Supporting Youth with Mental Health Concerns within the School System

I came to a new job last year where I am involved with Secondary School age students who are out of school for any number of reasons: academic failure, absenteeism, substance use, mental health, etc. My eyes were opened WIDE when I discovered that almost every student with whom I came into contact exhibited some symptoms of mental illness. Many of these students are not identified by their families or the school system as experiencing mental health concerns.

The students that I see are those kids that have disciplinary problems both at home and at school. So began this journey to find out how to support these students within the school system BEFORE they drop out or are asked to leave. Investigating how to promote student success in secondary schools, we know that academic success is strongly correlated with student health. Research indicates that barriers to academic success such as mental health disorders, substance use, and absenteeism can be overcome most successfully within the school system. “It can be argued, on the basis of evidence, that mental health should be a feature of all school health promotion initiatives and that effective mental-health promotion is likely to reduce substance use and improve other aspects of health-related lifestyles that may be driven by emotional distress.” (WHO, 2006, p.17).

The Centre for Addiction and Mental Health suggests that an integrated multiple setting approach with a focus on schools, family and community is best practice for improving youth mental health. Although the responsibility for the provision of formal mental health services lies primarily with the Ministry of Health and the Ministry of Children and Family Development - Child and Youth Mental Health division, any comprehensive process must include the Education system. (CAMH, 2008)

Mental health problems and mental illness affect about one in seven young people, and an estimated two-thirds of youth with mental health problems do not receive the help they need. Suicide is the second leading cause of death among young people between the ages of 15 and 24, and at least 90% of those who commit suicide have a diagnosable mental illness.

The number of students in BC identified with a mental health concern is approximately 15% of the total school population. These figures indicate that a significant number of students: approximately 4 or 5 in every high school classroom are experiencing some level of mental illness. Youth with social, emotional or behavioural problems are less likely to experience academic success and are at increased risk of school failure. British Columbia became a national leader in 2003 by developing the ‘MCFD Child and Youth Mental Health Plan’ (CYMH plan) for British Columbia (MCFD 2003). In this plan, the government of BC commits to improving resources and outcomes for the children and youth in the province, who have mental health needs. In this report, MCFD stresses the need for strong partnership with the schools and the health authorities, with schools being the primary setting for identification of mental health problems among children and youth.

Schools have an opportunity to play a crucial role in detecting a mental health problem at an early stage and then in providing access to effective support or treatment through community mental health services. Administrators, counsellors, and teachers are in a prime position to pick up and act on ‘early warning signals’ that students are struggling socially, emotionally, as well as academically. (Shortt, Fealy, & Toumbourou,2006, p2) Because secondary schools might be without the resources or the capacity to detect and manage youth with mental health disorders, many disorders are not recognized until they are more critical.

My experience is that most youth want to be in school, even those youth who are disengaged from peers, academics or athletics. School is often a ‘safe’ place for students, and in terms of intervention, there is the opportunity to reach students who would otherwise not access treatment. Schools can provide the supports for students to be successful in school, including mental health supports. The responsibility to provide mental health supports is ideally shared with the community resources such as MCFD and VCH. In-service professional development can be provided by community partners for counsellors, staff and administrators to prepare them to recognize mental health disorders in students and to provide initial intervention. Schools can promote mental health by developing a supportive school culture, in which mental illness is destigmatized, and there is support and integration of students (or staff) dealing with mental illness. District wide adoption and implementation of comprehensive policies to support students with mental health concerns in the school system can most successfully support students’ mental health.