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Twenty percent of kids sitting in classrooms are mentally ill. [8:41m]: Play Now | Play in Popup | Download (358)
Twenty percent of kids sitting in classrooms are mentally ill. [8:41m]: Play Now | Play in Popup | Download (358)Twenty percent of kids sitting in classrooms today are mentally ill. That’s shocking. What’s even more shocking is that only 1/5 of that twenty percent are getting treatment.
I could hardly believe my ears tonight when I heard that statistic on TVO’s The Agenda with Steve Paikin. Next week, May 3 - May 10, 2008 , is Children’s Mental Health Week and I suppose that’s why the program, “Kids aren’t right” aired tonight.
Steve Paikin discussed mental health issues with a panel consisting of
Leena Augimeri is the director of Program Development and Centre for Children Committing Offenses at the Child Development Institute, and adjunct assistant professor and sessional lecturer at the University of Toronto.
Carol Ann Curnock is a Special Education teacher for the Toronto District School Board. She teaches a self-contained class for learning disabled students in grades 6, 7, and 8. Dr. Curnock has degrees in Education and Counseling Psychology and a diverse background in both education and mental health.
Cathy Dandy is trustee for Ward 15 with the Toronto District School Board.
Susan Hess is president of Parents for Children’s Mental Health and the mother of a daughter with serious mental health problems. Susan was the driving force behind the creation of a Quilt of Honour, designed to be a visible testament to all children who struggle with mental illness.
Richard Meen is associate professor in the Department of Child and Adolescent Psychiatry at the University of Toronto, Faculty of Medicine. He is clinical director and psychiatric consultant with Kinark Child and Family Services.
Steven Singerman is a school social worker with the Toronto District School Board. Steven is also director of Clinical Development Resources & Concerned Parents’ Seminars and has a private practice in counseling and psychotherapy.
a distinguished panel to say the least.
At first I was totally shocked by the number of kids who are suffering from mental health issues. Twenty percent of kids in classrooms are suffering from mental health issues - that’s an average of 5 kids in a class of 25 students. Wow. Many classes are larger than 25 students. No wonder sometimes classes are so chaotic despite the teacher’s best efforts.
I said at first I was shocked and really didn’t believe was that large, but as I watched and listened to the panel discussion and began to better understand the problem, I realized a lot of inappropriate behaviour that I saw in classrooms could actually be dues mental health issues and not behavioural issues.
Let me just say here, that although I put down my cup of tea, grabbed a piece of paper and took notes furiously, I’m sure I didn’t get everything. Please keep that in mind. I’ve put a link to the web page so that you can watch the video for yourself. I realize my notes reflect who I am - a special education teacher who works with trouble, troubling and troublesome kids all day. I’m going to share what I learned and my thoughts about what I learned.
First, I learned mental health issues can look like behavior issues.
- Falling asleep in class to block out everything, breaking things like pencils, throwing things like chairs or books, shouting and refusing to do what is asked can be a sign of an anxiety disorder.
- Irritability, behaviour problems, explosive behaviour, disruptive behaviour, ADHD type behaviour of not focusing, not be able to concentrate , not being able to sit still can be a sign of depression. Depression is not just quiet behaviour of withdrawn.
- Anger is sometime mislabeled as bad and the assumption is that kids can be disciplined into good behaviour. Sometimes kids who are bullied respond in anger and that behaviour gets misdiagnosed.
I’m not a counselor, a social worker or therapist. I am a special education behaviour specialist. I can suspect mental health issues and then bring my concerns to professionals like social workers , counselors or therapists who are trained to provide treatment.
In fact, even as a special education behaviour specialist , I don’t know that much about mental health issues. My special education training was mostly about identifying behaviours and trying to put strategies in place to change the undesirable behaviour into a desirable behaviour. I’m not a special education specialist in mental health issues. Maybe there needs to be such a thing If 20% of kids are suffering from mental health issues.
Now, if I as a special education specialist has difficulty recognizing and identifying potential mental health issues , how does a regular classroom teacher fare. The panel maintained that the regular classroom teacher doesn’t get enough training to recognize mental health issues when they arise in the classroom. Teacher training is more concerned with curriculum and classroom management. That definitely needs to change. There’s no doubt about that.
Teachers have to have more training in recognizing potential mental health issues so that they can identify kids and bring their concerns to administration so that kids can get the appropriate help. We have meetings every month where we raise concerns about kids, but because our model is mostly behavioural that’s what we see. Our behavioural lenses determines what we see. What we need are bifocal lenses so that we can see the mental health issues as well.
I know that it’s really important for these kids to get help
- Some of these kids are so disruptive in the classroom that they preventing other kids from learning. It takes so much of the teachers time to deal with those disruptive 20% that we have little time for the other 80% of the class.
- All kids have a right to learn and anything that interferes with that learning is not acceptable and needs to be dealt with in an appropriate way. If a student is acting a certain way because of mental health issues lets not punish the student but get treatment for that student so he too can learn and be successful in school.
