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Mental Health

The Doctor Is In (Your Classroom)

As student mental health issues reach crisis proportions, schools and teachers are playing a larger role than ever providing support. Is it too big an ask? 

October 21, 2022

Even though she’s been teaching for more than a decade, Genevieve Bassett feels apprehensive this fall—more than ever before. 

Amid budget cuts and staff burnout, Alameda International Junior/Senior High School, the large Colorado school where Bassett is a history teacher, started the school year without a social worker, and with only two of the seven counselors they had in previous years. Yet her students, many of whom are immigrants from Central and South America and Vietnam, are exhibiting unprecedented levels of trauma and stress: some lost family members to Covid, one teen died of a fentanyl overdose, and another student lost a parent to gun violence. Because mental health and counseling resources are stretched so thin at the school, teachers will in many cases be the first and last resort for students. “Every adult in the building has acted as a mental health provider—whether we have performed it well, or willingly, or not,” Bassett said. “The mental health crisis is looming large, and I’m terrified.”

As schools try to figure out how to address and serve students’ growing mental health needs while keeping them academically focused, many middle and high school educators interviewed for this article—in districts large and small, urban and rural—feel caught in the middle of an impossible situation.

It’s not because teachers “don’t want to keep kids safe and nurture their healing,” writes high school English teacher Ellen Dahlke in a recent essay. “It’s because not enough teachers have even close to the amount of know-how (never mind time) required to do it well…. Having hours with a good teacher every week is not the same thing as having an hour with a good therapist. We meet different needs.” 

What’s a healthy balance of teaching and mental health support that will help students thrive while keeping teachers’ jobs manageable? We talked to teachers and mental health experts to find answers.  

The Buck Stops…at School

Rates of anxiety, depression, and suicidal ideation among adolescents are alarmingly high, and were trending upward prior to the pandemic. Last year, according to the CDC, 37 percent of adolescents reported clinically high levels of anxiety and depression—and one in five said they’d seriously considered suicide, numbers that are marginally higher than those reported in previous years. Even students who aren’t in crisis are lagging in their social and emotional development, and incidents of school violence, including fights among students and physical attacks on teachers, have increased. 

Meanwhile, schools and districts are scrambling to address the accelerating needs of students, training teachers to recognize signs of distress and implementing intervention strategies like morning mental health check-ins

But being the “first line of defense” in the mental health crisis is a role many teachers and schools aren’t realistically able to take on: According to a 2022 survey of 1,200 schools by the National Center for Education Statistics, half of the schools surveyed said they aren’t equipped to properly provide mental health services—especially for the one-on-one counseling that 84 percent of schools say is their most common intervention. The top limitations preventing them from meeting kids’ needs, according to the survey: inadequate access to mental health professionals and insufficient funding.

It’s not for lack of trying. Susan Norwood, a high school English and cinema studies teacher in Metro Nashville Public Schools, would never turn away a student in need. In the past few years, she’s taken 36 hours of professional development related to student mental health and emotional wellbeing—many more hours than she would otherwise dedicate to improving her teaching skills or pedagogy. Mental health support, Norwood says, has become just as much a part of her job as teaching—something that’s especially challenging for teachers of tested subjects like English and math, where there’s great pressure to help students meet academic benchmarks. “I see about 180 students in my classes,” Norwood said. “I’ve raised children and grandchildren, but I’m not a social worker. Where do we fit all this into the day?”

Schools have long been the place where many students received mental health treatment—“not on a leather couch in a wood-paneled office, as movies would have us believe,” says Boston University clinical psychologist Jennifer Greif Green. Providing access to mental health services in schools, through counselors and social workers, makes crucial supports more accessible to kids who are less likely to get treated for issues like anxiety and depression, especially low-income students and students of color. 

But there is a chasm between the ideal, in which a well-trained teacher can identify a struggling child and send them to the counselor’s office for help, and the reality: Most schools only have one counselor to every 415 students—half the recommended number—and in middle and high school, the ratio is often worse, says Jill Cook, executive director of the American School Counselor Association (ASCA). And according to an analysis of recent federal data by Education Week, nearly 40 percent of all school districts nationally lacked a school psychologist in the first full year of the pandemic. The National Association of School Psychologists recommends a ratio of one school psychologist to 500 students—last year, just 8 percent of districts met that ratio.

When schools are short on counselors and other staff, that job falls to teachers. “When we look at data from teachers, the vast majority say that SEL and mental health are part of their job responsibilities,” said Sharon Hoover, the co-director of the National Center for School Mental Health. “But often schools don’t have the staffing for something like the check-in/check-out strategy, where an adult checks in with a child at the beginning and ending of each day. Teachers shouldn’t have to do this all on their own.”

