As Teen Mental Health Worsens, Schools Learn How to Help

If you or someone you know is struggling with thoughts of harming or killing yourself, you can get help by calling the confidential National Suicide Prevention Lifeline at 800-273-TALK.

Teenage mental health was already deteriorating before the coronavirus pandemic. In the two years since, the isolation, grief and fear caused by school closures, deaths and loss of family income have led to an even greater decline in children’s mental health, experts say.

Inundated with federal funds for pandemic relief — some $190 billion in education and health grants over the next four years — states are responding.

According to the National Academy for State Health Policy, a Portland, Maine-based policy research group, in the past year 38 states enacted nearly 100 laws providing additional resources to support mental well-being in K-12 schools. Dozens of additional school mental health laws were enacted this year in at least 22 states, according to the group.

“This is a tremendous increase in legislative activity from anything we’ve seen in recent years,” said Tramaine EL-Amin, client experience officer at the National Council for Mental Wellbeing, a nonprofit organization representing mental health providers.

“The pandemic has put the mental health of our children in the spotlight,” she said. “There’s no question that we need to be vigilant and that we need to act fairly quickly to make sure it doesn’t get any worse.”

Broadly speaking, the new state laws aim to improve mental health schools’ resources and create comprehensive plans to prevent teen suicides and promote children’s mental well-being.

A central theme in many of the new laws inspired by the pandemic is mental health education.

At least 16 states from Alaska to Massachusetts, as well as the District of Columbia, now require K-12 teachers and other school staff to attend training sessions explaining how to recognize mental distress in students and what to do when they see it .

California, Connecticut, Illinois, Kentucky, Rhode Island, Utah and Washington have passed new laws recommending high school students take mental health classes so they can help their friends, family and classmates.

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“Teachers are critical in identifying students who need mental health support,” said Nancy Lever, co-director of the National Center for School Mental Health at the University of Maryland School of Medicine.

“But we also need to ensure that parents and other school staff involved with students are trained to recognize mental health crises and understand how trauma impacts children’s mental health and learning,” she said.

In addition to legislation aimed at training teachers, bus drivers, and security and cafeteria workers, states are also providing money to help schools meet the recommended ratio of students to mental health professionals, including counselors, psychologists, and social workers .

In some states, new laws provide funding for mental health screening and data collection tools that schools can use to develop long-term mental health strategies and measure their progress. Other laws require school boards to develop evidence-based mental health protection plans for K-12 students.

“This isn’t new territory,” Lever said, “but it’s an important area for schools to plan for so they can promote the mental well-being of all students and staff while also identifying and caring for those in crisis.”

A key to the schools’ success will be building sustainability so programs can continue when funding ends, she added.

mental health crash

The COVID-19 pandemic exacerbated an already growing adolescent mental health crisis. Last year, a group of pediatricians, child psychiatrists and children’s hospitals state of emergency declared for children’s mental health.

In 2019, a national survey conducted by the Federal Substance Abuse and Mental Health Administration showed that the percentage of young people ages 12 to 17 who reported having experienced a major depressive episode in the past year increased over the past year almost doubled in the last decade, from 9% or 2.2 million children in 2004 to 16% or 3.8 million children in 2019.

By 2021, more than a quarter of parents in the US said their teen had seen a mental health specialist, with 59% doing so in the past year, according to a opinion poll published last month by CS Mott Children’s Hospital at the University of Michigan.

Suicide is the second leading cause of death among children ages 10 to 14 today, according to the Federal Centers for Disease Control and Prevention.

In 2020, emergency room visits for suspected suicide attempts by girls ages 12 to 17 increased 51% compared to 2019, according to CDC data.

This month, the federal health agency reported that in the first half of 2021, more than 4 in 10 high school students surveyed said they had had “persistent feelings of sadness or hopelessness” in the previous year, which marked a year of isolation and school closures for most teenagers.

“These data are an echo of a cry for help,” said Dr. Debra Houry, Deputy Associate Director of the CDC, in a press release. “The COVID-19 pandemic has created traumatic stressors that have the potential to further erode students’ mental well-being. Our research shows that with the right support, youth environments can reverse these trends and help our youth now and in the future.”

But mental health experts say schools, which are often the only place troubled youth can go, are unready to address the growing teenage mental health crisis.

Historically, most states have failed to meet minimum national standards for the number of students served by mental health professionals, including school psychologists, counselors and social workers.

Only Idaho and the District of Columbia meet the recommended ratio of one school psychologist for every 500 students. At the bottom of the list, Georgia schools hire just one psychologist for every 6,390 students America’s School Mental Health Report Cardpublished in February by a coalition of mental health organizations.

No state meets the nationally recommended ratio of one social worker for every 250 students. Farthest behind, West Virginia employs one social worker for every 15,433 students. And only New Hampshire and Vermont meet the standard of one advisor for every 250 students.

Mental health first aid

Called the number of K-12 schools that enroll in one of the most popular mental health training programs Mental health first aidis up 17.5% since late last year, according to the National Council for Mental Wellbeing, which administers the course.

“Every state in this country has introduced youth mental health first aid in some way in some schools,” the council’s EL-Amin said. “This year’s surge in legislative activity is helping to spread the word.”

Developed and tested in Australia, the approximately 32-hour training program was introduced in the USA in 2008 by the Council in cooperation with the Maryland Department of Health and Mental Hygiene and the Missouri Department of Mental Health.

With 25,000 instructors, the evidence-based curriculum has been used to train 2.7 million Americans in a variety of occupations. Offered online and in person, the course teaches people to recognize the signs of a mental health or drug problem, to respond rather than turn away from someone in crisis, and to urge the person to speak to a mental health professional.

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In the US, approximately 1 million people have completed a specialized version of the course designed for teachers, parents and others involved with youth. More than half work in K-12 schools.

The course has also been adapted so that youth can help each other, and as of 2020 more than 125,000 students in 700 schools and youth groups have taken it.

Graduates of the course say they can apply what they learn to help someone in an average of three months, EL-Amin said.

Emma Bap, who last year completed the first aid course at Bellows Free Academy High School in St. Albans, Vermont, told the council that the program has given her “more confidence to reach out to someone who is struggling shines – and possibly saves a life.”

Mental health training courses typically provide scripts for what to say and not say to teenagers who may be contemplating ending their lives. The training also emphasizes that teens should report to a teacher or other adult any potential suicidal concerns they may have in relation to a friend or classmate.

Separate training programs for adults and adolescents identify ways to intervene in the event of suicide and emphasize that suicide is preventable.

But training alone isn’t enough to prevent suicides and ensure children with mental illness get the care they need, said Julie Goldstein Grumet, a suicide prevention expert.

“Schools need to create a safe and open culture where kids know it’s okay to talk about suicide and mental illness,” said Grumet, vice president of the Boston-based Education Development Center, a policy research group.

They also need to develop and sustain strong mental health partners they can rely on to help their at-risk students, she added.

“Training is great and important, but it needs to be embedded in a comprehensive approach where it’s not ‘one and done’,” Grumet said. “Schools shouldn’t say, ‘We did the training,’ they should say, ‘We changed the whole culture around suicide prevention and mental health.'”

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