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NPR

A Silent Epidemic

Our public schools are struggling
to handle millions of students
with mental health problems.
Here’s why.

Sept. 7, 2016

There are more than 50 million public school students in the U.S.

Source: 2013 CDC report on children’s mental health

As many as 1 in 5 shows signs of a mental health disorder.

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A mental health disorder is a condition that disrupts a person’s mood, thought or behavior, often for a long period of time.
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When a child is struggling, it is harder to learn.
Kids who suffer from mental health disorders … inevitably miss out on opportunities for learning and building relationships.

— David Anderson, expert on schools and mental health at the Child Mind Institute

Most of the nearly 5 million affected students — nearly 80 percent — won’t receive counseling. Or therapy. Or medication. They won’t get any treatment at all.

Source: 2002 research in the American Journal of Psychiatry

In every school, there are people who could play a big role in identifying problems and helping these kids succeed.

But far too often, they can’t.

Teachers see students every day and could spot sudden changes. But teachers have almost no mental health training. And they have lots of other roles and demands.
Counselors can help. But there just aren’t enough of them. On average, every counselor has nearly 500 students.
School nurses are medical professionals. But often one nurse is responsible for hundreds of students. Many schools don’t even have a full-time nurse. Or they have to share one.
School psychologists can be the best people to step in. They have the specialized training — if a school is lucky enough to have one to itself.

In a perfect world, all these professionals would work together.

Here’s how experts say a system might look:

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Level 1 From parents to principals to teachers to the lunch staff: Everyone helps create a safe, caring environment. A place where mental health problems aren’t stigmatized. Everyone watches for warning signs in a child — such as changes in mood, headaches, slipping grades and missing class.
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Level 2 When those warning signs pop up, specialist staff — counselors, nurses or school psychologists — step in.
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Level 3 If a student needs outside help, the specialists make the call. Some schools have a visiting psychiatrist or an in-school clinic.

That’s how it should work.

But it hardly ever does. There are too many other demands and not enough training.

And staff are sometimes dividing their attention among hundreds or thousands of students.

Visualization of ratio
21-27 students per class
Visualization of ratio
491 students per counselor
Visualization of ratio
1,151 students per nurse
Visualization of ratio
1,400 students per psychologist
Mental health is all too often one of the last things that we pay attention to, even though we know how immensely important it is …

— David Anderson, expert on schools and mental health at Child Mind Institute

In schools, mental health should be everybody’s job.

Too often, it ends up being no one’s.