Making Mental Health Part of the School Safety Solution
As the country continues to respond to the school shootings in Newtown, Conn., there is an urgent need to broaden the public conversation from a focus on gun control and arming teachers to the equally important issue of untreated mental illness in young people.
I have no intention of minimizing the loss of 20 innocent children and six educators, but I believe that this unspeakable tragedy offers an opportunity to turn national attention to the need for "mental-health literacy" and expanded mental-health services in schools.
I challenge others to remember that the gunman at Sandy Hook Elementary School, Adam Lanza, was once an innocent elementary school student himself. How might his life have unfolded differently if he had received high-quality services, treatment, and supports for his behavioral needs throughout childhood and adolescence? Is it possible that the shootings could have been prevented?
We will never know the answers, but we can consider an additional, essential question: How can schools help the underserved and often invisible population of youths who struggle with mental-health disorders and promote mental health, wellness, and safety for all students at the same time?
It should be noted upfront that the vast majority of people with serious mental illnesses are not violent. But those with an untreated serious mental illness who are suffering from a psychotic episode are more likely, on average, than members of the general population to commit a violent act.
Fortunately, in the last 20 years, there has been growing interest in child and adolescent mental health, with recognition among psychologists that young people have many unmet mental-health needs and that schools have the potential to address many of them. Unfortunately, efforts to train educators to support youth mental health, however, are sorely lacking.
School districts and teacher-training programs in colleges and universities need to remedy these oversights by equipping teachers with the skills and confidence necessary to provide accurate mental-health information at a time when students most need it—and, in fact, at a time when their lives may literally depend on it. If teachers could be better equipped to identify students who may be suffering from anxiety or depression, or who may have suicidal thoughts—or even disordered and paranoid thinking—the chances of helping such students and keeping school communities safe would greatly improve.
Teacher training should include coursework on how to promote youth mental health, identify signs of possible mental illness, and utilize whole-school approaches to help students and promote learning. Advocates can make a strong case for including mental-health literacy, or an ability to recognize optimal behaviors and feelings as well as challenges, in pre- and in-service training for teachers. They should consider the following well-documented points: (1) Schools are primary places for fostering healthy youth development; (2) good student mental health is required for optimal learning; and (3) teachers are distinctly situated to become role models and coaches regarding mental health by virtue of their close relationships with students.
This month, following Newtown, President Barack Obama proposed sweeping gun-control reforms. But he also unveiled a proposed executive action to support "mental-health first aid," or MHFA, training for teachers. MHFA was developed in Australia as a two-day workshop to teach adults how to provide preliminary help to a person developing a mental-health problem or experiencing a mental-health crisis. It is a potentially powerful tool, and I'm thrilled the Obama administration is considering putting it into practice, but we need more evidence before implementing any such interventions on a large scale. We also need broad and comprehensive approaches that promote health, as opposed to simply identifying illness and distress.
I am not suggesting that teachers receive training comparable to that of mental-health professionals, nor am I advocating that teachers diagnose or treat young people in the way that licensed providers do; such propositions would be both unrealistic and dangerous.
Instead, teachers should organize to spearhead the primary prevention tier of school mental health. With proper and ongoing training, teachers can become adept at identifying children who need services while also promoting mental health throughout the school community. Through evidence-based classroom practices and the teaching of mental-health literacy, teachers can lead schoolwide efforts to improve climate; nurture social-emotional learning; encourage communication, negotiation, and conflict resolution; and decrease stress.
Mental health and mental illness are still the least likely content areas to be included in the curriculum for school health classes. Despite federal initiatives, mental health is still generally considered from a deficits-based perspective as opposed to a health-promotion one, and schools continue to respond to mental-health problems reactively instead of proactively. Indeed, most schools initiate dialogue or programming only in response to such horrific events as school shootings or a student's suicide or suicide attempt. Often, expert speakers are brought in to lead one-day workshops or address packed auditoriums, with no continuing discussion or ongoing activities afterward.
Instead of such stand-alone actions after the fact, we should work with allies in our schools and communities to make mental-health literacy and promotion an integrated part of the curriculum across grade levels and over time.
How can we even begin to do this? First, educators should forge partnerships with parents, counselors, and psychologists, working collaboratively to shed light on the issue of unmet youth mental-health needs and threats to learning; scholars must work across disciplines to design and test school-based efforts to promote mental health; young people should be encouraged to initiate, engage in, and evaluate mental-health-related activities in their schools; advocates should continue "stigma busting" efforts to reduce the shame that too often keeps young people from seeking help when they need it; and policymakers ought to take youth mental health seriously when considering educational reforms.
Educators truly do have the potential to lead a national effort to reform education and optimize healthy youth development by bringing comprehensive school-based mental-health literacy and promotion to scale. In addition, all of us must start thinking of school violence and youth mental health as related issues. By improving the climate in schools and encouraging pro-social behaviors, by training educators to be mental-health "ambassadors," and by offering targeted services and supports to students who need them, we will go a long way to reducing school violence. We may even save a child's life.
Vol. 32, Issue 19, Pages 24-25, 27
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