Mental health is one of those topics that Americans don’t like to talk about much, unless it is forced into public view by tragedies such as Monday’s mass shooting at the Washington Navy Yard by a man who told police that he was hearing voices shortly before he killed 12 people. In the area of school reform, the mental health of students has been ignored too, despite the irrefutable fact that sick kids have a hard, if not impossible, time learning in class. But the consequences of failing to address mental health issues in students goes well beyond academic problems, as a 2013 study reveals.
The 2013 study, called “Blind Spot: The Impact of Missed Early Warning Signs on Children’s Mental Health,” was written by Andrea M. Spencer, dean of the School of Education at Pace University in New York and educational consultant to the Center for Children’s Advocacy.
Spencer looked at data from 102 case studies drawn from school records of students ages 12 to 16 who had been referred to an area advocacy center because of persistent school failure, truancy, juvenile justice involvement or other court involvement. She sought to find out the types of developmental and social risk factors associated with behavioral and mental health problems in early adolescence, and what kind of services student get once they are identifying with mental health issues.
Spencer found that more than one in five Connecticut children struggles with a mental health or substance abuse problem in any given year — but that more than half of them get no treatment even though warning signs can appear as early as preschool.
For too many children, the interrelationship between mental health problems and poor academic outcomes is reflected in limited educational progress from their entry into school through their secondary school years.
Difficulties emerge early, with rates for expulsion from pre-school exceeding those of children in Grades 1-12, according to a national study conducted by the Yale Child Study Center. The same study notes that Connecticut had one of the highest rates of expulsion from state-funded preschool, with more than 10 students expelled per 1000.
The study also found that:
• Over 70 percent of students diagnosed with mental illness and behavioral health problems by middle school exhibited warning signs by second grade.
• Almost 25 percent exhibited red flags during pre-kindergarten years, including developmental and health issues, adverse social factors and exposure to trauma.
• Twenty-five percent of the children studied had documented traumatic experiences in their records.
Yet it is not until middle school that mental and behavioral health problems are identified, according to educational records of children referred to the Center for Children’s Advocacy, a Connecticut nonprofit that provides legal support for abused and neglected children.
All of the adolescents in the sample had evidence of significant behavioral and/or mental health problems and 51% had or were at-risk of court-involvement, juvenile justice intervention, or through court referral for families with service needs. Multiple school suspensions, aggressive incidents, and explosive or disruptive behavior were common (82%). Depression (25%), anxiety disorders (20%), post-traumatic stress disorders (17%), suicidal and self-injurious behaviors (16%) were evident as well, with 17% of students documented as having been hospitalized in psychiatric settings, some for multiple times or for extended periods. Twelve per cent of records contained reports of physical, emotional, or sexual child abuse.
Spencer recommends better and earlier screening and identification of students with early risk factors, which are identified as
… those developmental, genetic, physical, or health issues that may place children at risk of mental health issues in childhood or adolescence. Examples include prenatal exposure to drugs, history of lead poisoning, sickle cell anemia and history of head trauma. There is evidence that a number of other chronic health conditions, such as asthma, ear infections and other medical conditions impact not only school success, but also appear to have a complicated relationships to psychosocial and mental health status…
Adverse social factors that can influence mental health include
… interrupted schooling, parental loss/incarceration, homelessness, foster placements, exposure to domestic violence, abuse, and other traumatic experiences.
Spencer also makes the following recommendations:
• Improve referral to early intervention services (mental health and special education)
• Improve collaboration between service providers
• Improve community and parent education about risk factors and support available
• Improve training and accountability for school staff and other providers