Mental health is something all of us need to be aware of. School based occupational therapy covers many basis simply because of the school-based occupations and functions that students in the school environment do on a daily basis. Mental health is one aspect that impact students from kindergarten through high school and it’s a consideration that school-based OTs need to keep in mind. In this blog post, we’re covering information and resources about mental health for students.
Mental Health for Students
The number of cases of mental illness continues to rise dramatically. Mental Health for students is a big topic to cover. According to the National Institute of Mental Health, 1 in 7 children and teens worldwide experience a mental health condition. In the US, 49.5% of adolescents have a mental disorder, and 22.2% of those have severe impairment or distress. 1 in 7 children and teens worldwide experience a mental health condition. In the US, 49.5% of adolescents have a mental disorder, and 22.2% of those have severe impairment or distress.
Young people used to be relatively unscathed from psychological difficulties. It was believed children had no stress and nothing to worry about. According to a study posted by the American Psychological Association; In recent years, evidence reveals the contrary. The rate of individuals reporting symptoms consistent with major depression in the last 12 months increased 52 percent in adolescents from 2005 to 2017 (from 8.7 percent to 13.2 percent) and 63 percent in young adults age 18 to 25 from 2009 to 2017 (from 8.1 percent to 13.2 percent).
There was also a 71 percent increase in young adults experiencing serious psychological distress in the previous 30 days from 2008 to 2017 (from 7.7 percent to 13.1 percent). The rate of young adults with suicidal thoughts or other suicide-related outcomes increased 47 percent from 2008 to 2017 (from 7.0 percent to 10.3 percent).
There was no significant increase in the percentage of older adults experiencing depression or psychological distress during corresponding time periods. The researchers even saw a slight decline in psychological distress in individuals over 65.
How can we care for the mental health for students? We can start by looking at what we believe causes, or exacerbates mental illness.
WHAT CAUSES MENTAL health issues IN STUDENTS?
What has changed in the past fifty years to cause an increase in stress and disability? People always ask me if there is an increase, or are we just noticing and diagnosing more? I believe both is true. We are noticing and diagnosing every twitch, however, there are definitively more people struggling now. 50 years ago there was a stigma to acknowledging mental health issues.
The diagnostic criteria for diagnosing has changed during the past couple of decades.
To provide mental health for students, we first need to unravel how they are getting to this point. Take a look at the wellness wheel. Basically this wheel has a spoke with different areas and components that make us each who we are. Every person’s wellness wheel will be different, and that’s ok! The variances make us who we are. However, the outer ring has underlying components that impact each of us.
You’ll see spokes on the wellness wheel for emotional, intellectual, spiritual, physical, occupational, and social. If one of these spokes are deflated, or deficient, we might see mental health issues like stress, anxiety, worries, or even harsher results.
Environmental impacts on mental health
We can also take a look at how environmental considerations impact mental health. These issues compound on our students because they might have something at home that they bring with them to school, emotionally. They might experience different things at home and then think about it at school. It’s a trauma response in some cases. In other cases, it might not seem like not getting enough sleep or a nutritious diet effects mental health, but it does. And we see that overflow at school when our students are under stress of keeping up with their peers, socializing, stressing out about grades or physical performance, or any other aspect of the school day.
Here are some environmental considerations that impact mental health in students:
- Diet impacts mental health. People eat horribly now. Everything is processed, full of colored dyes and preservatives, or artificial ingredients. Efforts are being made in schools to add some healthy choices, but kids are not picking fruit and vegetables. Schools also realize students need to eat something, so they opt to offer popular choices like sugary cereal, Pop Tarts, Doritos, pizza, bread sticks, and French fries. I cringe when I see what parents pack for their kid’s daily snack. It takes work to make your children eat and enjoy healthy food. I would rather eat a Pop Tart than carrots. There have been correlations between colored dyes and attention problems.
- Exercise and mental health (or lack of exercise). Schools make efforts to send students outside for recess, but they can not make them play. If the weather is slightly off, they stay indoors and watch movies. Parents are not sending their children outside to play all day, or taking them to the park. We have students come to our school program at age four, and have no idea how to play on a playground. Heavy work organizes the sensory and central nervous system. This impacts brain function.
- Genetics and mental health– There is definitely a genetic component to what is plaguing our young people. This goes for all types of genetic diagnoses. For example, the rate of autism was one in ten thousand thirty years ago. It is now less than one in 40. When interviewing parents, more often than not, one of the parents admits to anxiety, depression, mental illness, ADHD, or some other ailment. When there is a diagnosis or undiagnosed challenges that students experience, there can be mental health issues also occurring, simply because of the challenges that neurodiversity brings in various settings and environments.
- Technology and mental health– People rave about technological advancements, but they do not spend enough time assessing the damage it is doing. The magnetic waves emanating off technology is harmful. There is a relatively new term, Virtual Autism, on the rise. Post–Digital Nannying Autism Syndrome (PDNAS) in another term used for virtual autism. Check out my post on Virtual Autism for more insight. Children with autism are prone to anxiety ,obsessive-compulsive traits, social anxiety. Screen time is associated with increased risk for OCD and social anxiety, while contributing to high arousal and poor coping skills. Serotonin regulation and amygdala changes have been implicated in screen time.
- Social media and mental health– Everything seems to be public knowledge. Rumors spread like wildfire. Bullying and harassment continue to rise. There is a lot of pressure to live up to the expectations of friends and celebrities on social media. People unknowingly skew their social media feeds. They post only the great things happening, or fill their feed with unhappy thoughts depending on their mood. My Facebook feed looks like one vacation after another. I have had friends facing divorce, that came as a surprise to everyone, solely based on their social media profile. While this can be a great way for people to connect, it causes anxiety and stress at the same time.