- These kids need help so when they grow up and become adults they can function optimally to become contributing members of society.
- These kids need help so that the family dynamics and life can improve.
- These kids need to be identified and receive treatment so that they can develop to their full potential and lead satisfying life.
There’s just no excuse.
I’ve also learned that there are seven years of warning about mental health issues. The first warning happens at age 7 when kids get into minor problems at school, then age 9.5 , then age 12 and finally age 14.5 when kids get into very serious problems with the law. When we look back, we can see the signs. Let’s not wait until kids get themselves into trouble and all we can say is “He was trouble in grade two. What do you expect”. I expect better.
Unfortunately, I’ve seen that pattern myself but didn’t recognize it for what it was. I thought it was a behaviour problem, just as I was trained to do and then devised strategies to help turn that behaviour around. Regrettably, sometimes none of the strategies worked and I could only feel badly. What good is feeling badly. I’m getting angry now just thinking about how the system is failing kids. I’ve thought that grade nine is too late to to help some of these kids.They really need help in grade one. I wasn’t wrong.
I’ve learned that in the Toronto Board there is one social worker for every seven schools, and it can take up to seven months for non emergency cases to have a psychological assessment done. I’m not sure what it is in other district but I know that it takes about the same time in my district. Getting a quick psychological assessment seems impossible at this time. That’s got to change if we are serious about helping these kids.
I’m still shocked about this whole thing. Twenty percent of kids sitting in classrooms have mental health issues and only 1/5 of them get treatment. I’m really glad I decided to sit down and have that cup of tea and watch The Agenda tonight. I have to say that this program tonight has been an eye opener. I have to do something. What I’m not sure yet. The first thing I’ve done is to write this post and share what I’ve learned with you. Beyond that, I don’t know yet. But I cannot, not do anything. My conscience won’t let me.
What will you do?
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Elona:
I appreciate your posting and the thought that has gone into it. I have worked as a social worker (not in a school), and a brief stint as a teacher, but mostly I am a parent. I have a child with bipolar disorder. This is the base for my experience and many of my reactions as I read your commentary.
I appreciate your concerns, first and foremost, and believe that there is in fact much that schools have to learn about students with mental health issues. But think about how we react. Imagine if a panel had said to you that 20% of students in a classroom have physical health issues–and only 1/5 were getting treatment for them. What would you know? And would your sense of alarm be the same? My point is that physical illness runs a gamut from mild allergies and runny noses through childhood leukemia and HIV/AIDS. Each of these is likely to affect a child’s classroom behavior in some way, but in a wide range of ways from exhibiting mild discomfort and distraction to daily seizures.
The same is true with mental health issues. As you point out, depression in children may manifest in ways that are not expected, but so can depression in children spring from a variety of causes (situational through bio-chemical) and be episodic or chronic. The result may or may not be classroom chaos–or 20% of students preventing the other 80% from learning.
I think that you have set up a false dichotomy is classing yourself someone knowledgeable in behavior as opposed to someone knowledgeable in mental health. It may even be something of a false dichotomy to separate physical from mental health (I have read that some clinicians are advocating that bipolar disorder be checked off as “other health impairment” on IEPs). Behavior is always a very important key to understanding when something is not right with a kid. Recall when a baby is sick and too young to “tell where it hurts.” Moms look for things like not playing as usual, tugging on their ear, clinging, etc.
In going through a diagnostic process–and arriving at an effective medication regimen, it was all about looking at behavior. At one point, in order to see if the medication was having an effect, we asked his teachers (all special education teachers) to to put some dots on a graph to record anger and sadness a couple of times a day. They had a really hard time understanding what they were to do. What they wanted to do was to talk to him to get him to change what his behavior was indicating.
We recently had to “break in” an new professional in the vast network involved in my son’s life. This person is a social worker–and wanted to know about the reason for the IEP, asking “is it just for behavior?” It is really hard to know how to answer questions like this. I shared the diagnosis–but in his mind any “mental health” diagnoses were “just about behavior.” Actually, the kinds of behavior that we have dealt with in the last five plus years in school aren’t the kind that wreak havoc–they all have to do with escaping from things he cannot do.
For instance, one common component attached to bipolar disorder (that docs don’t necessarily think about, and isn’t a “behavior”) is grapho-motor difficulties. In other words, the writing process is so labored that it is a terribly ineffective conduit for learning or showing what has been learned. So copying sentences from the board into a notebook is a torture and a waste of time. But it is a common “accommodation” for kids in “special education.” One of the other effects of his disorder on his education is that, particularly in the early years of diagnosis and medication changes, he had a lot of “bad days,” along with good days. It would make sense to try to maximize protections for the bad days and maximize the learning on the good days. But the behaviorists were always insisting on punishing for the bad days on the good days that followed, or trying to motivate good days by setting rewards (like going on the field trip) for a string of good days. It would have made so much more sense, both in terms of classroom managment and his understanding of the ups and downs of his disease to say–if you are having a good day when we go on the trip, you can go. If you are having a bad day, we will see that you have a quiet day here and hope the next time works out better.
