Mental Health, Relationships
Educators across the country are heading back to the classroom for what could be a mental health crisis in their schools.
Before the pandemic began about 1 in 6 school-aged children were found to have enough behavioral or emotional symptoms and impairment to be diagnosed with a childhood mental health disorder. Meanwhile, a recent poll by the National Alliance on Mental Illness (NAMI) found that about 1 in 4 teens have been diagnosed with a mental health condition, and 64% feel the world is more stressful now than when their parents were their age.
The reality is there are an increasing number of children and adolescents who need mental health help. As families and educators start the school year, our children’s mental health deserves a lesson plan on its own.
While changes in a child or adolescent’s behavior can be attributed to normal development, significant shifts in attitudes and emotions could indicate a more serious mental health concern. Here are a few ways for parents, guidance counselors, and educators to approach these situations with curiosity and confidence.
Ask children to speak up about their thoughts and feelings. It’s common for children to express stress, anxiety, or depression in various ways unique to them. Feelings of sadness and excessive worrying could manifest physically—body aches, tiredness, headaches, or stomach aches—as well as emotionally, like increased irritability or outbursts of anger and frustration. In these instances, children are likely overwhelmed but can’t easily identify or articulate what’s bothering them. Adults should meet these signs with more support, love, reassurance, and ask children why they think these changes, either in their body or behaviors, are occurring. Adults can also utilize an active listening tool called “Reflective Listening.’ This means that instead of providing answers, offering suggestions, or giving advice, the adult summarizes what they’ve heard from the child. This ensures that the child feels heard and understood and communication is clear.
Watch out for warning signs. A child who is sad for two weeks or more, avoids social interactions, or demonstrates out-of-control and harmful behavior may have underlying mental health issues. An educator or parent should start asking questions not only to the child, but to their wider social circle of other teachers, friends, and friends’ parents to find out if they’re noticing similar warning signs.
Monitor for behavioral regression. It is not uncommon for children to regress to more juvenile behaviors when stressed or overwhelmed. Children may regress when they feel angry, fearful, insecure, or are unable to communicate their needs. As adults, our instinct is usually to reprimand these types of behaviors. However, regression is often child communicating that they require more reassurance, not more space or distance. Make sure children feel safe, supported, and try to acknowledge this kind of regressive behavior without shaming them.
Seek to understand what you don’t know. Each child has unique cultural and life experiences that influence their perspective. It’s important to recognize that no two children are the same. Seek to understand more about their life at home, the community they come from, and what they have experienced outside of the school environment. You should also consider your specific school and how socioeconomics and demographics factor into their experience. The journey to the classroom is key to determining the best way to address and ultimately help children. Teachers can ask parents how their child typically acts when distressed or what warning signs to look for that may indicate that the child is not doing well emotionally.
When to find professional help. If at any point a child expresses thoughts of wanting to harm themselves or others or has a significant decline in basic functioning, please contact your child’s primary care provider or psychiatrist, and if urgent or an emergency, call 911 or 988, or take your child to the nearest emergency room. A child expressing suicidal or homicidal thoughts is a psychiatric emergency and requires immediate evaluation.
A recent review of our mental health crisis in schools found that all 50 states lack the proper infrastructure and policies to address the mental health of their students. Educators can lean on the tips above to help normalize mental health conversations both at home and in the classroom.
The same 2022 NAMI poll of teens found that about 4 in 5 teens who seek mental health information from their teachers say they trust those adults. Another seven in 10 teens agree schools should teach them about mental health. Creating a safe space for children and teens to understand the importance of mental health is an important lesson to teach.
While an important step, it won’t overcome the challenge of our child and adolescent psychiatrist shortage. The American Academy of Child and Adolescent Psychiatry estimates that the national average is 14 child and adolescent psychiatrists per 100,000 children, compared to 16.6 adult psychiatrists per 100,000 adults. Both of those numbers are lower in rural communities.
When educators and parents face a shortage of mental health clinicians in their community, they should know that telehealth is just as effective as in-person care. Children and teens are already familiar with the technology and accustomed to communicating virtually. Plus, with virtual care, they are less likely to miss school to travel to an in-person appointment since sessions could be conducted in a convenient and comfortable place like home, the guidance counselor’s, or the nurse’s office at school. Clinically, telehealth enables mental health clinicians to treat more patients who might otherwise struggle to receive care because of distance and accessibility.
It will take all of us to heal and help one another through our collective mental health journeys. There are small but important steps we can take in our schools to increase awareness, understanding, and empower our children to end the stigma around mental health that persists. Identifying warning signs and knowing when to refer a child to a higher level of care is an important place to start so educators be more prepared to raise a hand when someone needs help.
If you, a child, or someone you know is experiencing suicidal thoughts, please seek professional help by calling or texting the National Suicide Prevention Lifeline at 988 or call the National Alliance on Mental Health Helpline at 1(800) 950-6264.
Dr. Nicole Christian-Brathwaite is a double Board-certified adult, child, and adolescent psychiatrist. She is the SVP and Chief Medical Officer of Non-Acute Care at Array Behavioral Care, the nation’s leading clinician-centric virtual psychiatry and therapy practice. Dr. Christian-Brathwaite’s specialties include trauma-informed care, telepsychiatry, mental health in communities of color, school psychiatry, implicit bias, and racism in mental health.
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