful too.

8. Chat about what led up to the panic attack.

Sometimes people want to talk about what happened and sometimes they don't. But if the person you're with is up for it, getting into what happened before the attack can enable them to find long-term solutions-I know it did for me.

To be fair, they might not know what led up to this panic attack, but rehashing what's been on their mind lately can clue them in. Say their panic attack came after a week of crappy sleep and intense work deadlines-which Dr. Bacow says happens-maybe they'll realize that they need to take some time off, practice better pre-bed habits, or even find a new job. Sometimes the next step is finding a mental health professional to get to the bottom of it, Dr. Bacow adds. No one needs to make decisions like that with you, but you can still encourage them to consider their options.

9. Ask (and listen to) how the panic attack made them feel.

Discussing what the panic attack was like can support people as they regulate their emotions and process what happened, says Dr. Bacow. So, again, if they're open to it, you could start with something like, "Seems like that was really scary for you." Then, let them take it from there.

Assist them as they work through that debilitating experience by reflecting back whatever they say, Dr. Bacow suggests. If they're like, "OMG I felt like I was dying," you could respond with, "That sounds really terrifying!" In my experience, having my friends and my dad there to listen as I cried made me feel supported and heard.

10. Find out what helped them come down from the attack.

When you're aware of what's most useful in a moment of panic, you learn how to self-soothe. And verbalizing that with another person can solidify it in your brain.

If you're helping someone, encourage them to write down what worked so they can better manage a future attack on their own, suggests Dr. Maniar Nagula. Bonus points if they screenshot that list and set it as their phone background, she says. It's great to be there for them, but they shouldn't rely on you, she explains.

That said, this is still good intel for you as a support person. Julia says now that her husband knows what's most effective, he feels more confident helping her get back to baseline.
*Name has been changed. Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.

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10 Ways to Help Someone Having a Panic Attack

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Therapists and people who've been there explain how to help someone having a panic attack in the moment and afterward.

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Working hard should not be confused with overworking at the expense of relationships and physical health.

Cite this

American Psychological Association. (2018, October 14). Coping with stress at work. https://www.apa.org/topics/healthy-workplaces/work-stress

Everyone who has ever held a job has, at some point, felt the pressure of work-related stress. Any job can have stressful elements, even if you love what you do. In the short-term, you may experience pressure to meet a deadline or to fulfill a challenging obligation. But when work stress becomes chronic, it can be overwhelming-and harmful to both physical and emotional health.

Unfortunately, such long-term stress is all too common. In fact, APA's annual Stress in America survey has consistently found that work is cited as a significant source of stress by a majority of Americans. You can't always avoid the tensions that occur on the job. Yet you can take steps to manage work-related stress.

Common sources of work stress

Certain factors tend to go hand-in-hand with work-related stress. Some common workplace stressors are:

Low salaries

Excessive workloads

Few opportunities for growth or advancement

Work that isn't engaging or challenging

Lack of social support

Not having enough control over job-related decisions

Conflicting demands or unclear performance expectations

Effects of uncontrolled stress

Work-related stress doesn't just disappear when you head home for the day. When stress persists, it can take a toll on your health and well-being.

A stressful work environment can contribute to problems such as headache, stomachache, sleep disturbances, short temper, and difficulty concentrating. Chronic stress can result in anxiety, insomnia, high blood pressure, and a weakened immune system. It can also contribute to health conditions such as depression, obesity, and heart disease. Compounding the problem, people who experience excessive stress often deal with it in unhealthy ways, such as overeating, eating unhealthy foods, smoking cigarettes, or abusing drugs and alcohol.

Taking steps to manage stress

Track your stressors. Keep a journal for a week or two to identify which situations create the most stress and how you respond to them. Record your thoughts, feelings, and information about the environment, including the people and circumstances involved, the physical setting, and how you reacted. Did you raise your voice? Get a snack from the vending machine? Go for a walk? Taking notes can help you find patterns among your stressors and your reactions to them.

Develop healthy responses. Instead of attempting to fight stress with fast food or alcohol, do your best to make healthy choices when you feel the tension rise. Exercise is a great stress-buster. Yoga can be an excellent choice, but any form of physical activity is beneficial. Also make time for hobbies and favorite activities. Whether it's reading a novel, going to concerts, or playing games with your family, make sure to set aside time for the things that bring you pleasure. Getting enough good-quality sleep is also important for effective stress management. Build healthy sleep habits by limiting your caffeine intake late in the day and minimizing stimulating activities, such as computer and television use, at night.

Establish boundaries. In today's digital world, it's easy to feel pressure to be available 24 hours a day. Establish some work-life boundaries for yourself. That might mean making a rule not to check email from home in the evening, or not answering the phone during dinner. Although people have different preferences when it comes to how much they blend their work and home life, creating some clear boundaries between these realms can reduce the potential for work-life conflict and the stress that goes with it.

Take time to recharge. To avoid the negative effects of chronic stress and burnout, we need time to replenish and return to our pre-stress level of functioning. This recovery process requires "switching off" from work by having periods of time when you are neither engaging in work-related activities, nor thinking about work. That's why it's critical that you disconnect from time to time, in a way that fits your needs and preferences. Don't let your vacation days go to waste. When possible, take time off to relax and unwind, so you come back to work feeling reinvigorated and ready to perform at your best. When you're not able to take time off, get a quick boost by turning off your smartphone and focusing your attention on nonwork activities for a while.

Learn how to relax. Techniques such as meditation, deep breathing exercises, and mindfulness (a state in which you actively observe present experiences and thoughts without judging them) can help melt away stress. Start by taking a few minutes each day to focus on a simple activity like breathing, walking, or enjoying a meal. The skill of being able to focus purposefully on a single activity without distraction will get stronger with practice and you'll find that you can apply it to many different aspects of your life.

Talk to your supervisor. Employee health has been linked to productivity at work, so your boss has an incentive to create a work environment that promotes employee well-being. Start by having an open conversation with your supervisor. The purpose of this isn't to lay out a list of complaints, but rather to come up with an effective plan for managing the stressors you've identified, so you can perform at your best on the job. While some parts of the plan may be designed to help you improve your skills in areas such as time management, other elements might include identifying employer-sponsored wellness resources you can tap into, clarifying what's expected of you, getting necessary resources or support from colleagues, enriching your job to include more challenging or meaningful tasks, or making changes to your physical workspace to make it more comfortable and reduce strain.

Get some support. Accepting help from trusted friends and family members can improve your ability to manage stress. Your employer may also have stress management resources available through an employee assistance program, including online information, available counseling, and referral to mental health professionals, if needed. If you continue to feel overwhelmed by work stress, you may want to talk to a psychologist, who can help you better manage stress and change unhealthy behavior.

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Working hard should not be confused with overworking at the expense of relationships and physical health. Cite this American Psychological Association. (2018, October 14). Coping with stress at work. https://www.apa.org/topics/healthy-workplaces/work-stress Everyone who has ever held a job has, at some point, felt the pressure of work-related stress.

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UR Well-Being for Life and Learning Training Program

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UR Well-Being for Life and Learning Training Program

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Learn how to better support student mental health and well-being.

Did you know that approximately 85% of University of Rochester faculty and student support staff have spoken with a student about their mental health in the last 12 months? Yet the majority have never received any specialized instruction to navigate these difficult discussions. We aim to provide a comprehensive training program to address this gap.

This self-paced training includes a series of required and elective workshops offered by a team of University of Rochester content experts. Workshops have been thoughtfully developed and include topics such as how to have supportive conversations with students, how to recognize and connect students in distress with appropriate campus resources, how to deal with your own compassion fatigue, and many more!

Our Goals

The goals of the Well-being for Life and Learning training program are to create supportive environments, positively impact student health, improve academic success, and mobilize cultural change on campus. We hope to provide faculty, instructors, and student support staff with simple strategies which can be implemented both in and out of the classroom to help students flourish.

In 2021 and 2022, the UHS Health Promotion Office held a successful workshop series called Supporting Students Mental Health. These workshops provided education to faculty and staff about navigating the difficulties students were experiencing during COVID. Over 300 faculty and staff participated in this program.

Many participants shared that students often approach them and disclose difficulties that go beyond academic, including concerns about anxiety, depression, and trauma. Many also admitted that they were not very confident in their ability to have these difficult conversations and looked forward to UHS providing additional educational opportunities on these topics.

Based on this feedback, we began work to further evolve the original workshop series. Throughout the 2022-2023 academic year, we conducted surveys with faculty, instructors and student support staff, held focus groups with students, and gathered a cohort of campus experts to help contribute to this initiative. This program is set to launch in September 2023.

Over the past decade, there has been a gradual decline in the mental health and well-being of college students, with a notable increasing following the onset of the COVID-19 pandemic (Lee, Solomon, Stead, Kwon, and Ganti, 2021). At many institutions nationally, student well-being programming, services, and policy have been one of the largest priorities since 2020 however yet, students continue to face even higher levels of anxiety, stress, and depression as a result of the fallout of the pandemic.

In our biennial National College Health Assessment (NCHA) survey conducted among our undergraduate and graduate student populations, we discovered concerning results from 2022. More than three-quarters of our students (80% of undergraduates and 70% of graduate students) reported experiencing moderate to severe psychological distress. These distress levels not only pose a risk to students' emotional and physical well-being but also have a detrimental effect on their academic performance. Our survey revealed that a significant portion of students (29.8% and 20% respectively) attributed their academic struggles to stress and anxiety (American College Health Association, 2022a; American College Health Association, 2022b).

Given the increased demand for student mental health support at higher education institutions, faculty and student support staff have been deemed as the "gatekeepers" of student mental health as they are often be the first person that students have gone to when they are in distress or in mental crisis. In fact, a 2020 study conducted by the Boston University School of Public Health, the Mary Christie Foundation, and the Healthy Minds Network found that almost 80 percent of faculty stated that they spoke with students regarding their students' mental health and wellness in the past 12 months (Boston University School of Public Health, Mary Christie Foundation, the Healthy Minds Network, and Hazelden Betty Ford Foundation, 2021). Of those faculty, 51% reported that they felt equipped to recognize a student in distress and yet 73% wanted to have more knowledge on how to best support the mental health of students (Boston University School of Public Health et al., 2021).

We decided that we wanted to gain more insight into our own U of R faculty and staff by launching a survey the Spring of 2023. Comparably, our findings showed that 85% of faculty and staff have spoken one-on-one with a student about their mental health and/or well-being in the last 12 months and over half of staff (59%) and faculty (74%) stated that they had never received specialized training to navigate discussions with students in distress. However, akin to the national average, 70% of them stated that they are motivated to learn.

Probably our most notable findings have come from students. According to the recent Student Voice survey on health and wellness, students rated professors as the number 1 group on campus that have a responsibility to help them ease their stress and 45% of professors say that faculty have a responsibility to help students struggling with their mental health, which goes beyond just dealing with stress (Flaherty, 2023). On our own campus, we have found through our NCHA survey data from 2022 that 25% of undergraduates and 34.4% of graduate students reported that faculty had negatively impacted their performance in class. Even more concerning, 18.8% of graduate students stated that faculty delayed one's progress towards their degree (American College Health Association, 2022b).

With the large percentage of faculty and staff poised with this additional role on supporting students on top of their job responsibilities, these data demonstrate the need to equip them with tools to recognize students in distress and support the well-being of the students that they engage with on a regular basis in quick, effective, and compassionate ways.

The learning environment is the most influential factor in a student's overall college experience and is deeply connected to academic success and personal wellness, putting faculty in unique and critical positions for supporting student well-being (Okanagan Charter, 2015). Extensive research has shown that student well-being is impacted through various aspects of learning environments, from the course curriculum, course design, assignments and testing, grading, classroom culture, the classroom space, as well as the teachers (Di Placito-De Rango, 2019; Stanton, Zandvliet, Black & Dhaliwal, 2016).

At academic research institutions, learning does not stop as one leaves the classroom; Students are often highly involved in a variety of offices and departments on campus through work positions, student groups, volunteering, and tapping into student support services. To enable and empower students to thrive, engaging with student support staff is thus critical to establish a shared understanding of student well-being as well as education on tools to compassionately support students in all places students are engaged with on campus.

This self-paced training includes two tracks. The Campus Environments track for student support staff, and the Learning Environments track for faculty and instructors.

Each track includes 4 required workshops and your choice of at least 2 electives. Workshops will be offered in a hybrid format, twice per semester. All curriculum details including workshop descriptions and scheduling will be provided through the MyPath learning platform.

Once all components of the training program have been completed, participants will receive a certificate of completion, a Well-being for Life and Learning guidebook, a sticker to place on their office door, an icon to place in their email signature, and recognition on the Well-being for Life and Learning website.

To get started with the Well-Being for Life and Learning training program, first fill out the brief registration form below. This will also add you to our email communication list so you will be informed about any future program updates. Upon registration you will receive (after September 1 st) a welcome email detailing next steps for MyPath and individual workshop registrations.

American College Health Association (2022a). American College Health Association-National College Health Assessment III: University of Rochester Graduate Data Report Spring 2022. Silver Spring, MD: American College Health Association.

American College Health Association (2022b). American College Health Association-National College Health Assessment III: University of Rochester Undergraduate Data Report Spring 2022. Silver Spring, MD: American College Health Association.

Boston University School of Public Health, Mary Christie Foundation, the Healthy Minds Network, and Hazelden Betty Ford Foundation. (2021). (rep.). The Role of Faculty in Student Mental Health. Retrieved from https://marychristieinstitute.org/reports/the-role-of-faculty-in-student-mental-health/.

DiPlacito-DeRango, M. L. (2016). Acknowledge the barriers to better the practices: Support for student mental health in higher education. Canadian Journal for the Scholarship of Teaching and Learning, 7(2), 2.

Flaherty, C. (2023, May 17). Survey: Stress is impacting college student success. Inside Higher Ed | Higher Education News, Events and Jobs. https://www.insidehighered.com/news/student-success/health-wellness/2023/05/17/survey-stress-undercutting-student-success

Lee, J., Solomon, M., Stead, T., Kwon, B., & Ganti, L. (2021). Impact of COVID-19 on the mental health of US college students. BMC psychology, 9(1), 95.

Stanton, A., Zandvliet, D., Dhaliwal, R., & Black, T. (2016). Understanding Students' Experiences of Well-Being in Learning Environments. Higher Education Studies, 6(3), 90-99.

Okanagan Charter: An International Charter for Health Promoting Universities and Colleges (2015).

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Well-Being for Life and Learning Training Program - University Health Service

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Skip to content Learn how to better support student mental health and well-being. Did you know that approximately 85% of University of Rochester faculty and student support staff have spoken with a student about their mental health in the last 12 months? Yet the majority have never received any specialized instruction to navigate these difficult discussions.

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Chapel, interfaith services for the University of Rochester

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The last weeks of this Spring semester are here - with everyone completing projects and papers, preparing for exams and Finals, making summer plans for work and new experiences. We celebrate the graduating seniors whose U of R experience had to flex around the Covid pandemic and who have been determined to accomplish their goals. We appreciate the work and contributions of graduate students reaching the end of their programs.

Thank you for your resilience, persistence, and care for yourselves and others that has also been part of the journey. This has been another year when campus conflict and painful events reflect national and global conflicts, targeting people of color and members of faith communities. AND we see you standing against racist actions, violence in the Middle East and elsewhere, transphobic laws, and threats to body autonomy and healthcare self-determination.

You already know that health and mental health can be affected by stress. We can push hard, use reserves of strength, lose sleep - if we replenish our stores of energy as soon as possible even in small ways! Rest breaks of 10 minutes, moving around the library, hydrating, quick calls or texts to supportive friends, and remembering to eat and sleep will increase your endurance and effectiveness.

The UCC, among other resources on campus, is available and glad to be of help in consultation sessions. For late night (24/7) support, remember that all U of R students can use TELUS (described below) at any time for calls, texts and even out-of-Rochester summer counseling.

Respect and affirmation for all people are central to the mission and hearts of the University Counseling Center. We welcome you to explore the range of support services we can provide to students and to the campus community.

If you are in crisis and would like to speak to someone immediately, please call us at (585) 275-3113. A Counseling Center professional is on-call 24/7.

You can also call the national suicide and crisis lifeline at 988.

If you are outside of the US, the Suicide Stop website contains mental health emergency resources worldwide.

Schedule an appointment

UCC's current hours of operation for summer 2023 are Monday - Friday 8:30 a.m. - 5:00 p.m. To reach the UCC Professional On-Call after hours for emergencies call 585-275-3113.

To schedule your first appointment, call us at (585) 275-3113 or log into UHSConnect.

The Counseling Center is available for full-time students who pay the mandatory health fee using HIPAA compliant Zoom. Just call (585) 275-3113 for an initial assessment. Based on that initial assessment, a treatment plan will be developed by the clinician that addresses your unique needs and concerns.
More information Additional resources while waiting for therapy

Crisis Services

If you are a University of Rochester student or are concerned about a student experiencing a mental health crisis, please call the University Counseling Center Professional On-Call at (585) 275-3113.

If you have someone you are concerned about, remember that the Counseling Center is available for consults 24/7. Just call us (585) 275-3113. For non-urgent situations where you are concerned, make use of the CARE Network to help someone get connected to all the support and University of Rochester services they need!

You can also download the TELUS Health app on any phone to access phone and text crisis support https://myssp.app/ca/home from anywhere in the world.

If you are outside of the US, the Suicide Stop website contains mental health emergency resources worldwide.

Link to full crisis services: https://www.rochester.edu/uhs/ucc/crisis-services/

ThrivingCampus: Finding an off campus therapist

The Counseling Center has partnered with ThrivingCampus to make it easier for students to learn more about community mental health providers and access treatment off-campus and in many other states. ThrivingCampus is an online directory that allows University of Rochester students to access a list of off-campus, licensed mental health clinicians. Go to rochester.thrivingcampus.com or make an appointment for an Initial Assessment with one of our therapists for assistance. The website also includes resources to assist students through the process of securing off-campus outpatient care.

If you are a provider and wish to participate in the University of Rochester Thriving Campus site, please use this link: Thriving Campus - for providers to create a new free account or to update your existing account.
Free Transportation to Off Campus Mental Health Care
Thanks an anonymous donor, UCC is able to provide Lyft passes for students to access off campus mental health care. Students simply need to call UCC (585-275-3113), ask for the Transportation Request form to be added to their UHSConnect account, complete the form, and submit it at least three days before their appointment. Two codes, each good for a round trip to an appointment, will be provided through their UHSConnect account. Students can request additional passes as needed.

Release of information

If you are asked to fill out a Release of Information, please download and fill out one of the below files.

When complete, you can either:

Fax or mail to the number/address on the top of the form

Follow the instructions and upload your release forms to UHSConnect

Accommodation requests

University Health Service does not provide accessibility accommodation evaluations and recommendations.

The UCC maintains this list of off-campus providers who do provide accessibility accommodation evaluations. Please go to the Office of Disability Resources for more information on academic, housing, and dining accommodations.

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Counseling Center - University Health Service

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Skip to content The last weeks of this Spring semester are here - with everyone completing projects and papers, preparing for exams and Finals, making summer plans for work and new experiences. We celebrate the graduating seniors whose U of R experience had to flex around the Covid pandemic and who have been determined to accomplish their goals.

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Crisis Line: 585.275.8686

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Everyone experiences feelings of anxiety, distress, sadness, or other feelings that are difficult to overcome from time to time. But when emotional or behavioral problems are disrupting your life, it's time to ask for help.

Many people struggle with anxiety. But if it becomes too troublesome, our Anxiety Management Group can help. Learn to manage negative self-talk, develop a better mindset, confront and overcome your fears, and escape the cycle of worry and rumination.

A step-by-step guide for seeking help when your child or adolescent is facing a behavioral health problem or crisis.

Coping with mental illness can be challenging or even overwhelming at times. We're here to "connect" patients, their families, and caregivers with local resources.

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Mental Health & Wellness - University of Rochester Medical Center

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Everyone experiences feelings of anxiety, distress, sadness, or other feelings that are difficult to overcome from time to time. But when emotional or behavioral problems are disrupting your life, it's time to ask for help. Many people struggle with anxiety. But if it becomes too troublesome, our Anxiety Management Group can help.

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University Health Service (UHS) | University of Rochester

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The mission of University Health Service is to improve, guard, and care for the health and safety of University of Rochester students and staff.

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Assessments are usually referred from student conduct, residential life, or court ordered as a result of an arrest, legal requirements or student conduct violations. Assessments help determine if alcohol or substance abuse criteria are met and then a recommend level of intervention is given. Student's may complete their required recommendations through ASAC or outside referrals will be given. The following assessments are offered:
Assessment Codes & Fees:
1) B - $100 Court Ordered Alcohol/Drug Assessment - 1 ½ hour appointment
Provided by a Licensed Alcohol and Drug Counselor
Students charged with an alcohol or drug related offense that require a court ordered assessment. Could include, but not limited to : Public Intoxication, UIP, Fake ID, transporting an open container, possession of any illegal drug or paraphernalia). Recommendation report is given to student at the end of the assessment.

2) C - $50 OSU Alcohol/Drug Assessment-NOT used in court proceedings- 1 hour appointment
Provided by ASAC staff or supervised graduate student
Students charged with a Residential Life or Student Conduct substance related offense that does NOT require a court ordered assessment for. Could including, but not limited to: UIP, possession of alcohol in Residential Life, possession of marijuana, possession of paraphernalia, or the smell of marijuana. Recommendation report is given to student at the end of the assessment.
3) D -Alcohol Incapacitation Intake - No Charge- 1 hour appointment Provided by ASAC staff or supervised graduate student
Student was transported to the hospital for alcohol incapacitation or possible alcohol related medical required attention. Recommendation report is given to student at the end of the assessment.

4) Marijuana Education Class - No Charge -2 sessions, 1 hour each.

Provided by ASAC staff or supervised graduate student
Students who are referred from residential life or student conduct for marijuana rule violations. Must be on time and complete time and participation requirements to receive completion certificate. No charge - unless no show or late cancelation.
Required ASAC Counseling Fees:
$10 per session - ASAC Individual Counseling

$60 - Alcohol & Other Drug Group (1 session a wk for 6 wks)

$100 - Alcohol & Other Drug Group (1 session a wk for 12 wks)

$130 - Alcohol & Other Drug Group (2 sessions a wk for 12 wks)

(Group fees include 15 minute group intake & materials, but not assessment fees.)

Voluntary - Counseling Fees: Intake & first 4 sessions no charge

$10 - ASAC Individual Counseling starting 5 th session $10

No Charge for Group Sessions

Fees for court-ordered assessments may not be charged to your Bursar account. ASAC accepts cash or check only for the exact amount.

For questions or to schedule an assessment, call 405-744-5458 or come by 320 Student Union.

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Alcohol and Substance Abuse Counseling - Oklahoma State University

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The Alcohol and Substance Abuse Center (ASAC) is committed to providing quality, confidential services for OSU students affected by problems related to substance abuse. We promote and provide innovative, campus-based services that improve well-being and quality of life. The goal of the ASAC is to help students maximize their potential by supporting their intellectual, personal and social growth.

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HelpLine specialists are prepared to answer your questions on mental health issues. Contact us Monday-Friday, 10 a.m. - 10 p.m. ET. 1-800-950-NAMI (6264) or info@nami.org

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Say It Out Loud: Creating Connections Through Conversations

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Stigma about mental health prevents teens from seeking help. Learn how NAMI's Say it Out Loud can get teens talking and asking for help when they need it.

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There are also 8-minute, 30-minute versions.

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Marconi Union - Weightless (Official 10 Hour Version)

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A new study by US researchers has revealed that playing the "world's most relaxing song" before surgery could be just as beneficial for calming a patient's nerves as medication.

Patients in the trial were either given the drug midazolam or played the song "Weightless" by the British ambient band Marconi Union for three minutes, while having an anaesthetic to numb a region of the body.

The song performed well as a sedative in the study of 157 people, although patients said they would have preferred to choose their own music.

"Weightless" was written by the UK band Marconi Union in 2012 specifically to reduce anxiety, blood pressure and heart rate.

They incorporated scientific theory to unlock the "world's most relaxing song", working with sound therapists during the recording process in a similar way to a music composer and filmmaker.

The song is filled with dreamy, mellow synths, soothing melodies and instrumentation composed of piano, guitar and electronic samples of natural soundscapes. The song is so effective that it is considered dangerous to play while driving.

According to Mindlab International, the group behind the research, the power of this song is outstanding compared to any other song they have ever tested. "Weightless" induces a 65% reduction in anxiety and a 35% reduction in usual physiological resting rates.

Richard Talbot from Marconi Union said upon the song's release: "It was fascinating working with a therapist to learn how and why certain sounds affect people's mood. I always knew the power of music but we have previously written using gut feeling."

The University of Pennsylvania researchers, writing in a BMJ journal, now want to look at whether the type of music and how it is played to patients makes a difference to the results.

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This is the world's most relaxing song, according to science

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A new study by US researchers has revealed that playing the "world's most relaxing song" before surgery could be just as beneficial for calming a patient's nerves as medication. Patients in the trial were either given the drug midazolam or played the song "Weightless" by the British ambient band Marconi Union for three minutes, while having an anaesthetic to numb a region of the body.

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Student Counseling Center

320 Student Union

Monday-Friday, 8 a.m. - 5 p.m.
405-744-5458
Student Counseling Center (SCC) services include individual, group, grief and substance abuse counseling. The SCC also offers a virtual walk-in clinic and crisis counseling. An on-call counselor is available during regular business hours for crisis counseling. You may contact the OSU Police if it's after regular business hours at 405-744-6523. First four sessions are free, $10 per additional session.
Learn more about the Student Counseling Center

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Student Mental Health Resources - Oklahoma State University

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320 Student Union Monday-Friday, 8 a.m. - 5 p.m. 405-744-5458 Student Counseling Center (SCC) services include individual, group, grief and substance abuse counseling. The SCC also offers a virtual walk-in clinic and crisis counseling. An on-call counselor is available during regular business hours for crisis counseling.

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Center for Family Services

101 Human Sciences West

Monday-Thursday, 9 a.m. - 8 p.m.

Friday 9 a.m. - 5 p.m.
405-744-5058
The Center for Family Services is the on-campus training clinic for the Marriage and Family Therapy graduate program. The CFS offers individual, couple, and family therapy sessions, including in-person and teletherapy options. For OSU students, the first four sessions are free. Then, any following sessions are $10 per session. Go to our website below to request an appointment online or call the number above to get started.

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Employee Mental Health Resources - Oklahoma State University

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101 Human Sciences West Monday-Thursday, 9 a.m. - 8 p.m. Friday 9 a.m. - 5 p.m. 405-744-5058 The Center for Family Services is the on-campus training clinic for the Marriage and Family Therapy graduate program. The CFS offers individual, couple, and family therapy sessions, including in-person and teletherapy options.

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Most students will experience sadness, overwhelming stress, and/or crisis during their college years. These experiences will range in severity but can affect a student's wellbeing and success at Oklahoma State. You may interact with students who need assistance. Being aware of signs of distress and resources on campus can help in handling these situations. You play an important role at Oklahoma State University in providing resources to support student success.

