Leigh Meldrum, David Venn and Stan Kutcher
The following article is reprinted with permission from Health and Learning, May 2009, published by the Canadian Teachers’ Federation. The article has been edited to conform to Association style.
Working in education is exciting yet highly demanding, especially when teenagers are in the picture. The impact that a teacher may have on a teen’s development and well-being is profound, and as a result the role of the teacher often extends beyond the traditional classroom. This can be challenging for some teachers, particularly when faced with mental health problems that youth may be experiencing.
The mental health of students in schools is an often overlooked, yet extremely relevant issue for today’s educator. In Canada, between 15 and 20 per cent of youth suffer from a mental disorder that would benefit from professional care, and 6 to 8 per cent of young people suffer from depression. By learning how to recognize and address adolescent mental health problems, as well as how to appropriately refer those young people suffering from mental health problems to health professionals for treatment, educators have a unique opportunity to play an important role in the health and well-being of Canadian youth. It is imperative, therefore, that teachers be equipped with the practical tools and knowledge required to recognize and intervene appropriately in situations where mental illness may be a concern.
According to the World Health Organization, mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” Although it is often overlooked, mental health is as important to a person’s well-being as their physical health, particularly during the turbulent years of adolescence.
During adolescence, the brain undergoes a significant period of growth and development, which continues into the twenties. This means that during secondary school, students are passing through a vulnerable time of neurodevelopment that can have a serious effect on all aspects of their life. Indeed, adolescence is a time when much new behaviour begins to emerge, including changes in attention, motivation and risk-taking behaviour.
When the brain (or part of the brain) is not working well or is working in the wrong way, a person may experience many different kinds of problems, such as difficulty thinking or focusing, extreme emotional highs and lows, or sleep problems. When these symptoms significantly disrupt a person’s life, we say that the person has a mental disorder or a mental illness, the causes of which are extremely complicated and may be the result of a complex interaction of genetics, environment and neurodevelopment.
How does mental health affect students?
The statistics regarding youth mental health problems are staggering. At any given time in Canada, approximately 20 per cent of young people may be suffering from some form of mental disorder, which translates to one in five students in the average classroom. Mental disorders include depression, schizophrenia, anorexia nervosa, bipolar disorder, panic disorder and so on. These problems can seriously influence the day-to-day functioning of youth in the classroom. Mental disorders represent the most common and disabling condition affecting young people and therefore have major implications for students and for schools.
1. Mental disorders affect a student’s emotional well-being
If ignored, mental health problems can impede social development, leaving young people feeling socially isolated, stigmatized and unhappy. In an attempt to cope with or overcome the symptoms of these disorders, some young people acquire socially or personally inappropriate behaviours, such as dropping out of school or becoming heavily involved in the illicit use of drugs. Mental disorders may also impact the young person’s ability to make and retain a strong and supportive peer network or appropriate relationships with adults. Teachers represent a prominent and positive adult role model in the student’s life. It is part of their role to be supportive and aware of student difficulties and direct them to the appropriate resources for help if needed.
2. Mental disorders affect a student’s ability to learn
Mental health problems may pose a significant and unnecessary obstacle for students to overcome in the classroom. Studies show that students with emotional disturbance and poor social-emotional functioning have difficulty meeting academic standards. Some mental disorders such as learning disabilities and Attention Deficit Hyperactivity Disorder present unique and specific challenges to optimizing learning outcomes. By being aware of these factors, teachers can better meet the specific needs of students to help them learn most effectively.
3. Mental disorders are a factor in why some students drop out of school
About 15 per cent of youth attending postsecondary education drop out before finishing their programs, often for reasons related to their mental health. Therefore, addressing students’ mental health concerns before they become a serious disruption and lead to negative behaviours, including dropping out of school, is an important step.
