How to Improve Mental Health at School

You can listen to this episode of the MindShift Podcast on Apple Podcasts, Google Podcasts, NPR One, Spotify, Stitcher or wherever you get your podcasts.

Mental health has only become more important and more fraught as the pandemic has confined children to their homes and limited their social interactions. With parents losing jobs and COVID-19 claiming loved ones, adolescents are experiencing a lot more strain on their mental health.

“There’s just a lot more worry about everyday things. So there’s anxiety about things – and I’m not talking necessarily diagnostic anxiety. I’m just talking about the result of living in a really chaotic, stressful world,” says Tracy Smith, director of the Wright Institute’s School-Based Collaboration, a clinical psychology program that connects therapists in masters and doctoral programs with schools in the San Francisco Bay Area.

According to Smith, middle-school-age students experienced anxiety about general safety and whether they’re communicating with their peers enough, whereas high schoolers are stressed about family security and took on more responsibilities like childcare or jobs outside of school.

There are ways, however, that schools can try to ensure that children can get their needs met when they are struggling and be proactive about maintaining their mental health and wellbeing. Long before the pandemic, educators at Urban Promise Academy (UPA), a middle school in Oakland, California, started offering their students therapy services through a partnership with the Wright Institute to address mental health concerns. UPA’s students faced things that many adolescents experience, like anxiety, trauma and self harm. Although UPA uses social and emotional learning and counseling that’s common in many schools, they benefited from having therapy services that offer individualized and hands-on support tailored to each student. With a few big adjustments, they continued to support students’ mental health even when they were no longer in school buildings.

Cultivate a Positive School Culture

When UPA first opened in 2001, the founders, including current school counselor Mary Ellen Bayardo, wanted to create a school that responded to students’ needs and focused on student mental health. Bayardo worked to destigmatize mental health care by giving counseling and support services a strong presence at the school. Outfitted with plush chairs and blankets, her counseling office is a comforting space where students are encouraged to drop in with any concerns. “When you have that kind of environment, you really get all the information you need to be able to really match the services to the kid,” says Bayardo.

School environments are complex and one solution rarely solves all problems. Additionally, people often overlook how schools can be sites of trauma and the attention is usually focused on addressing the trauma that children “bring to school.” For UPA, school culture was as important as the services themselves. “If a school is iffy or mixed about how important mental health is to education, we have a harder time,” says Smith about how schools must normalize mental health care to make therapy services more effective.

Getting Help

Strong relationships with teachers is a priority at UPA because teachers are instrumental in noticing signs that a student might be in need of support. Research shows that it’s important for children to have at least one trusted adult in their life. “We’ve had strong leadership and because we have teachers that stay for years and years, this is what’s built up: that core of resiliency, that core of safety and stability,” says Bayardo.

One UPA sixth grader I spoke with got connected with therapy services when a teacher noticed she had lower energy than usual. “[The teacher] said that it’s not good to keep my problems inside of me. It’s better to talk to someone than to keep it to myself,” said the student, recalling when her teacher invited her to use UPA’s therapy services.

Many students are new to therapy and just starting to learn how to describe their complex emotions as they navigate home life and adolescence. “There are questions that I really don’t want to answer, but I have the need to answer them because I don’t want to keep them in my chest,” says the sixth grader.

But not all needs are visible to teachers, so in order to help identify students in need of support, UPA distributes a school-wide student wellness survey every six weeks. These types of surveys are used in school districts around the country to assess every student and then connect them with services. The survey asks questions such as, “Is there food in the fridge?” to get more information about how things are at students’ homes. There are also questions about students’ experience at UPA like: “Do you have friends?” and “What is your overall rating of UPA?” Then there are general questions about their state of mind, including “How are you feeling?” and “Do you need support for those feelings?”

After receiving survey results, Bayardo and other members of UPA’s care team will follow up individually with students who need help.

Connecting with Reluctant Parents and Caregivers

Even though UPA has systems in place to provide mental health services, parents and caregivers play an important role. However, it can be challenging for schools to engage them. In particular, many families of color and caregivers who are recent immigrants have stigma around therapy, so they are often concerned when asked if their child can be in therapy, according to the National Alliance on Mental Illness. That’s where UPA’s family coordinator Glendy Cordero Rodriguez plays an important outreach role. She’s there to help families, often in Spanish, understand how therapy can help their children.

“I personally make the first call to the families and let them know how we have our intakes for therapy,” says Rodriguez. “I explain to them clearly what those reasons are – mainly feeling overwhelmed, stressed out, all other emotional situations that had been happening in the child’s life.”

She works with parents and caregivers who are initially resistant to having their children start therapy and patiently answers any questions they might have. She’s even invited them to see their child on the playground. Her hope is that parents see the way their child interacts with others and gain insights into bullying, isolation or fighting that they wouldn’t know about at home. She also provides resources like parenting workshops or English classes to caregivers to support families and build stronger community relationships.

Parents’ continued support is important. “Not just by signing the agreement or waivers,” says Rodriguez. “But as well to continue developing their skills at home so they can support the child.”

Communication and Flexibility

When remote learning started, UPA had to scramble to make sure students had the devices they needed to continue therapy at home. Some of the essentials include access to Wi-Fi, access to a computer, access to a phone and “enough minutes on the phone to have regular sessions,” says Smith.

“Sometimes, some of our kids don’t have phones, so they’re using their parents’ phones. And so they can only do that when their parents are home,” according to Smith.

With entire families in the house, privacy is also hard to come by. Kids who are normally comfortable sharing about their struggles on campus may shut down when siblings are within earshot. Glendy recalls checking in with a student on Zoom when the screen suddenly got darker. “And I asked, ‘Where are you right now?’ And he said, ‘I opened up my tent in the middle of the living room just to have a sense of privacy.’”

UPA staff addressed students’ access and space concerns by upping the communication and flexibility, knowing that students were going to miss appointments.

“We used to say, ‘Oh, yeah, that student is in room 21, let me go get that kid for you.’ All of a sudden it’s like, ‘I need to find that phone number, I need to track that kid down, I need to make sure we have a secure line – Zoom or phone – for you to talk to that kid,’” says Bayardo.

Bayardo and Rodriguez were constantly following up with students to work around their childcare duties, jobs and device schedules. They tried to find a time that would allow for students to have consistent weekly support.

And with many districts committed to having students in school buildings this year, therapy will continue to be important in supporting students during the transition, especially for children who have fared better with remote schooling.

“What I realized is that for some of my students, their biggest source of stress is their peers,” says Bayardo about kids’ experiences with bullying and social anxiety. She says that many aspects of remote therapy will remain as they figure out the safest way to have students in the school.

“We’ll be checking in with our students and anybody who has anxiety, anybody who’s really having trouble adjusting from pajama wardrobe to dress code, from mom’s cooking to school lunch, whoever is having whatever difficulty. That’s why we have therapy.”