If you see something, say something. The vigilance of all community members is critical in keeping the campus safe. We are unable to mitigate a situation until we are aware of it. The university expects all members of our community to act quickly and responsibly if they hear or see something that is out of the ordinary. It is important to report any concerns, even if they seem minor. Do not assume someone else will call. Are you concerned about the well-being or safety of a student? Have you observed student behaviors that caused concern?
Supporting students in distress Request a hardcopy
Recognize

Sudden decline in quality of course work and/or grades

Lack of organization skills

Multiple requests for extensions on assignments

Overly demanding of faculty/staff's time and attention

Unusual content in writings or presentations

Your conversations tend to be more about personal topics rather than academic

Significant changes in physical appearance (grooming/hygiene, weight loss/gain)

Excessive loss of sleep or fatigue

Consistent intoxication, hangovers, or the scent of alcohol

Seems to be disoriented or "out of it" often

Disconnected or slurred speech

Strange behavior that is out of context

Delusions or paranoia

Concern from peers

Extreme emotional response to events

Excessive crying or panicked reactions

Unusual irritability

Heightened apathy towards things they normally cherish or look forward to

Disclosure of personal issues (family or financial issues, grief, suicidal ideation)

Physical violence towards others (shoving, grabbing, assault, use of weapons)

Implying or making direct threat to harm self or others

Themes of hopelessness, rage, worthlessness, despair, suicidal ideation, etc. found within academic assignments

Stalking or harassing others

Communicating threats of others or self

Respond

Stay Safe: Call police or 911 if there is an imminent danger to the student, you, or anyone else.

Stay Calm: Take a few deep breaths to calm yourself. Use a calm voice when talking and asking questions.

Use Active Listening: Make eye contact and give your full attention. Restate what the student says to make sure you understand what is causing the distress and/or what they are asking for help with.

Ask Direct Questions: Don't be afraid to directly ask the student if they are having thoughts of harming themselves or others (by asking, you are not instilling the thought).

Use OARS to help an individual who may be struggling.

Open-Ended Questions - Ask questions that require a full answer

Affirmations - Acknowledge the individual's distress without judgment

Reflective Listening - Understand what an individual says and feels and then relaying this back to them

Summarize -Validate the individual for seeking help. Determine if you can provide assistance at that time and encourage them to connect with support resources on campus.

Is Immediate Assistance Needed?
Refer

Behavior that is severely disruptive, directly impacts others, and is actively dangerous including life-threatening, self-injurious behaviors.

Behavior is at an elevated state and is increasingly disruptive or the behavior is related to impaired ability to manage oneself, emotions, and actions.

The vast majority of students will experience stress in college. However, some students may experience additional needs when these stressors are accompanied by multiple stressors at once, a lack of coping skills, or have limited or no support network.

1. Call 911 for immediate response or call OSU Police Non-Emergency Line for assistance 405-744-6523.

1. Submit a Care Report or call Student Support & Conduct for guidance.

1. Check in with student and refer them to appropriate campus resources.

2. The report will be reviewed and sent to the appropriate office and staff to address the concerns.

2. If you feel the student needs more support, submit a Care Report for case management services through Student Support & Conduct.

Resources for Support

University Counseling Services (UCS) provides group, grief, substance abuse, and crisis counseling. The Student Counseling Center also offers a walk-in clinic and psychiatric referrals.

Call SAM: 855-225-2SAM (2726) (Student Assistance by Mercy) has licensed counselors available 24 hours a day, seven days a week to respond to crises, and provide referrals and consultations.

TAO: Free online library of interactive programs to learn life skills and to help you bounce back from disappointments and stumbling blocks in life.

Student Support and Conduct houses staff trained in supporting students who may be experiencing mental health struggles, sexual violence, college stressors, and crisis. Student Support & Conduct enforces the Student Code of Conduct for when student behavior falls outside of the University's expectations. Student Support & Conduct receives the Care reports and leads the Behavioral Consultation and Care Teams.

University Health Services is an acute care facility that provides a wide variety of services including outpatient medical care, nutritional counseling, a full retail pharmacy, women's clinic, as well as mental health and psychiatry services made possible by partnerships with OSU's School of Community Health Sciences, Counseling and Counseling Psychology and Grand Lake Mental Health.

Student Accessibility Services offers academic support services to students with disabilities.

Employee Assistance Program is available to OSU employees provides confidential support, resources, and information for personal and work-life issues.

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Supporting Students in Distress - Oklahoma State University

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Most students will experience sadness, overwhelming stress, and/or crisis during their college years. These experiences will range in severity but can affect a student's wellbeing and success at Oklahoma State. You may interact with students who need assistance. Being aware of signs of distress and resources on campus can help in handling these situations.

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Let’s Talk About It - Oklahoma State University

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It’s time we treat mental health needs more openly as a society. Let’s Talk About It and make it a normal part of life to get help and heal. Talk with your friends and family, OSU staff and mental health professionals. Let’s start the change.

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Abstract

This chapter will provide an overview of the school mental health field which has grown significantly since its beginning days in child guidance clinics and primary focus on expanded models inclusive only of community providers. The opportunity to provide mental and behavioral health services within the school setting has been an ongoing goal for many mental health professionals (e.g., social workers, psychologists, counselors) who desire to improve access to care by providing evidence-based interventions to a greater number of children and families. Service delivery models that emphasize teaming and collaboration across school, community, and family stakeholders within the system of a multitiered public health continuum of promotion, prevention, early intervention, and treatment are increasingly showing positive outcomes for children in need.

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Authors and Affiliations

1. School Psychology Program, University of Arizona, Tucson, AZ, USA

Katie Eklund

2. University of Arizona, Tucson, AZ, USA

Lauren Meyer

3. University of South Carolina, Columbia, SC, USA

Joni Splett & Mark Weist

Corresponding author

Correspondence to Katie Eklund .

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Editors and Affiliations

1. Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA

Bruce Lubotsky Levin

2. Behavioral Health Concentration, College of Public Health, University of South Florida, Tampa, FL, USA

Bruce Lubotsky Levin

3. Research and Education Unit, Shimberg Health Sciences Library, University of South Florida, Tampa, FL, USA

Ardis Hanson

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Eklund, K., Meyer, L., Splett, J., Weist, M. (2020). Policies and Practices to Support School Mental Health. In: Levin, B.L., Hanson, A. (eds) Foundations of Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-030-18435-3_7

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# data[].attributes.attachment_link.title
Policies and Practices to Support School Mental Health

# data[].attributes.attachment_link.description
This chapter will provide an overview of the school mental health field which has grown significantly since its beginning days in child guidance clinics and primary focus on expanded models inclusive only of community providers. The opportunity to provide mental and...

# data[].attributes.attachment_link.readable_text
Highlights

*

Better teacher wellbeing is associated with better student wellbeing and with lower student psychological difficulties.

*

Lower teacher depressive symptoms are associated with better student wellbeing.

*

Teacher presenteeism and the teacher-student relationship may be mediating factors in these relationships.

*

There is an association between teacher-student relationship quality, teacher presenteeism and teacher absence with student wellbeing and psychological distress.

Abstract

Background

Factors within the school environment may impact young people's mental health and wellbeing. The aim of this study was to understand the association between teacher and student mental health and wellbeing. Further, it seeked to identify possible explanations by examining whether the strength of any association is weakened once quality of teacher-student relationships, teacher presenteeism and absence are considered.

Methods

Cross-sectional data were collected from 3216 year 8 (aged 12-13 years) students and from 1182 teachers in 25 secondary schools in England and Wales. The association between teacher wellbeing (measured by Warwick Edinburgh Mental Wellbeing Scale (WEMWBS)) with student wellbeing (WEMWBS) and with student psychological distress (Total Difficulties Score (TDS)) was assessed using Random Effects Mixed Models. Analyses were repeated using teacher depression (measured by Patient Health Questionnaire) as the explanatory variable.

Results

Better teacher wellbeing was associated with i) better student wellbeing (standardised effect = 0·07, 95% CI = 0·02 to 0·12) and ii) lower student psychological distress (standardised effect = −0·10, 95% CI = −0·16 to −0·04). Teacher presenteeism and the quality of the teacher-student relationship appeared to be on the pathway of these relationships. Higher levels of teacher depressive symptoms were associated with poorer student wellbeing and psychological distress (standardised effect = −0·06, 95% CI = −0·11 to −0·01 & 0·09, 95% CI = 0·03 to 0·15). This association did not withstand adjustment for teacher presenteeism.

Limitations

Cross sectional in design so unable to establish temporal associations.

Conclusions

Associations were found between teacher wellbeing and student wellbeing and psychological distress. There were also an association between teacher depression and student wellbeing. Both may be partially explained by teacher presenteeism and quality of teacher-student relationships.

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Better teacher wellbeing is associated with better student wellbeing and with lower student psychological difficulties. * Lower teacher depressive symptoms are associated with better student wellbeing. * Teacher presenteeism and the teacher-student relationship may be mediating factors in these relationships. * There is an association between teacher-student relationship quality, teacher presenteeism and teacher absence with student wellbeing and psychological distress.

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References

Atkins, M. S., McKay, M. M., Arvanitis, P., London, L., Madison, S., Costigan, C., et al. (1998). An ecological model for school-based mental health services for urban low-income aggressive children. The Journal of Behavioral Health Services & Research, 25(1), 64-75. https://doi.org/10.1007/BF02287501

Backer, T. E., Liberman, R. P., & Kuehnel, T. G. (1986). Dissemination and adoption of innovative psychosocial interventions. Journal of Consulting and Clinical Psychology, 54, 111-118.

Baltimore City Public Schools. (2017). Building a generation: City schools' blueprint for success. Resource document. https://www.baltimorecityschools.org/sites/default/files/2019-01/Blueprint-complete.pdf. Accessed 28 November 2018.

Baltimore City Public Schools. (2019). District overview: City schools at a glance. https://www.baltimorecityschools.org/district-overview. Accessed 1 September 2019.

Creswell, J. W. (2007). Standards of validation and evaluation. In Qualitative inquiry and research design: Choosing among five approaches (pp. 201-222). Thousand Oaks: Sage.

Fixsen, D. L., Naoom, S. F., Blase, K. A., & Friedman, R. M. (2005). Implementation research: A synthesis of the literature. Resource document. University of South Florida. https://nirn.fpg.unc.edu/sites/nirn.fpg.unc.edu/files/resources/NIRN-MonographFull-01-2005.pdf. Accessed 8 May 2018.

Glaser, B. G., & Strauss, A. L. (1967). The constant comparative method of qualitative analysis. In The discovery of grounded theory: Strategies for qualitative research (pp. 101-158). Chicago: Aldine Publishing.

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Quarterly., 82, 581-629. https://doi.org/10.1111/j.0887-378X.2004.00325.x.

Maryland State Department of Education. (2019). Maryland Report Card, Baltimore City. https://reportcard.msde.maryland.gov/. Accessed 21 August 2019.

United States Census Bureau (2017). QuickFacts Baltimore City, Maryland. https://www.census.gov/quickfacts/fact/table/baltimorecitymaryland,US/AGE295216#viewtop. Accessed 14 September 2019.

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Acknowledgments

We would like to thank the school administrators in Baltimore City who participated in this study, and the school staff, families, and students who participated in the Project POWER Trial. We appreciate your support!

Funding

This study was funded by the National Institute of Mental Health (grant numbers T32 MH109436 02, Barry; T32 MH109433, Mandell), the National Institute of Child Health and Human Development (grant number 1R01HD090022, Mendelson), and the Institute of Education Sciences (grant number R305A160082, Mendelson).

Author information

Authors and Affiliations

1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., 3rd Floor, Philadelphia, PA, 19104, USA

Kimberly T. Arnold

2. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Keshia M. Pollack Porter & Shannon Frattaroli

3. School of Education, Notre Dame of Maryland University, Baltimore, MD, USA

Rachel E. Durham

4. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Kristin Mmari & Tamar Mendelson

5. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Laura K. Clary & Tamar Mendelson

Corresponding author

Correspondence to Kimberly T. Arnold.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Johns Hopkins Bloomberg School of Public Health Institutional Review Board, protocol #00007165) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Arnold, K.T., Pollack Porter, K.M., Frattaroli, S. et al. Factors that Influenced Adoption of a School-Based Trauma-Informed Universal Mental Health Intervention. Prev Sci 21, 1081-1092 (2020). https://doi.org/10.1007/s11121-020-01144-0
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Keywords

Program adoption

Trauma

Urban schools

Mental health intervention

Adolescents

# data[].attributes.attachment_link.title
Factors that Influenced Adoption of a School-Based Trauma-Informed Universal Mental Health Intervention - Prevention Science

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We know little about why school administrators choose to adopt preventive mental health interventions within the context of school-based prevention trials. This study used a qualitative multiple-case study design to identify factors that influenced the adoption of a trauma-informed universal intervention by urban public school administrators during an efficacy trial.

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Abstract

Purpose

School principals are generally seen as key facilitators for the delivery and long-term implementation of activities on school health promotion, including health literacy. However, there is little evidence on the health literacy and health status of this occupational group. The purpose of this paper is to investigate the health literacy of school principals and its association with mental health indicators.

Design/methodology/approach

A cross-sectional online survey with German school principals and members of the management board (vice principals) was conducted ( n = 680, 68.3% female). Demographic (gender, age) and work characteristics (type of school, professional role) as well as health literacy served as independent variables. Mental health as a dependent variable included well-being, emotional exhaustion and psychosomatic complaints. Next to uni- and bivariate analysis, a series of binary logistic regression models was performed.

Findings

Of the respondents, 29.2% showed a limited health literacy with significant differences to the disadvantage of male principals. With regard to mental health, respondents aged over 60 years and those from schools for children with special educational needs were less often affected by low well-being as well as frequent emotional exhaustion and psychosomatic complaints. Taking into account demographic and work characteristics, regression models revealed significant associations between a low level of health literacy and poor mental health across all indicators.

Research limitations/implications

The cross-sectional nature of this study does not allow to draw conclusions about the causal pathways between health literacy and mental health. Although the sample has been weighted, the results cannot be generalized to the whole population of school principals. There is a need for evidence-based interventions aiming at promoting health literacy and mental health tailored to the needs of school principals.

Originality/value

This is the first study to investigate health literacy and its association with health indicators among school principals.

Citation

Dadaczynski, K., Kotarski, C., Rathmann, K. and Okan, O. (2022), "Health literacy and mental health of school principals. Results from a German cross-sectional survey", Health Education, Vol. 122 No. 3, pp. 350-363. https://doi.org/10.1108/HE-10-2020-0094

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Emerald Publishing Limited

Copyright

# data[].attributes.attachment_link.title
Health literacy and mental health of school principals. Results from a German cross-sectional survey

# data[].attributes.attachment_link.description
School principals are generally seen as key facilitators for the delivery and long-term implementation of activities on school health promotion, including health literacy. However, there is little evidence on the health literacy and health status of this occupational group. The purpose of this paper is to investigate the health literacy of school principals and its association with mental health indicators.

# data[].attributes.attachment_link.title
What Happens When Training Goes Virtual? Adapting Training and Technical Assistance for the School Mental Health Workforce in Response to COVID-19 - School Mental Health

# data[].attributes.attachment_link.description
The Northwest Mental Health Technology Transfer Center (MHTTC) provides workforce training and technical assistance (TA) to support evidence-based school mental health practices. Historically, this support targeted school professionals through in-person and online trainings, workshops, and coaching. However, in response to COVID-19 restrictions, all support moved to online formats, and the Center introduced trainings for families and caregivers.

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Abstract

Purpose

This study assessed the psychological distress, life satisfaction, and perceived stress of Ecuadorian teachers who adopted online learning in response to the COVID-19 pandemic. It also aimed to qualitatively report the coping strategies used to maintain their mental health and well-being.

Methods

A web-based cross-sectional survey was conducted from June to mid-August 2020.

Results

In total, 394 teachers completed the questionnaire, and from those, 320 also completed an optional open-ended question included in the survey. More than half of the participants reported taking care of children under 11 years and/or adults over 65 years. At the time of the study, most of the participants were teaching in higher education settings. Age was significantly correlated with all the psychological variables, females presented higher levels of perceived stress, and teachers with home care responsibilities presented higher psychological distress as well as perceived stress. Teachers who had previous training and experience with online teaching presented lower levels of distress, perceived stress as well as higher levels of life satisfaction. The most used coping strategies included seeking social support, exercising, and engaging in leisure activities.

Conclusion

The results provide useful information to help develop initiatives that promote teacher well-being. Future studies should consider using a more diverse sample and dedicate attention to work-family conflicts as well as social and structural inequalities that may have a toll on teachers' mental health and performance.

Keywords: education, lockdown, online teaching, psychological distress, self-care, stress

Plain Language Summary

Since COVID-19 became a pandemic, the field of education has experienced drastic changes including the adoption of remote learning. As a result, teachers have had to continue their job amid a series of circumstances and stressors that may have had a toll on their mental health state. This study sought to understand the emotional well-being and coping strategies used by Ecuadorian teachers who completed an online survey in the midst of the COVID-19 global health emergency. Results indicate that:

participants who had previous training and experience with online teaching presented lower levels of emotional distress as well as higher levels of life satisfaction,

the most common coping strategies included seeking social support, exercising, and participating in leisure activities.

This study exposes the need to deepen our knowledge about teachers' experiences and challenges related to the pandemic. It also suggests the need to develop re institutional support mechanisms to ensure their well-being.

Introduction

The rapid spread of the Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic that has claimed millions of lives thus far.1 This unprecedented health emergency has taken a toll on the economy of millions of individuals and families and, to date, continues to test the capabilities of health systems worldwide. The pandemic has also impacted the educational systems of many countries as it forced educational institutions to adopt online remote learning to continue offering their services. This rapid adoption of Information and Communications Technologies (ICTs) as the primary resource in the teaching-learning process has evidenced several challenges for students and teachers,2 including tech-illiteracy and access to adequate technological infrastructure,3,4 and are expected to aggravate the previously existing learning disparities across regions.5

On an individual level, the pandemic has brought a series of stressors to the daily lives of people, including fears of death and infection, the loss of loved ones, confinement and mobility restrictions, increased home and care responsibilities, economic instability, among others.6-11 As a result of the pandemic and the series of prevention and control measures taken, there has been an increase in the number of symptoms and signs of stress, anxiety, and depression among the general population and other specific subgroups including people in the epidemiological fence,12,13 medical staff,14-16 and mental health professionals.17,18

There is also increasing evidence that suggests that the pandemic has had a significant impact on the well-being of teachers and students. In China, a study conducted by Huang & Zhao19 found that 35.1% of teachers and students presented moderate symptoms of anxiety and 21% moderate symptoms of depression, whereas in Germany, teachers experienced a medium-to-high amount of stress during lockdown.17 In the United Kingdom (UK), teachers reported high levels of anxiety20 and, in Chile, the pandemic negatively affected teachers' quality of life, especially among women and younger teachers.18

Changes in the mental health condition of teachers are possibly associated to changes in their working conditions. Data suggests that most educators were not prepared to face the technological challenges that came with the pandemic due to a lack of preparedness and experience in terms of digital competencies and remote learning pedagogical methods.21 For others, there is uncertainty on the impact of remote education on academic progress as it has been reported that students experience higher levels of psychological distress due to the pandemic.22 In this new context, the particularities of each student are now visible to some teachers and this can be a cause of stress and feelings of helplessness.23 Female teachers have also had to face the consequences of previously existing gender disparities concerning care and household chores that unequally augmented their demands and responsibilities.24,25

Despite several countries allowing teachers and students to return face-to-face classes and other hybrid modalities, by 2021, Ecuador continues to implement online remote education to prevent new infections. Current data suggests that the pandemic has already had a toll on students' mental health. A study conducted with high school students between 14 and 18 years of age indicate that 16% of students presented symptoms compatible with major depression disorder.26 This percentage is alarming if compared to those found in studies conducted prior to the pandemic which indicate a prevalence of 6.2% of depression among students.27 Unfortunately, there is still limited information on the mental health condition of teachers in Ecuador.

To contribute to the growing literature on the effects of the COVID-19 pandemic on educators, this study turned its focus to the analysis of teachers' mental health and well-being. More specifically, this research aimed to assess the level of psychological distress, satisfaction with life, and perceived stress of Ecuadorian teachers. In addition, it sought to identify the specific actions and behaviors that teachers report using as coping strategies to maintain their emotional well-being and mental health. Studying these variables is important since stress and burnout are related to negative outcomes for teachers, students, and institutions28 and given previous research indicating that teachers with high levels of distress are more likely to use negative coping strategies such as avoidance and throwing objects to reduce anger.29 Studying these variables may also help establish comparisons with findings from previous studies in pre-pandemic conditions,30-33 as well as those from other cultural settings during the pandemic.17,34 Online learning using ICTs is certainly not new; however, using these methods while living in a state of emergency and confinement is certainly novel. Thus, we believe this study will add valuable information to help develop future interventions that help restore and maintain educators' well-being and mental health.

Materials and Methods

Study Design and Participants

We conducted this study using a web-based cross-sectional survey that collected quantitative and qualitative information about the experiences of teachers in Ecuador in the context of the COVID-19 pandemic. Participants were asked to provide quantitative information about their psychological distress, satisfaction with life, and perceptions of stress. They were also given the option to provide qualitative information regarding the coping strategies they used to maintain their emotional well-being during the COVID-19 health emergency.

We used an online survey because, during the months of data collection, there were strict mobility restrictions in the country that limited our in person access to the population. Mail services in Ecuador are no longer used as the main form of communication, and teachers do not necessarily use these types of services. Most teachers started using ICTs to teach their lessons during the pandemic and thus were familiar with technological tools. Based on these factors, we concluded that using an online survey was the safest, fastest, and easiest way to recruit participants and collect their responses.

After approval from the Ethics Committee of Universidad de Las Américas, Ecuador (Ref: 2020-0611), we started recruiting participants using snowball sampling. The link to the survey was distributed using the personal and social networks of the research team members. The researchers also used institutional mailing lists to contact all faculty members at a private university. They also sent an invitation to the Ministry of Education of Ecuador and two private schools in Quito, Ecuador's capital, inviting their personnel and asking them to disseminate the invitation to other potential participants.

Participants were included in the sample if they were at least 18 years of age and were teaching in the country at the time of the COVID-19 pandemic. In addition, participants had to be teaching at any of the education levels that comprise the Ecuadorian Educational System (ie, preschool to postgraduate). Teachers interested in participating read the informed consent which contained the objectives, benefits, and risks of participation in the study. The participation was voluntary. The informed consent also included information to facilitate contact with the research team if any clarification was needed at any point of the study. Data collection was conducted between June and August 2020.

Measures

Data was collected using an online survey created and distributed through Microsoft Forms. The following information was collected:

Sociodemographic Information

This section included questions about participants' gender, age, and whether they had caregiving responsibilities of children under 11 years and/or adults over 65 years. Other questions were related to the education level at which participants taught at the time of the study (ie, teaching level), as well as pre- and post-pandemic experiences and training related to online teaching.

Clinical Outcomes in Routine Evaluation-10 (CORE-10)35

This brief self-report measure was used to screen general psychological distress. It includes items about depression, anxiety, physical problems, trauma, general functioning, and risk to oneself. Higher scores indicate higher levels of psychological distress. This measure has presented excellent psychometric properties (α = 0.90) in a previous study in the UK. The Cronbach alpha in the present study was 0.85 with a 95% Confidence Interval [82, 87]. In this study, we used the mean of the scores as the total score. As indicated by the authors, items two and three were reverse scored.

Perceived Stress Scale (PSS)36

This self-report scale was used to assess participants' perceived stress in the previous month. Higher scores indicate higher levels of perceived stress. The original version of the scale,36 as well as its translation to Spanish,37 h presented good psychometric properties. The 10-item Spanish version of the PSS (PSS-10)37 was used in the present study and scores evidenced high internal consistency with an alpha of 0.87 with a 95% Confidence Interval [80, 89]. In this study, we used the sum of the scores as the total score, and items four, five, seven, and eight were reverse scored, based on authors' instructions.

Life Satisfaction (LS)

To assess this variable, we included a single question developed by the UK Office of National Statistics:38 "Overall, how satisfied are you with your life?" Respondents were asked to respond using a scale that ranged from 0 ("not at all") to 10 ("completely").

Coping Strategies

This was a single optional open-ended question that required teachers to write the behaviors or strategies that they have used to cope and maintain their well-being during the COVID-19 health emergency.

Data Analysis

Descriptive statistics were conducted to characterize the sample. Frequencies and percentages were calculated for gender, participants with caregiving responsibilities, teaching level, pre-pandemic training in online teaching methods, pre-pandemic experience with online teaching, and post-pandemic training in online teaching methods. Mean and standard deviations were calculated for the age and the scores of CORE-10, PSS-10, and LS measures. The associations of demographic and teaching characteristics were analyzed through the calculation of the mean difference and the corresponding bootstrapped 95% confidence interval (CI) of the level of each variable (gender, presence of caregiving responsibilities, teaching level, pre-pandemic online training, pre-pandemic teaching experience, post-pandemic training) in relation to each one of the three measures (CORE-10, PPS-10, and LS). Means and standard deviations for each measure are presented. Also, the correlation between each measure was calculated using Spearman correlation. Bootstrapped 95% confidence intervals around sample statistics, including observed effect sizes, were reported rather than p-values, responding to guidelines that indicate that making inferences from p-values can be misleading.39 Analyses were conducted using R statistical software version 4.0.2.40

The qualitative information assessing participants' coping strategies was explored through deductive content analysis.41 Being an exploratory study, no analytical categories were established a priori. To ensure the quality of the analysis, credibility, dependability, confirmability, and transferability criteria42 were considered. For credibility and dependability, the first author obtained codes by analyzing each of the participants' responses using Microsoft Excel. Codes were later organized into categories (themes) using an Excel matrix that was later reviewed independently by each of the co-authors. At the end of the review process, discussions were held between the team members to reach a consensus and ensure validity. For higher dependability, the research process is explained, including the inclusion and exclusion criteria, as well as the contexts of the data collection. Regarding transferability, we are aware of the limitations of the generalization of the results due to its sample.

Results

In total, 394 participants met the inclusion criteria and completed the quantitative part of the study; of those, 320 (81.2%) responded to the qualitative question regarding coping strategies. Of the total of 394 participants, 56.9% ( n = 224) were women and 42.6% ( n = 168) were men, 2 participants indicated gender as "other". The mean age was 43.4 years ( SD = 9.89), ranging from 23 to 70 years. More than half of the participants (53.6%, n = 211) declared to take care of children under 11 years and/or adults over 65 years. The mean level of distress measured by the CORE-10 was 0.99 ( SD = 0.62), the mean level of perceived stress measured by the PSS-10 was 13.0 ( SD = 6.8), and the mean life satisfaction was 8.23 ( SD = 1.39). Most of the participants (89.1%, n = 351) were teaching in higher education (undergraduate and graduate programs). Around half of the participants (50.3%, n = 198) indicated having taught online courses before the COVID-19 pandemic and 63.5% ( n = 250) declared having received online education training prior to the pandemic. Most of the participants also indicated receiving training regarding online teaching methods during the pandemic (77.9%, n = 307).

Sociodemographic Variables Related to Psychological Distress, Perceived Stress, and Life Satisfaction

When comparing scores of the measures by gender, significant differences were identified only for the PSS total scores with 95% CI of the mean difference between the scores not containing zero. Women presented greater levels of perceived stress than men. Age was significantly and negatively correlated with the CORE-10 scores ( rs = −0.22, 95% CI [−0.32, −0.12]) and PSS scores ( rs = −0.29, 95% CI [−0.38, −0.20]), while it was positively correlated with LS ( rs = 0.18, 95% CI [0.008, 0.27]). Despite significant p-values, the strength of the correlations was small. Regarding caregiving responsibilities, differences were identified for CORE-10 scores and PSS scores. Those having caregiving responsibilities presented greater levels of psychological distress and perceived stress than those who do not have them. Mean, standard deviations, 95% CI and mean difference of each characteristic in relation to CORE-10, PSS, and LS scores are presented in Table 1 .

