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FAQ: What you need to know about mental health and schools

Seattle Times - 9/2/2020

Sep. 2--More and more Washington youth report feelings of anxiousness, hopelessness and suicidal thoughts -- and there's something we can do about it.

Although some families can afford mental health care outside of school, many families can't. For this reason, schools tend to play a role in children's ability to get help when they need it. A healthy well-being is critical for students' academic success, and across Washington, education leaders, teachers, parents and students themselves say they are taking youth mental health seriously.

How students access mental health services is bound to be more challenging during school closures, but many who are on the front lines of this work are looking for creative solutions. Here are answers to common questions about this topic.

What do we mean by 'mental health'?

Mental health is made up of a diverse set of social, psychological, emotional and physical factors. Like health, everyone has mental health. It's part of how we think, feel and act on a daily basis. Mental health is generally thought to be on a spectrum: It can vary from day-to-day, and from one stage of life to the next.

Mental health is different from mental illness, and these words are not interchangeable. Mental illness refers to mental health conditions that change a person's pattern of thinking, their mood or their behavior. Depression, anxiety, bipolar disorder and schizophrenia are a few examples of such conditions; like mental health, the severity of these conditions and their traits are on a spectrum. Many mental health conditions are highly heritable, but environmental factors may also be at play.

The words people use to describe mental health vary. Why?

How to approach conversations about mental health varies from community to community. Among some communities, mental health conditions are viewed as a weakness; in others, mental health isn't discussed openly, or at all. Some people are discriminated against if they have a mental health diagnosis, and face stigmatizing language or negative opinions from people around them. We hope our coverage helps break down such stereotypes and myths.

In the United States, mental health care is sometimes based on approaches that don't take family situations or cultural needs into account. To better represent these perspectives we include voices from a range of affinity groups from across the region in our coverage.

How common are mental health conditions among Washington youth?

Most of what we know about youth mental health in Washington comes from a statewide analysis called the Healthy Youth Survey; about 230,000 students from 900 schools participated in the most recent survey in 2018. The questionnaire has historically asked sixth, eighth, 10th and 12th graders questions about their well-being, bullying and whether they feel supported by adults, among other things.

The most recent data is relatively bleak. Feelings of anxiety, suicidality and hopelessness -- a proxy for depression -- are common among youth in Washington. For instance, about a third of 10th graders say they're often anxious, and roughly one in 10 attempted suicide in the past year. Many of these traits are more common than they were in 2008: Roughly a third more students report feelings of hopelessness and suicidal thoughts than did students back then.

LGBTQ students, and some students of color, such as Hispanic and non-Hispanic American Indian students, report high rates of suicide attempts. More girls than boys say they've made a suicide plan or attempted suicide.

How do Washington schools help students with mental health concerns?

In short: Tt depends. It depends on where you live, where you or your child goes to school, and what resources are available.

In the broadest sense, all Washington public schools are supposed to hire staff -- counselors, social workers, psychologists or some combination of these -- to help students in need. Schools have varying amounts of funding to hire people for these positions. And these staff have different levels of training, and time, to help students work through their concerns.

These staff may be responsible for helping children with mental health concerns, but they may have other competing responsibilities, such as creating special education plans. For instance, many school psychologists say they spend their time writing students' special education plans; some children with mental health conditions may need special education accommodations, and get support from school psychologists, while others may not. Likewise, some school counselors tend to students' social and emotional needs, while others focus on student academics.

Some schools, or entire districts or counties, work with outside health care and community providers to boost students' access to mental health professionals; during the pandemic, many of these services are being offered remotely. But there are limits to how schools intervene. Some children need more intense medical interventions that aren't feasible or appropriate to provide in school settings.

What's next?

Many schools say they are stretched thin to help students. Some state lawmakers have recognized this, and this past legislative session, drafted several bills aimed at improving access to mental health care in schools. One bill, for example, would have changed the state's funding formula for school counselors and other staff. A second bill aimed to empower school counselors to spend more time working with students one on one; many counselors say they're frequently called on to do tasks outside their job description, such as monitoring recess.

These bills both died in committee. But lawmakers have said they hope these proposals drummed up interest in making lasting change.

Former Seattle Times engagement editor Anne Hillman contributed reporting.

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