The SEL Connection

This summer, Congress’ approved $1.7 billion aimed at expanding school-based mental health services and addressing chronic counselor shortages. While ASCA is heartened by the injection of federal funds, the effort to supply more counselors might quickly run up against a challenge: lack of qualified candidates. “As with all of education, we don’t have nearly enough qualified people to fill existing positions,” Cook said. “In 48 states, educators need a master’s degree to be a school counselor.” 

Meanwhile, even with an influx of much-needed funding, critics of school-based social and emotional curricula argue that allowing the language and practices of therapy to enter the classroom amounts to “mission creep,” and sets up insurmountable challenges for schools and teachers. Teaching has become a job that “mere mortals” can’t do in a sustainable way, says Robert Pondiscio, senior fellow at Washington think tank the Thomas B. Fordham Institute, and author of the 2021 paper “The Unexamined Rise of Therapeutic Education.” Asking teachers to be experts in everything from their content area to mental health, all for 40k a year, is a big ask that sets teachers up for failure. “We are going to have to have a conversation about the societal expectations of schools,” Pondiscio said. “Maybe school should be social services—but we have to ask that question. Or else we continue to make assumptions and blithely pile responsibility onto public schools and expect good things to happen.” 

There’s an important distinction to be made, however, between the beneficial impacts of school- and classroom-based SEL efforts and the crisis-level response the youth mental health emergency so urgently requires. “Education and mental health have developed as two separate (if connected) professional worlds, and we work in separate buildings,” Dahlke asserts, pushing back on the notion that teachers are responsible for taking on students’ mental health. Many students need “more time in the physical presence of clinical and non-clinical mental healthcare workers. Therapists, pediatricians, psychiatrists, life coaches and mentors, trusted community volunteers, restorative justice coordinators, social workers, crisis teams.”

School-based cultures of support—while certainly not enough all on their own to turn the tide in the mental health crisis—can and do have an impact, reducing levels of student stress, isolation, and depression. Students who felt connected to adults and peers from school during the early months of the pandemic were “significantly less likely than those who did not to report persistent feelings of sadness or hopelessness; that they seriously considered attempting suicide; or attempted suicide,” notes a 2022 report from the CDC. Fewer than half of the high school students surveyed, however, reported feeling close to people at school during the pandemic, the report concluded. 

Yet the bleak trajectory among kids towards greater levels of anxiety and depression, suicidal ideation and even attempted suicide, suggests that while the wellness structures that teachers can provide are important, they’re unlikely to be commensurate to the need. 

The Role of Teachers

Piling more responsibilities on teachers—already stretched to the limit with overcrowded classrooms, long hours, and intense workloads—is not the answer. Ultimately, teachers should stay focused on the academic success of students, which is intertwined with emotional and psychological wellbeing, but should not be subsumed by it. Other funded structures and supports must be put in place; schools and districts need counselors, social workers, psychologists, and other experts either on site, or in close partnership with local community resources. This moment demands practical changes to school structures, operations, and staffing to effectively supplement the academic and social-emotional work educators do every day. 

In building school-based cultures of support, teachers who don’t feel comfortable in the role of emotional counselor can explore simple strategies that benefit students while staying within content areas, says Phyllis Fagell, a school counselor and author of the book Middle School Matters. English teachers can have students discuss the emotions of a character in an assigned book; science teachers can discuss how to “activate your parasympathetic nervous system to calm your thoughts,” Fagell suggests. Across grade levels, teach kids emotional literacy, the ability to understand emotions’ biological basis—not only their own, but others’ as well, and how to name emotions, and take others’ perspectives. Focus on building resilience: research shows that higher levels of resilience are correlated with fewer mental health problems like depression and anxiety. “Resilience works like a muscle we can build through effort and repetition, and we want to keep our muscles strong and flexible so we can think of many ways to solve a problem,” says psychologist and author Mary Alvord

Meanwhile, we need to examine why teachers and schools are left to solve problems that are out of their control and outside most educators’ professional training, says Micere Keels, associate professor and founder of the Trauma Responsive Educational Practices at the University of Chicago. To help ease this burden, communities need to be willing to step up to relieve some of the burden on teachers—a pointed message delivered by sociologist Robert Putnam in the 2001 book Bowling Alone: The Collapse and Revival of American Community. “We no longer have the extended family and local community that keep us mentally healthy,” says Keels, who developed a set of free mental health lessons for teachers to use with students. “That’s where our schools are trying to pick up the slack.” 

To be effective, however, not all mental health interventions need to involve curricula, a medical team, or licensed professionals, Hoover contends.

In Dahlke’s classroom in Oakland, California, for example, she takes a “more hands” approach by asking a trusted community member, an expert in youth development, to assist her in the classroom. In reality, he’s there for when students need someone they can talk to and confide in. “I can get class started, and the kids can talk to this ‘therapist’ that’s in the room with us,” Dahlke said. “It’s weird, in all of human history, communities have helped raise the children. Why do we ask so few adults to take so much responsibility for raising our children?”

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  • Social & Emotional Learning (SEL)
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