Table 1

Characteristics

CORE-10

PSS-10

Life Satisfaction

Mean (SD)

95% CIa

Mean Difference [95% CI]a

Mean (SD)

95% CIa

Mean Difference [95% CI]a

Mean (SD)

95% CIa

Mean Difference [95% CI]a

Teaching Variables Related to Psychological Distress, Perceived Stress, and Life Satisfaction

Results in Table 1 also show significant differences in CORE-10 scores and PSS scores based on teaching levels. K-12 teachers (elementary and high school teachers) presented higher levels of psychological distress and perceived stress than college teachers. No significant differences were found concerning life satisfaction. Regarding pre-pandemic online education experience and training, significant differences were found for the three measures. Participants with pre-pandemic online teaching experiences presented lower levels of psychological distress and perceived stress and greater levels of life satisfaction than teachers who had not had that experience before the COVID-19 pandemic. A similar pattern was found in relation to pre-pandemic training. Finally, regarding training during the pandemic, no significant differences were found in any of the three studied measures.

Coping Strategies

Results indicated a wide variety of strategies that teachers used during the health emergency to maintain their emotional well-being. Table 2 summarizes the seven categories and 17 codes found in the analysis, with their respective definition. Table 2 also presents the number of participants that mentioned each code. The main categories were 1) social support, 2) healthy living, 3) leisure activities, 4) mental health promotion, 5) work and study activities, 6) spiritual activities, and 7) avoidance activities.

Table 2

Category

Definition

Codes (n)

Health-related habits (38)

Organizing and scheduling (21)

Other (32)

Attitude (80)

Meditation (47)

Rationalization (18)

News avoidance (15)

Professional support (9)

Study-related (35)

Nature (20)

As can be seen in Table 2 , social support was the most frequently used strategy among participants. The activities within this category included seeking and providing support by sharing with family and friends to maintain active and ongoing contact with them. The second most frequently mentioned strategy included activities directed at maintaining and improving participants' physical health. Within this category, we found responses that included exercising, practicing yoga, having a healthy diet, and maintaining daily routines.

The third most frequently mentioned category involved leisure activities. This category included a variety of activities such as watching movies, reading, playing music, knitting, family recreation, and hobbies. The code "other" was also included to encompass activities such as "helping around the house," "drinking tea" or "not going out." The fourth category, that is, mental health promotion, included activities related to maintaining and promoting participants' psychological well-being, mental health, and self-care. Some strategies mentioned within this category were crying, talking about emotions and problems, focusing on oneself, thinking positively, having patience, laughing, being grateful, meditating, rationalizing, not watching the news, and following treatment with a psychologist or psychiatrist.

The work and study category included activities related to professional growth. Among these, "working" or "studying" were mentioned, in addition to other statements such as "distracting myself by preparing lessons or talking with the students" and "looking for new information related to the subjects I teach" or "following online courses on different topics." Participants also mentioned using spiritual strategies as ways to find meaning in life, and other religiously oriented strategies such as praying or reinforcing their beliefs in God to cope with the situation. Other participants also commented engaging in activities to connect with nature and their pets; these were included under the category of spiritual activities due to their meaningful sense of connection with the environment and other living creatures. Finally, participants reported using strategies that were coded as avoidant. Responses within this category included statements such as "keeping myself busy" and "keeping my mind occupied".

Discussion

Teaching is an essential task that had to carry despite the COVID-19 pandemic. The closure of educational institutions, the adoption of remote online education, and other factors including teachers' technological illiteracy21 and students' increased psychosocial and educational demands,43 had a potential toll on teachers' mental health. Given the novelty of this pandemic, and the limited research in Latin American countries, this study assessed teachers' mental health as well as the coping strategies of Ecuadorian teachers. We believe that research in this area could help design future strategies to actively support teachers' self-care and emotional processing of the pandemic. Helping teachers maintain their well-being will help them work more effectively with students and their families. Focusing on teachers, and closely examining the series of factors associated with their mental health, will also help raise awareness and actions to reduce the series of inequalities that the COVID-19 pandemic has shown across many countries in the world.

Psychological Distress, Perceived Stress, and Life Satisfaction

Our results indicate that psychological distress and perceived stress levels were lower than those reported in other studies. The mean level of psychological distress in our study was 0.99 ( SD = 0.62), which is slightly lower than the general psychological distress cut-off score of 1.1 reported by Barkham et al.35 before the pandemic and the mean of 1.05 reported during the pandemic in Brazil with one of the CORE system measures.44 The perceived stress score was lower ( M =13, SD = 6.8) than the scores reported by Pieh, Budimir, and Probst45 in a study conducted in Austria with the general population during the COVID-19 lockdown ( M=15.98, SD = 7.47). In addition, life satisfaction was high in our sample.

A closer inspection of our results indicates that several sociodemographic characteristics were associated with the assessed variables. Age was significantly correlated with all three variables. It was negatively correlated with CORE-10 and PSS-10 perceived scores and positively correlated with LS scores, indicating that younger participants were more stressed, had greater levels of psychological distress, and less life satisfaction than older participants. These results are similar to other studies conducted during the pandemic which indicate that the younger adult population present greater levels of depression, anxiety, and distress.19,45 As in our study, research with Spanish46 and Philippine47 samples have shown that younger participants present significantly higher levels of stress than participants older than 50 years. However, in other studies conducted with participants from China,22,46,48 Poland47 and Iran,49 the presence of a relationship between age and levels of stress has not been evident.

In our study, we found significant differences between men and women in their levels of perceived stress. In contrast, no differences were found in the CORE-10 nor the LS scores. Similar to the studies conducted by Klapproth et al17 in Germany, Lizana et al18 in Chile, and Saldívar-Garduño et al25 in Mexico, women in our study reported greater levels of perceived stress than men. Gender differences in the stress levels have also been reported in studies carried out in Austria,45 China,22 Poland,48 and the Philippines,47 in which women presented higher levels of stress than men. The presence of gender differences, in our study, might be explained due to gender roles and unequal domestic task distribution. Participants who reported being responsible and taking care of children and/or older adults also presented higher levels of distress and perceived stress than those who do not have these responsibilities. These findings are consistent with those indicating that work-family conflict has intensified among women due to the adoption of mandatory telework while facing the consequences of living in an emergency state caused by the pandemic.

We also studied the relation of stress, psychological distress, and life satisfaction with several teaching-related variables that might be relevant to describe possible impacts of online education. In our sample, most of the responses came from higher education teachers (89.1%); however, when comparing them with K-12 teachers, we found that the latter were experiencing greater levels of perceived stress and psychological distress. This is probably explained by the job conditions and characteristics of K-12 teachers, such as the age of their students, the illiteracy of teachers on the usage of the online education methods and tools, students' lack of technological skills, and the fact that they must interact with parents.

Regarding online teaching, as expected, participants with pre-pandemic experience and training in online teaching methods reported lower levels of psychological distress, perceived stress and greater levels of life satisfaction. We were surprised by the high number of participants who reported having done online teaching (50.3%) and received training (63.5%) before the pandemic. These results might reflect a general interest in online education and innovative teaching and learning methods, even before the emergency was declared. These results might also be explained by the fact that most participants were higher education teachers, for whom the use of ICTs resources (eg, virtual classrooms) are mandatory, especially among those in private institutions. Another possible explanation is that online teaching was not unfamiliar for most teachers of this sample because, in October 2019, Ecuador experienced a lockdown due to violent social protests that resulted in an emergency scenario in which online teaching was adopted for seven days.

Coping Strategies

The qualitative section of the study analyzed the strategies that teachers used as ways to maintain their emotional well-being and mental health during the pandemic. Our results are presented in separate codes and categories to facilitate comprehension; however, it must be acknowledged that many of the strategies used in our sample were, in many cases, related to more than one category. For example, "being thankful" may represent an attitude towards life as well as the practice of spirituality or meditation. Similarly, "exercising as a family" may be linked to physical activity as well as social companionship.

Our results indicate that most teachers used more than one coping strategy and the three most frequently reported strategies were social support, physical activity (exercise), and leisure activities. These results differ from those in another study50 carried out with language teachers during the COVID-19 pandemic which show that the three most frequent coping strategies are acceptance, advanced planning, and re-framing.50 One explanation for this difference could be the data collection method; in MacIntryre et al's, study the Brief-COPE inventory was used using a set of pre-defined categories. However, based on the existing critiques toward quantitative approaches on coping,51 in this study, we decided to ask teachers to openly report the coping strategies they used during the health emergency.

It has been previously seen that burnout is negatively related to positive or task-oriented coping strategies that aim to limit or solve the stressful situation, and that it has no relationship with negative coping, such as avoidant strategies.52 Thus, the activities reported by most of the teachers in this study may be effective for burnout prevention (eg, learn a new task while at home, exercise, time management with a to-do list). Also, many teachers maintain their emotional well-being through activities directly related to work and improving their teaching quality. These activities could be a form of problem-solving, which has been negatively related to stress.29 This may be because, in this context, teaching-learning experiences must be carefully designed in such a way that they do not deepen structural inequalities in education.43 Spending time working and studying may also be relevant in a time in which career changes are expected as ways to cope with economic burdens and limitations. Institutions should pay attention to people who disengage and suggest other strategies to promote their well-being.

The results of this study support previous recommendations to provide personal and material resources, improve the digital skills of teachers and students,53 prepare the educational community psychologically and emotionally with resources, create policies that guarantee socioemotional stability, and strengthen teaching skills and support.54 Results are also in line with previous research that indicates that starting and maintaining hobbies is related to better mental health and fewer symptoms of anxiety and depression.55-57 School and system policies also affect teachers' stress28 and could either facilitate or complicate their coping. Based on our results, we believe that educational institutions could help develop strategies that use social support, physical exercising, and leisure activities to help them cope with the series of stressors associated with the pandemic. For example, educational institutions could promote virtual workshops to facilitate physical exercise, social connection, and leisure activities courses. These kinds of initiatives could be shared with friends, family members and peers to promote social support, which has been found to be effective promoting well-being.58

Interestingly, only one participant explicitly mentioned the use of online social networks as a coping strategy. Online sites such as Facebook or Twitter may be a source of information, but they may also be a source of stress and fake news. Thus, we believe that future interventions directed at teachers could consider using other media such as radio, television, podcasts, as well as other applications such as Zoom or Teams, to share useful information and offer people strategies to improve their mental health and cope with the current health situation. Interventions to prevent teacher stress should be adapted according to the educational level and type of center. Research shows that the type of coping strategies used varies according to the teaching level; for example, compared to secondary education teachers, pre-school and primary school teachers use more rational planning when facing student behavior problems and less pessimistic passivity when dealing with work overload.59 Our results partially support these findings. Although most of the strategies were used by teachers regardless of any sociodemographic characteristics, the strategy "rationalization" was mentioned only by higher education teachers. However, this result must be interpreted cautiously, given the composition of our sample.

Limitations

Overall, our results help understand the mental health state of Ecuadorian teachers during the pandemic; however, some limitations must be acknowledged. First, given the nature of this descriptive study, no causal interpretation can be drawn from our data. Also, our results must be considered with caution as most of the participants were higher education teachers, and data was not analyzed based on their institutions' characteristics (eg, public vs private, urban vs rural). It seems likely that the situation of teachers working in K-12 settings, and those in rural areas, are not the same, as they must face low access to ICTs. Moreover, this study used a snowball sampling strategy using an online survey. Thus, we may have an overrepresentation of technology-savvy participants with high access to the internet, limiting our capacities to generalize our results to the general population of educators.

Conclusions

Despite its limitations, this study presents a snapshot of the psychological distress, perceived stress, life satisfaction, and coping strategies reported by teachers in Ecuador during the COVID-19 pandemic. These results provide ideas for specific actions that can be promoted in all educational settings. This study calls attention to the need to further explore teachers' experiences concerning the pandemic and the importance of providing institutional support to enable well-being. The support can include psychological interventions using ICTs60,61 which have been used in other countries to reduce psychological distress.

Future studies must attend work-family conflicts, as our results indicate that teachers with caregiving responsibilities experience more psychological distress and perceived stress than those who do not have those responsibilities. Future studies could also gather information about teachers' mental health in samples with different sociodemographic characteristics. Additionally, future research could explore individual, work, and family conditions associated with the adoption of specific coping strategies and the experience of certain symptoms of discomfort and psychological stress.

The COVID-19 pandemic is evolving, and other challenges seem ahead. Future research might include efforts to understand the perceptions and willingness of teachers to get vaccinated against COVID-1962 and the psychological impact of returning to face-to-face teaching which, in countries such as Spain, has already increased educators' discomfort.63 Providing further information on the COVID-19 pandemic is highly needed to get a wider picture of today's "new normal" education and to develop supportive strategies to enhance educators' well-being in future pandemics or emergency confinements.

Acknowledgments

We would like to show our appreciation to all the teachers who continue to seek ways to improve society through education.

Abbreviations

CI, confidence interval; CORE-10, Clinical Outcomes in Routine Evaluation-10; COVID-19, Coronavirus disease 2019; ICTs, Information and Communication Technologies; PSS-10, Perceived Stress Scale −10.

Data Sharing Statement

The data that support the findings of this study are available on request from the corresponding author, CP.

Ethics Approval and Informed Consent

The study was carried out in accordance with the Declaration of Helsinki. The protocol of the study was approved by the Ethics Committee of the Universidad de Las Américas, Ecuador (Ref: 2020-0611). Participation in the study was entirely voluntary with no monetary incentives nor compensation for the participants. All teachers interested in participating read the informed consent which contained the objectives, benefits, and risks of participation; those who agreed to participate in the study gave their informed consent, accepting to continue with the survey.

Author Contributions

All authors made significant contributions to the work reported, including the conception, study design, execution, acquisition of data, analysis, and interpretation; furthermore, they took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

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# data[].attributes.attachment_link.title
Teachers' Mental Health and Self-Reported Coping Strategies During the COVID-19 Pandemic in Ecuador: A Mixed-Methods Study

# data[].attributes.attachment_link.description
This study assessed the psychological distress, life satisfaction, and perceived stress of Ecuadorian teachers who adopted online learning in response to the COVID-19 pandemic. It also aimed to qualitatively report the coping strategies used to maintain their mental health and well-being. A web-based cross-sectional survey was conducted from June to mid-August 2020.

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OAR@UM: Mental health promotion in schools : a comprehensive theoretical framework

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Gina Dimitropoulos 1,2,

Emma Cullen 2,

Olivia Cullen 1,

Chris Pawluk 5,

Alan McLuckie 1,2,

Scott Patten 2,3,

Andrew Bulloch 2,3,

Gabrielle Wilcox 4 na1 &

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Paul D. Arnold 2,3 na1

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Abstract

To date, minimal research has explored the perceptions of secondary school staff regarding their realized and potential contributions to the redress of mental health stigma and support of students with mental health concerns within school environments. The aim of this study was to identify and describe the practicable roles school staff perceive of themselves to hold with respect to promoting mental health, challenging stigma, and responding to student mental health problems. Using an interpretive qualitative approach, semi-structured interviews were conducted following purposive and convenience sampling of school staff ( n = 48) including classroom teachers, school counsellors, psychologists, administrators, and various support staff members employed with two secondary schools in southern Alberta, Canada. A structured interview guide was utilized to assess the roles, tasks, and processes school staff undertake to assist students with their mental health concerns. Four main themes inductively emerged from the data: (1) Relationships matter: Establishing and maintaining strong relationships with students, their caregivers, and other staff members are critical to addressing student mental health issues; (2) Empathetic and receptive communication is an antidote to stigma: Various communication processes contribute to disclosures of mental health concerns and challenges; (3) Connecting and facilitating timely access to the right person is key for students experiencing emotional crises; and (4) Facilitators and barriers to addressing student mental health concerns. Clinical implications and policy recommendations are provided to inform directions for administrators, educators, and caregivers regarding student mental health supports.

Levels of Evidence: Qualitative study.

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Funding

This study is funded by Brain and Mental Health Strategic Research Fund, University of Calgary, and the Alberta Innovates Translational Health Chair in Child and Youth Mental Health.

Author information

Author notes

Gabrielle Wilcox and Paul D. Arnold are co-senior authors.

Authors and Affiliations

1. Faculty of Social Work, University of Calgary, Professional Faculties, MLT 301, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada

Gina Dimitropoulos, Olivia Cullen & Alan McLuckie

2. The Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

Gina Dimitropoulos, Emma Cullen, Alan McLuckie, Scott Patten, Andrew Bulloch & Paul D. Arnold

3. Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

Scott Patten, Andrew Bulloch & Paul D. Arnold

4. Werklund School of Education, University of Calgary, Calgary, AB, Canada

Gabrielle Wilcox

5. Rocky View Schools, Rocky View, AB, Canada

Chris Pawluk

Corresponding author

Correspondence to Gina Dimitropoulos.

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Data are available from the corresponding author on reasonable request.

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Approval for this study was obtained from the University of Calgary's Conjoint Health Research Ethics Board (REB 16-1352).

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Dimitropoulos, G., Cullen, E., Cullen, O. et al. "Teachers Often See the Red Flags First": Perceptions of School Staff Regarding Their Roles in Supporting Students with Mental Health Concerns. School Mental Health 14, 402-415 (2022). https://doi.org/10.1007/s12310-021-09475-1
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# data[].attributes.attachment_link.title
"Teachers Often See the Red Flags First": Perceptions of School Staff Regarding Their Roles in Supporting Students with Mental Health Concerns - School Mental Health

# data[].attributes.attachment_link.description
To date, minimal research has explored the perceptions of secondary school staff regarding their realized and potential contributions to the redress of mental health stigma and support of students with mental health concerns within school environments.

# data[].attributes.attachment_link.readable_text
Abstract
The COVID-19 pandemic has placed significant demands on teachers. The current study uses needs assessment data gathered from 454 New Orleans charter school teachers (81% women; 55% Black; 73% regular education) during the first months of the pandemic. On average, teachers experienced seven stressors (out of 18 surveyed) and four protective factors (out of six surveyed). Teachers who experienced more stressors reported worse mental health and found it harder to cope and teach. Experiencing more protective factors was associated with finding it easier to cope and teach. In comparison to White teachers, Black teachers reported better mental health, more protective factors, less of a negative impact of stressors, and more of a positive impact of protective factors. Lack of connection and online teaching challenges were the most difficult aspects of teaching during the pandemic; support from coworkers and administrators were the most helpful. Recommendations to support teachers are discussed.
Impact Statement
Teachers experienced considerable stress as a result of the COVID-19 pandemic, which was related to poorer mental health, coping, and teaching. At the same time, teachers reported resiliencies, which were related to better coping and teaching. Supporting teachers' well-being is critical to prevent significant adverse consequences for teachers, their students, and the education system as a whole.

Supplemental data for this article is available online at http://dx.doi.org/10.1080/2372966X.2020.1855473.

DISCLOSURE

The authors have no conflicts of interest to report.

Additional information

Funding

This work was supported by the United Way of Southeast Louisiana.

Notes on contributors

# data[].attributes.attachment_link.title
The Experience of COVID-19 and Its Impact on Teachers' Mental Health, Coping, and Teaching

# data[].attributes.attachment_link.description
Abstract The COVID-19 pandemic has placed significant demands on teachers. The current study uses needs assessment data gathered from 454 New Orleans charter school teachers (81% women; 55% Black; 73% regular education) during the first months of the pandemic. On average, teachers experienced seven stressors (out of 18 surveyed) and four protective factors (out of six surveyed).

# data[].attributes.attachment_link.readable_text
ABSTRACT
There is a growing expectation in the UK for teachers to have an understanding of common mental health problems in young people. This study aims to identify the training needs of secondary school teachers to enable them to adequately support and educate their students around mental health. Nine focus groups, each with between four to eight participants, were conducted with secondary school teachers in the UK. Discussions were centred on the needs and wants of teachers in terms of mental health training, provision and advice. Participants were also shown three online resources as an example of existing training. Thematic analysis was used to structure the data. Participants wanted training on how to identify and provide early support for students who are struggling, without taking on the perceived role of a therapist. Participants also emphasised the strong need for practical, interactive and expert-led training that provides resources that can be adapted to individual settings. Implications and recommendations are discussed.

Acknowledgments

We would like to thank the teachers who took part in this research for their help. The research materials can be accessed by contacting the corresponding author.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The PhD of the lead researcher (LS) is funded by The Charlie Waller Memorial Trust, a charity aiming to improve mental health in young people. The Trust had no involvement in the research process, from study design to submission. PW is funded through a NIHR-funded postdoctoral fellowship [PDF-2016-09-092].

Notes on contributors

Lucas Shelemy
Lucas Shelemy is a PhD Researcher in Psychology at the University of Reading. His main research interest is mental health training, support and education in schools.

Kate Harvey
Kate Harvey, PhD, is Associate Professor of Health Psychology in the School of Psychology and Clinical Language Sciences at the University of Reading, UK. Her primary research interest is in understanding children and family eating, and she has extensive expertise in qualitative methodologies.

Polly Waite
Polly Waite is Associate Professor in the School of Psychology and Clinical Language Sciences at the University of Reading, UK where she is a NIHR Postdoctoral Research Fellow. Her specific research interest is in anxiety disorders in adolescence. In her additional roles as Director of the Anxiety and Depression in Young People (AnDY) Clinic and a Clinical Psychologist, her focus is on improving our understanding of anxiety disorders in teenagers in order to guide our development of more effective psychological treatments.

# data[].attributes.attachment_link.keywords[]
focus groups (fg); qualitative research methods

# data[].attributes.attachment_link.title
Supporting students' mental health in schools: what do teachers want and need?

# data[].attributes.attachment_link.description
ABSTRACT There is a growing expectation in the UK for teachers to have an understanding of common mental health problems in young people. This study aims to identify the training needs of secondary school teachers to enable them to adequately support and educate their students around mental health.

# data[].attributes.attachment_link.readable_text
Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy

Perceptual Robotics (PERCRO) Laboratory Scuola Superiore Sant'Anna, 56010 Pisa, Italy

Department of Psychology, University of Rome La Sapienza, 00185 Rome, Italy

Author to whom correspondence should be addressed.

1. Introduction

The Italian population has recently experienced the first nationwide lockdown of the 21st century due to the Covid-19 infectious disease. After the Covid-19 outbreak in China in December 2019, the epidemic moved to the European region and was declared a pandemic by the WHO on 11 March 2020 [ 1], when Italy was the worst affected country outside China and was soon becoming the new center of the virus spread. City and regional lockdowns in Italy had already started in February, but the nationwide lockdown started on 9 March 2020, with an estimated 56 million people ordered to remain at home: bars, restaurants, schools and churches were closed and only essential services were permitted (e.g., vital health-care, food stores, electricity/gas/water/fuel suppliers, garbage collection). At the release of the toughest lockdown measures, on 4 May 2020, Italy had officially experienced 210,717 Covid-19 cases and had suffered 28,884 deaths due to this disease [ 2].

Besides the casualties and the economic loss (with a −9.1% estimated drop in GDP for 2020 [ 3]) associated with the Covid-19 pandemic, the fear of the virus and the 2-month lockdown had a serious psychological impact on a large part of the Italian population. Early reports emerging in the literature have shown that between 40% and 50% of adults have experienced psychological distress following the Covid-19 outbreak [ 4, 5], and that 30% of adults and children are at high risk for post-traumatic stress symptoms [ 6]. These results are in line with those previously collected from Chinese samples [ 7, 8, 9, 10], and extend our previous knowledge of the psychological burden of quarantines coming from past (shorter and smaller scale) experiences of isolation due to public health emergencies and relative confinement measures [ 11].

Previous experiences with global health emergencies have shown that the effective use of lockdown as a public health approach requires minimizing the harmful effects associated with it: the fundamental steps to this purpose seem to be the ensuring of sufficient primary supplies during the lockdown, and a clear communication, by the authorities, of the reasons for the restrictions and of the protocols to be followed [ 11], as well as cash transfers and job retention acts [ 12]. Moreover, other institutional and individual interventions have been proposed to protect mental heath in vulnerable groups, in particular during emergency situations such as the Covid-19 outbreak. These include stigma mitigation [ 13], psychological/psychiatric assistance [ 14, 15], psychoeducation [ 16] and teaching self-help methods [ 15, 17].

Teaching evidence-based self-help methods often represents a viable option to address the urgent need of psychological support for large numbers of people, when in-person services are suspended [ 18, 19]. A recent review of the meta-analyses of self-guided interventions to alleviate anxiety, depression and stress concluded that such interventions significantly improve well-being in comparison to control groups, albeit with effect sizes smaller than those associated with traditional guided individual or group therapies [ 20]. The interventions that proved to be the most effective included self-guided cognitive-behavioral therapy, acceptance and commitment therapy, and Mindfulness-Based Interventions (MBIs).

Mindfulness-Based Interventions are generally based on meditation practices taken from the Buddhist tradition and adapted into contemporary, psychologically-oriented programs [ 21]. These programs are usually delivered over 8 consecutive weeks, with eight group meetings led by a mindfulness instructor and daily individual practice at home [ 22]. Several studies have highlighted the benefits of MBIs mainly in terms of self-reported reductions in anxiety, depression and stress levels [ 23, 24, 25]. Other improvements due to MBIs have been reported for job burnout [ 26], interoceptive awareness [ 27, 28], empathy [ 29, 30], character traits [ 31, 32] and psychological well-being [ 33, 34]. It is important to underline that, after the completion of the program, participants can maintain and enhance the benefits gained during the training program by continuing with the meditation on their own. Two decades since the introduction of MBIs, research has showed that they could be effective in promoting well-being also when delivered through a single introductory group meeting, during which the meditation practices are taught and participants carry on the program individually [ 35, 36], or when delivered via the internet [ 37, 38]. MBIs are therefore tools potentially suitable for dealing with stressors arising during lockdown periods, because they can help manage psychological suffering and they can be delivered even in situations where face-to-face meetings are suspended and a large number of people need psychological support.

In the present study, an 8-week Mindfulness-Oriented Meditation course (MOM, which is a standardized MBI) was delivered, through two face-to-face meetings (before these meetings were prohibited by the government due to the spread of the Covid-19 pandemic) and six video-lessons, to a sample of female teachers ( Figure 1). Although the MOM course was not originally aimed at mitigating the psychological distress resulting from the Covid-19 pandemic, as this event was unpredictable, it ended up being addressed to a class of the general population most vulnerable to the consequences of this event: many studies have indeed frequently shown that being a woman is one of the risk factors for poor mental health outcomes during the Covid-19 pandemic [ 5, 6, 39, 40, 41, 42].

Moreover, it is well known that, when a population faces the same stressful situation, such as in the case of the Covid-19 pandemic, not everyone suffers the same way. Individual adaptive or non-adaptive responses to adverse events depend on a variety of biological, cultural, social and psychological components, which can be encompassed in the concept of psychological resilience [ 43]. Past research found that resilience is directly related, on the one hand, to secure attachment [ 44, 45], mental health [ 46, 47], psychological well-being [ 48], empathy [ 49], mindfulness [ 50] and interoceptive awareness [ 51], and, on the other hand, inversely related to childhood trauma [ 45], anxiety, depression [ 52] and burnout [ 53]. Many studies have shown the link between measures of resilience and personality traits, such as harm avoidance, self-directedness, persistence and neuroticism [ 45, 54, 55, 56, 57]. The sample of teachers who received the MBI were studied here in terms of their resilience profile, generated on the basis of temperamental (i.e., mainly innate) and characterological (i.e., mainly due to personal experiences and education) measures taken at baseline with the Temperament and Character Inventory [ 58, 59].

