“School districts across the country reported spikes in both self-harm and suicide attempts,” said Javaid Siddiqi, president and CEO of The Hunt Institute. “In the heart of the pandemic, the mental health toll on students even led some districts to reopen schools to combat rising suicide rates.”
Experts agree offering more mental health support can benefit students and the entire school community. But stakeholders need to think more widely than holding a single assembly when they’re considering the help they want to offer.
Consistent activities and routines throughout the school day are more effective, say experts. That may be something as simple as a check-in every morning with a teacher or could be ensuring staff are trained to identify mental health concerns before students even ask for help.
Bringing mental health support into a classroom or school-wide environment also helps to de-stigmatize the idea of seeking help: If everyone is talking about how to help each other and themselves, the secrecy and shame are reduced. Additionally, this can allow students to find support by talking about their feelings more widely with educators, outside groups and even their fellow students.
“Community is everything when it comes to mental health,” said Cindy Marten, deputy secretary for the U.S. Department of Education. “No child is alone. They’re inside a larger, broader community of peers where they become mentors and learners.”
Normalizing mental health help
To even begin to support students — or keenly create an environment where they feel safe enough to ask for help — mental health assistance needs to become as routine as getting an annual checkup with a doctor. Instead, adults often stigmatize therapy or support groups. Almost half of adults (47%) believe those who pursue therapy are showing weakness. That stigma can make it more difficult for the 44% of high school students who said they felt sad or hopeless over the past year to find the help they need
“One student said to me they were going to a mental health clinic with their counselor, and another student saw them and said, ‘You must have it bad if you’re going in there,’” said Loretta Whitson, the executive director of the California Association of School Counselors. “The student never went in and never went back.”
That’s why Megan Blanco, director of safe and healthy schools with the National Association of State Boards of Education, believes the topic of mental health needs to be normalized. If not, young people will not talk about their mental health, nor seek the help they need for anxiety, depression, or thoughts of suicide or self-harm, she said.
“Just as a student would seek a dentist for a toothache or an optometrist for glasses, students must feel safe to seek mental health services,” Blanco said.
But normalizing doesn’t come by holding an occasional assembly, or having a one-off lesson that’s never repeated — nor backed by trusted adults. Instead, students need to feel some consistency and even some repetition, which can come by weaving mental health support into classroom curricula.
How to embed mental health in curriculum
Establishing a daily routine can help. Simple deep breathing exercises can be one way to start. Educators can be specific in describing the intention of why they’ve introduced breathing exercises. They can tell students the activity is a way to pause and allow them to leave behind what was outside the classroom while getting ready to absorb new information.
With older students, the teaching behind breathing exercises can go deeper. Educators can talk about the science behind taking a breath and how it activates and impacts parts of the nervous system.
“When we go at it from an educational perspective — ‘Why does this work? What parts of the body are affected?’ — then it reinforces that skill and gives [students] a rationale for doing it,” said Katie Peinovich, a licensed clinical social worker with the Child Mind Institute.
Some states, including New York and Virginia, require mental health instruction during the school day, while California requires mental health topics including mood disorders and depression to be discussed in high school health classes, said Siddiqi. But even in states lacking mental health requirements, teachers can work with students as young as pre-K to help them develop mental health skills.
Still, as Marten noted, one lesson can't bring the changes students need today, many of whom have been impacted by the pandemic and continue to need assistance. Changes like those require more of a systemic approach, woven throughout an entire school and their entire educational career. Only then can pupils begin to feel lifted, secure and safe.
“Feeling safe doesn't happen through one lesson or a counselor coming once a week for a lesson,” said Marten. “It’s in your math class. In science class. In your history, writing and reading class.”
Professionals play a key role
A network of people involved in mental health support on school sites can also increase a student's feeling of safety. That includes professionals available to teachers and students who can tackle topics educators aren't trained to address, said Whitson.
Within these networks, Whitson points to complex issues such as talking about suicide prevention or helping educators know how to help students when they report concerns about friends or themselves.
“Let’s say you have a social studies lesson about someone like Abraham Lincoln, and you bring up how his wife had mental health issues to normalize this,” Whitson said. “For [teachers], this feels like opening a can of worms. What happens if a student brings up ‘My uncle committed suicide’? They don’t want that to surface because they don’t know how to handle this."
Support for adding more professionally trained mental health staff and programs is coming through the $2 billion Bipartisan Safer Communities Act. The bill will include funding to train school-based staff on identifying and responding to mental health issues in students. Among its planned expenses are $500 million to fund school-based mental health service providers, and another $500 million to bring professional development to current school staff, including psychologists, counselors and social workers dedicated to mental health needs.
Whitson said those needs can vary: While some students’ cries for help may be very vocal and visible, others may be less apparent. While teachers may have pupils who feel comfortable enough to talk about their feelings in class or have students who raise a red flag by acting out, others never call attention to themselves despite needing support. These may be pupils who sleep in class, never speak or appear disheveled, are “acting in,” or show other signs of needing help, said Whitson.
Here, professional mental health experts at schools serve students as trusted adults for support while also training teachers and school counselors to know what to spot. And the need is not going away, said Whitson — regardless of whether COVID-19 has abated or not.
“That’s the fear,” she said. “That people will ease on the gas on addressing mental health because we think everyone is okay. And I don’t think that’s going to be the case for some time to come.”