Every seat was full in the classroom as teachers gathered to hear what they could do to help students with mental illness. But the answers were complicated.
Dealing with mental health issues among their students is a growing issue in schools. Teachers might spend more hours per day with teens than their parents do, but how do they help children address problems ranging from stress and anxiety to severe abuse and post-traumatic stress disorder?
Several times a year, teachers and school employees can gather for a day-long training session in Belleville with experts from local mental health agencies to study issues specific to teens and how best to handle them.
Jamie Martens-Perry, of the agency Chestnut Health Systems, said a teacher can have 30 students in a class, several of whom might have a personal problem or mental health issue such as depression.
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“You can’t spend all day in group therapy — you have to educate,” Martens-Perry said. There is usually a school social worker, but he or she might have as many as 5,000 students in a caseload. And a social worker can’t share personal details with the teachers without the student’s permission, which is a difficulty for teachers who could help more if they knew what was going on, she said.
The student might have parents working two or three jobs, and school might be where they get the most adult interaction, according to Natalie Ruth, also of Chestnut Health. Social media can inflate conflicts with other students, and students might be crying in the bathroom or even inflicting self-harm.
Ruth said teachers must face how mental health issues and depression can affect the student and the classroom, but it is also a matter of safety for other students and faculty and staff. “If a kid is hungry or something is going on at home, how do they focus on math class?” Ruth said.
At the same time, approaching parents might be difficult if the parents are resistant; and it gets even more complicated if the parents are divorced — or if the parent is the problem.
In an example Martens-Perry mentioned in a training session, a girl complained to her teacher about having trouble with her chores and not wanting to do them. It turned out one of her “chores” was showering and sleeping with her father.
Cindy Steele, a school psychologist with Edwardsville District 7, said they have tried to incorporate mental health into the curriculum, working on self-esteem and coping strategies for stress from an early age. Older students are taught about the warning signs of depression, about developing trusted relationships with adults and how to tell an adult when a friend is showing signs of depression or suicidal thoughts.
If parents consent, Steele said, the school can help link them with professional help, which she said is important.
“The more the educational team can be linked with mental health and a medical team, the better for the student,” she said. “Once the student is safe to reintegrate back into the school setting, we have collaborative teams to develop a safety support system for the student. … There’s a lot of teamwork.”
Steele said Edwardsville has been “very fortunate” to keep a good ratio for staff — two social workers, one or two school nurses and one psychologist at the high school, with another psychologist at EHS South, the alternative high school. That’s the team for nearly 2,400 students in the largest school district in the metro-east.
In 2017, Edwardsville District 7 also started offering technology that students could use to anonymously report concerns, including those about suicide. School officials recently started offering the same service in Collinsville Unit 10.
High Mount School in Swansea also gives students a place to talk with their classmates about the issues they face. School social worker Yvette Hicks created a class for students in seventh and eighth grades that’s all about becoming a teenager. It covers topics such as self image, drugs, questioning authority and bullying, and it tries to teach decision-making and coping skills.
“They start talking about different situations without sharing names if the person’s not here to volunteer that, and because of all of the support that it generates, the ability to assert what’s going on, there’s so much empathy amongst the other kids because they understand that,” Hicks said. “‘I’ve been in those shoes’ or ‘I could be in their shoes’ even if it’s not mental illness, but just the ability for our kids to be able to empathize with one another goes across the whole area of our school and our school culture of support.”
Collinsville High School Principal David Snider said in addition to other outreach efforts, CHS was host for the National Alliance on Mental Illness and the American Foundation for Suicide Prevention for Mental Health Week this month.
“We rely on our school psychologists, social workers and counselors who have the expertise to assess student needs and facilitate referral to appropriate community resources,” Snider said. “They utilize the latest research, best practices and ethical considerations to do what is best for the school body as a whole. There may be times when individual students or parents do not see — or agree with — the complete picture.”
Schools must work with confidentiality policies and regulations, and what Snider called a “woeful lack of societal resources” for students and families affected by mental illness. “Access to these services is what will make a difference,” he said.