In our study, we therefore analyzed, within the full sample of female teachers receiving the MOM course, the data of a group of teachers with a high-resilience (HR) profile, and the data of a group of teachers with a low-resilience (LR) profile. These teachers were assessed with validated self-report instruments one month before (when the Covid-19 outbreak in China did not seem to threaten the Italian population) and one month after the imposition of the national lockdown in Italy (when the population was shocked by the unprecedented measures taken by the Italian government to deal with the spread of the Covid-19 infectious disease). In this period, the teachers received an 8-week mindfulness meditation course-partly (25%) delivered in person and partly (75%) via the internet. They were assessed in terms of their mindfulness skills, empathy, personality profile, interoceptive awareness, psychological well-being, emotional distress and burnout level.

Three main objectives were pursued in our study. Objective 1: to establish whether the two groups of teachers, who had two opposite profiles of resilience at baseline (obtained from teachers' personality profiles before the MOM course), were different at baseline in the other measures employed in our study as well. Based on previous research on resilience [ 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57], we hypothesized that the low-resilience group, compared to the high-resilience group, had worse baseline levels of psychological well-being, mindfulness skills, interoceptive awareness, emotional distress, empathy and burnout (H1).

Objective 2: to examine the changes in the two groups that occurred from before to after the MOM course; this also allows observation of the between-group differences after the intervention. Based on the previous literature on the effects of MBIs [ 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34], which referred to periods free from global health emergencies like that related to the Covid-19 pandemic, we hypothesized that both groups of teachers experienced similar improvements in mindfulness skills, empathy, character traits and interoceptive awareness (H2). As the psychological impact of compulsory isolation in the context of a world-wide pandemic has not previously been examined in relation to mindfulness meditation courses, the analyses of changes in the measures of psychological well-being, burnout and emotional distress (anxiety and depression) were exploratory.

Objective 3: to evaluate the teachers' satisfaction with the MOM course and their perception of the course's impact on their lives in the context of the Covid-19 outbreak. Based on our many years of experience in conducting MOM courses (see Methods), we hypothesized a moderate to high course satisfaction (H3a). Based on the perceived effectiveness of mindfulness meditation as a self-help method [ 20], we also hypothesized that participants could perceive mindfulness meditation as a useful practice in living through the Covid-19 lockdown period (H3b).

2. Method

2.1. Procedure

An 8-week Mindfulness-Oriented Meditation (MOM) training program was organized by the University of Udine on behalf of the Prevention Department and financed by the Friuli Venezia-Giulia region, in the northeast of Italy in a preventive medicine project. This project was originally designed to support teachers' mental health (i.e., to prevent professional burnout and improve well-being [ 60]). After participant recruitment, two parallel MOM courses were scheduled and two schools were chosen as the locations for the courses. Participants enrolled in one of the two courses based on the location of the course (the locations of the courses were about 60 km away). The MOM courses were held by two of the authors (A.M., a professional socio-health educator, and A.P., a psychologist), who have more than five years of experience in practicing and teaching mindfulness meditation.

In the original design of the study, data collected from participants in the MOM training should have been compared with data from control participants obtained after the end of the MOM course (in two sessions, eight weeks apart-the same time that elapsed between the pre- and post-MOM course assessments). However, due to the Covid-19 outbreak in Italy in the first weeks of the MOM course, the control group of participants was not assessed; data from teachers attending the MOM course who were assessed one month before and one month after the national lockdown could not have been fairly compared to the data from teachers who were in a condition with fewer restrictions thanks to the loosening of the lockdown.

The MOM training program started on Tuesday 11 February 2020. At the end of the second week of the course, on Sunday 23 February, the regional government of Friuli Venezia-Giulia ordered the closure of all schools and universities. The following six teachings were therefore delivered through 30-minute video lessons sent via the internet, and participants were asked to continue their MOM practice on their own (see Figure 1). They could communicate with their MOM instructor through emails, telephone messages and phone calls in case they wanted to share their meditation experiences or to pose questions about the contents of the video lessons.

Participants were assessed in the days before the training program (Time T0, between 6 February 2020 and 11 February 2020) and after the end of the program (Time T1, between 2 April 2020 and 15 April 2020). Data was obtained using paper-and-pencil questionnaires at T0 and using internet-based questionnaires at T1. For T1, the teachers agreed to complete the survey entirely in one session (as done at T0), paying close attention.

2.2. Participants

In total, 67 school teachers (1M, 66F; all Caucasian) were recruited through official communications sent to primary and secondary State schools and preschools in the province of Udine, Friuli Venezia-Giulia. The sample size was determined by the maximum number of participants eligible for the two MOM courses. In the two MOM courses, there was an equal proportion of teachers from different school levels (21 teachers from primary schools, 4 from secondary and 2 from preschools in the first course; 22 from primary, 5 from secondary and 4 from preschools in the second course).

This study concerned the 66 female teachers (age: 51.5 ± 7.9 years) participating in the MOM training program. The sample considered is representative of the Italian teachers, which are on average older than in most other developed countries (average age of teachers in Italy-48.6 years; average for countries of the Organization for Economic Cooperation and Development-44.1 years) [ 61].

Written informed consent was obtained from all participants during the first assessment session. This study was approved by the Ethics Committee of the University of Udine and all procedures performed in the study were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments (ethical code: CGPER-2019-12-09-01). All data was processed anonymously and data confidentiality was ensured.

2.3. Mindfulness Oriented Meditation (MOM) Course

The MOM course is an 8-week training program, with a 2 h group meeting per week and 30 min daily meditation practice at home [ 31, 32, 36, 60, 62, 63, 64]. In its structure it is similar to an MBSR course (Mindfulness-Based Stress Reduction), the most common mindfulness meditation program developed by Kabat-Zinn [ 65]. Each MOM meeting is divided into three parts: a 15/30 min teaching on topics related to meditative practice, a 30 min guided MOM practice and a final phase during which participants can share their experiences and ask questions to the instructor. These are the topics covered in the teachings [ 64]: historical introduction to mindfulness meditation, what is mindfulness meditation and how to practice it, facing pain with a mindful attitude, attention and awareness, being in the here and now, disidentification, deautomatization, and letting go. The MOM practice, which is the same throughout the course, entails a 10 min session of paying attention to one's breathing (anapanasati meditation), 10 min dedicated to heeding one's bodily sensations (body scan meditation) and 10 min dedicated to being aware of one's emotional and mental phenomena (vipassana meditation). The main reference for these practices within the Buddhist context, from which mindfulness meditation was adapted, is the Satipatthāna discourse [ 66], although the instructions given to participants during the meditations do not refer to Buddhism. The same three practices are part of other contemporary, secular and psychologically-oriented mindfulness meditation courses, such as MBSR. After the first meeting, participants are provided with a 30 min audio recording containing a guided MOM practice ( http://www.medita-mom.it/materiale), as an aid for home meditation practice. Participants are provided with articles and book suggestions on the topics covered in the course based on personal requests.

The theoretical or practical parts of the MOM course delivered in this study were not tailored for the specific group of teachers participating in the study during the Covid-19 outbreak: the teachings remained adherent to the original version of the MOM course [ 64] and the meditation-guided by instructors in the first two meetings and to be performed at home by the participants throughout the course-remained the same during the 8 weeks of the course. Discussions between participants and instructors, which normally take place in the final part of each MOM meeting, were replaced by personal communications via mail, phone messages or calls in the last 6 MOM weeks (see Figure 1), after the government prohibited face-to-face meetings due to the Covid-19 outbreak.

2.4. Measures

Demographic characteristics were obtained at T0. Participants reported their age, gender, level of education, body height and body weight, previous experiences in meditation and if they were diagnosed with any medical disease or psychiatric disorder.

Home practice was assessed through diaries collected every two weeks. Teachers were asked to record their daily practice of mindfulness meditation in the diaries.

Mindfulness skills were assessed with the Italian version of the Five-Facet Mindfulness Questionnaire (FFMQ [ 67, 68]). This 39-item instrument measures five mindfulness scales: observing (OBS), describing (DES), acting with awareness (AWA), non-judging of inner experience (NJU), and non-reactivity to inner experience (NRE). Respondents are asked to rate each statement using a 5-level Likert scale (1 = never or very rarely true, 5 = very often or always true; item example: "I watch my feelings without getting lost in them"). Higher scores in each scale reflect a greater level of mindfulness. FFMQ has a high internal consistency for the total score (Cronbach's α = 0.86) and acceptable values for its five scales (α ≥ 0.74) [ 68] (see below the Results section for present sample Cronbach's α).

Empathy was assessed with the Italian translation of the Questionnaire of Affective and Cognitive Empathy (QCAE [ 69, 70]). Using a 4-level Likert scale response format (1 = strongly disagree, 4 = strongly agree), this 31-item instrument assesses the two main components of empathy, namely affective empathy (AE, a person's emotional resonance to other people's experiences; item example-"It worries me when others are worrying and panicky") and cognitive empathy (CE, the ability to understand how other people feel; item example-"I always try to consider the other fellow's feelings before I do something"). QCAE has acceptable internal consistency for the AE and CE components, and the total score (α ≥ 0.77) [ 70].

The personality profile was assessed with the Italian adaptation of the 125-item Temperament and Character Inventory (TCI; [ 58, 59, 71]). This tool assesses the temperament and character dimensions of personality using a dichotomous true-false response format (item example: "I'm often so determined that I continue working long after other people give up"). Temperament scales include novelty-seeking (NS, the propensity towards impulsivity, exploratory excitability and eccentricity), harm avoidance (HA, the propensity to respond strongly to aversive stimuli), reward dependence (RD, the propensity to respond intensely to signs of social gratification) and persistence (P, the tendency to pursue goals despite fatigue and frustration). Character scales include self-directedness (SD, the ability to recognize the self as autonomous, and the feeling of self-confidence, honor and hope), cooperativeness (C, the ability to recognize the self as an organic part of society) and self-transcendence (ST, the ability to recognize the self as an organic part of nature and its source). TCI in its 125-item version has acceptable internal consistency for all scales (α ≥ 0.71) [ 71].

Interoceptive awareness was assessed with the Italian version of the Multidimensional Assessment of Interoceptive Awareness scale (MAIA [ 72, 73]). This 32-item instrument uses a 6-level Likert scale response format (0 = never, 5 = always; item example-"I notice when I am uncomfortable in my body"). MAIA measures interoceptive awareness through eight subscales: noticing (NOT, the awareness of neutral, comfortable and uncomfortable body sensations), not-distracting (NDI, the propensity not to distract oneself from sensations of discomfort or pain), not-worrying (NWO, the propensity not to worry when sensations of discomfort or pain are experienced), attention regulation (ARE, the ability to focus and sustain attention to body sensations), emotional awareness (EAW, the ability to connect body sensations to underlying emotional states), self-regulation (SRE, the ability to manage distress by listening to body sensations), body listening (BLI, the propensity to actively listen to the body for information) and trusting (TRU, the tendency to trust your body). The Cronbach's α values for internal consistency varied between 0.53 and 0.80 in the eight MAIA scales [ 73].

Psychological well-being was assessed with the Italian version of the 18-item Psychological Well-being Scales (PWB [ 74, 75]). This tool uses a 4-level Likert scale response format (1 = strongly disagree, 4 = strongly agree; item example-"I like most parts of my personality") and the six scales included are self-acceptance (SA), autonomy (AU), environmental mastery (EM), personal growth (PG), positive relations with others (PR) and purpose in life (PL). Higher scores on any scale indicate greater indices of happiness and psychological well-being. PWB Scales showed Cronbach's α values ranging from 0.60 to 0.70 [ 76], which appears to be a sufficient level of internal consistency based on the fact that each subscale comprised only three items.

Emotional distress was assessed using the Italian version of the Hospital Anxiety and Depression Scale (HADS [ 77, 78]). This 14-item instrument uses a 4-level Likert scale response format, with levels that differ depending on the question. Although originally developed to measure anxiety (item example: "Worrying thoughts go through my mind") and depression (item example: "I look forward with enjoyment to things") in non-psychiatric clinical settings, the HADS has been extensively employed as an effective tool even in non-clinical populations [ 79]. It provides separate scores for anxiety, depression and global emotional distress. In a review of the literature, HADS showed a high internal consistency across studies for both anxiety (mean Cronbach's α = 0.83) and depression measures (mean Cronbach's α = 0.82) [ 80].

Teacher burnout was assessed with the Italian translation of the Maslach Burnout Inventory Educators Survey (MBI-ES [ 81, 82]). Using a 7-level Likert scale response format (0 = never, 6 = always; item example-"I feel frustrated by my job"), this 22-item instrument measures three components of burnout in relation to teacher-student interaction: feelings of overwhelming emotional exhaustion (EE), depersonalization and detachment from the job (DP), and a lack of personal or professional accomplishment (PA). Burnout is indicated by high scores for EE and DP, and a low score for PA. MBI-ES has acceptable internal consistency for each of its components (α ≥ 0.76) [ 82].

The evaluation of the MOM course, also in relation to the Covid-19 outbreak, was obtained at T1. This included six general questions prepared by the authors of the study about the MOM course, and four questions related to the Covid-19 emergency (see Table 1). Each question was rated on a 5-point Likert-type scale (for Q1-Q8, 1 = not at all, 5 = very much; for Q9-Q10, 1 = much worse, 5 = much better).

2.5. Statistical Analyses

Before all analyses, missing values in participants' responses were imputed using the mean score of the whole sample for the corresponding item, since the total percentage of missing values was very low (0.10%).

Analyses of baseline data and pre- to post-course changes included a between-subject Group factor. As past research has shown that the most influential TCI scales on self-reported resilience were harm avoidance (HA, negatively correlated to resilience) and self-directedness (SD, positively correlated to resilience) [ 54, 55, 56], participants were classified as having a low-resilience (LR) or high-resilience (HR) profile on the basis of their HA and SD scores obtained at baseline. Participants in the LR group therefore had higher HA and lower SD scores than participants in the HR group. The clustering procedure, which assigned each participant to one of the two groups, was performed on the participants' standardized HA and SD scores (see Figure 2) with the k-means algorithm [ 83].

Between-group differences at baseline were analyzed using independent-sample t tests. Pre- to post-course changes in all the tests were submitted to separate analyses of variance (ANOVAs). All the scales of QCAE, MAIA, PWB, HADS, MBI-ES and the temperament scales of TCI were analyzed, using ANOVAs with Time (Time T0, Time T1) as within-subject and Group (LR, HR) as between-subject factors. While the four temperament scales of TCI are assumed to measure relatively independent aspects of the temperament, the three character scales of TCI are considered to globally measure three aspects of the maturity and development of the self [ 31], and were therefore analyzed using a single ANOVA with Time (Time T0, Time T1) and Scale (SD, C, ST) as within-subject factors and Group (LR, HR) as the between-subject factor. The same analysis was conducted for FFMQ, where the Scale levels were the five facets of mindfulness (i.e., OBS, DES, AWA, NJU and NRE), as these facets can be considered parts of the unique construct of mindfulness [ 63].

For these ANOVAs, sensitivity power analyses were carried out as a function of available sample size (with α = 0.05, β = 0.02). These analyses showed that, except for the small main effect of Group in the RD dimension of TCI, the significant effects of interest in this study were greater than the Minimum Detectable Effect's size (for the main effects of Group, all ηP2 > 0.109, average MDE ηP2 = 0.104; for the main effects of Time, all ηP2 > 0.108, average MDE ηP2 = 0.025; for interaction effects between Time and Group, all ηP2 > 0.081, average MDE ηP2 = 0.014).

The analyses were performed with the free software environment R, version 3.6.3 (R Foundation for Statistical Computing, Vienna, Austria). The assumptions of normality and homogeneity of variance were checked for each group of data (using a significance threshold of 0.01 to avoid alpha-inflation). Data transformation or robust tests were used in the case of violations of the normality assumption. In the case of violations of the sphericity assumption, the degrees of freedom in the ANOVA were corrected by applying the Greenhouse-Geisser procedure (indicated by [GG] in the results). All post-hoc pairwise contrasts were performed using the Holm-Bonferroni procedure. As a measure of effect size, the Partial Eta-Squared (ηP2) was used. All effects are reported as significant at p < 0.05.

3. Results

Eight teachers could not complete the training, and this resulted in an 11.9% drop-out rate. The final sample consisted of 58 female teachers (age: 50.8 ± 8.0 years).

3.1. Objective 1: Baseline Differences in Teachers with LR and HR Personality Profiles

Sample Partitioning Based on Resilience Profile

The k-means algorithm included 26 of the 58 participants who completed the MOM course in the high-resilience (HR) profile group and the remaining 32 participants in the low-resilience (LR) profile group ( Figure 2). The solution found was stable (i.e., the same classification was invariably obtained by repeating the clustering procedure). When comparing the resilience profiles of the 58 teachers who completed the MOM course with those of the 8 teachers who dropped out (HA: z = −0.20 ± 0.58; SD: z = 0.25 ± 0.40), it was observed that the HA and SD scores of the drop-outs mainly fell in between those of the teachers in the HR group (HA: z = −0.26 ± 0.82; SD: z = 0.64 ± 0.51) and those of the LR group (HA: z = 1.25 ± 0.56; SD: z = −0.77 ± 0.93). The resilience profiles of the 8 teachers who dropped out of the MOM course were not included in the clustering procedure.

The LR and HR groups were significantly different in most of the baseline measurements (see Table 2). First of all, they were different in terms of HA and SD z-scores; this means that the clustering procedure could successfully separate the participants according to their HA and SD features. Moreover, participants in the HR had significantly higher baseline scores in the AWA, NJU and NRE facets of the FFMQ, lower AE scores in the QCAE, higher scores in the NWO and SRE scales of the MAIA, higher scores in all scales of the PWB, lower anxiety and depression scores in the HADS, and lower EE and higher DP and PA scores in the MBI (Hypothesis H1).

3.2. Objective 2: Pre-Post MOM Changes in Teachers with LR and HR Personality Profiles

3.2.1. Mindfulness Skills

The raw scores in each FFMQ scale were normalized by dividing the observed scores by the number of items in each scale (eight items for each scale except for the NJU scale, which has seven items). The overall sample total FFMQ score's Cronbach's α was 0.91 (time T0) and 0.93 (time T1).

The ANOVA on the normalized FFMQ scores highlighted three significant main effects: a main effect of Time (F(1,56) = 9.7, p = 0.003, ηP2 = 0.303) with increased scores at Time T1 (vs. T0), a main effect of Group (F(1,56) = 13.6, p[GG] < 0.001, ηP2 = 0.195) with increased scores in the HR group (vs. LR), and a main effect of Scale (F(4,224) = 5.4, p[GG] = 0.001, ηP2 = 0.203), with significant differences in between-scale scores. A significant interaction effect between Time and Scale was found (F(4,224) = 2.8, p[GG] = 0.03, ηP2 = 0.048), due to different improvements over time in the five scales. Other two- or three-way interactions were not significant (all F < 2.4, p > 0.12, ηP2 < 0.041).

3.2.2. Empathy

The overall sample QCAE score's Cronbach's α was 0.67 (time T0) and 0.85 (time T1) for AE and 0.76 (time T0) and 0.80 (time T1) for CE.

In the AE scores, the ANOVA revealed a significant main effect of Time (F(1,56) = 17.5, p < 0.001, ηP2 = 0.238) with an overall decrease in scores from T0 to T1, and a significant main effect of Group (F(1,56) = 9.9, p = 0.003, ηP2 = 0.150), with higher scores in the LR group (vs. HR). There were no other significant main effects or interactions in the AE or in the CE scores (all F(1,56) < 1.6, p > 0.21, ηP2 < 0.028).

3.2.3. Personality Profile

Individual raw scores on each TCI scale were converted to z-scores using the age- and gender-matched average scores of a control sample consisting of 320 healthy individuals (Table S3 in [ 84]).

The overall sample TCI temperament score's Cronbach's α was 0.74 (time T0) and 0.68 (time T1) for NS, 0.85 (time T0) and 0.82 (time T1) for HA, 0.65 (time T0) and 0.51 (time T1) for RD, and 0.58 (time T0) and 0.53 (time T1) for P. In the temperament scales of TCI, the ANOVAs revealed a main effect of Group in the HA and RD scales (F(1,56) = 65.7, p < 0.001, ηP2 = 0.540 for HA; F(1,56) = 6.0, p = 0.02, ηP2 = 0.097 for RD). Participants of the LR group had higher scores than participants in the HR group in both scales. A significant main effect of Time was also observed in the HA scale (F(1,56) = 28.6, p < 0.001, ηP2 = 0.338), with an overall decrease in HA scores from T0 to T1.

The overall sample TCI character score's Cronbach's α was 0.80 (time T0) and 0.80 (time T1). The ANOVA on the character scales of TCI highlighted three significant main effects: a main effect of Group (F(1,56) = 12.8, p < 0.001, ηP2 = 0.186), with higher scores in the HR group (vs. LR), a main effect of Time (F(1,56) = 23.7, p < 0.001, ηP2 = 0.298), with an overall increase in scores from T0 to T1, and a main effect of Scale (F(2,112) = 6.8, p[GG] = 0.003, ηP2 = 0.108), with the C and ST scores being greater than the SD scores (z = 4.9, p < 0.001 and z = 5.2, p < 0.001, respectively). The ANOVA also highlighted two significant interaction effects: an interaction effect between Group and Scale (F(2,112) = 8.2, p[GG] < 0.001, ηP2 = 0.127), with a between-group difference in SD scores but not in C and ST scores, and an interaction effect between Group and Time (F(1,56) = 5.6, p = 0.02, ηP2 = 0.090), with scores improving over time more in the LR (χ²(1) = 29.1, p < 0.001) than in the HR group (χ²(1) = 2.9, p = 0.09).

3.2.4. Interoceptive Awareness

The overall sample MAIA score's Cronbach's α was 0.90 (time T0) and 0.90 (time T1). Significant main effects of Group were found in the NWO and SRE scales (F(1,56) = 8.2, p = 0.006, ηP2 = 0.128; F(1,56) = 9.0, p = 0.004, ηP2 = 0.138, respectively), where scores were higher in the HR than in the LR group.

Significant main effects of Time were found in six of the eight MAIA scales (NOT, ARE, EAW, SRE, BLI, TRU) (for all F(1,56) > 7.6, p < 0.008, ηP2 > 0.120), with an increase of scores from T0 to T1. All other main effects and interactions were not significant (for all F(1,56) < 2.7, p > 0.11, ηP2 < 0.046).

3.2.5. Psychological Well-Being

The overall sample PWB score's Cronbach's α was 0.85 (time T0) and 0.85 (time T1). Significant main effects of Group were found in all PWB scales except PR (for all F(1,56) > 5.8, p < 0.02, ηP2 > 0.109): scores in the SA, AU, EM, PG and PL scales were higher in the HR vs. LR group. Significant main effects of Time were observed in the AU, EM and PR scales (for all F(1,56) > 7.9, p < 0.007, ηP2 > 0.124), with an increase of scores from T0 to T1. A significant interaction effect between Group and Time was observed in the PR scale (F(1,56) = 8.7, p = 0.005, ηP2 = 0.134), with scores improving over time significantly in the LR (χ²(1) = 25.6, p < 0.001) but not in the HR group (χ²(1) = 0.3, p = 0.55).

3.2.6. Emotional Distress

The overall sample HADS score's Cronbach's α was 0.84 (time T0) and 0.81 (time T1). Significant main effects of Group were found in the anxiety and depression scores (F(1,56) = 14.2, p < 0.001, ηP2 = 0.202; F(1,56) = 9.1, p = 0.004, ηP2 = 0.139, respectively): scores in the LR were higher than in the HR group. Significant main effects of Time were also observed in the anxiety and depression scores (F(1,56) = 8.7, p = 0.005, ηP2 = 0.135; F(1,56) = 13.8, p < 0.001, ηP2 = 0.198, respectively), with an overall decrease in scores from T0 to T1. A significant interaction effect between Group and Time was observed in depression scores (F(1,56) = 5.3, p = 0.03, ηP2 = 0.086), corresponding to a significant decrease in scores in the LR group from T0 to T1 (χ²(1) = 20.1, p < 0.001), but not in the HR group. Due to the different decrease of depression scores in the two groups, the between-group difference in depression scores was significant at T0 (χ²(1) = 13.6, p < 0.001), but not at T1 (χ²(1) = 3.2, p = 0.07).

3.2.7. Teacher Burnout

The overall sample MBI score's Cronbach's α was 0.88 (time T0) and 0.87 (time T1). Significant main effects of Group were found in the EE component of burnout (F(1,56) = 17.7, p < 0.001, ηP2 = 0.240), with higher scores in the LR (vs. HR) group, and in the PA component of burnout (F(1,56) = 10.4, p = 0.002, ηP2 = 0.157), with higher scores in the HR (vs. LR) group. A significant main effect of Time was observed in the EE component (F(1,56) = 6.7, p = 0.01, ηP2 = 0.108), with an overall decrease in scores from T0 to T1. All other main effects and interactions were not significant (for all F(1,56) < 2.6, p > 0.11, ηP2 < 0.044).

3.2.8. Adherence to Practice

Each teacher reportedly meditated on average for 1307.7 ± 22.5 min during the MOM course (i.e., about 26 min per day). The teachers in the HR group reportedly meditated more than teachers in the LR group, but this difference was not significant (average meditation practice during the MOM course in the LR group: 1277.4 ± 220.9 min; in the HR group: 1338.4 ± 224.2 min).

In sum, the data on the pre-post MOM change showed that both groups significantly improved in terms of mindfulness skills, affective empathy, harm avoidance, character traits (with greater improvements in the low-resilience group) and interoceptive awareness, supporting Hypothesis H2. Both groups significantly improved also in terms of psychological well-being (in the scales of autonomy, environmental mastery and positive relations with others), anxiety, depression (with greater improvements in the low-resilience group), and in the emotional exhaustion scale of burnout.

3.3. Objective 3: Teachers' Satisfaction with the MOM Course (in General and in the Context of the Covid-19 Outbreak)

Evaluation of the MOM Course

When asked at T1 about their satisfaction with the course (Q1-Q6, see Table 1), the participants reported that they generally enjoyed the course (average score: 4.1, SD = 0.7), that they found it rather challenging (M = 3.7, SD = 0.9) but quite useful (M = 4.0, SD = 0.7), that they considerably engaged in it (M = 3.9, SD = 0.6), that the course moderately met their professional training needs (M = 3.6, SD = 0.8) and that the instructors' competence was very good (M = 4.5, SD = 0.6). A significant between-group difference was found only in the question about the usefulness of the course (in the LR group: M = 3.81, SD = 0.69; in the HR group: M = 4.15, SD = 0.73; Fisher's exact test p = 0.046).

In the questions about the course in the context of the Covid-19 lockdown (Q7-Q10, see Table 1), the participants reported that thinking about Covid-19 distracted them slightly during practice sessions (M = 2.5, SD = 0.9), that the practice of meditation helped them very much during the particular period of isolation related to the emergency (M = 3.6, SD = 0.7), that the absence of the practice would have made the period a little worse (M = 1.9, SD = 0.6) and that the distance learning methods of the last six meetings of the MOM course somewhat reduced the effectiveness of the course (M = 2.1, SD = 0.7). No significant between-group differences were found in these questions (for all, Fisher's exact test p > 0.26).

