The national mental health crisis has impacted students of all ages, yet efforts to address at least one specific mental health issue affecting those of school age—suicide—have largely focused on high schoolers. The mental health issues of a schools’ most vulnerable population, its youngest students, are often overlooked in this area.
Reporters and experts shined a much-needed spotlight on that group during an Education Week online summit last week broadly focused on the growing mental health needs of students and staff in the nation’s schools.
Schools in 22 states are mandated to have suicide-prevention policies, according to the American Foundation for Suicide Prevention. These often entail annual staff trainings on suicide prevention and how to have suicide-related conversations with high school students. While suicide risk and ideation is higher in teenagers, data from the Adolescent Brain and Cognitive Development Study, the largest long-term study of brain development and child health in the country, show that over 8 percent of 9- and 10-year-olds had previously had suicidal thoughts, and more than 1 percent had attempted suicide, indicating that millions of younger students need these resources, too.
Here are five takeaways for educators from last week’s online discussion:
Young kids can experience suicidal thoughts
Contrary to popular belief, kids under 10 are capable of wanting to die and can conceive of death or suicide.
“[Kids as young as 5] understand killing themselves better than the word suicide,” said John Ackerman, a child clinical psychologist and the suicide prevention coordinator at the Center for Suicide Prevention and Research at Nationwide Children’s Hospital. But they may not grasp the finality of death. “Often they know that they would be dead, but they don’t understand the permanence of that in the same way. They don’t understand that doesn’t mean they’re coming back or they’re not having conversations with loved ones,” he added.
That is why Ackerman said it is important that educators and those in the mental health field have developmentally appropriate conversations with young children when they feel deep emotional stress.
“Those conversations should be direct, concrete, and done in a way that’s really compassionate and curious, rather than sort of born out of fear or anger or pushing them away and picking up a punishing approach,” Ackerman said.
Signs of mental health struggles may be harder to recognize in young children
Part of the problem, said Ackerman, is that warning signs of serious mental health issues, suicide risk, and self-harm risk can look different in younger children than in older children.
Ackerman said younger kids often possess less-developed language skills and less experience in regulating more-intense emotions. They can communicate and manage stress and trauma in ways that look different than for students with more-developed skills.
“A lot of times they’re left with intense feelings that they’re not able to communicate, or potentially the parts of the brain that do a good job of helping manage and find out solutions on how to deal with those don’t have as much practice,” he said.
Younger children may have different stressors than adolescents
Younger children may also be triggered by different stressors than older kids, because they tend to spend more time with adults than older children do.
“Young kids are stuck in this very difficult spot of having the people that they turn to for safety also be a major source of stress,” Ackerman said.
“A lot of things you see in terms of risk for self-harm is around family conflict and exposure to things like community violence, domestic violence, things that are more interpersonally related,” he added. “And that can be very stressful for a young child who’s reliant on caregivers and parents.”
Supportive adults can help
Ackerman said having supportive adults in their lives significantly reduces a child’s suicide risk by making them feel more valued and connected to their school, home environment, or extracurricular activity. “That may not feel like a suicide-prevention program, but [these outside activities] really do act in that way,” Ackerman said.
Younger children may prefer to speak with adults in their lives who are not their teachers or counselors, he added. Other school staff including bus drivers, sports coaches, and cafeteria staffers can also benefit from mental health awareness and assisted suicide prevention training.
School psychologists and counselors are in short supply
The pandemic has stoked demand for school counselors and psychologists by students. Nine in 10 teachers and school and district leaders surveyed by the EdWeek Research Center said that the percentage of students seeking school-based mental health services in their communities has increased since the fall of 2019.
Millions of students across the K-12 spectrum are feeling the effects of these shortages. Nearly 2 in 5 districts, which represent 5.4 million students, didn’t have any counselors during the first year of the pandemic, according to an Education Week analysis.
During the same period, only 8 percent of districts in the United States met the recommended ratio of 1 school psychologist to 500 students, and 14 percent of districts met the recommended ratio of 1 school counselor to 250 students, a federal study showed.
Despite the influx of federal money going to mental health resources through programs like the American Rescue Plan Act last year, Ackerman said that, as a country, the United States is “definitely far behind the curve” in its resources for young children.
“We shouldn’t be this far behind, but we are,” Ackerman said. “And so the only thing we can do now is invest in learning what we can do to address that gap.”