- Internet accessibility and mental health– Information is just a button away. We used to have to wait to talk to a doctor; now we can Google our symptoms. This helps people stay informed, but also has the potential to cause undue worry. Because everything is just a touch away, we do not have to wait for anything, or exhibit impulse control. Young people have access to inappropriate content that they are not mature enough to understand, or find themselves addicted to gambling, pornography, shopping, or diagnosing all their friends with illness.
- People are not talking (or listening) – This is a big one but not something that we think of right away. Conversations consist of video clips, memes, and text messages. That is not adequate conversation for processing feelings and information. Non face to face communication can be misinterpreted. Parents and teachers are busy. They are not sitting down talking with children and really listening to what is being expressed. In addition, children are not building the social skills to know how to talk about their feelings. If you read about teen crime or suicide, there is often something caregivers missed because they were not paying attention.
- Pressure to succeed and the mental health issues that result– A grade of 70 or a C is an average grade. When did people decide a C was below average, and only A’s were acceptable? There is a ton of pressure for students to make all A’s, whether they are in fact A students or not. Teachers are blamed if they are not giving out enough 100’s on papers. If your friends around you are all getting great grades, and you are average, it can feel like a failure. My daughter hung out with gifted students. The norm in her social life was to be above average. When she, or her peers were not perfect, there was an uptick in anxiety and negative coping.
WHEW, THAT IS A LOT GOING ON
The list above is only the tip of the iceberg. None of those theories occurs in isolation. Many students are affected by several factors at once. This can be a double or triple whammy to their fragile mental health. I have sleepless nights thinking about the damage we are doing to our young people. I am afraid we are not going to turn the clocks back to a simpler time, but continue to cause more difficulties for children. What do we do? We put a small band aid on a gaping wound.
HOW DO WE HELP IMPROVE MENTAL HEALTH FOR STUDENTS?
Mental health promotion and prevention interventions aim to strengthen an individual’s capacity to regulate emotions, enhance alternatives to risk-taking behaviours, build resilience for managing difficult situations and adversity, and promote supportive social environments and social networks.
There are some factors like genetics that we are not able to readily change. We can however, change many of the other factors. It starts by providing a better environment and foundation for our kids. Parents can start this at home. As therapists, provide education to families on the importance of diet, exercise, and a good sleep routine.
- Limit technology – The Academy of Pediatrics recommends that children under the age of two not be exposed to screens at all, 2–5-year-olds less than one hour per day, and older children be limited to two hours a day. Therapists can be mindful of adding technology to treatment sessions. Yes, children will work better for an iPad, but there has to be a better way. It’s a must to balance screentime for kids and teens. This screen time checklist is a good way to get started.
- Limit or be vigilant about social media presence. Parents hate to have to watch their kids Instagram, TikTok, and Facebook feeds. It feels like an invasion of privacy to be looking over their shoulder, or snooping on emails and text messages. As a therapist, be vigilant to what your students have access to.
- Normalize appropriate grades. Emphasize appropriate expectations for students. Not all students can achieve great grades, but rather they should be pushed to their potential and demonstrate good effort. Encourage children that the most important measure of success is effort.
- Talk with your kids. Start by teaching them to express themselves, either through words or pictures. Mental health for students starts by talking and listening. Practice listening. Children will often open up in therapy sessions (OT, PT, speech) because we have helped them with self-regulation, and they are in their just right zone. We take the time work with them one on one, or in small groups. We put a significant amount of pressure on ourselves to provide jam packed treatment sessions. This is a great work ethic, but make sure there is time for talking and listening. I will often get much further in OT sessions with a student, than if they go to traditional counseling.
- Educate on mental health. Start talking to school administration, teachers, parents, and other community members. Make them aware of the challenges facing our students. I wish more parents had parenting classes, and pediatricians were more vigilant. OTs often build a great rapport with parents and other support people. We become trusted members of the team. Use this trust to provide support and education to families.
WHAT HAPPENS WHEN STUDENTS ALREADY HAVE MENTAL ILLNESS, and we are beyond prevention?
Sometimes, despite all our efforts, students still suffer with mental illness. We need to be hyper vigilant with these students. After removing and monitoring potential hazards, we need to offer support. Support comes in teaching coping skills. Students often lack the skills to deal with adversity. Not only do they not have the skills to talk about their feelings, but they do not have the mechanisms for dealing with them.
Provide resources and help with:
- Coping techniques
- Mindfulness
- Relaxation breathing
- Stress reduction for teens
- Social skills
- Check out the OT Toolbox Mental Health Archives and topics on Mental Health
- Understanding sensory dysregulation can also help provide support
This is a heavy burden and conversation. It is easy to get bogged down in all that effects our young people. Like I mentioned, I lose sleep over this. I try to remind myself to do what I can, and help one person at a time. I try and practice what I preach (although I could eat better and shop less). Try and be an advocate for change, even if it only effects the mental health of a couple of students.
Victoria Wood, OTR/L is a contributor to The OT Toolbox and has been providing Occupational Therapy treatment in pediatrics for more than 25 years. She has practiced in hospital settings (inpatient, outpatient, NICU, PICU), school systems, and outpatient clinics in several states. She has treated hundreds of children with various sensory processing dysfunction in the areas of behavior, gross/fine motor skills, social skills and self-care. Ms. Wood has also been a featured speaker at seminars, webinars, and school staff development training. She is the author of Seeing your Home and Community with Sensory Eyes.