Addressing mental health problems at school: The three-pronged approach
Schools can be an important location for mental health promotion, early identification and intervention, combating stigma associated with mental illness and possibly providing interventions and ongoing care. What can teachers do to make a difference in the mental well-being of students? The answer is not always easy, and requires cooperation at all levels of the education system and a positive collaboration with health care providers.
1. Reducing stigma
One of the largest obstacles facing youth with mental illness is the associated social stigma against people living with a mental disorder. While the scientific understanding and treatment of mental disorders, as well as the awareness of the importance of mental health in all aspects of life, has advanced considerably in the past decade, the public’s perception about people with mental illness has been much slower to change.
In the classroom, stigma associated with mental illness can affect how teachers, classmates and peers treat the student living with a mental disorder. School-based antistigma activities present an opportunity to enhance understanding of mental illness and improve attitudes towards people living with mental illness. Furthermore, school-based antistigma activities reach people on all social levels, from teachers, principals and administrators to parents and community members to most important, the students themselves.
2. Identify and intervene
Early identification and effective intervention for youth with mental disorders are critical. If left untreated, the symptoms of a mental illness may increase in severity, and its effects may become more serious and potentially life threatening. Educators and school personnel are in an ideal position to recognize behavioural or emotional changes that may be symptomatic of the onset of mental illness.
By providing training related to youth mental health and mental disorders in young people that is specific to educators, we will be better equipped to protect and promote the mental health of our youth. Educator-specific programs, such as Understanding Adolescent Depression and Suicide Education Training Program (www.teenmentalhealth.org), address the signs and symptoms of depression, as well as risk factors for suicide, methods of identification and appropriate referral of high-risk youth. The basis of this innovative Canadian program is supported by documented evidence of effectiveness and has been demonstrated to improve mental health literacy in educators and health professionals.
3. School curriculum and mental health
A potential starting point for the integration of mental healthcare into existing school health systems is through the implementation of a gatekeeper model. A gatekeeper model provides training to teachers and student services personnel (social workers, guidance counselling and school psychologists) in identifying and supporting young people at risk for, or living with, a mental disorder. It also links education professionals with health providers to allow for more detailed assessment and intervention when needed.
Schools can also address students’ mental health by implementing mental health promotion strategies through innovative curriculum initiatives. Improving mental health literacy through curriculum development and application could enhance knowledge and change attitudes in students and teachers alike, and embedding mental health as a component of health promoting activities could enhance mental health while decreasing stigma associated with mental disorders. Two examples of recently developed Canadian mental health curriculum for schools are
Healthy Minds, Healthy Bodies (Nova Scotia) and the Secondary School Mental Health Curriculum (Canadian Mental Health Association).
What role can teachers have in advancing mental health in schools?
Teachers are in a unique position to make a difference when it comes to promoting and addressing student mental health concerns in and out of the classroom. Here are four suggestions to consider.
Policy reform—Support the development of policies and plans that recognize the importance of integration of mental health into educational institutions.
Curriculum—Support the application of a mental health curriculum, which in turn provides health promotion and addresses stigma through scientific knowledge.
Support System—Implement infrastructures and support systems within your school, for example, establish a mental health task force that can pioneer a program including gatekeepers, student services expertise and community links.
Teacher Training—Support the development and implementation of appropriate professional mental health training programs for teachers and other educators. Mental disorders in young people are now being increasingly recognized, and educators are being asked to address those needs in and out of the classroom. Understanding what these issues are and the many different avenues available to effectively deal with them is an important challenge in today’s educational environment.
Dr. Stan Kutcher is the Sun Life Financial Chair in Adolescent Mental Health at Dalhousie University, Halifax. The Chair is dedicated to improving the mental health of youth by the effective translation and transfer of scientific knowledge. For more information, visit www.teenmentalhealth.org.
Leigh Meldrum is a graduate in anatomy and cell biology at McGill University and is a member of Dr. Kutcher’s team.
David Venn is an advisor with the Sun Life Financial Chair in Adolescent Mental Health’s Knowledge Translation Team.