Children's Mental Illness: The Shared Responsibility of Schools and Society
Each child arrives at our doors with abilities and gaps. We are responsible for helping each child reach the graduation stage having met the same standards; some struggle and never reach them, some reach them, and others surpass them. Among each group are students suffering with mental illness. Some have a diagnosis and doctors, educators and families working together on their behalf. But, many remain undiagnosed.
It takes time, observations, collection of evidence, alert educators and consistent medical care to identify whether a child has a mental illness or not. And because of the many forms of mental illness, it is really difficult to accurately diagnose and treat. Success requires an active parent, school, physician partnership.
A child who is a recluse, disengaged, anti-social, who chooses not to join in activities, becomes withdrawn, or one who has outbursts or acts aggressively may be showing signs of a mental illness, or simply be revealing a troubling time in his/her life or his/her personality or even presenting a learned behavior. Diagnosis is a team effort and observation is a never ending part of it.
In addition, think about any list of professional development, pre-service courses, and graduate courses, and the expectations and limitations of special education law. How many of these teach about mental illness? How prepared are educators to recognize and work with children with mental illness? Have we left that as a specialty to a few? In reality, it is in front of all of us daily. Mental illness if part of the fabric of society in every community. It sees no boundaries between rich and poor, college educated or high school dropout, race doesn't matter to it nor does gender. Mental illness exists among us all. And, we have learned it sometimes erupts in violence and takes the lives of others. We must do more in early identification, in treatment and in support for families. But, before that, we, ourselves, our legislators, and even some of our pediatricians and their PA's must gain knowledge about mental illness.
Making a Difference
Have you noticed the alternative (foreign or domestic, part of a cell or a lone wolf) or an American with a mental illness? If it is the latter, swiftly the policy debate goes to gun regulation or the lack thereof. Isn't it time for this country to take its growing awareness of mental illness and create a system in which those who are mentally ill get the help they need and their families get support? Mental illness doesn't produce shooters, but at the end of a desperate stretch of troubled years and feeling out of hope and without options, tragedy happens. As the school year begins in so many parts of our nation, we wonder if we can make a difference in the lives these suffering young ones.
After all, the National Institute for Mental Health statistics report that approximately 13% of children ages 8 to 15 had a diagnosable mental illness in the previous year. Data from the National Alliance on Mental Illness are even more disturbing. One in five children between the ages of 13 and 18 in this country have a mental health condition but, unlike other childhood medical issues, for these affected children there are usually 10 between onset of symptoms and intervention. These are the years they are with us. And, who is surprised that 50% of this population become high school dropouts? We are on the cutting edge of this social issue.
Educators may have a student with a mental illness, diagnosed or not, in their class, but the educator's role is to deal with the behaviors that interfere with learning. The goal is to reach academic goals on the route to becoming college- and career-ready. We are not trained or expected to treat the mental illness. So, it is no wonder students can graduate from a school system with a diploma and a mental illness. Once a youngster reaches the age of consent, it is their individual right to choose to be treated or not. Oh yes, this is not only a question for schools, it is a question for our society.
What Schools Can Do
What remains in the school arena is alert attention. We must notice those students who are our outliers; those who don't fit in, who feel alone, and who suffer without being noticed. They may or may not be struggling with mental illness but, certainly, if they are struggling they aren't learning well. If they are not acting out, they may be overlooked. If their suffering results in diminishing grades, increasing absences, or quiet isolation and does not grab our attention and concern, they may slip through the cracks. Attention from an attendance officer, guidance counselor, or teacher ca begin an intervention path and identify the specific behavior that may be interfering with academic success. In the best of cases, those adults talk with the student and discover an underlying cause; a sick younger sibling, an unnoticed reading or writing or math gap, a failure to study perhaps.
Here are more facts from the National Alliance on Mental Illness. (The bolding is ours.)
A mental illness is a condition that affects a person's thinking, feeling or mood. Such conditions may affect someone's ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis...One in 5 adults experiences a mental health condition every year. One in 17 lives with a serious mental illness such as schizophrenia or bipolar disorder. Half of mental health conditions begin by age 14, and 75% of mental health conditions develop by age 24. The normal personality and behavior changes of adolescence may mimic or mask symptoms of a mental health condition. Early engagement and support are crucial to improving outcomes and increasing the promise of recovery.
School leaders can help the community understand the symptoms of mental illness and the gaps in policy that allow these children to live without benefit of medical help. We are not only institutions of learning. We are institutions where the precursors of learning must be recognized. If students do not come to us with those precursors in place, if students cannot achieve, schools are responsible for decreasing those gaps. Some gaps are more complex than others. Teachers are well prepared for the ones that are academic. Schools have built interventions to respond to those. But mental health issues are much harder to identify, diagnose and treat and require a team of professionals and families working together.
Mental illness is often an invisible disease. For the most part there is no physical manifestation for others to notice. Many of the behaviors are the same ones that can be fleeting, provoked by a single influence or dismissed as a characteristic of adolescence. And, we remain as a society with mental health as a taboo subject. Schools can begin to make the difference in how society views mental illness. Schools can begin to question, especially beginning with those 14 year olds, if there is something more they need. Teachers and leaders can speak differently to parents and each other about whether a youngster may need to see a psychiatrist for evaluation without wrapping that recommendation in a shroud of guilt or shame. Teachers and leaders can begin to think of mental illness the way they think of polio, or cancer, or chicken pox, or the measles. Mental illness is still not as easy to prevent or recognize. But maybe, just maybe, schools can be the social lever that can begin to remove society's view of mental illness as a shame, to be hidden. It is a disease to be managed or cured. Consider the debate about the Zika virus. Let's raise the mental illness of children to that level.
Photo by Oksana Bratanova courtesy of 123rf