However, Snider said the district is constantly looking for ways to improve, and “we encourage conversations with students and families.”
At one point in the St. Clair County training for educators, the teachers were given an example of a student who appeared to be having some problems. Sometimes they were listed in the role of teacher or coach, sometimes as a parent.
Approaches varied: A home visit for a troubled student might be effective but wouldn’t necessarily be considered appropriate. They discussed ways to show the student they are listening: making eye contact, nodding, repeating some of the things that are said without interrupting.
Discussing the problem in front of the class is never a good idea, they said, but they have to find ways to reach the students, let them know someone cares, someone has noticed what’s happening with them and wants to help.
What doesn’t help? Glancing at a phone or a watch, looking away, asking unrelated questions and interrupting.
Language matters. “We use a lot of inappropriate words regarding mental illness: crazy, bananas, psycho, loony, weird, not right in the head,” said Martens-Perry with Chestnut Health Systems.
She said she was once in a professional meeting with a school superintendent who said, “Oh great, you’re going to come in and take care of all my crazies.”
Martens-Perry said she replied, “I would really hate for you to talk about my dad like that.”
Steele, the school psychologist from Edwardsville, said it’s important for schools to build a climate where students can have trusting relationships with adults and feel safe, so they can help them cope with trauma and gain tools to hope for positive outcomes.
But after more than two decades working in schools, Steele said she has seen suicide move up as a leading cause of death among teens. “We are better at catching it, but there are a number of societal changes that can impact students,” she said.
Stephanie Lynn, of O’Fallon, primarily teaches students online as far away as Arkansas, and students will confide or share things that cause her concern. She went to the mental health training in order to find out the best way to handle those situations and know when to encourage them toward professional help.
“Our biggest goal is that this will help us do our jobs better and help the families,” Lynn said.
Another teacher, Shelley Schaefer, of Waterloo, attended the training to prepare for teaching a new age group in the next school year. “I needed a rundown of what I will see in the classroom, more behavior difficulties and challenges,” she said. “I think we are recognizing this need and getting the information out there more. We are able to talk about it and de-stigmatize it. … We have to make everybody understand that it’s an illness, not a weakness.”
Schools are sometimes “the front-line defense” to pick up on mental health concerns because they are with the children and teens for so many hours of the day, according to Jenna Farmer-Brackett, of the mental health agency Centerstone of Illinois.
In fact, many schools in Madison County are inviting in service providers such as Centerstone to work with students.
“There’s a greater recognition that there is more assistance needed,” said Jennifer Roth, executive director of the Madison County Mental Health Board. “You can’t compare generations, but there are a lot of kids with problems. We are more aware of it, but I also believe there’s a lot of disconnection, too. We don’t do a lot of socializing the way we used to; Facebook and online has taken over face-to-face communication and time together.”
The Madison County Mental Health Board also offered five days of training on trauma sensitivity that school staff and administrators could attend.
Those partnerships also can help alleviate the funding crunch that might mean one social worker for multiple schools or thousands of students, Farmer-Brackett said.
“That age is rough,” Farmer-Brackett said. “There’s a lot of things going on. If we can get into the environment where these things are happening, it can be effective for us to be in that environment where the stressors are coming from.”
Debbie Humphrey, associate director of the St. Clair County Mental Health Board, said the regular training sessions at the St. Clair County Regional Office of Education teach people how to be comfortable asking questions of a student who might be considering suicide.
“You’re not going to plant that in somebody’s mind by saying, ‘Are you feeling like hurting yourself?’ or ‘Do you feel suicidal?’ You need to just really be honest and ask that question,” Humphrey said.
Hicks, the school social worker, said High Mount wants to talk openly about suicide and mental health and teach students how they can help each other: not by trying to solve their problems but by listening to them.
“We want them to recognize it if it’s them and to recognize it’s OK to say, ‘I have some depression. I do, and I’m OK with that’ because once you recognize that, now your plan is ‘How am I going to manage this to live my full life, to live a healthy life?’ because it is possible,” Hicks said. “So we are breaking the stigma of mental health in so many ways.”