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.

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.

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.