Finally, we investigated whether there was any between-group difference in the relationship between the responses given in the questions concerning the MOM course in the context of the Covid-19 outbreak (Q7-Q10) and the pre/post changes in some of the tests used (namely TCI, PWB and HADS, the tests where a significant interaction between Group and Time was detected in the ANOVAs). This analysis was performed using multinomial logistic regressions, separately for each question, using Group membership (LR, HR) and responses (properly dichotomized into two levels) to the question as predictor variables, and changes in the test scores from before to after the MOM course as outcome variables. A significant result was found only for question Q9 ("How do you think you would have lived this period without the practice?"), the responses to which were dichotomized with '0' for "much worse" responses and '1' for responses from "somewhat worse" to "much better", in relationship with the HADS Anxiety change scores. The pre/post MOM change in the Anxiety scores was predicted, by Q9 responses, differently in the two groups (b = −0.81, p = 0.02): in the LR group the changes in the Anxiety scores were not related to Q9 responses (r = 0.10, p = 0.57), while in the HR group these changes were negatively related to Q9 responses (r = −0.53, p = 0.005). This means that, for the HR group only, the more the Anxiety scores decreased, the more participants felt that they would have had more difficulty living through the lockdown period without the meditation practice.

4. Discussion

In the present study, a sample of female teachers was assessed one month before and one month after the imposition of the Covid-19 lockdown in Italy, and received a mindfulness meditation intervention during these two months. The personality profiles of the participants at baseline were used to classify the participants into a low-resilience group and a high-resilience group. The scores obtained from the teachers in the self-report measures were studied as a function of time (pre- vs. post-course) and group (low- vs. high-resilience).

4.1. Objective 1: Baseline Differences in Teachers with LR and HR Personality Profiles

Results largely supported H1: the analysis of data at baseline revealed that the low-resilience group had significantly worse average scores than the high-resilience group in terms of personality profiles (by the definition of the two groups), mindfulness skills, affective empathy, interoceptive awareness, psychological well-being, anxiety, depression and burnout levels. This between-group difference is in line with previous research that found resilience to be directly related, on the one hand, to mindfulness [ 50], psychological well-being [ 48] and interoceptive awareness [ 51], and on the other hand, inversely related to burnout [ 53], anxiety and depression [ 52].

4.2. Objective 2: Pre-Post MOM Changes in Teachers with LR and HR Personality Profiles

The results also supported H2; at the end of the course, one month after the lockdown was imposed, significant improvements were observed in both groups in most of the self-report measures. Both groups had significantly improved scores in mindfulness skills, affective empathy, harm avoidance, character traits (especially participants in the low-resilience group) and interoceptive awareness (H2), as well as in psychological well-being (in the scales of autonomy, environmental mastery and positive relations with others), anxiety, depression (especially in the low-resilience group) and emotional exhaustion. These positive results in the measures used in our study could be related to participants' adherence to practice (participants' home practice in our study was about 88% of the assigned amount), which was similar in the two groups and could be classified as good compared to other standard introductory MBIs [ 85, 86]; various studies have indeed highlighted a direct dose-response relationship between the amount of meditation practice and the extent of the beneficial outcomes of MBIs (for a meta-analysis, see [ 87]), and in the case of online MBIs as well (for a meta-analysis, see [ 37]). It is indeed worth pointing out that mindfulness meditation was taught here with two face-to-face initial meeting and video lessons sent via internet for the next six weeks of the course (see Figure 1); our results therefore confirm the possibility of effectively delivering MBIs via the internet [ 37, 38].

During the early stages of the Covid-19 epidemic, many researchers reported the need to provide interventions to support the mental health of people affected by the Covid-19 crisis [ 15, 16, 19, 87, 88], in particular for healthcare workers [ 18, 89, 90, 91] and patients with the Covid-19 infection [ 92, 93]. For this purpose, many scholars suggested the use of mindfulness interventions [ 94, 95, 96, 97]. However, studies assessing the impact of interventions that supported mental health in the early stages of the Covid-19 related crisis are very limited. Although the improvements reported in the present study cannot be attributed to the MOM course given the absence of a control group, the results seem remarkable, as we are not aware of any studies reporting improved psychological well-being when comparing persons during the Covid-19 outbreak with their precedent condition. Various studies instead reported a deterioration of people's mental health [ 5, 6, 98, 99]. At the same time, it should be recognized that our research focused on a specific population, namely state school teachers, who might have been less impacted by the emergency than other workers, as their jobs were not at risk and they were not professionally exposed to the risk of the infection (as were, for example, health care workers). Although a recent meta-analysis on the psychological impact of Covid-19 on medical staff and the general public found that the prevalence of anxiety and depression was similar in these two groups [ 100], there is evidence that certain occupations, such as front-line nurses, were indeed more psychologically affected by Covid-19 than others [ 101, 102].

In our study, for most of the measurements where the improvements were observed, the rate of change over time was generally similar in the two groups of teachers differing in terms of resilience. Since the two groups were different at baseline in most of the measurements, the final data generally showed that the low-resilience and the high-resilience groups were still different after the MOM course in the dimensions in which they differed at baseline (mindfulness skills, affective empathy, harm avoidance, the self-regulation scale of interoceptive awareness, the autonomy and environmental mastery scales of psychological well-being, anxiety and emotional exhaustion) and still similar in the dimensions for which they were comparable at baseline (the noticing, attention regulation, emotional awareness, body listening and trusting scales of interoceptive awareness). This pattern was different in the "positive relation with others" (PR) scale of psychological well-being, in character traits, in depression scores and in the total score of emotional distress, wherein the low-resilience individuals showed greater improvement than the high-resilience individuals (see the Time X Group interactions reported in Table 3). LR individuals therefore made better progresses than HR participants, although both groups reported the same amount of home meditation practice. This could be due, at least in part, to ceiling effects, because highly resilient individuals already showed healthy profiles at baseline for these measures. The findings could also be linked to different levels of motivation, across HR and LR participants, to commit themselves to the mindfulness intervention, which is usually presented as a way to alleviate one's psychological suffering [ 103]; as described in our previous research [ 36] and similarly to the reactive control negative feedback process proposed in many theories of self-regulation [ 104], participants who are in a worse condition (i.e., the LR group in our study) could be more motivated to engage for their own recovery.

It is important to underline that the scores for the personality traits used to define resilience in our study (i.e., harm avoidance and self-directedness) also improved in both LR and HR groups in the present study. Resilience is indeed considered a modifiable characteristic [ 105] and, during the Covid-19 pandemic, it has been related to modifiable factors such as physical exercise and interpersonal relationships [ 106]. However, as observed in other measures of the present research, at the end of the training course the two groups in our study remained significantly different in terms of the two aforementioned personality traits, and therefore in terms of resilience.

4.3. Objective 3: Teachers' Satisfaction with the MOM Course (in General and in the Context of the Covid-19 Outbreak)

The answers to the questions about general satisfaction with the MOM course supported H3a; teachers generally enjoyed the course, found it challenging but useful, engaged in it and appreciated the work of the instructors and the course content for their professional training needs. In addition to these positive responses from the teachers who completed the course, the teachers' satisfaction with the course itself can also be expressed by the number of teachers who dropped out (11.9% of drop-out in our study), which, in the present study, can be classified as medium-to-low when compared to the corresponding past literature [ 30, 107, 108, 109]. The answers to the questions about the course in the context of the Covid-19 outbreak supported H3b; participants in general reported that the practice of meditation helped them during the particular period of isolation related to the health emergency, and that the absence of the practice would have made the period a little worse.

Finally, teachers' evaluation of the MOM course was analyzed in relation to the two different resilience profiles of participants. Some between-group differences were observed. Although teachers generally appreciated the course and actively engaged in it, those in the low-resilience group reported significantly lower scores than their colleagues in the high-resilience group when asked about the usefulness of the course. This is quite surprising, because both groups equally benefited from the course, and the low-resilience group even had greater improvements in the emotional distress and character traits scores. Moreover, for the question on how one would have lived during the Covid-19 lockdown period without practicing mindfulness meditation, only teachers in the high-resilience group gave answers that appeared to be coherent with their self-reported decrease in anxiety levels: the more the anxiety scores decreased after vs. before the MOM course, the more the participants reported that the same period would have been much worse without the meditation practice. Both aspects that emerged from the answers to these questions suggest that less resilient individuals could have been less able to explicitly recognize the positive changes following the MOM training during the emergency situation. This should be taken into account in future mindfulness interventions in this type of context, in particular to motivate people to continue to use the learned technique even after the end of the intervention.

4.4. Limitations

Some limitations should be noted in our study. First, both LR and HR groups received the same intervention; for the generalizability of our findings, a control group should have been employed. Second, again in relation to the issue of generalizability, future studies should include samples with younger participants than those included in our study, because younger teachers may react to states of emergency, such as the Covid-19 pandemic, differently than older teachers. Third, only self-report measures were used, which can be susceptible to socially desirable responding. Moreover, the questions about the evaluation of the MOM course were not taken from a validated instrument: in order to further explore how participants find and accept psychological/behavioral interventions, future studies could benefit from using instruments such as the theoretical framework of acceptability [ 110]. A final issue concerns individuals' spirituality. In different contexts and with different participants, past studies showed, on the one hand, that MOM practice may contribute to enhancing individuals' levels of implicit and explicit spirituality, [ 62] and, on the other hand, that spirituality is an important mediator of the positive health effects of mindfulness meditation [ 111]. Considering the strong connections between spirituality and healthcare (e.g., [ 112]), it might have been useful to explicitly test spirituality in our study (beyond the self-transcendence scale included in the TCI measuring the predisposition of human beings toward spiritual feeling, thinking and behaviors), and it might be important that future studies investigating the psychological impact of health emergencies, and the effectiveness of related interventions, include the dimension of people's spirituality (e.g., [ 113]).

5. Conclusions

We have shown that it is possible through mindfulness meditation to enhance the resilience and improve the well-being of school teacher participants during critical events, such as the Covid-19 lockdown in Italy. This was seen to occur both in female individuals with resilient personality profiles and in female individuals with weaker personality traits. The factors that, in our case, may have determined this success were as follows: (1) a consolidated and evidence-based program that was provided by institutional services, (2) the intervention started before the beginning of the pandemic (i.e., in a preventive approach) [ 114] and (3) the participants actively engaged daily in the practice of meditation to protect and promote their mental health.

Author Contributions

Conceptualization, F.F. and C.C.; Methodology, A.M., F.F., A.P. and C.C.; Software, A.M.; Validation, A.M. and C.C.; Formal analysis, A.M., C.C.; Investigation, A.M., A.P.; Resources, A.P., F.F. and C.C.; Data curation, A.M.; Writing-original draft preparation, A.M.; Writing-review and editing, D.C. and A.R.P.; Visualization, A.M.; Supervision, C.C.; Project administration, A.M., A.P. and C.C.; Funding acquisition, A.P. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Prevention Department of Regione Autonoma Friuli Venezia Giulia.

Conflicts of Interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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Figure 1. Timeline of Mindfulness-Oriented Meditation (MOM) training delivered to a group of Italian school teachers during the Covid-19 health emergency. The MOM training started with group meetings and continued with individual lessons via the internet.

Figure 2. The personality profiles in HA and SD baseline z-scores of the two groups of participants. The LR group (left of each plot, in red) had higher HA and lower SD baseline z-scores than the HR group (right of each plot, in blue). The HA and SD z-scores were obtained from raw scores using a large control sample of healthy individuals (Table S3 in [ 84]). Abbreviations: HA = Harm Avoidance, LR = Low-Resilience, HR = High-Resilience, SD = Self-Directedness.

Table 1. The questions for the teachers' evaluation of the MOM.

Q1

How much did you enjoy the course?

Q2

How challenging was it?

Q3

How useful was it for you?

Q4

How much did you engage in it?

Q5

In relation to training needs and your professional role, to what extent has it met your needs?

Q6

How adequate do you think the instructor's competence is with regards to content and teaching methods?

Context of the course (COVID-19 lockdown)

Q7

How often have you been distracted by thinking about Covid-19 during practice sessions?

Q8

How much do you think the practice of meditation helped you during this particular period of isolation related to the emergency?

Q9

How do you think you would have lived through this period without the practice?

Q10

How do you think the distance learning methods of the last 6 meetings have conditioned the effectiveness of the course?

Table 2. Baseline data (expressed as average score and standard deviation) and between-group statistical differences. For baseline data, raw scores are used for all measures except TCI, for which z-scores are reported (obtained using a large control sample of healthy individuals-see Table S3 in [ 84]). Text in italics indicates that results were obtained using a robust version of the t test.

Table 3. Pre/post change in the scores (calculated as post score minus pre score; expressed in the table as average change and standard deviation) and results of the ANOVAs (detailed for the main effect of Group, the main effect of Time and the interaction effect between Group and Time). For TCI, z-scores are used (obtained as in Table 2). Text in italics indicates that results were obtained using a robust version of ANOVA. Abbreviations are as in Table 2.

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Positive Impact of Mindfulness Meditation on Mental Health of Female Teachers during the COVID-19 Outbreak in Italy

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The Covid-19 pandemic and subsequent public health measures were shown to impact negatively on people’s mental health. In particular, women were reported to be at higher risk than men of developing symptoms of stress/anxiety/depression, and resilience was considered a key factor for positive mental health outcomes.

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A Moment for Teachers: Self-Care for Busy Teachers - 101 free ways for teachers to become more inspired, peaceful, and confident in 30 seconds

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HOW TO USE THIS BOOK You will need 30 seconds. That's all. Start at the beginning, or turn to a random page. Every page has a title, a benefit, and simple directions. Read and complete the task on the page. If you know that you are in the mood for a creative, confidence-boosting, stress-releasing...

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Positive Mindset Habits for Teachers: 10 Steps to Reduce Stress, Increase Student Engagement and Reignite Your Passion for Teaching

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Amazon.com: Positive Mindset Habits for Teachers: 10 Steps to Reduce Stress, Increase Student Engagement and Reignite Your Passion for Teaching: 9780998701943: Stevens, Grace: Books

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The global impact of 2019 novel coronavirus disease (COVID-19) is unprecedented and has left countries grappling with uncertainties. Various public health measures all over the world have been implemented to reduce associated illness severity and mortality. Countries are now coming out of lockdown with cautious optimism after successfully flattening the curve with measures such as social distancing, quarantine, and closure of public places including schools. However, the challenges related to the impact on students' mental health continue beyond this phase of the pandemic. This article highlights key issues and offers practical solutions to address the mental health of adolescents during the COVID-19 pandemic from a high school student's perspective.

To the Editor:

The global impact of 2019 novel coronavirus disease (COVID-19) is unprecedented and has left countries grappling with uncertainties. Various public health measures all over the world have been implemented to reduce associated illness severity and mortality. Countries are now coming out of lockdown with cautious optimism after successfully flattening the curve with measures such as social distancing, quarantine, and closure of public places including schools. However, the challenges related to the impact on students' mental health continue beyond this phase of the pandemic. This article highlights key issues and offers practical solutions to address the mental health of adolescents during the COVID-19 pandemic from a high school student's perspective.

Implications of the COVID-19 Pandemic for High School Students' Routine

As with many schools and universities, my school has been closed since March 13, 2020, and it is uncertain when classes will resume. Adolescence is a crucial period for social development. Social distancing and school closures during the COVID-19 pandemic can worsen existing mental health problems in adolescents and increases the risk of future mental health issues. A loss of routine for many students, social isolation, and feelings of loneliness increase the risk of mental illness. An increase in domestic violence and abuse during this pandemic further exposes adolescents to risks of developing mental health problems. Historically, schools may provide a social support network and mental health services for vulnerable teens. However, closure of schools during the COVID-19 pandemic has taken away the protective layer of school-based mental health support. Closure of community agencies makes the situation even harder. Conversely, the COVID-19 quarantine has afforded time for family bonding over traditional board games and other activities. However, some students may need additional support for their well-being. Virtual meetings with guidance counselors from schools can facilitate early recognition and referral to primary care and mental health services.

Within a pandemic environment of furloughs and job cuts, families may struggle to purchase technology for high school students who could benefit from school-based counseling support for mental health problems. Efforts should be made for equitable access to technology for adolescents seeking telemental health services through school and community providers.

Potential Implications of the COVID-19 Pandemic for High School Students' Mental Health

The last few months have seen social media platforms such as Instagram, Snapchat, Reddit, and TikTok flooded with COVID-19 materials. Trending of information on these social media sites is due to the "likes" and "shares," and any misinformation leaves adolescents exposed to associated vulnerabilities. The social media infodemic has been linked to anxiety, feeling powerless, and catastrophizing situations. Further, COVID-19-themed jokes and memes circulating on social media can lead to pandemic issues not being taken seriously, which increases the risk of infection and associated distress and trauma. Partnerships with parents and social influencers can guide students toward healthy information-seeking behavior and positive mental health strategies. Both increased social media use and traditional forms of education moving to digital platforms have led to the majority of adolescents spending more time in front of screens. Excessive screen time is often associated with poor sleep, sedentary habits, mental health problems, and physical health issues.

Uncertainty, fear of getting the virus, sleep problems, and worries about the future are some of the common mental health issues impacting adolescents in the face of the pandemic. Increased incidence of mental health problems, including stress-related disorders, depression, anxiety, and substance abuse, have been described in adolescents during a pandemic. Quarantine, trauma, and grief during the COVID-19 pandemic further increase the risk of mental health problems. A lack of adequate support systems leaves adolescents to find resources by themselves in an underfunded area that continues to face stigma. Family and community supports to foster stronger relationships with children and adolescents and involvement of children safeguarding agencies when needed can help mitigate risks.

Five Strategies to Support High School Students' Mental Health During the COVID-19 Pandemic

The COVID-19 pandemic is a challenging time, and a multilayered action plan to support students' mental health during the pandemic is necessary. Such a plan could include the following strategies:

* Improving resilience of high school students with self-help strategies: The psychological impact of COVID-19 on adolescents will be felt both in the short-term and in the long-term, and efforts should be made to equip adolescents with strategies to build resilience. Students can be encouraged to create short-term goals and schedules and taught mindfulness techniques to build resilience. Acts of gratitude and compassion, such as helping those in need through volunteer activities, can also help.

* Developing peer support networks (buddy system): Creating a buddy system allows high school students to form peer connections and check in on friends through network hubs or mentoring supports, either created by adolescents connected to each other (eg, sports clubs, hobby clubs) or facilitated by youth organizations.

* Leverage digital technology for mental health support: High school students can access digital options for support and resources by exploring online portals that offer resource hubs and self-assessment tools. Self-help apps, digital counseling, and telemedicine services will continue to allow increased access to mental health services from home.

* Collaborative partnerships: Community mental health organizations should partner with high school students, their families, and schools to co-create mental health promotion programs. The COVID-19 pandemic has provided us with an opportunity to be digitally connected and work on collaborative projects, such as community mindfulness sessions.

* Ongoing government support through its networks: As a high school student, I would like to advocate for greater cohesiveness in governance across all levels-regional, provincial, and national-to mobilize and invest in community resources that promote engagement with local youth organizations.

Benjamin Franklin famously said: "Out of adversity comes opportunity." The COVID-19 pandemic has presented us with myriad challenges, and the way we respond is going to shape the mental health of adolescents for the future.

Footnotes

The author has reported no funding for this work.

The author wishes to thank Anupam Thakur, MBBS, MD, Assistant Professor, University of Toronto and Psychiatrist at Centre for Addiction and Mental Health, Toronto, for his guidance in manuscript preparation.

Disclosure: Mr. Thakur has received honoraria from Children's Mental Health Ontario (CMHO) and Reach Out Centre for Kids (ROCK) for various volunteer roles.

All statements expressed in this column are those of the authors and do not reflect the opinions of the Journal of the American Academy of Child and Adolescent Psychiatry. See the Instructions for Authors for information about the preparation and submission of Letters to the Editor.

References

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Mental Health in High School Students at the Time of COVID-19: A Student's Perspective

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The global impact of 2019 novel coronavirus disease (COVID-19) is unprecedented and has left countries grappling with uncertainties. Various public health measures all over the world have been implemented to reduce associated illness severity and mortality.

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Bipartisan Safer Communities Act

The BSCA is a historic investment of over $1 billion additional funding for mental health and other school-based services. As the first major federal gun safety legislation in decades, the law expands gun safety measures like increased background checks, and targets interstate gun trafficking. The law also addresses violence more broadly by expanding school-based mental health services, reducing obstacles to schools' billing for services under Medicaid, and creating a technical assistance center to facilitate compliance and operations.

The BSCA treats schools as a key point for observation and intervention. States can now extend Medicaid's reach beyond the IEP and tap into Medicaid funding to increase access and resources for comprehensive school-based health services. Despite the considerable increase in funding and additional mental health services for students that this expansion provides, at the time of publication, only 18 states have expanded Medicaid's reach beyond the IEP for school-based health services. States must act in order to maximize this historic opportunity!

NEA has created a resource that details how affiliates can work with state decision makers to use the BSCA to increase mental health and other services for students, and reduce gun violence in schools and communities. This resource provides recommended actions and includes actions of states successfully moving forward.

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The current mental health crisis in schools, colleges, and universities continues to impact both students and educators across the country.

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Two years ago during the height of the pandemic, I published a blog titled "Are the kids okay?" that cited a June 2020 Gallup poll finding that 43% of parents warned that their children were "already experiencing [emotional or mental] harm" and/or "reaching their limits" from social distancing practices.

Fast forward to the present, and even though most schools are back to in-person learning, USA Today reports that 87% of all Americans are concerned about the mental health status of young people, with two in three parents saying they're "extremely" or "very" worried. Concerning data like this has even prompted The American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association to declare a National Emergency in Child and Adolescent Mental Health.

Unfortunately, the student mental health crisis is just one component of education's perfect storm, also consisting of staffing shortages (e.g., only two states exceed the nationally recommended ratio of one school psychologist for every 500 students, and no state meets the recommended ratio of one social worker for every 250 students), teachers' poor mental health, racial tensions between families of color and their children's schools, and the critical need to help students remain on-track academically as the pandemic continues.

Tackling the student mental health crisis amidst this unprecedented upheaval may seem insurmountable, or at the very least, time-consuming when time has become a scarce resource, but educators don't have to do it all themselves: recent research lays out four social support considerations that can help them leverage students' connections and community toward improved mental and academic wellbeing.

Even better? These supports are mapped to indicators of success, meaning educators can understand if and how the relationships on offer actually meet students' needs; in other words, by measuring these social supports, educators can determine whether or not they're effective.

However, the considerations listed below are predicated on educators already knowing their students deeply, as well as students' access (or lack thereof) to connections. For educators looking to know their students better, Turnaround for Children provides a list of tools and activities for this initial relationship-building, and to help educators identify their own stress responses and create communication strategies for when "things get tough." The Institute's recent five-step playbook for mapping and measuring students' relationships is also helpful.

Social support 1: The student has someone in their network whom they feel comfortable turning to for help.

To help ensure students are building relationships grounded in trust, research across mentoring programs suggest that focusing on indicators of quality is a fundamental first step. Indicators include how a student is experiencing a relationship and the extent to which the student is receiving the care, support, or resources she needs. The National Mentoring Resource Center offers a toolkit with a host of such indicators as well as a validated survey that can be used by schools. Some survey instruments likewise capture information about mentors' or adults' perceptions of the relationship.

Asking students directly if they feel comfortable turning to the adults they are connected to for help is the clearest approach for ensuring adults' perceptions match students' reality. Matriculate, a virtual platform that supports high-achieving, low-income students in navigating the college application process, for example, directly asks students to agree or disagree with the following statement: "I feel comfortable asking my advisor questions related to my application process."

The Search Institute has also developed a framework identifying five elements that contribute to "developmental relationships": expressing care, challenging growth, providing support, sharing power, and expanding possibilities. Search Institute's recently released Developmental Relationships Survey obtains insights from youth in grades four through twelve on the quality of developmental relationships within reach, their social-emotional competencies, and equitable practices such as the extent to which students are building social capital.

Social support 2: The student has individuals stepping in to offer various kinds of support based on actual needs.

Different connections offer different values. Surrounding students with an interconnected web of diverse, positive relationships can help surface students' actual needs and make sure those needs are fulfilled.

An example of this in practice comes from the Phoenix Union High School District (PUHSD), which serves 30,000 students. Even as one of the largest high school districts in Arizona, PUHSD during the height of remote learning worked to connect with Every Student, Every Day to provide the resources and support they needed. Staff were assigned to ten students to call each day and ask simple questions such as, "How are you doing emotionally? Do you need any food? How is your online learning going? Do you have a laptop and connectivity? Has anyone lost their job recently?" The district's "PXU Remote Learning 2.0" also included career and college counseling in response to student requests.

Social support 3: The student feels a sense of belonging.

Students' sense of belonging is shown to affect their wellbeing, academic performance, and commitment to staying in school. But when school buildings closed in the spring of 2020, only one in three students said they really felt like part of their school community and felt connected to the school. On average, students reported that this is worse than usual.

One effort to assess and strengthen students' sense of belonging during ongoing remote learning was launched by The New Teacher Project (TNTP). Their freely accessible Learning Experience Survey enables districts and schools still offering some remote learning to surface actionable input from students and parents on their sense of connections and support. Students, for instance, are asked, "How true are the following statements for you?" Statements include: "There is at least one adult at my school that I can talk to about how I'm doing." and "My teachers make me feel like I belong in their class(es)."

For students from diverse backgrounds and students of color, creating a sense of belonging can start with inclusive family engagement by creating structures that deliberately leverage and involve all families, not just those with the comfort or ability to take the initiative themselves. By authentically engaging with students' families, schools can harness each family's cultural wealth of resources and insights about what their children need to thrive.

For example, the Parent Institute for Quality Education (PIQE) is a national, social justice-focused nonprofit that helps build parents' capacity to engage in their children's education and strengthen parent-school collaboration. In partnership with 128 school districts in California and 380 schools across the nation, PIQE provides families with the information and skills they need to advocate for their children through scores of hands-on workshops and seminars. For more ways that schools can reimagine family engagement, read " Family engagement reimagined."

Social support 4: The student's relationships are poised to outlast specific interventions.

Young people need relationships that provide critical care, support, and encouragement right at the moment. But they also need longer-term relationships that can expand their options and connect them to new opportunities for the future-like advice, jobs, and learning experiences. In other words, assessing the quality of student supports today can ensure students have the networks they will need tomorrow.

For example, an engineer in the local community may be asked to present to a classroom what it means to be an engineer. This is a discrete experience. Putting in place a system that enables any interested student to have access to a career professional for follow-up questions, career advice, and additional learning experiences (e.g. internships) outlasts discrete experiences. To ensure these longer-term connections, schools must start to treat relationships as outcomes in their own right, quantifying and tracking them over time alongside academic metrics.

For instance, students at Comp Sci High School complete a summer internship reflection survey in which they respond to the question, "I met with an adult or older peer who I will reach out to in the future to help me with my job/career goals." Educators at this Bronx, NY charter school know that students with access to high-quality relationships-ones built on trust and aligned with their needs-can translate to a reservoir of relationships that students can mobilize as their needs evolve.
Resource for educators/school staff: Four guiding questions with indicators to ensure student supports

Navigating an ongoing pandemic is uncharted territory. Despite a perfect storm of competing demands for resources, schools and educators have the will to support students' mental and academic wellbeing. With these considerations, indicators, and resources to ensure the quality of students' networks, they now have a way. (Additional survey and data collection approaches to measure the quality of students' relationships can be viewed in the Appendix of our recent report which highlights early innovators designing and measuring for students' relationships.)

Mahnaz R. Charania, PhD is a senior research fellow at the Christensen Institute. Her work focuses on studying disruptive innovations in education that amplify equitable opportunities for students to achieve social and economic mobility. In her current role, she leverages her deep expertise in measurement and evaluation to drive innovations that expand students' social capital.

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No, the kids aren't okay. Here are four social supports that can make a difference. - Christensen Institute

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Two years ago during the height of the pandemic, I published a blog titled "Are the kids okay?" that cited a June 2020 Gallup poll finding that 43% of parents warned that their children were "already experiencing [emotional or mental] harm" and/or "reaching their limits" from social distancing practices.

