Resolving Mental-Health Stigma in School
Editor's Note: Rima Sehgal, a school counselor in India, and a recipient of a Fulbright Distinguished Award in Teaching, shares ways that classroom-guidance programs can help overcome the stigma of mental illness in school.
By guest blogger Rima Sehgal
It is well-known that transitions can lead to stress. School-going children and adolescents are in a developmental stage where they are experiencing ongoing changes in their physical size, social/peer relations, emotional sensitivity, and self-consciousness. The resulting stress, conflicts, socio-emotional challenges, and academic challenges require the support of adults around them.
Students in this position may still not meet with their school mental-health professional due to peer pressure or other beliefs about counseling and psychotherapy. In addition, teachers and parents often fall short of a student's need for empathetic listening. The Mental Health Commission of Canada defines stigma related to mental-health problems as "beliefs and attitudes about mental health and mental illness that lead to the negative stereotyping of people and to prejudice against them and their families."
Stigma is a universal concern for any mental-health professional. According to psychiatrist Lars Jacobsson, humans, as well as all higher animals, are always evaluating the creatures around them. He observed that this evaluation is the basis for the stigmatization process resulting in discrimination against and exclusion of the mentally ill. This stigma makes it difficult to accept mental illness as being the same as physical illness.
In school, students pick up the same attitudes and opinions about the school counselor or psychologist from their peers and parents. Therefore, they avoid seeking help, even when they need it. At the same time, when students see their peers with academic or behavior concerns being referred to school counselors, they tend to form an opinion that "counseling is for those who create trouble or are poor performers academically,"therefore, "it's not for me!"
During my initial years as a counselor, I realized the immense potential of classroom guidance as a tool for psychoeducation, advocacy, and, most of all, prevention. Adolescents learn about the world they live in and how they can safely navigate it. These programs provide appropriate information and skills they can carry with them through future issues. Challenging or sensitive issues could also be covered as topics in classroom-guidance programs, allowing healthy messages to be communicated through the safety of the classroom, with classmates. Such programs are received well due to the participatory design of the program—the topics are engaging and related to students' lives.
The most interesting and positive outcome, however, is not the students' responses in class; rather, their responses to the professional outside the classroom is heartening. All of a sudden, they begin to feel comfortable talking and sharing with the counselor. Appointments scheduled after a classroom-guidance program would max out the counselor's schedule. The students' familiarity with the counselor due to the program eased fears and dissolved the myths about the stigma of making an appointment.
Beyond the significant benefit brought by regular classroom-guidance programs, counselor-student interaction can serve the best and most effective way of advocacy and psychoeducation.
Here is one example of age-appropriate classroom-guidance-program topics that could be modified according to the individual needs of a school:
Grades 1 through 4:
Kindness and compassion; good touch/bad touch (safe boundaries); effective study habits; positive attitude toward self; identifying feelings; learning self-control; and resolving differences.
Grades 5 through 8:
Substance abuse (Be smart, Don't start); managing peer pressure; friendships; prevention of bullying; respecting differences; problem solving; empathy; effective study habits; and the vast world of work.
Grades 9 through 12:
Self-awareness; managing anger and stress; mental health dos and don'ts/early intervention; career guidance; effective communication skills; effective interpersonal skills; decisionmaking; resilience building; and test-taking anxiety.
If not more often, a once-a-month classroom-guidance program presented by a counselor can ensure comfort and ease stigma. There are diverse techniques to convey the key messages. Those that work best with schoolchildren and youths to invoke interest and participation include the combination of brainstorming, worksheets, small-group discussions, and presentation of the key messages discussed above through activities like role play, creating songs, posters, poems, raps, street plays, and so on.
In addition, this program can work well in building resilience through life-skills topics, such as stress management, coping with emotions, empathy, and interpersonal skills, thereby preventing higher incidences of mental illness or suicide risk. These skills are critical as students leave high school and face the transition into a more independent world and challenging situations. Navigating this stage of 'identity formation' and the social environment of distractions, addictions, and overexposure to information is a huge challenge and it can be difficult to make it through this stage without feeling anxiety or low moods. Many first-time college students face stress from challenges that are academic, socio-emotional, or linked to separation from family. Colleges and universities are prepared to make the transition as easy as possible. Nevertheless, self-blame and self-stigmatization often follow!
Possible ways to counteract self-blame and self-stigmatization are to increase knowledge about the causes and the background of mental-health problems. Self-stigmatization is also an effect of having a stigmatizing attitude toward others with mental illness. So, it is necessary to work on the stereotypes and prejudices regarding mental illness in general. This can be successfully achieved by discussing mental health in classroom-guidance programs and touching the lives of each student in school.
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Bemak, F., & Cornerly, L. (2002). The SAFI model as a critical link between marginalized families and schools: A literature review and strategies for school counselors. Journal of Counseling and Development, 80, 322-331.
Bryan, J. (2005). Fostering educational resilience and achievement in urban schools through school-family-community partnerships. Professional School Counseling, 8(3), 219-228.