Mental health and our schools

EDITORIAL CORNER

BBack in May, I wrote about the many ways schools are unsafe for children’s physical and mental health. Since then, new threats are on the horizon: Today show reported last month, a district in Missouri has brought back corporal punishment (aka physical assault) as a form of student discipline — and parents are getting involved. As you’d expect, students are pushing back against the protests, concerned about their lack of consent and the potential for abuse behind closed doors.

Studies show that corporal punishment is not effective in improving children’s behavior and causes lasting damage to their psyche. Nor can it be good for the mental health of children when the adults who are supposed to educate them humiliate and hurt them. (And how does it make you know your parents are okay with that?) Other research, reported in a NPR story on the district’s move, shows that corporal punishment is disproportionately inflicted on black and disabled students. Major mental health organizations, including the American Psychological Association and the American Academy of Child & Adolescent Psychiatry, oppose it. Still 19 states still allow the practice, following a 1977 Supreme Court ruling that it is constitutional. Is your state one of them?

Emotional Wellness Initiatives

Fortunately, the news is not all bad. I collected articles about new school programs and services designed to protect the emotional well-being of students. Some of the trends include:

  • Mindfulness lessons. Schools have always offered courses based on real-world skills, such as workshop and public speaking, and now schools across America are teaching self-awareness. One such program, implemented throughout Michigan, is called TRAILS. Among other things, it trains teachers to mentor K-12 students to identify their feelings and develop CBT-based emotional regulation skills. Elsewhere in Michigan, teachers are encouraging students to learn and practice “Four Circles of Self-Care » (physical, mental, emotional and spiritual) and keep a journal. Such mindfulness lessons are part of a larger, long-term trend called whole child approach to education, which generally integrates Social and Emotional Learning in the academic course.
  • Safe spaces. Schools offer retreats for young people who are having a bad day or generally going through difficult times. A school in Buffalo, NY has a mindfulness room, with dim lighting and yoga mats, where stressed kids can talk to an adult about what’s bothering them. (The city’s public system has similar programs at its other schools, where children can practice relaxation techniques such as deep breathing, drawing, etc.)
  • Free time. If a short break isn’t enough, high schools in 10 states, including Arizona and Maine, are offering students “Mental Health Days” an excused absence for troubled youngsters who may need a break from school pressures to pull themselves together.
  • Links. In Alabama, there is now a statewide program to place « mental health coordinatorsin schools. Among other things, these paraprofessionals help connect struggling students and their families with personalized local resources (if desired) and run programs on issues such as bullying and suicidality.

The subtext of the articles covering these initiatives is that they are a palliative solution to the “real problem” of too few professional psychologists, psychiatrists and social workers in schools and communities. (This perceived lack has recently prompted new funding for mental health of the Biden administration as part of an overall national strategy.) Although data validating these new preventive approaches is still being collected, they seem valid in their own right: they privilege self-reflection and make informed choices rather that identify “symptoms of mental illness,” are designed to be tailored to the communities they serve and are available to all students (not just those with a diagnosis label).

Possible pitfalls

For all their positive potential, I hope these programs don’t become a backdoor way to “screen” children for mental illness and then steer them toward psychiatric treatments they may not need while in Other supports might be more appropriate. It is of some concern, for example, that West Hertel Academy’s mindfulness initiative asks children to complete a daily form about how they are feeling. Social and emotional learning has been shown to promote both better academic performance and happier children, but I hope mindfulness lessons don’t make children then hyper aware of their emotions which they constantly monitor. Or cause adults to overreact when they hear young people express strong feelings, like whipping a suicidality assessment form if children use certain words. (The form is part of the TRAILS program, which includes a “risk management” component.)

And while school mental health coordinators can help children and families access professional help or learn about issues they may not have been aware of, coordinators may be tempted to target and to coerce “problem” students in their school. They are also likely to direct people to the same conventional biomedical approaches that have poor or unknown long-term results.

Not to mention what these programs ask of teachers: to care for the hearts and minds of their students. Educators are already leaving the profession in droves for other reasons, including program censorship and the expectation that they act as human shields in active shooter situations. Yet, for those with the heart and courage to do so, a teacher is sometimes the only safe adult in a child’s life, and these programs implicitly recognize that.

Should parents support such programs? If there was one in my children’s school, I would make a point of finding out and even asking them what they think. However, I would not be automatically suspicious, like some parent groups who believe that school mental health initiatives usurp the rights of parents and inaccurately link SEL-based curricula to critical race theory (typically found in law schools, not kindergartens).

Address underlying issues

I’m more encouraged by other programs that, rather than asking teachers to become lay therapists or meditation instructors, actually help students deal with specific stressors in their lives. They are not called mental health programs, but in fact they are.

For instance, a 2019 Washington, D.C. law, implemented last year, gives teenage victims of sexual assault the right to an attorney to support them and help them navigate their options. Schools in the district are expected to play an important role in the network of agencies involved (although this has happened to a limited extent so far). This initiative is important because 1 in 9 young people under the age of 18mostly girls, are victims of sexual assault.

And now, thanks to recent legislation, each of California community colleges will offer centers to help students meet their basic needs such as food and shelter. Tailored to each campus, the centers offer help with everything from accessing low-cost medical care or public benefits to paying for car insurance or internet service. These centers make it easy for teachers or other students to refer young people to help.

Both of these initiatives have come from the political arena, validating the idea that it is at least as important to address the plight of young people at the community level as at the individual level. As I mentioned, the jury is still out on the effectiveness of school mental health initiatives. Do you know of any in your area? What do you think of them?

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Mad in America hosts the blogs of a diverse group of writers. These posts are designed to serve as a public forum for discussion – broadly defined – about psychiatry and its treatments. The opinions expressed are those of the authors.

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