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As adults, we all have diverse needs and different ways of coping with stressful situations. For children, it is the same. Some children will have dealt well with restrictions and school closures caused by the COVID-19 pandemic. For others, it is challenging to cope with all the changes and uncertainty. Some children will return to school having experienced some level of stress, anxiety, isolation and grief. Some may have experienced increased violence at home.

School teachers and personnel are critical in supporting children's transition back to in-person classroom learning, particularly after extended periods of school closure. In addition to continuing to use the different skills teachers have been using to ensure their students' learning and emotional well-being while schools were closed, the following suggestions might be helpful when schools reopen:

1. Listen to children's concerns

COVID-19 and school closures impacted many children and adolescents' mental health and well-being. As teachers, it is essential to listen to students' concerns and demonstrate understanding as well as empathy. Offer your students the opportunity to have a one-to-one conversation with you to reconnect and discuss any concerns that might have arisen when their school was closed. If a child shares anything that is particularly concerning, please follow the protection or child safeguarding systems in place.

2. Check how children are doing

Before teaching new academic content to students, teachers and school personnel should take time to check how children are doing. Remember that children may have difficulty concentrating at first or may need more time to get back into the routine of learning. Provide opportunities for children to take breaks, move around, and re-connect with their friends and peers.

3. Provide children with accurate information around COVID-19

As children return to school, they may have different thoughts and questions about COVID-19. Children want and need factual information. Use child-friendly and age-appropriate resources available in your country/region that is based on scientific evidence to respond to children's questions about COVID-19 accurately.

While it is important to acknowledge the scale of what is happening globally, make sure to emphasize all the efforts made and precautions taken to reduce risks in the school reopening plans. Do not forget to remind children of school safety protocols, including what to do in case there is a COVID-19 case detected in the classroom.

4. Seek suggestions from children on how to create a welcoming, safe and comfortable classroom

Engage children in making the classroom a welcoming, safe and comfortable space. When doing so, make sure to respect school safety procedures and use available material resources.

Children can provide suggestions; help decorate the walls of the classroom with colourful and welcoming messages and work in small groups so they can support each other to catch up on learning. Let them know that being supportive of each other will help them get through this together. Remember to praise children for their contributions and efforts. Teachers can foster feelings of safety and security by interacting and developing positive relationships with each student and using routines during the day to help children feel safe and secure.

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8 ways teachers can support students' mental health during COVID-19 school returns

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Transitioning back to in-person classroom learning during COVID-19

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We know that being there for students is important, but it's not always obvious how to support them - especially when we're seeing them through a screen some or all of the time.

At the same time, the emotional and social challenges of the pandemic have made it even more crucial for teachers to attend to students' mental health needs. Here are some tips for doing that, both remotely and in person.

By building social emotional learning into the daily routines of your classroom, you'll provide students with a reliable way to deal with whatever feelings they're experiencing. Even small exercises can go a long way toward helping kids feel safe and validated.

For example, at the start of each day (after the physical temperature check, if you're teaching in person!) you might have your students take their "feelings temperature" by labeling their emotions using a feelings word chart. Then, they can rate the intensity of the emotion on a scale from one to ten and notice where in their body they're experiencing the feeling. Is their heart beating faster than usual? Do they feel tension in any part of their body? Do they have a stomachache? Students can track these "feeling check-ins" in a journal and share with the class if they comfortable doing so, for example during morning meeting. Practicing identifying their feelings and body responses will help kids learn how to cope with their feelings.

You can also normalize and validate feelings by taking bits of time throughout the day for direct social emotional education. For example, you can lead read-alouds about feelings or mindfulness, or facilitate journaling, role-playing, media discussions, or even just quick group check-ins about feelings. The idea is to let students know it's okay to feel exactly what they're feeling in the moment and give them tools for days when they might be experiencing uncomfortable feelings. Specific tools students can practice using might include a mindfulness corner, a hanging visual about belly breathing or a list of self-calming strategies taped to their desk.

Isolation can cause feelings of depression and anxiety. This has become especially apparent in recent months. While social distancing makes building interpersonal bonds harder, helping students form strong relationships at school has never been more important.

The social learning that occurs between peers at school can be just as important as academics. When you can, prioritize opportunities for your students to get to know each other and bond. With online learning, this might look like playing class games through video chat or assigning group work that students complete together. Group discussions are also a great way for students to practice interacting and build relationships.

Having a close relationship with the teacher can also be a strong protective factor against the development of mental health issues. It's important for students to feel they can go to their teacher if they're having a hard time. Discussing emotions in class can help with this, and you can also emphasize to students that you're available to talk one-on-one if anything gets tough. If you notice a student seeming down or having trouble engaging, consider checking in on them - even a simple "How's class been going for you?" can go a long way.

Put simply, mindfulness means paying attention to the moment on purpose and without judgment. There are many creative ways to incorporate mindfulness into your classrooms, including these simple exercises:

Two-minute meditation: Try starting the day (or taking scheduled breaks) with two minutes where you encourage your students to focus only on their deep, slow breathing.

Noticing details: Kids can practice mindfulness during activities like coloring, dancing, listening to music or even eating. Help them notice small details about their surroundings and what they're doing. What do they hear, smell, see, feel, taste?

Relaxation skill of the week: Teaching relaxation strategies when kids are calm gives them tools to use when their feelings do get intense. Build their toolkits by introducing a new relaxation skill every week and practicing it daily as a class. Some simple skills to focus on include paced belly breathing, progressive muscle relaxation and guided imagery. Remember, you are your students' model, so take time to verbalize moments when you are beginning to feel stressed or overwhelmed and narrate as you use one of the relaxation strategies to calm yourself.

Kids can usually tell when adults are hiding things from them. That can make an already anxiety-provoking situation feel even worse to kids, since they often assume that things are worse than they actually are. That's why it's important to help your students understand what's happening - without overwhelming them with information.

When students do come to you with questions and concerns, it's important to validate their feelings: "I get that the uncertainty about our school schedule is making you anxious." Then, provide answers to their questions as much as you can: "You're right that there's a chance we might have to switch back to remote learning, but right now we're still coming in person. I promise to let you and your family know as soon as we have any indication that might change."

For younger kids, visuals and stories can help you provide information in a way that they'll understand. For example, you might create a document with pictures highlighting the rules in your classroom around masks, hand-washing and social distancing so that students have a clear sense of what's expected.

Even with school underway, many kids have a lot of free time right now and they're still limited in the kinds of activities they can do. This often leads to kids spending a lot of unstructured time in front of screens, which can have harmful repercussions for their mental health.

Teachers can help with this by structuring as many active, hands-on activities into the day as possible. Even if you're engaging with students online, you can work as a class to come up with a list of fun non-screen activities (taking a walk, playing board games, drawing) and have students complete one activity from the list as part of their daily school assignments. You can also encourage kids to schedule their favorite activities into their daily routines and share with the class about what they've been up to.

Amid so much stress and uncertainty, you may not be able to promise your students that everything will be okay. But by actively supporting their mental health in the classroom, you'll help them feel safe, valued and cared for during a truly challenging time.

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Supporting Students' Mental Health During COVID - Child Mind Institute

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We know that being there for students is important, but it's not always obvious how to support them - especially when we're seeing them through a screen some or all of the time. At the same time, the emotional and social challenges of the pandemic have made it even more crucial for teachers to attend to students' mental health needs.

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Educators are key in protecting student mental health during the COVID-19 pandemic

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Focused, meaningful interactions matter greatly.

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How teachers can use existing processes in schools to identify students who may need extra support-especially regarding anxiety and depression, which can often go undetected even under the best of circumstances.

Cite this

American Psychological Association. (2020, September 22). Student mental health during and after COVID-19: How can schools identify youth who need support? https://www.apa.org/topics/covid-19/student-mental-health

In the face of the global COVID-19 pandemic, schools have confronted unprecedented challenges as they moved to quickly shift classes to an online format, provide equitable access for all students, support teachers' and students' educational needs, and make plans amidst great uncertainty. The pandemic itself has caused much worry, stress, and grief. These stressors can cause mental health challenges for anyone and can cause acute symptoms to appear for people who may experience preexisting mental health challenges.

Some of the typical indicators teachers may use to identify students experiencing mental health difficulties may not be available. Some teachers may not be meeting with students in person. Some teachers may not have the same student drop-ins. Some teachers may not be able to read students' masked faces. As such, teachers may wonder how students are doing or the degree to which they are struggling, particularly with respect to emotional problems.

Here we address how teachers can use existing processes in schools to identify students who may need extra support-especially regarding anxiety and depression, which can often go undetected even under the best of circumstances.

Universal screening to identify students in need

An established method to identify students who may have difficulties with anxiety or depression is through systematic screening of the school population. For elementary school students, screening involves teachers and students completing brief questionnaires regarding students' emotions and classroom behaviors. At the middle and high school levels, screening primarily relies on student questionnaires regarding the frequency or severity of any emotional concerns.

Teachers also may be asked to nominate students who appear to be excessively anxious or frequently sad. Students can complete questionnaires using paper-and-pencil surveys or, more appropriately for online instruction phases, through online, secure questionnaires. School mental health professionals (e.g., counselors, school psychologists) use scores on these questionnaires to identify students who appear at risk for anxiety or depression difficulties. Sometimes, these at-risk students are asked to complete the questionnaire again a few weeks later to determine whether their mental health challenges are enduring.

Prior to the COVID-19 pandemic, approximately 15 to 20% of students could be expected to be identified as needing support through screening (Dowdy et al., 2015); this percentage will almost certainly be higher given the potential emotional fallout of the pandemic.

Different roles of school professionals

School-based mental health professionals can provide direct support to students who are potentially at risk for emotional issues by helping to implement systematic screenings. While each school-based helping profession's ultimate goal is to facilitate the optimal development of each child, there is a differentiation in roles that each specialist takes.

For instance, within the screening process teachers are the professionals who are the most knowledgeable about students' general behaviors because they have the most contact with students daily. As a result, observant teachers may be able to detect subtle changes in children's daily mood, habits, and school-based practices.

In order to take a closer look at teachers' concerns regarding problem behavior, a second professional (i.e., school psychologist) typically administers rating scales such as the Behavioral Assessment System for Children-Third Edition (BASC-3) or the Behavioral and Emotional Screening System (BESS). School psychologists administer scales such as these to multiple informants such as parents, teachers, and students themselves to provide a global view of a child's functioning. Students that the school psychologist identifies as at-risk are typically referred to the school counselor.

Within this tiered screening process, school counselors may decide to implement another round of screening before intervention implementation by administering a more specified rating scale in an area identified as at-risk (Erickson & Abel, 2013). For instance, if a student was identified as being at-risk for attention problems, the school counselor could administer the ADHD Rating Scale-5 which can help to accurately identify students who meet the DSM-V criteria for attention deficit/hyperactivity disorder (ADHD; DuPaul et al., 2016).

Screening process case study

Michael makes every effort to reach out to his students with recent disruptions in face-to-face school instruction. Most students respond to check-ins and complete academic work at an expected level, but Sarah has not responded to communication and frequently fails to complete assigned work.

Michael first reaches out to other teachers who work with Sarah and determines through this network that Sarah shows similar behavior with other teachers. The team confirms that technology is not a barrier and fails to find any evidence of environmental concerns that would prevent her from connecting. Concerned about potential mental health distress, Michael contacts the school psychologist to inquire about screening. Michael's school was already planning on administering a universal screening tool for all students the following week.

As a result of this screening, the school psychologist found that Sarah needed some additional supports and connected her with the appropriate school and community mental health resources. If results of the screening had not indicated specific mental health concerns, a school-based team would probe further to identify other factors that are preventing Sarah from finding success.

Screening is one part of the prevention and support process. What happens after identification?

Once students are identified as being at-risk for emotional difficulties, it is important for the school to have a plan of action to connect youth to effective support services. Ideally, this would involve in-school individual or group counseling as part of a multi-tiered system of support (Eagle et al., 2015). Alternatively, students could be referred to community agencies that treat youth with mental health disorders. Some school districts contract with community agencies to provide mental health support in the school setting.

Given the many mental health challenges that students may experience during and after the pandemic, it is important for educators to (a) assist in identifying at-risk students through systematic screening; (b) advocate for universal screening of the school population during and following online learning phases; and (c) increase awareness of the importance of mental health screening with their teacher colleagues as well as school administrators and parents.

References

Dowdy, E., Furlong, M., Raines, T. C., Bovery, B., Kauffman, B., Kamphaus, R. W., ...Murdock, J. (2015). Enhancing school-based mental health services with a preventive and promotive approach to universal screening for complete mental health. Journal of Educational and Psychological Consultation, 25 (2-3), 178-197.

DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (2016). ADHD rating scale-5 for children and adolescents: Checklists, norms, and clinical interpretation. Guilford Publications.

Eagle, J.W., Dowd-Eagle, S.E., Snyder, A., & Holtzman, E.G. (2015). Implementing a multi-tiered system of support (MTSS): Collaboration between school psychologists and administrators to promote systems-level change. Journal of Educational and Psychological Consultation, 25, 160-177.

Erickson, A., & Abel, N. R. (2013). A high school counselor's leadership in providing school-wide screenings for depression and enhancing suicide awareness. Professional School Counseling, 16 (5), 283-289.

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Student mental health during and after COVID-19: How can schools identify youth who need support?

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How teachers can use existing processes in schools to identify students who may need extra support-especially regarding anxiety and depression, which can often go undetected even under the best of circumstances.

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In partnership with families and communities, schools play a central role in supporting young people's social and emotional development. All parts of the school, from the cafeteria to the hallway to the playground, offer students opportunities to practice and reinforce social and emotional learning (SEL). Their learning experiences and instruction shape how they develop and use social, emotional, and academic competencies.

SEL efforts both contribute to and depend upon a supportive school environment with strong and positive relationships. How students feel in school-whether they feel connected to their teachers, other adults in the school, or each other-is a powerful contributor to their personal and academic success. Adults in the school help shape this environment by practicing and modeling their own SEL, while working together to continuously improve students' learning and experiences.

The result? Schools that put SEL at the center are better positioned to create an environment where all adults can offer their best selves and where students have ample opportunities to practice the skills that support their learning and development.

This page examines how SEL appears in the school-both in terms of creating positive learning environments and offering opportunities inside and outside the classroom to practice SEL.

The first thing that I would suggest to any district is if you care about outcomes. you need to care about SEL. It is the pathway to get the outcomes that we all desire.

Assistant Superintendent

What have we learned?
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SEL implementation at the school level focuses on four main areas of activity: Build foundational support and plan, strengthen adult SEL competencies and capacity, promote SEL for students, and reflect on data for continuous improvement.

Within those, there are ten indicators that offer a clearer picture of what schoolwide SEL looks like. These indicators capture what you see when schoolwide SEL is fully implemented. For example, you'd see explicit SEL instruction using an evidence-based program, opportunities to encourage and listen to youth voice, supportive and equity-focused forms of discipline that center on restorative approaches rather than punishment and exclusion, and all the other activities shown here:

Fig.1: Indicators of Schoolwide SEL

In full implementation of schoolwide SEL, you see evidence of all these indicators, working together to create a supportive, engaging learning environment where all students have frequent opportunities to learn and practice social and emotional competencies.

Everyone has a role to play in schoolwide SEL implementation. From the principal's office to the classroom to the cafeteria and school bus, SEL is everyone's responsibility.

The principal leads commitment to and support for SEL implementation and communicates that SEL is prioritized.

Other members of the leadership team ensure that academic instruction, discipline, student supports, and other areas align with SEL.

Teachers offer consistent SEL learning opportunities by employing evidence-based SEL practices and programs, incorporating SEL into all academic instruction, and fostering a supportive, caring classroom environment where students feel cared for, valued and affirmed in their identity.

Support staff (e.g. counselors, nurses, front office clerks, cafeteria staff, etc.) extend opportunities to practice SEL through supportive relationships.

Families and community partners can ensure all segments of students' lives support social and emotional development.

And beyond these responsibilities, everyone in the school can look for opportunities to continue to build and strengthen relationships with students and each other to help build a school culture where every student feels like they belong.

How is CASEL advancing this work?
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We offer quality guidance and tools to support schools nationwide in pursuing a systemic approach to SEL implementation. Our work has developed out of decades of research and two-way, collaborative partnerships with schools and school districts to build our knowledge about what works and the resources that can support the use of best practices. Our efforts include:

A Process for Schoolwide SEL

Working closely with schools and districts, we created a free online resource that outlines a step-by-step process for creating a caring, participatory, and equitable learning environment that promotes SEL for all students. Organized according to CASEL's school framework, the Guide to Schoolwide SEL includes guidance and resources on:

Building foundational support for SEL implementation

Creating an implementation plan

Strengthening adult SEL

Promoting SEL for students

Continuously improving SEL implementation

In support of our commitment to continuous improvement, the process was first documented more than 15 years ago and continues to be updated as more is learned about what it takes to support high-quality SEL in schools. A randomized control trial study was conducted in Chicago Public Schools where 14 schools implemented an evidence-based SEL program, and another 14 implemented the same SEL program plus the 2014 version of the School Guide. It was found that teams that used the School Guide demonstrated substantial improvement over the two year implementation process on all of the key activities in CASEL's schoolwide model, and staff in schools showed greater improvement on their perceptions of long-term planning for SEL, use of data, and staff involvement.

Workshops Series to Support School-Level Implementation

We offer the Learning Together SEL Workshops, a four-part series on schoolwide SEL. The workshops support school teams in coming together to learn about SEL and bring those learnings back to their schools. The series is offered two ways: With a live group virtually twice a year and on-demand for a self-paced version.

"This workshop has been instrumental in being able to introduce SEL to my school in a way that is attainable and connects to all staff levels." - Past Participant

Research-Practice Partnerships at the School Level

Through collaborative work with practitioners in the field, we are testing and refining approaches to schoolwide SEL implementation. In this process, we are exploring specific problems of practices that our partner school communities have identified, such as how SEL can be integrated into mathematics instruction or how strategies used to implement SEL in service of equitable learning environments can align with the continuous improvement components of CASEL's district-level theory of action. At the conclusion of each partnership, we share our learnings broadly in a series of research partnership briefs. Download the PDFs.

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In partnership with families and communities, schools play a central role in supporting young people's social and emotional development. All parts of the school, from the cafeteria to the hallway to the playground, offer students opportunities to practice and reinforce social and emotional learning (SEL).

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"If you could do one thing that will help you, not only be a better teacher, but also a better parent, sibling, son, daughter, husband, wife, friend, a better human, wouldn't you do it? Breathe For Change is that thing. Take some time for yourself to learn, to grow, to be inspired, to inspire.... Better education begins with better teachers... and the best teachers aren't jaded, burnt out, exhausted. The best teachers are passionate, exhilarated, and joyful... Breathe For Change will help you get back in touch with the amazing teacher in you.

- Serena | Assistant Principal, NYC DOE

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Breathe For Change offers trainings and professional development on yoga, social-emotional learning, and mindfulness for educators, schools, and families. Our digital trainings empower educators to enhance their own well-being and become equipped with the skills to enhance the physical and social-em

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Student mental health is at the forefront of educators' minds these days after two years of pandemic-driven stress and disruption-but district leaders forget about the adults in the school building at their own peril, experts say.

About 1 in 4 teachers said they were experiencing symptoms of depression in an early 2021 survey by the RAND Corp., a research group and think tank. In a separate survey, RAND also found that most secondary school principals were experiencing frequent job-related stress -and one of their big stressors was supporting teachers' mental health and well-being.

Left unaddressed, that stress could lead to a massive exodus of educators. Despite that, only a third of district and school leaders said they have made counselors or mental health services available to staff since the start of the pandemic or added to the mental health services already offered, according to a nationally representative EdWeek Research Center survey of nearly 900 educators conducted in January and February.

Forty-four percent of those who responded said they have offered or increased their offerings of professional development on self-care, which educators and experts say is not enough on its own to address clinical mental health needs. And 17 percent said they have not taken any steps to address staff mental health needs during the pandemic even though their current offerings are inadequate.

Targeted mental health support for staff is crucial for a thriving school environment, experts say.

"Teacher well-being is incredibly important, not only for them but for their students' learning experiences as well," said Leigh McLean, an assistant research professor at the Center for Research in Education & Social Policy at the University of Delaware.

Her research has found that teachers with depression spend less time doing whole-class instruction -likely because it's more demanding and energy-intensive-and have fewer warm and responsive interactions with students. They also spend less time planning and organizing their lessons.

Having structural supports for teacher mental health will ultimately benefit everyone in the school building, including school leaders. If teachers and students have access to counseling and other mental health support, that's a heavy burden taken off their principals' backs.

Building a culture of support

McLean's research has found that teachers' mental health and commitment to their career is better protected when they experience more support and autonomy from school leaders. Having colleagues whom teachers can turn to for help also boosts mental health, she said.

In preliminary research, McLean found that during the pandemic, certain teachers are struggling with their mental health more than others: teachers of color, early-career teachers, and those in high-needs schools.

Ronn Nozoe, the chief executive officer of the National Association of Secondary School Principals, has advocated for districts and schools to use some of their federal COVID-19 relief funds to set up targeted support programs for school leaders' mental health.

However, there's a huge demand for mental health care professionals nationally, and school districts may be competing with others with deeper pockets.

Additionally, Nozoe said, even school leaders who know the importance of mental health care are more willing to spend available funds on students and teachers than themselves. And there's still a stigma around mental health, he said.

"It's not for lack of want, it's not for lack of ideas," Nozoe said. "It's really a lack of available professionals who are willing and qualified to provide these kinds of services to help kids and families and ultimately educators."

How can school leaders best respond to these pressures? One way is to take stock of their resources, make workers aware of them, and ensure they're available.

In May, the Colorado School of Public Health's Center for Health, Work, & Environment partnered with the University of Colorado's Depression Center to launch a workplace mental health module -an online tool kit for employers to take stock of the management and workplace strategies they have in place to address the mental health of their staff. Employers take a survey that assesses their workplace culture, employee benefits, education and training, and equity and accessibility.

The module is open to all employers in the country, including schools. So far, five districts in Colorado have signed on, including the Denver public schools, said David Shapiro, the program manager for Health Links at CHWE, which distributes the module. These districts typically score high on employee benefits for mental health, he said, but there was a need for more education and training.

For example, all school employees should learn how to access available supports for their own mental health needs. And schools should establish peer-support programs, so some employees learn "how to be an ally or 'askable' adult for their colleague to get the support they need," Shapiro said. He recommends that districts train certain teachers or other staff members so there are "champions for mental health within the school district" who aren't in leadership positions. (After all, it can be intimidating to confide in your boss, Shapiro noted.)

Also, school and district leaders should make sure they're sharing information about mental health benefits in an equitable way, he said. Some school staffers, like bus drivers, might not check their emails as frequently as teachers-so principals should consider delivering the information through nonelectronic methods, like posters or mailers, too. Also, the information should be available in multiple languages.

And school leaders must create a workplace culture where people can be open about mental health, he said.

It's important to have "people be willing to share their stories, and I think this starts with leaders," Shapiro said. "[They can tell staff], 'This pandemic has been challenging for my own mental health-here's how it impacted me, and I've used my mental health benefits [to get help]'. The more we can build the story of mental health, the more we can spread awareness, the more we can reduce stigma."

Partnerships to Uplift Communities Schools, or PUC Schools, which serves students in northeast Los Angeles and the San Fernando Valley in California, has counseling sessions available for students, teachers, and principals. Max Valadez, the principal of PUC Lakeview Charter Academy, said those sessions have helped him navigate challenges in his personal life and served him in his role as a school leader.

"As a principal, there are so many moving pieces, sometimes I just need to talk to somebody who is not going to judge or anything like that-just to let me know if I am doing things correctly or if I'm not," Valadez said.

Modeling and demonstrating concern for mental health

When Sarah Broome was the executive director of Thrive Academy, a statewide public boarding school in Baton Rouge, La., everybody on staff knew when her weekly therapy appointment was because she spoke about it so freely. Broome, who resigned as the executive director in June 2021 and is now an education consultant, said that openness about mental health helped lessen any stigma for other adults in the building to get help.

When students returned to campus in August 2020 after the initial coronavirus shutdowns, Paul Sampson, Thrive's principal at the time, and Chelsea Trice, the school's head social worker, decided that it wasn't enough to prioritize students' mental health-they needed to offer robust support to educators, too. Broome agreed.

"We are not a place that cares about mental health unless we care about mental health for everybody, and that includes our adults on campus," Broome said. "Teaching was really hard before the pandemic, and it's only gotten exponentially more so. Teachers need places to process [their feelings]."

The school began offering teachers the option to participate in individual therapy sessions with school social workers every other week. (Thrive later hired contract social workers, in case teachers felt more comfortable talking with someone who wasn't on staff.) The social workers kept all information shared during the sessions confidential but also compiled top-level trends and shared that data with administrators.

Moreover, the school held weekly group therapy meetings where teachers could talk about specific student academic and social-emotional needs and discuss the best strategies to take. The meetings allowed administrators to hear teachers' concerns and address them immediately, Broome said.

But none of this work was an overnight fix, she said. And teachers were able to go to these therapy sessions because school leadership had built significant amounts of teacher planning time into the schedule.

"You can't mental-health-support your way out of structural challenges," Broome said. "There is literally nothing you can do for a teacher who is not able to go to the bathroom all day."

Valadez, the Lakeview Charter Academy principal, has also been trying to find ways to reduce the strain on his teachers, especially those who've had to fill in for colleagues who're absent because of COVID-19.

A few nonteaching staff members have recently obtained their teacher-substitute permits, and the charter school network also contracted with a substitute company, which allows the school to have a substitute ready if a teacher gives two weeks' notice that he or she will be absent. Both changes reduce the frequency teachers will be called upon to fill in for peers-eliminating a huge stressor.

Outside resources and partnerships can help

The PUC charter schools network relies heavily on graduate interns studying American family therapy-a cheaper way to staff counseling programs for students and educators, since the interns are not paid and are getting experience and credit toward their degrees.

That program was started in the early 2000s and is run by Christine Sartiaguda, a licensed marital and family therapist who also has a doctorate in education. It has grown from Sartiaguda and 16 interns to include 50 to 60 clinical interns annually, working under a team of five licensed clinical supervisors. While the program was initially geared to support students, teachers and school leaders were always able to tap into it. But the outreach to teachers and principals became more systematic since the pandemic.

"With COVID, we realized that it wasn't a matter of waiting for the teachers to ask, it was about us being proactive-recognizing and just seeing the impact COVID has had on teachers trying to pivot to online learning," she said. "They look tired, they look stressed, and we just need to provide the support and hope they take advantage of it."

Just one month after the initial shutdown in spring 2020, Sartiaguda started offering teacher-support groups via Zoom. By fall of the 2020-21 school year, those groups were available at all the network's campuses. Staff meetings include meditation and mindfulness exercises. Professional development has self-care for teachers-"simple, simple ways that they can fit in one minute of mindfulness in their day, just to kind of disconnect from the chaos of having to practice and teach," she said.

Sartiaguda's staff can tailor supports to meet individual schools' needs.

"If a [school] leader comes to us and says, 'I've had a lot of my teachers who've experienced deaths in their families since COVID began, can you do a specific group just addressing grief and loss?,' the answer is yes," she said. "Whatever the need is, we can accommodate it."

Because the interns are receiving their degrees in marital and family therapy, their primary focus in schools remains getting experience in those areas.

"But we have really restructured our program to include the teacher piece," Sartiaguda said. In addition, her team provides referrals to low-cost counselors and therapists in the community.