I am happy to read your commitment to doing something. I suggest that you talk to some parents about their experiences. I suggest you keep going to learning experiences that focus on kids with “mental health” issues. I think that these things are far more important than worrying about how quickly you can get a diagnosis. Once you have a diagnosis, what will be different. I would urge you to allow your professional practice to be enriched (for all kids) by the learnings of the mental health field. Glad you’re out there.
Margo:
I think that what Elona was headed to was the concept that behavior is communication. It’s a symptom; just like a headache may be a symptom for a variety of ailments from minor to serious (is it eyestrain, the flu, a migraine or a stroke?) Behavior doesn’t exist in a vacuum, and it’s a fair job getting the lawyers to understand this.
I am a special education teacher in middle school. I will use a particular student as an example. He came in to my new class of 6th graders with reading and writing delays that were fairly serious, so already there’s some frustration going on. What was worse was his intense–and I mean white-hot, nuclear-powered, blindingly intense–anger that would flare up in a second–never mind heading off his “escalation”, you never saw it coming. It blindsided teachers and students alike. Coupled with that was his inability to let go. You could just SEE the kid turn the incident that angered him over and over in his head, giving it momentum like a snowball rolling downhill. I would try to talk him down but he would just look right through me and next thing you know he was throwing punches and cursing up a storm.
My AP would just give him detention, but as someone with a low flashpoint myself, I could see what was wrong. Not only that, but I’d had his brother a couple years back, so I knew his mom’s parenting style (definitely a colorful one). Yes, it was considered a “mental illness” and he did get regular therapy. By the end of the year, after talking myself blue in the face and basically drawing a picture for the kid of what I saw him going through, he started taking my cues for not saying what came into his head, accepted removal from the class NOT as punishment, but as a “breather” and actually accused me once (in a nice way) of reading his mind when he was about to blow. He was starting to let the adults around him help him get over things. At the end of the year he said to me, “You know all those times I got mad at you called you names, and said I didn’t care what you did to me? I really did care. ” I asked him if he understood that I already knew that and he did.
My point is not that I’m some great teacher. This kind of success happens with maybe one difficult kid per year. He is responding to a lot of talk therapy from his counselor (weekly) and me (daily). HE’s doing all the work–and it’s important to let him know that it’s HIS success. It’s a situation where identifying the antecedent to his behavior and making him aware of his triggers works in a normal classroom situation. For a lot of kids, a normal classroom, even a normal special ed. classroom with fewer students, is too little structure. They need more monitoring than than that. They need adults who do not take it seriously when they are flung with insult after insult. They need adults who they can bump up against emotionally without getting hurt.
One of the BIG problems I see is that when we do behavior analyses on students, no analysis actually happens. We are taught, as teachers, that we are NOT mental health diagnosticians, but I am beginning to think that ALL teachers should have a lengthy component of this in their training, not just a short survey of different conditions, which is what we get now. “Classroom management” skills are a joke the way we are taught to use them. And most teachers are either working in classrooms too large for them to really get to know their students, or resent any type of assistance in this area, or view it as beneath them to get to know their students as individuals (those teachers who engage in the “us and them” talk).
All I can do is work on it in my classroom. Making it emotionally expensive for the students to act out by strengthening my connections with them, loving the ones who try to make themselves as unlovable as possible, teaching the kids to analyze themselves when they feel “wrong” inside. I put up with being regarded as an enabler by other teachers and suspected of being “easy” on them. But because it’s about the kids, not the adults, I don’t have a problem with that! And if I don’t do all that, I won’t be able to recognize when a student has a problem more serious than I am able to address.
Margo,
Thanks so much for sharing your insights about mental health issues. I’ve taken a long time to respond to what you have said because I wanted to reflect carefully about what you have said.
I don’t think I’m setting up a false dichotomy by classing myself as someone knowledgeable in behavior as opposed to someone knowledgeable in mental health.
The training I got about behaviour did not include mental illness.It included what to do if a student is misbehaving because he is bored, is in a power struggle, wants revenge etc. It was not what to do with kids who exhibit behaviour due to being manic or depressed or suicidal.
Margo’s experience is much like mine. When she says
“Making it emotionally expensive for the students to act out by strengthening my connections with them, loving the ones who try to make themselves as unlovable as possible, teaching the kids to analyze themselves when they feel “wrong” inside. I put up with being regarded as an enabler by other teachers and suspected of being “easy” on them.”
I’m pleased to say that more training around mental health issues is being made available for teachers but first we need to know that we need the training because we teach kids who have metal health issues and are not “just kids acting bad”.
In September when I’m back at school, I’m going to look into this whole area and make sure people are aware that so many kids need mental health support of varying degrees.