One in five youths has a mental disorder; schools need to learn to recognize the signs

by Alan Wechsler

On Board Online • October 23, 2017

By Alan Wechsler
Special Correspondent

The mental health of students is increasingly an issue that public school districts must deal with. But teachers and staff can help make a difference in identifying troubled students and getting them into therapy.

That was the message of Caroline Axelrod Mendel, a child psychologist who spoke during NYSSBA's 98th Annual Convention & Education Expo in Lake Placid in one of several sessions on how school leaders and school personnel can help students with mental health issues. NYSSBA previously held a summit meeting on the topic in Albany during May.

Mendel, associate psychologist at the Child Mind Institute in New York City, said if school staff learns to recognize the symptoms of mental illnesses, they can help avoid worsening symptoms, get patients to therapy faster and reduce the chance that a student might abandon school or suffer an even worse fate.

She noted that one in five youths suffer from a mental health disorder - 17.1 million in all - more than cancer, AIDS and diabetes combined. Fifty percent of mental disorders begin before age 14, she said, and suicide remains a leading cause of death for both children and adolescents.

"It is a huge problem in our nation," she said.

Students with a mental disorder (the preferred term among clinicians to "illness" or "disease") are more likely to cut class or skip school, and be suspended or expelled. Fifty percent of those with a disorder are likely to quit school. And dealing with students with this disorder may lead to teacher burnout as well, she added.

"That's why early identification and intervention is incredibly important," she said.

Identifying students with problems is the first step, and it's not always easy. Disorders manifest at different ages - the median age for onset of anxiety is 6, ADHD is age 11, mood disorders age 13 and substance abuse age 15.

Students with ADHD are perhaps the easiest to spot. With externalized behaviors like inattention, hyperactivity and daydreaming, it doesn't take an expert to figure out something is up.

Anxiety is another issue. Teachers might spot young students who are having difficulty leaving their parents when being dropped off or who are consumed by worry that something might happen to their parents.

But symptoms can be more subtle. Anxiety can prevent children from raising a hand in class or giving presentations. Some can have difficulty eating in front of others. A child afraid to go to a school bathroom might have an accident because of fear of exposing themselves to a stressful situation.

Some students with anxiety are model students. For instance, students who appear to be perfectionists could be hiding an anxiety - one that can make them, for instance, feel terrible about getting a 95 on a test because they're pounding themselves over the 5 percent they didn't get.

Depression is another concern. At least 3 million adolescents ages 12 to 17 will suffer from a depressive episode, and catching the illness early can help head off more severe attacks later. While it's normal for teens to be irritable or angry some of the time, a student who is angry all the time could be depressed. A sudden decline in grades can also be a giveaway, as is frequent absences or lateness, fatigue or failure to do work.

Of course, being aware of these problems is only part of the battle. Mendel suggested that districts invest more into mental health initiatives. "You have a positive outcome on grades and increased test scores. One study found suspensions were reduced by half. They work."

Mendel suggested several steps schools can take to support students with mental health disorders. A first step would be to train all staff to identify the symptoms of mental disorders. A secondary program would be to target students at risk - for instance by identifying specific groups of kids more likely to have difficulties, and providing programs for that audience meant to prevent illness or monitor behavior.

While schools generally work with outside clinicians, therapy can be done in school, as well. While that's not something a school psychologist can offer, there are examples of schools bringing in counselors to work with troubled students one-on-one. In some cases, grants are available to pay for programs. Other schools have benefited from psychologists willing to work with students for a certain time period as part of a research study.

Some hospitals contract with districts to provide a school-based mental health program. Such programs benefit students who otherwise would not be able to make therapy appointments.

While the costs may be higher than doing nothing, the advantages benefit both the district and society in general, she said.

"Schools are in a unique position to identify and target social and emotional needs," she said. "This would help reduce the public health burden of mental illness and promote children's academic success."

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