Getting buy-in from educators

Although teachers are stressed, not all are taking advantage of the mental health resources the PUC network is offering, Sartiaguda said.

After the end of a long day, some teachers did not want to log on to Zoom for another hour-even if they knew the benefits, she said.

"We do try sometimes to offer it during lunchtime, and sometimes teachers say, 'You know what. I just want to eat my lunch [or] I need to prep.'" But she added, "what we emphasize is, it is here if you change your mind. If you reach a point of, 'Well, I actually want to make time for this support,' it is absolutely available."

Valadez, who became the principal of PUC Lakeview Charter Academy just a few months before the pandemic, said about 20 percent of the school's teachers have taken advantage of the on-site counselors over the last two years. Some needed help with family issues such as deaths in the family and anxiety related to a child heading off to college amid a pandemic.

Valadez knows that some teachers may be uncomfortable speaking with him and the assistant principal about professional and personal problems, so he always lets them know that "there's somebody else they can talk to."

Jennifer Lopez, a teacher at PUC Community Charter Elementary School in Los Angeles, started a self-care committee shortly after the shutdown in March 2020, with the support of Principal Jocelyn Velez, to help teachers focus on their well-being, develop coping skills, and provide other support, amid the pandemic.

Both say the committee will become a permanent part of the school going forward.

"One of the teachers said, 'This is the one meeting I can miss but the one meeting I don't want to miss because I need this type of support,' " Velez said. "That's always really nice to hear."

The topics Lopez tackles during the meetings, which initially were held over Zoom, come from teacher surveys and feedback. She's also organized book studies on wellbeing and hosted sessions on yoga and financial wellness.

Now back on campus, the group continues to meet weekly. Administrators have also joined in, including on a recent nature walk.

"It's been really cool to bring that community back to campus," Lopez said. "It's been really awesome to have our admin support and [have] them thinking of ways for us to take care of our mental health."

Weekly emails go beyond self-help pick-me-ups, Velez said, and provide concrete tips and techniques that teachers can use to weather this traumatic period.

This semester, the group is studying Tina Boogren's 180 Days of Self-Care for Busy Educators, a guide to helping educators find the right balance.

Lopez recently hosted a "vision board" activity to help staff members visualize both their professional and personal intentions.

"It was nice to take that time in our busy lives to sit down, cut out pictures, and print out pictures, and sit down with our staff members, and talk about our goals in a very genuine way," said Velez. "In a time of chaos, ... allowing ourselves to be ourselves, bringing that person behind the professional into the classrooms with a group of teachers-that was very impactful, I think."

Principals can create an environment in which teachers know they can go to their bosses and say they need to take a break, Velez said. She has been encouraging teachers to take the day off when they need to and she's been modeling that behavior to staff.

"We have a trusting relationship at our school and we've built that culture-it's taken some time, but it's that trust," Velez said.

For example, a teacher, who is pregnant, recently texted Velez one night saying that her feet were swollen.

Velez responded, "You can take the day off tomorrow," she said. "I would just need to know so I can get a sub. But we want you to be healthy, we want you to take care of yourself. We want you to follow the doctor's orders. So, if it means extra rest-take the day off.

"It's really letting them know it's going to be OK," she said. "I just want you to take care of yourself."

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Don't Forget the Adults: How Schools and Districts Can Support Educator Mental Health

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The pandemic's mental health toll on teachers, principals, and school staff demands redoubled attention to resources and support.

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School Mental Health

Public health emergencies such as COVID-19 have a significant impact on students and their families, educators and the school mental health workforce, as well as the school mental health system. Addressing the mental health impact on students, parents, teachers and school personnel has become more important and necessary than ever before. The MHTTC Network recognizes this, and we are available to assist the school mental health workforce by providing training and technical assistance to help during these trying times.

Access the full list of MHTTC events & resources related to school mental health and COVID-19 here.

COVID-Related MHTTC School Mental Health Products and Resources

Back to School After COVID-19: Supporting Student and Staff Mental Health Toolkit | New England MHTTC

This toolkit is designed to help guide conversations to include a trauma-informed, equitable, and compassionate lens to providing mental health supports to every member of the school community.

As schools prepare to return to learning-in the classroom and virtually, they can help create a sense of safety that supports staff and student mental health by cultivating a culture of joy and forming positive connections in the school community. Three thought leaders share how their work in the fields of education, recovery-oriented care, and trauma recovery overlap to provide practical strategies to school staff and community members who care deeply about addressing the trauma that will be prevalent this fall.

Be Our Lunch Date? A "Think Tank" Time: A Gathering of School Mental Health Practitioners to Surface School Mental Teleheath Needs and Resources| Northwest MHTTC & Pacific Southwest MHTTC

For the past couple of months the Northwest and Pacific Southwest regions have been engaged in learning about the Interconnected Systems Framework - a structure and process to integrate PBIS and school mental health within school systems. This systems work is just as important now, as schools explore how to best provide school mental health, telehealth, and virtual student supports. This "think tank" workshop served to identify the needs we are noticing; the resources in our field that can support those needs; and ways we can develop tools and supports to fill the gaps.

Campus Mental Health: How Do We Come Back to the New Normal? | Mountain Plains MHTTC

In this Mountain Plains MHTTC virtual session, presenters discussed what coming back to the "new normal" looks like for college students' as they return to their respective campuses. It is anticipated that many students' will have experienced some trauma, if not just the shock of being dispersed from campus to the actual trauma of personal or familial illness.

Changing the Conversation about Mental Health to Support College Students During a Pandemic | Mountain Plains MHTTC

This virtual session focuses on the emergent pandemic and the impact it is having on college students' mental health and well-being.Topics covered include ways we can successfully support students' mental health needs remotely; coping strategies for adapting to a new normal; and techniques for supporting social connectedness during a time of social distancing and educational disconnect.

Clinical Strategies to Promote Emotional and Behavioral Health in College-aged Youth During COVID-19 | Mountain Plains MHTTC

This training focuses on evidence based practices, strategies, and supports for use with college-aged youth as they return to campus during the COVID-19 pandemic. The session addresses the context and needs of campus mental health during COVID-19.

Considerations for Systematic Screening PK-12: Universal Screening for Internalizing and Externalizing Behaviors in the COVID-19 Era | Northwest MHTTC

As educational leaders across the country navigate the complexities for providing instruction during the 2020-2021 academic year, questions have arisen regarding systematic screening practices. In this presentation, we offer considerations by Lane and Oakes (2020) for conducting systematic screenings for internalizing and externalizing behaviors in the COVID-19 era. We recommend educators continue to screen, use multiple sources of data to inform programming, and screen responsibly.

This webinar, presented by Dr. Briana Woods-Jaeger, examines the various adversities experienced by racial and ethnic minority students as a result of the outbreak COVID-19. Additionally, this webinar will highlight how teachers and school staff can provide support to students disproportionately affected by incorporating cultural humility practices in a school/classroom setting.

COVID-19 Effect on Child Mental Health Fact Sheet | Central East MHTTC

This 2-page fact sheet describes the effect of COVID-19 on the mental health of children.

Creating Resilience in Children to Foster Potential and Increase their Success in the World | Northeast and Caribbean MHTTC

Do you want to prepare your children to become healthy, productive, contributing adults that will allow them to navigate an increasingly complex and changing world? This webinar explores how to create resilient children who can overcome adversity and view challenges as opportunities for growth and creativity. We identify ways that parents can accomplish this task from the doorways of their very own homes.

Crisis Readiness, Response, and Recovery Webinar Series | Pacific Southwest MHTTC

Bereavement outside the context of a crisis is common - the vast majority of children experience the death of a close family member or friend. These deaths have a significant and often long-term impact on learning, social and emotional development, behavior, and adjustment.

Part 1 - Principles of Commemoration and Memorialization: Commemorative activities and memorialization in schools present opportunities for students and staff to take an active role in constructing an enduring memory related to a crisis event and to honor those whose lives were lost. This session reviews key considerations for planning commemorative and memorial activities in school settings.

Part 2 - Supporting Grieving Students During a Pandemic: The current pandemic is associated with a large and growing number of deaths. This presentation provides practical suggestions on how schools can talk with and support grieving children in general. This presentation also highlights the unique challenges for supporting students during the pandemic and describe free resources from the Coalition to Support Grieving Students that can be used to address these challenges.

Part 3 - When School Starts Back: Helping Students, Staff, and Yourself Cope with Crisis During the COVID-19 Pandemic: This session summarizes the principles of psychological first aid and common reactions that may be seen in any crisis event, including the current pandemic. It also provides practical advice on how to help students and staff understand and cope with the current pandemic and begin to prepare for what may be needed to offer support to students when schools re-open. The session underscores the need for professional self-care and highlights some of the barriers as well as some potential solutions.

Culturally Responsive Strategies to Promote Student Success | Northeast and Caribbean MHTTC and National Hispanic and Latino MHTTC

This webinar provides strategies to facilitate culturally responsive supports for student mental health and affirming approaches that capitalize on student strengths and avoid reinforcing stigmatizing beliefs.

DBT STEPS-A Q&A Sessions with Jim and Lizz Mazza | Northwest MHTTC

Have you been watching the Mazza's live or online videos as they support their kids and your kids in developing DBT, otherwise known as, critical life skills? These 1-hour, interactive Q&A sessions with Doctors Jim & Lizz Mazza focus on their online, live-streamed 16-lesson DBT STEPS-A curriculum to teach the basics of emotional regulation and specific skills such as mindfulness, distress tolerance and interpersonal effectiveness-essential skills at any time, but even more critical during COVID-19.

Educator Self-Care and Thriving During a Public Health Crisis | Northeast and Caribbean MHTTC

With the current public health crisis, we are facing a new way of engaging and teaching our students. While some of us may have been doing some assignments remotely in the past this new platform and the current social distancing orders have created a whole new set of stressors on our educators, their students, and families. This webinar provides some helpful hints to help us all survive and thrive during this time while simultaneously taking care of ourselves, our students, and their families.

Educator Wellness Series | Northwest MHTTC

The Northwest MHTTC, in Partnership with WellEducator & the Northwest PBIS Network, brings you the Educator Wellness Series! This Educator Wellness Series is designed for you, the educator, to take a break from what can feel like an overwhelming hustle to prepare, deliver, and support your students and focus on your own wellbeing. We designed this 4 Session Series to support you in tapping into your resiliency skills, increasing your self-compassion, creating self-care routines, building a practice of gratitude and appreciation, and celebrating - even those small successes - to support your wellbeing.

¡En español! Apoyando el bienestar emocional y salud mental de los estudiantes hispanos y latinos y sus cuidadores durante la pandemia de COVID-19 | National Hispanic and Latino MHTTC

Today's economic crisis, driven by the COVID-19 pandemic and social distancing measures, poses significant challenges for state budget-makers. This webinar, led by health care financing expert Dr. Adam Wilk, discusses those challenges in the context of school and school district leaders' efforts to finance school mental health programs.

Fostering Resilience in Families during Uncertain Times | South Southwest MHTTC

The coronavirus pandemic has disrupted life as we know it Prevention strategies used to stop the spread of the coronavirus pose challenges to the education system, school-age children, and the families trying to support their education. More than at any other time in history, families are feeling the challenges of supporting the health and emotional well-being of the children in their care. Fostering resilience in families during uncertain times is the focus of this brief.

Fostering Resilience: Responding to the Needs of School-Age Children | South Southwest MHTTC

This brief discusses how educators, school-based mental health providers, and school-age children and families can foster resilience during a pandemic-related disruption.

This presentation focuses on prioritizing self-care while working from home. Presenters introduce the impact of job burnout, as well as how to recognize signs and symptoms; define "Social Emotional Learning" and provide examples on how this can be included in the classroom or virtually; discuss tools to help prevent burn-out, and set boundaries to separate work time from personal and develop a self-care plan.

Having Difficult Conversations: A Guide for Providers, Teachers, and Parents | Northeast and Caribbean MHTTC

The pandemic, ongoing social and racial injustices, and the recent violent events on the Capitol may have you and those close to you feeling uncertain, unsettled, and overall fearful. As behavioral health providers, teachers, parents, peers, and community members, you can provide support during these challenging times in several impactful ways. Having Difficult Conversations: A Guide for Providers, Teachers, and Parents presents a number of steps you can take when having difficult conversations.

Helping Students Cope with Stress | Northeast and Caribbean MHTTC

In this webinar, participants learn to define stress and how it manifests in children; look at how COVID-19 affects stress; recognize the parallel between stress and mental health; identify how educators and school mental health personnel can help children deal with stress; identify what teachers can do; learn about concrete strategies and resources to help students cope.

K-12 COVID Best Practices Poster | National American Indian and Alaska Native MHTTC

This poster can be used in schools to help promote best practices for reducing the spread of the virus. It can be printed on 11x17 paper or smaller.

Leading Trauma Informed School Systems Change - Before, During & After Pandemic Times | Southeast MHTTC

This Southeast MHTTC webinar focuses on systems leadership approaches that embrace trauma-informed care at both the district and state levels. Highlighting local and regional leaders, this series offers both the theory and practical tips to support school workforces to implement trauma informed principles in our practices, programs and policies.

LEARN Saves Lives Suicide Prevention for Parents and Caregivers | Northwest MHTTC

The Northwest MHTTC partnered with Forefront Suicide Prevention & the University of Washington SMART Center to bring the LEARN® Saves Lives Suicide Prevention Training for Parents/Caregivers directly to you in your own home, free of charge. Developed by Forefront, the five simple and effective Forefront Suicide Prevention LEARN® steps empower individuals to help others move in the direction of hope, recovery, and survival.

LGBTQ Youth Tobacco Prevention: COVID-19 and Lung Vulnerability | Central East MHTTC

LGBTQ populations are at higher risk for COVID-19 due in part to wildly disproportionate rates of smoking, vaping, and other forms of tobacco use. Tobacco dependence usually starts in adolescence, and studies have shown LGBTQ youth are especially vulnerable to substance misuse, predatory ad campaigns, and peer influence. This webinar explores the rates, risks, and intersections of tobacco use and the novel coronavirus among queer and gender expansive teens and young adults.

Making a Good Connection: Engaging Students and Families in School Tele-Mental Health | MHTTC Network

Making a Good Connection: Engaging Students and Families in School Tele-Mental Health is a three-part webinar series geared toward providers who are making the transition from in-person to telehealth services. Session content focuses on practical strategies and equity concerns related to engaging children, adolescents, and families using distance technology. Attendees are given the opportunity to submit questions upon registration, enabling our Technology Transfer Center (TTC) Network specialists to shape their content to meet your needs.

Managing Anxiety & Return to School Webinar Series | Northwest MHTTC

Anxiety is one of the most common mental health concerns youth face. While it is a normal emotional experience, it can grow to become incredibly distressing and interfering, particularly as it comes to school. In these webinars, we discuss how to identify, understand, and intervene for problematic anxiety for youth in your classroom.

As an unprecedented new school year begins, this 60 minute webinar addresses basic classroom management strategies with a focus on preventing undesirable behaviors and increasing awareness of challenging behaviors related to trauma, grief, and stress. Viewers will learn easy-to-implement interventions to promote resiliency.

Mental Health & Equity in Schools | South Southwest MHTTC

This webinar focused on teaching general mental health, including the signs/symptoms of anxiety, depression, and suicidal ideation as well as practical steps teachers can take to support students. Additionally the webinar focused on the stressors and mental health implications of COVID/race/police/equity issues in the world right now as they impact high school students.

Mental Health Resources for K-12 Educators During COVID-19 | Mountain Plains MHTTC

In response to the recent pandemic (COVID-19), several national organizations and associations have shared and promoted resources to assist K-12 educators. Parents, family members, school staff, and other trusted adults play a critical role in helping children make sense of what they hear and making sure that it is honest, accurate, and minimizes anxiety and fear. This product compiles all recent toolkits, guides, tip sheets, and infographics that have been developed by reputable sources to assist educators during this time.

Native Youth Telehealth Initiative Webinar | National American Indian and Alaska Native MHTTC

In this session, Dr. George Baston, MHRD, Ed.D CTE, and Natasha Peterson, BS, cover how to implement telehealth using the "Let's Talk Interactive" platform and opportunities to collaborate with the National American Indian and Alaska Native MHTTC. An opportunity to participate in our Native Youth Telehealth Initiative, and receive intensive technical assistance, is announced in this webinar. Application information is given at the end of Dr. Baston's presentation. Six sites are chosen from the applicants.

In this webinar, Dr. Stephen Brock provides an overview of the third edition of PREPaRE, a curriculum that contains current research and strategies for integrated school safety and crisis prevention, planning, response, and recovery efforts. He also discusses how to adjust school crisis response plans to accommodate the reality of a global pandemic. Yesmina Luchsinger shares her crisis planning and response lessons learned as a state leader, including the development and dissemination process of the Pandemic Preparedness Guide the state released in March 2020.

Promoting Educator Well-Being: Compassion Fatigue, Burnout and Secondary Traumatic Stress in the Era of COVID-19 | Central East MHTTC

This webinar training explores the differences between and strategies to counter fatigue, burnout, and secondary traumatic stress. Participants also learn strategies to enhance well-being and promote job satisfaction.

The focus of this webinar is to provide the support and information that teachers, supervisors, BCBAs, therapists and other professionals supporting youth during COVID 19 have been seeking. The challenges that COVID 19 poses to clients and students are discussed. Strategies for reaching and supporting clients via telehealth platforms and teaching students through the virtual classroom are identified and discussed. Individuals across the Autism Spectrum have specific needs and profiles that are discussed and the supports and strategies needed to address their specific strengths and weaknesses are explored.

This training was designed as a five-step crisis response strategy based on communication skills that educators and school staff use every day. The goal of Psychological First Aid for Schools - Listen Protect Connect/Model and Teach have relevance to the COVID-19 pandemic which has seriously disrupted the daily lives of children and adults all over the world. The closure of schools and businesses adds to the health risks faced by all which contribute to the stresses that students and adults face under orders of physical distancing, stay at home directives, or quarantine conditions.

Recruitment and Retention of School Mental Health Providers | Southeast MHTTC

This webinar series highlights the importance of sustaining the school mental health workforce for achieving the goals of an effective, high-quality school mental health services system. Dr. Mark Weist and Dr. Janet Cummings discuss recruitment and retention approaches that community mental health providers and local education agencies may want to consider implementing to support these goals, the current evidence concerning these approaches, and key resources to inform implementation efforts.

This webinar focuses on the mental health and well-being of children and families during the COVID-19 pandemic and the early data that provides insight into the challenges and opportunities for substance misuse prevention practitioners to support families and communities during this time. The webinar also highlights many of the resources available from Child Trends, the nation's leading research organization focused exclusively on improving the lives of children and youth, especially those who are most vulnerable.

Rising Telehealth Behavioral Health Practices-Centering the Needs of Historically Marginalized Youth in California | Pacific Southwest MHTTC

COVID-19 has forced us into conditions that challenge best practices for serving the mental health needs of youth we marginalize. Through these two sessions, we supported California school mental health advocates, educators, administrators, and other school systems leaders in managing stress and trauma in their communities.

School Community of Practice Connections and Conversations: Adapting to COVID-19 | Mountain Plains MHTTC

This meeting was an informal facilitated gathering for the cohorts that had participated in the Mountain Plains Mental Health Technology Transfer Center's Every Moment Counts Community of Practice (CoP) to gather and discuss the challenges, changes, and adaptations required by the COVID-19 pandemic.

School and Community-Based Trauma-skilled Practices Supporting Youth Virtual Workshop | New England MHTTC

This virtual workshop helps you cultivate a compassionate school community, using mindfulness practices and community-based visioning to address trauma, will help staff, as well as students and their families, return to school this fall with tools to overcome the mental health challenges presented by COVID-19 and amid widespread collaborative support to end racial inequity and injustice across the globe.

School Mental Health Crisis Leadership Lessons: Voices of Experience from Leaders in the Pacific Southwest Region | Pacific Southwest MHTTC

This guide highlights how school mental health leaders can - and do - work with and through crises; provides an overview of the crisis continuum; explores the intersection between school crises and school mental health leadership; and examines each component of the school crisis continuum (readiness, response, recovery, and renewal) by learning from voices of experience from the field. A complementary Reflection Worksheet is designed to help readers work through the guide.

School Mental Health Professional Series | Mountain Plains MHTTC and Mid-America MHTTC

In this webinar series, school counselors, social workers, and psychologists addressed the current and immediate needs of school mental health professionals in Region 8, due to the pandemic. Participants met every other week and received training on different topics related to school mental health before walking through a case presentation. This was a closed group.

In this period of stress and uncertainty, now is the time to gather and resource one another. In collaboration with the Meaning Makers Collective, the Pacific Southwest offered a series of School Mental Health Wellness Wednesdays. Each Wellness Wednesday is a 60-minute virtual session for the school mental health workforce to connect, reflect, and support each other.

Self-Care Through the Summer | Mid-America MHTTC

This handout for educators and school mental health providers provides tips for recharging after a school year cut short because of the COVID-19 pandemic.

Self-Care and Compassion for the Educator Webinar Series | Northwest MHTTC in partnership with the Northwest PBIS Network

During these sessions, participants practice skills to decrease stressors on mind/body systems to stay connected to the wonders and curiosities of teaching using evidence-based mindfulness practices, radical acceptance and values-driven goal setting.

Social Emotional Learning at Home: Remote Learning Options | Great Lakes MHTTC

We are all learning to navigate remote learning and education from afar. There are several reputable, evidence-informed resources available to help educators and families promote social and emotional well-being in their students outside the classroom. The Great Lakes MHTTC School-based Supplement has compiled a list of SEL resources, lesson plans, activities, games, and tip sheets to get you started on your SEL at home journey.

Social Emotional Learning at Home: Remote Learning Options | Great Lakes MHTTC

We are all learning to navigate remote learning and education from afar. There are several reputable, evidence-informed resources available to help educators and families promote social and emotional well-being in their students outside the classroom. The Great Lakes MHTTC School-based Supplement has compiled a list of SEL resources, lesson plans, activities, games, and tip sheets to get you started on your SEL at home journey.

Special Weekly Series for Tribal Schools as they Reopen Amidst COVID-19 | National American Indian and Alaska Native MHTTC

The challenge posed by the COVID-19 pandemic adds to existing issues present in some Native communities such as teacher shortages and the lack of infrastructure for high speed internet, which further impedes their ability to offer appropriate distance learning programs. The National American Indian and Alaska Native MHTTC's K-12 program invited the entire school community to special weekly listening sessions covering relevant topics.

Staying Connected with Students and Youth during COVID-19 | Great Lakes MHTTC

In the wake of COVID-19 school closures, educators, parents, and students across the globe are coping with a new reality. In this webinar series, we explore research on belonging and connectedness, they key tenants of virtual communication for educators, and effective strategies for building virtual connectedness.

Stress, School, and Self-Care: COVID-19 Highlights Inequities, Mental Health Challenges, Systemic Needs, and Possible Solutions | New England MHTTC

This Childhood-Trauma Learning Collaborative (C-TLC) issue brief shares results of the reflective conversations the New England MHTTC has had with C-TLC Fellows - a unique group of district leaders, educators, and school-based mental health professionals with whom the New England MHTTC has built a sense of trust and community over the past 18 months.

Student Mental Health During COVID-19: How to Prepare as Schools Reopen | Mid-America MHTTC and MHTTC Network Coordinating Office

This webinar is geared toward emergency managers, public health professionals, and school administrators who are working together to create school reopening and response plans. Session content is focused on the mental health needs of children, adolescents, and educators related to crises and how community and school organizations can partner to develop responsive plans that address these needs during the COVID-19 pandemic.

Supporting Latinx Students and Caregivers Emotional and Mental Health Well-being during the COVID-19 Pandemic | National Hispanic and Latino MHTTC

This is a 3-part webinar series on Supporting Hispanic and Latino Students Emotional and Mental Health Well-being during the COVID-19 Pandemic.

Supporting School Mental Health in the Wake of COVID-19: A Virtual Conference | Northeast and Caribbean MHTTC

Delivered by the Northeast and Caribbean Mental Health Technology Transfer Center and the Mental Health Association in New York State, Inc., this two-day conference for K-12 educators, staff, and administrators focused on strategies to support students and educator mental health as they transition back to school (remotely or in-person). View the recordings and slide decks for all presentations here!

Supporting Student Resilience: Strategies for Teachers During School Closures | South Southwest MHTTC

This infographic outlines the opportunities for educators and other school staff to support student resilience during the pandemic. The product provides a graphic depiction of strategies that school staff can use to promote coping and resilience. It serves as a companion to a brief report that can be found here.

Telehealth Learning and Consultation (TLC) Tuesdays: Telehealth with Children and Adolescents | Mid-America MHTTC, Mountain Plains MHTTC, and Mid-America ATTC

Mindy Chadwell, Ph.D., LP, BCBA; Erika Franta, Ph.D., LP; Jennifer Cox, LSW; and JK Costello, MD, MPH, discuss their experience working with children and adolescents via telehealth.

FAQ Document (This resource includes answers to the most frequently asked questions during the Telehealth for Children and Adolescents TLC Tuesday session).

Telehealth Toolbox for School Personnel | Mid-America MHTTC

The Telehealth Toolbox for School Personnel is a practical and concise guide to incorporating telehealth into your routine as a provider working with students. In addition to a handy, overarching guide entitled Getting Started , the toolbox contains handouts on each of the following topics:

The Future of Education: Equity, Inclusion, and Racial Justice | New England MHTTC

In this session, leaders and partners of the New England MHTTC share their insights, discuss innovative programs and recommendations, and vision for equity and inclusion in schools in 2021. You will leave with practical ideas and resources to help alleviate stress and create a brighter future, even in the midst of all we are handling today.

The Impact of COVID-19 on School Mental Health in Washington | Northwest MHTTC

The Northwest MHTTC is excited to co-sponsor the UW SMART Center's 2020 Virtual Speaker Series. Originally a series of in-person events, these presentations transitioned to a virtual format due to COVID-19. Recently, Washington State Superintendent Chris Reykdal presented on the Impact of COVID-19 on School Mental Health in Washington.

The Mental Health Impacts of Surviving COVID-19: Implications for School Mental Health Systems Leaders and Providers | Pacific Southwest MHTTC

How might the experience of surviving COVID-19 and experiencing long-haul COVID-19 impact mental health, and what can and should we as school mental health providers and leaders understand about that experience? This is a special conversation with four survivors of COVID-19, all of whom identify as long-haulers. As our speakers will share, trauma may be now surfacing because people aren't needing to focus on surviving; this trauma is surfacing as schools are reopening and as survivors are now beginning to process their experience and new realities.

The School Leader Series | Northwest MHTTC

This webinar series is focused on the role of the school leader in creating and maintaining a positive climate and culture virtually during the global pandemic and in the building upon the return to school. We know these are challenging times and want to provide information you can use immediately and to use for the plans to return to school as part of your MTSS framework.

The Value of Teacher Well-Being: A Research Brief | Mid-America MHTTC

In this research brief, learn common barriers to well-being, how teacher well-being impacts outcomes, how social-emotional learning (SEL) can improve teacher well-being, strategies for improving well-being, and steps that states, districts, and schools can take to improve teacher well-being.

This virtual session aims to provide strategies for educators to use in supporting parents as they transition to a new and uncertain role in providing daily instruction for their children. Dr. Tami DeCoteau brings her extensive knowledge and experience working with children, families, and school personnel to explore how educators can support parents in this difficult time.

Tools for Educators During a Public Health Crisis | Northeast and Caribbean MHTTC

Educators have had to adjust to new learning environments, provide emotional support to students, maintain communication with parents, take care of themselves and their families, among other responsibilities. At the same time, they are experiencing anxiety and worry about the public health crisis along with the rest of the community. These tools were developed by the Northeast and Caribbean MHTTC to help.

Top 4 Strategies to Increase Student Motivation: What Every Parent Should Know | Northeast and Caribbean MHTTC

It can be extremely challenging to keep kids motivated during this time. The good news is there are simple strategies parents can use at home to increase motivation and engagement. In this webinar, we review these easy-to-implement strategies to help keep your kids fully engaged and ready to learn.

Trauma Informed Suicide Prevention: Leading School District, County & State Systems | Pacific Southwest MHTTC

This three-part webinar series is for school field leaders who are leading systems' support for student suicide prevention. Session content focuses on providing timely, effective, competent, and evidence-based suicide prevention support to students and families. Each session is contextualized with experience and suggestions from on-the-ground regional leadership

Visioning Onward: A Guide for All Schools | New England MHTTC

These guides help school leaders implement recommendations from the guided discussion series Visioning for the Future of Education in their own schools and districts.

Well-Being Wednesdays: Taking Care of Educators Who Take Care of Kids | Mid-America MHTTC

This is a monthly webinar series geared toward education professionals, administrators, and stakeholders who are working together to create a culture of well-being that supports students and educators. Each session focuses on one of the 10 ARC practice modules and follows a tell-show-do approach. Session leaders teach one skill per session, outlining the skill, providing examples, and promoting use of the skill.

What will school be like next year? Visioning for the Future of Education | New England MHTTC

In this webinar, participants receive a study guide to take our virtual approach back to your schools and districts to conduct your own visioning sessions. Participants are guided through our 8-step iterative visioning approach, explaining the importance of visioning for success in business and in education, and helping you plan for visioning with your staff and local communities.

The COVID-19 pandemic has caused a seismic shift in how practitioners and school-based mental health professionals provide services. This session focuses on the pragmatic questions of how to do these services with practical suggestions about what helps and what interferes with client engagement, how to prevent problems, and how to manage when challenges arise.

School Mental Health Resources From Other Organizations
American Academy of Child & Adolescent Psychiatry: Talking to Children About Coronavirus
American Academy of Experts in Traumatic Stress: Helping Children Cope Emotionally with the Coronavirus
Centers for Disease Control and Prevention: Talking With Children About Coronavirus Disease Centers for Disease Control and Prevention: Tips for Parents While School's Out
Child Trends: Resources for Supporting Children's Emotional Well-being During the COVID-19 Pandemic
Letters to Strangers: Mental Health Made Personal National Alliance on Mental Illness (NAMI): Supporting the Emotional Needs of Youth During COVID-19 Webinar
National Alliance on Mental Illness (NAMI): Ask the Expert Webinar: In-Person, Virtual and Everything In Between - Supporting Families and Children Returning to School, Thursday, August 27, 2020

(also available in National Child Traumatic Stress Network: Fighting the Big Virus: Trinka's and Sam's Questions Spanish, Chinese, Finnish, Portuguese, and Mandarin)

(also available in National Child Traumatic Stress Network: Parent/Caregiver Guide to Helping Families Cope with COVID-19 Spanish and Chinese)

(also available in and National Child Traumatic Stress Network: Trinka and Sam Fighting the Big Virus: Trinka, Sam, and Littletown Work Together Spanish Chinese, Finnish, Portuguese, Mandarin)
The Institute for Innovation & Implementation at University of Maryland: Coping with COVID-19 as a Family
For Educators and School Mental Health Professionals
American School Counselors Association: Planning for Virtual/Distance School Counseling During an Emergency Shutdown American Academy of Child and Adolescent Psychiatry (AACAP) and American Psychiatric Association (APA) Detail Steps Necessary for Safely Reopening Schools This Fall Centers for Disease Control and Prevention: One-Stop Shop COVID-19 Resources | K-12 Schools Center for Mental Health in Schools and Student/Learning Supports: Responding to the Coronavirus Crisis
Center for Mental Health in Schools and Student/Learning Supports: Embedding Mental Health as Schools Change
Center for Mental Health in Schools and Student/Learning Supports: Restructuring California Schools to Address Barriers to Learning and Teaching in the COVID 19 Context and Beyond Center on Positive Behavioral Interventions & Support: Resources for Returning to School During and After Crisis Center to Improve Social and Emotional Learning and School Safety: Strategies for Trauma-Informed Distance Learning Child Trends: As Schools Reopen, Addressing COVID-19-related Trauma and Mental Health Issues Will Take More Than Mental Health Services Department of Education COVID-19 Handbook: Roadmap to Reopening Safely and Meeting All Students' Needs
Ed Redesign Lab at Harvard Graduate School of Education: Re-Envisioning School-Based Health Centers During Covid-19: A Spotlight on Innovative Approaches
Kaiser Permanente: When Learning Starts: Playbook for Healthy School Communities Mental Health America: Young People's Mental Health In 2020
Mental Health Association in New York State School Mental Health Resource and Training Center: Maintaining Mental Health in Schools During Social Distancing:An MTSS approach
National Association of School Psychologists: Countering Coronavirus Stigma and Racism | Tips for Teachers and O: er Educators National Association of School Psychologists: Preparing for Infectious Disease Epidemics| Brief Tips for School Mental Health Professionals National Association of School Psychologists: Responding to COVID-19 | Brief Action Steps for School Crisis Response Teams National Association of School Psychologists: When One Door Closes and Another Opens: School Psychologists Providing Telehealth Services National Center for School Crisis and Bereavement: COVID-10 Pandemic Resources National Center for School Mental Health: COVID-19 Resources National Center for School Mental Health and the School-Based Health Alliance: School Mental Health Planning for the 2020-21 School Year During COVID-19 National Child Traumatic Stress Network: Coping in Hard Times: Fact Sheet for School Staff National Child Traumatic Stress Network: PFA-S: Provider Self-Care National Child Traumatic Stress Network: Trauma-Informed School Strategies during COVID-19
SAMHSA: COVID-19 Guidance for Schools and Childcare Programs
School Social Work Association of America: Supporting LGBTQ Students During the Coronavirus Pandemic: A Tipsheet for School Social Workers The National Academies of Science, Engineering, and Medicine: Reopening K-12 Schools During the COVID-19 Pandemic | Prioritizing Health, Equity, and Communities Thriving Schools: Resources for Schools and Families Impacted by COVID-19
SAMHSA's Disaster Distress Helpline is standing by 24/7 to support you during the pandemic & beyond. Toll-free, multilingual, & confidential support services are available to all residents in the U.S. & its territories. Call 1-800-985-5990 or text TalkWithUs to 66746 to connect with a trained counselor.

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Responding to COVID-19 | School Mental Health Resources

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Public health emergencies such as COVID-19 have a significant impact on students and their families, educators and the school mental health workforce, as well as the school mental health system. Addressing the mental health impact on students, parents, teachers and school personnel has become more important and necessary than ever before.

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Mental health and wellbeing of teachers is just as important as that of your students. Here are some resources to get you started.

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TFA COVID-19 Education Resource Hub

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For Self-Work, Insight, or to Ground and Unwind

Onward and Onwardthebook.com

Onward:: Cultivating Emotional Resilience in Educators

Why Recharging Matters

Gratitude Journal Prompts & PDF

For Anxiety and Processing loss Amid COVID-19

Care for your Coronavirus Anxiety

Grieving the Losses of Coronavirus

Maybe You Should Talk to Someone, New York Times

That Discomfort You're Feeling is Grief

For Listening, Joy, and Comfort

Poetry and Reflections

Meditations with Lizzo

Songs of Comfort

Isle of Calm

For Teaching in the Time of Coronavirus

Self-Care for Educators and Students

The Child Mind Institute

For Supporting Social-Emotional Learning and Student Wellness

Mindfulness Activities for the Classroom

Phrases to Calm an Anxious Child

Emotional Development Videos

Coping Skills

Secondary Student Help

Find Resources & Support for Teaching Online
TFA Slack Network How Educators Can Address Trauma During the Pandemic How Teachers Can Stay Balanced During the Pandemic
Note: This resource list includes articles, organizations, apps, and program artifacts to support staff, teachers, and student wellness. Users are responsible for researching resources and professionals to find the best supports to meet their needs. Teach For America does not endorse these services in any way.

Find guidance on how to support students and communities on TFA's COVID-19 Education Resource Hub.

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Mental Health Resources for Educators | Teach For America

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Explore mental health and wellness in the time of COVID-19 with health and wellness resources for teachers.

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Supporting Teachers’ Mental Health: 4 Strategies

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With teachers leaving or considering leaving the profession in an effort to improve their mental health, here are 4 ways you can support their wellbeing.

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Considering the ongoing traumatic upheaval on school communities in recent years, and the unrelenting pressure on educators to work under difficult, uncertain and constantly vacillating circumstances, it is not a matter of if educators will experience the corrosive effects of prolonged and extreme stress, but rather when. The question is, what can schools do to prioritize and support the mental health and well-being of the invaluable educators at the heart of their school communities?

Through our Voices of Change project, EdSurge has been conversing with educators and school leaders to understand how schools are adapting to meet the needs of their learning communities as they face the 2021-22 school year. EdSurge researchers conducted surveys and facilitated focus groups, small-group virtual convenings and in-depth interviews with more than 90 educators to learn more about their experiences.

In our conversations throughout the year, educators reflected on the pressures they've endured and how in focusing on caring for students and families, their own health and well-being was often overlooked and in urgent need of addressing. We saw how having the language to talk about difficult experiences -such as prolonged exposure to intense stress and collective trauma-serves as a critical first step in being able to acknowledge, process and face these widespread events.

We also asked educators what might help them feel more supported by their schools given these circumstances. Three broad themes emerged from these conversations about what school communities can do to better support educator mental health and well-being. First, schools can play a significant role in reducing stigma and barriers to mental healthcare, such as helping with accessing providers, removing financial obstacles and offering dedicated, timely services for educators; second, schools can provide educators with a safe space to consistently discuss experiences with fellow educators; and third, they can establish and maintain a culture of healthy work boundaries and relationships.

Reducing Systemic Barriers to Getting Mental Healthcare

Receiving mental healthcare in this country is no easy feat. The provider shortage and financial roadblocks-even for individuals with insurance-pose major barriers to access for the general public. For teachers, these challenges are compounded by a number of issues, from work hours that create a need for high-demand appointment slots in the narrow windows of time before or after school, to low salaries that exacerbate already high costs for services. This is to say nothing of the time it takes to identify the right provider or overcoming social stigmas related to mental health. Here's why schools are well positioned to help.

As workplaces, schools can intentionally structure systems and provide resources that decrease some of these barriers, such as addressing the scarcity of dedicated services and supporting educators through convoluted insurance hurdles that make it even harder to seek professional help. By increasing support and creating safe spaces to openly discuss common experiences of stress, schools can establish a culture that normalizes addressing mental health, which can reduce stigma.

If I'm referring a student, I should be able to refer myself too, right?"

Antonieta Avila, Los Angeles-based sixth grade teacher

Across our conversations with educators, many shared that they would readily utilize professional mental healthcare services to process the heavy weight of ongoing traumatic events they experienced themselves, or that their students or fellow teachers shared with them this past school year, but that time constraints and a lack of access pose significant blocks to getting the help they need.

"If I'm referring a student, I should be able to refer myself too, right?," Antonieta Avila, Los Angeles-based sixth grade teacher reasoned, explaining that she would like to see a therapist, but time is a real issue. She says that it "would be ideal to have a therapist or some mental health support at school where we can reach out," adding that if she ran her own school, she would prioritize having someone onsite for teachers and other adults working in the building in addition to having counselors for students.

Avila described some of the challenges this could solve-scheduling appointments after school during busy hours, accounting for travel time, needing to wait two or three months to see a provider.

Not only would a dedicated, onsite mental health professional for educators reduce the time teachers have to spend identifying a provider and waiting to schedule in their services, it would also normalize taking care of one's mental health.

Given the structural barriers to getting counseling, including navigating health insurance plans and booked in-network counselors, high cost for professional services, or the time and energy it takes to seek and schedule them, schools and districts have an opportunity to examine gaps in what is working for the adults in their communities and to leverage systemic changes to better support them.

While systematically investing in the mental health of individual educators is inherently valuable, fostering communities of practice is also key.

Creating a Safe Space For Educators to Process Together

Indigenous and spiritual wisdom, ancient practices and a growing body of contemporary scientific research all suggest that healing from the isolating impacts of grief and trauma comes through engaging in spaces that foster safe connection and supportive community. This critically important practice has been shown to help people who regularly witness or interact with traumatized individuals as part of their job, such as first responders, medical professionals or journalists covering war, assault or other traumatic events, and increasingly applies to educators who have essentially been the "first responders" of school communities too.

In conversations with educators about the pressures of adapting to the shifting demands and regulations brought on by the pandemic this school year, our researchers kept hearing the same phrase: I thought it was just me. Educators repeatedly expressed relief to be surrounded by others who understood what they were going through.

It's one thing to have an understanding that the ongoing pandemic and social unrest have created a shared experience of immense stress, but it's quite another to sit in a room with a person you've never met, and see yourself so clearly in their descriptions of the same struggles you are also experiencing.

"Sometimes things get very isolating just because you're in the confines of your own classroom...teachers don't necessarily share things with one another, especially when it involves a traumatic situation such as this," said Oakland, California elementary school teacher Nikita Gibbs, referring to the upheaval due to the pandemic.

"It was really nice to be able to talk to other people and see that they were actually going through some of the same things," she told EdSurge researchers in an interview, adding that it was "comforting to hear that, and just find out how they were getting through it."

Despite hectic, overcommitted schedules, the educators we talked with intentionally carved out time to come together, often expressing relief and gratitude that there was a dedicated time and space to talk openly with a community of peers. Even hailing from vastly different corners of the U.S., this was a place where they felt seen, heard and validated-and for many, the only hour or two they had allowed themselves in recent history to pause and process the toll of the professional challenges they faced throughout the pandemic.

"You're so busy with the day-to-day, and handling problems, and putting out fires, and scheduling things and so on and so forth," reflected New Jersey-based preK-12 special programs supervisor Christie Schutz Vincelli, Ed.D., in an interview. "It was really refreshing to sit and have my own little session where I could just say, "Okay, it's not just me...there are other people struggling too...I actually felt better when I left," she admitted.

Recognizing this need for community and fellowship, some educators formed or reinvigorated their own formal or informal groups, such as book clubs or check-ins because they found that fostering this kind of safe space helped them to support each other and move towards healing together.

Like any group with a major shared experience, educators can benefit from intentionally-designed safe spaces to connect with each other. This is always true, but particularly salient in a time of collective trauma and change.

Establishing a Culture That Practices Healthy Boundaries

The importance of setting and maintaining healthy work and relational boundaries was also a popular thread in conversation. But most of the educators we heard from said that could only happen within a school setting that actively set the stage for it.

In one small-group virtual discussion, educators commiserated over the rapidly changing regulations that impacted schools during the pandemic and the unrealistic expectations set forth for them. A number of them expressed frustration that despite the constant disruptions to teaching, their schools expected them to go about business as usual. That included keeping up with assessments and reporting paperwork, and administering the same pre-pandemic standardized tests they used to give in-person to their current students but now online. Several educators expressed that policymakers pulling the levers seemed far removed from the classroom, especially when they simultaneously acknowledged the extenuating circumstances classroom teachers were facing, while still requiring unrealistic teaching and learning goals.

"At my school it was 'self care,' and then, 'I need you to do these five things before school on Monday," reflected Daria Hall, a high school teacher from North Carolina. She understood that the shifting demands were difficult for everyone-school leadership was responding to late directives from the district, and the district was late because it was waiting on guidelines from the state. However, she and other educators still felt the effects of policies coming down the pike that were clearly meant to be rapidly implemented, while the reality of their workload and mental health were not being seriously considered or prioritized.

At my school it was 'self care,' and then, 'I need you to do these five things before school on Monday.'"

Daria Hall, high school teacher in North Carolina

"It just was like a catch 22, where you're saying 'oh yeah, take care of yourself,' but not really, honestly giving us an opportunity to try and take care of ourselves," she reflected.

In small group discussions, some teachers talked about setting firm boundaries and advocating for their well-being, sharing the importance of explicitly saying no when they're at capacity, even when it's uncomfortable. Some recommended being explicit when reaching emotional and physical limits, and asking school leaders directly for support, like replacing a professional development session with paid time off to spend time recuperating.

Some schools and districts do give mental health days, but even that can backfire if it's not implemented equitably. Niki Henry, the curriculum and instruction coordinator for the Saginaw Chippewa Indian Tribe in Michigan says that these mental health days can be a much needed reprieve for teachers, but in her district, the mental health days only apply to classroom teachers. Henry says it's also important to consider all of the administrators who have been overextending themselves to make the whole system work. If not, she says, "it actually compounds the frustration" and experience of burnout for them.

While some solutions have to come from institutional and systemic levels, such as declared mental health days, other boundary work can be done at the school level or through personal practices.

For example, Schutz Vincelli, the special programs supervisor in New Jersey who works with a range of early childhood, elementary, middle and high school teachers in her district, was well aware of the pressures teachers are under, and vigilant about the likely risks of educator burnout, or worse, if not careful. So she made it a mission to model and reinforce a culture of setting and maintaining healthy work communication boundaries when she saw more and more teachers working late nights and weekends, pushing themselves to the limits.

"I had to set those boundaries as a leader so that my people felt that they could take those liberties too," she shared. It doesn't have to be a whole program or curriculum, she explained, but can be as simple as setting expectations about appropriate hours to engage with work emails and other forms of communication.

"Guys, I took email off my phone," she told her staff. She explained to them how working from home, she had access to it all the time. "I would go to sleep, wake up in the middle of the night and be like, 'oh I forgot to answer that email.'" The incessant feeling of needing to be "on" to help and immediately respond to each seemingly urgent message every day and at all hours was starting to get to her. She knew she had to be better at deciphering real emergencies from everyday communication that would still be there tomorrow, for both herself and the teachers and students she worked with. "You have to take care of yourself," Schutz Vincelli said. "If you can't take care of yourself, you can't take care of anybody else."

This act of committing to working during set hours is simple and effective, yet requires intentionality, consistency and a supportive environment to maintain. Schutz Vincelli does her best to practice what she preaches, but says that sometimes she needs help maintaining and reinforcing boundaries too. The good thing about establishing a culture of healthy communication and work expectations is that accountability goes both ways. If her teachers receive work emails from her during evenings, weekends and other "off" hours, they call her out on it, and she checks herself to prevent overstress and burnout.

I had to set those boundaries as a leader so that my people felt that they could take those liberties too"

Christie Schutz Vincelli, Ed.D., preK-12 special programs supervisor in New Jersey

Other educators described similar experiences of firming up work and communicative boundaries, including scheduling in five minute walking breaks, setting up office hours specifically for work conversations and making it a point to not engage about work when running into families at the grocery store or at restaurants in the neighborhood. Having a school culture that sets up expectations that everyone in school communities maintains these norms means that everyone can support others to enforce healthier work boundaries and relationships, and in turn, everyone benefits from it.

Understanding Both Individuals and Institutions Play a Role

Many school communities have focused on how teachers and administrators need to address the traumatic experiences students had during the pandemic, and not the impact of ongoing direct or vicarious trauma experienced by educators. To move towards healing and better supporting everyone, the effects of the pandemic on adults in learning communities needs to be considered and addressed.

The pandemic qualifies as a collective traumatic experience on a global scale. As such, processing and moving forward requires a collective approach. Educators are looking to school and district leaders to provide support in this area, saying they cannot do it themselves. While educators have a role to play in building their own awareness and coping strategies so they can better take care of themselves and their students and families, they can only do so with structural, institutionalized support-including having dedicated mental health services for educators, carving out time and space for educators to reflect and heal together, and setting expectations around healthy work-life boundaries.

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How Schools Can Build a Culture of Support for Educator Mental Health - EdSurge News

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Considering the ongoing traumatic upheaval on school communities in recent years, and the unrelenting pressure on educators to work under difficult, uncertain and constantly vacillating circumstances, it is not a matter of if educators will experience the corrosive effects of prolonged and extreme stress, but rather when.

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50 Resources to Support the Mental Health of Teachers and School Staff

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K-12 teachers are busy supporting others and may overlook their own well being. We collected mental health resources for teachers and school staff.

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Information on a range topics from handling stress to preventing burnout and self-care tips. All designed to keep you informed and healthy.

Discover resources

Working in education is demanding. Our resources help you check how your teams are coping, and boost everyone's wellbeing.

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Free resources to help improve the mental health and wellbeing of teachers and education staff

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Information on a range topics from handling stress to preventing burnout and self-care tips. All designed to keep you informed and healthy. Discover resources Working in education is demanding. Our resources help you check how your teams are coping, and boost everyone's wellbeing.

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Virtual Calming Room - Paraclete High School

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This Virtual Calming Room is a place for the Paraclete Family to find tools and strategies for managing emotions and feelings in a positive way. Enjoy and take some time for yourself.

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Sometimes life can be overwhelming and it can be hard to work through difficult times. This Virtual Calming Room was designed to assist in identifying different strategies for managing emotions. We hope these tools will provide helpful outlets and practices for when life gets tough.
Disclaimer: The following links are purely for educational purposes and are not intended as psychological interventions or as a substitute for psychological treatment. If you are in need of psychological help you should seek the consultation of a licensed mental health professional.

Resources

The followings resources are curated using information and links from a variety of local and national organizations. This information is not meant to diagnose or treat any medical condition.

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Virtual Calming Room - Eastview High School

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Sometimes life can be overwhelming and it can be hard to work through difficult times. This Virtual Calming Room was designed to assist in identifying different strategies for managing emotions. We hope these tools will provide helpful outlets and practices for when life gets tough.

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Important Notice: The following links are purely for educational purposes and are not intended as psychological interventions or as a substitute for psychological treatment. If you are in need of psychological help you should seek the consultation of a licensed mental health professional.

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Virtual Calming Room - Merced Union High School District

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Important Notice: The following links are purely for educational purposes and are not intended as psychological interventions or as a substitute for psychological treatment. If you are in need of psychological help you should seek the consultation of a licensed mental health professional.

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Virtual Calming Room - Northshore School District

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Counselors want you to know that your feelings are valid, no matter what they are. You might feel scared, confused, overwhelmed, angry, alone, grateful, or completely calm. Your feelings are normal; the situation is not. Don't forget to take care of yourself and the ones you love.

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Take The Happiness Quiz Today! How Happy are you?

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How Happy Are You? The Happiness Quiz Measures Your Personal Happiness, Based On Recent Scientific Studies. Find Out How You Can Improve Today!

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DrBrown's Student Check-In Google Form, V.2

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DrBrown's Student Check-In Google Form, V.2

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DrBrown's Student Check-In Google Form, v.1

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DrBrown's Student Check-In Google Form, v.1

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Google Forms - create and analyze surveys, for free.

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Take The Happiness Quiz Today! How Happy are you?

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How Happy Are You? The Happiness Quiz Measures Your Personal Happiness, Based On Recent Scientific Studies. Find Out How You Can Improve Today!

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An Experiment in Gratitude | The Science of Happiness

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Seeing Happy: Cultivate happiness through photography

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Seeing Happy: Cultivate happiness through photography

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Join Us SeeingHappy encourages people to take and share photos of what makes them happy. Submit a Photo View Happy Feed About The Project What are the little things that make you smile as you go through your day? Often it is the small things that make life worthwhile. And small changes can make a ……

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Fulghum: All I really need to know I learned in kindergarten (excerpt)

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Fulghum: All I really need to know I learned in kindergarten (excerpt)

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Excerpt from All I Really Need to Know I Learned in Kindergarten | Penguin Random House Canada

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Essays on life that will resonate deeply as readers discover how universal insights can be found in ordinary events.

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Music Heals: Addiction & Recovery

We know addiction is a scary, hard experience for all involved, but we also know that the stigma around addiction is extremely dangerous. Join us from 5 AM to 7 PM PT, Thursday, April 13th, on the airwaves to talk about it, share stories, and play music that is a salve to our souls. You are not alone. You can share how music played a part in your addiction and recovery story by emailing stories@kexp.org If you or someone you know is in crisis and needs immediate help, call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 9-8-8.

"Music has incredible power," says KEXP Morning Show host John Richards. "I hear from listeners every day about a song or a lyric that helped them heal, process, grieve or just find the strength to go on."

Through the Music Heals series, KEXP uses curated music, interviews, listener stories and live events to help people in our community understand they are not alone. Music can provide comfort, validation, encouragement, consolation, perspective, catharsis, and community, and the Music Heals series explores how music can also heal our bodies and lift our spirits. Use the navigation below to explore the different topics.

#YouAreNotAlone
#MusicHeals

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We know addiction is a scary, hard experience for all involved, but we also know that the stigma around addiction is extremely dangerous. Join us from 5 AM to 7 PM PT, Thursday, April 13th, on the airwaves to talk about it, share stories, and play music that is a salve to our souls.

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KEXP DJ John Richards (John in the Morning) was one of the reasons I started talking with my students about Mental Health. KEXP is an amazing, listener-powered radio station with the FANTASTIC tagline: Where The Music Matters.

I'm proud to be a KEXP Amplifier!

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As Voted on by KEXP Listeners

KEXP listeners have great taste in radio stations, obviously. They also have great taste in music! That's why, each year, we take the time to build a listener-powered list of the best albums of the year. And now is that time! We asked our listeners to vote on their favorite albums of 2022. See what they picked as their best albums from a remarkable year!

Check Out the List Here

LIVE AT KEXP Volume 10

For the past 20 years, we've partnered with BECU-a member-owned credit union-to strengthen our community of independent music listeners. That's why we're thrilled to team up once again on our latest collab: Live at KEXP Volume 10, featuring 19 tracks piled high and pressed on a double LP, celebrating 50 years of KEXP.
Learn More

As Voted on by KEXP Listeners

In celebration of our 50th Anniversary, KEXP counted down the Top Album of the last 50 years, as voted on by all of you! Our fall fundraising drive may be over, but you can still support listener-powered KEXP by making a donation today.

Check Out the List Here

Upcoming KEXP Events + In-Studio Sessions

Please note: in-studio sessions are broadcast only; video will be shared on our YouTube channel at a later date. All times are reflected in Pacific Time.

More KEXP Events

Throwaway Style

Throwaway Style is a monthly column dedicated to examining all aspects of the Northwest music scene. Whether it's a new artist making waves, headlines affecting local talent, or reflecting on some of the music that's been a foundation in our region; this space celebrates everything happening in the Northwest region. Check out some past columns below, and stay tuned for new ones published on the first Thursday of every new month on KEXP.org

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KEXP listeners have great taste in radio stations, obviously. They also have great taste in music! That's why, each year, we take the time to build a listener-powered list of the best albums of the year. And now is that time! We asked our listeners to vote on their favorite albums of 2022.

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EarthCam is the leading network of live streaming webcams for tourism and entertainment. Explore unique and interesting locations around the world with 4K streaming technology. EarthCam provides complete infrastructure services to manage, host and maintain live streaming video solutions for its consumers and corporate clients.

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Webcams - Yellowstone National Park (U.S. National Park Service)

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A variety of webcams provide live views throughout Yellowstone.

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Over the past few months we've been profiling some of the talented photographers who participated and had their work shortlisted by our judges, including Rankin, Moses Sumney, Shygirl, Sacha Lecca, Jill Furmanovsky, Dana Scruggs and Simon Wheatley.

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Over the past few months we've been profiling some of the talented photographers who participated and had their work shortlisted by our judges, including Rankin, Moses Sumney, Shygirl, Sacha Lecca, Jill Furmanovsky, Dana Scruggs and Simon Wheatley.