American teens are in a mental health crisis.
If that sounds alarmist, consider that one in eight reported having a major depressive episode in 2019, up 60% from 2007; suicide rates were up nearly 60% by 2018, compared with a decade prior; and emergency room visits among teens for self harm nearly doubled over that same period.
The pandemic made things worse: about a third of teens reported that their mental health was not good most or all of the time (a quarter of boys and half of girls); and nearly half of all teens reported feeling “sad or hopeless almost every day for two or more weeks in a row.”
In a recent report, the Centers for Disease Control (CDC) called the situation “devastating.”
It’s also confusing, because while the numbers cited above paint a dire picture, in many other measures, teens are thriving: drug and alcohol use, sex, and pregnancy among teens are all at 20 year lows, according to the CDC’s Youth Risk Behavior survey.
The good news is that America’s Congressional leaders have reportedly woken up to the threat. In rare bipartisan fashion, they intend to do something about it by allocating billions to solve the problem. We should direct the money to where it will have the greatest impact, meeting American teens where they spend most of their time: in school.
We have physical education and health education classes already, so why not mental health education class? We teach kids to make a habit of exercise and about basic health because we recognize that encouraging physical activity and teaching kids about how to live a healthy lifestyle has a positive impact on our youth. It’s obvious, but physical education has been found to have both physical and mental health benefits for students as well as increase academic performance; and, surprise surprise, a 2018 study in China found that health education helped children lead healthier lives, including spreading less infectious disease.
Why would we expect mental health education to be any less impactful at addressing the endemic mental health disorders we’re now seeing in our teens? Meaningful mental health education would set our children on a trajectory for not only less diagnosable mental illness, but also better relationships, more resilience, and even more productivity later in life.
We already do spend some money in schools on mental health, but it’s woefully little, and overwhelmingly reactive to crises rather than proactive and prophylactic.
Many schools employ psychologists, social workers, and counselors, but far too few of them. According to America’s School Mental Health Report Card, an exhaustive report ranking how each state handles mental health in schools, only the District of Columbia and Idaho have at least one school psychologist for every 500 students—the recommended ratio. Only two states meet the recommended ratio of one counselor for every 250 students, and no states meet the recommendations for social workers (1:250). The states at the bottom of the list employ so few of these essential workers that it’s hard to imagine they are effective: Georgia has one psychologist for every 6,390 students; Arizona has one counselor for every 905 students; and West Virginia has only one, lonely social worker for every 15,433 students.
These underappreciated and overworked professionals are responsible not only for students who are disruptive as well as behavior escalations in the school system (of which there are many!), but they are also typically asked to create a positive mental health culture in the school. With a daily flow of mental health concerns from a population of thousands of students in some cases, this is an impossible task. I think it’s time to give them some help.
Mental health, much like physical health, should be the responsibility of the entire school—not just the school counselor. Instead of conceptualizing mental health as a disease or disorder to be treated, schools should manage mental health by doing what they do best: educating. We need to equip schools with a standard curriculum that addresses critical mental health topics like coping with stress, loss, and trauma, understanding anxiety and depression, and navigating relationships. Imagine mandatory classes that taught mental health “first aid” for life crises, tips for mindfulness and self-care, an introduction to cognitive-behavioral therapy tools, or even media literacy lessons. Knowledge from these classes and tools that are provided early in life could have dramatic positive impacts for youth that would be an excellent return on the investment. Even just opening the discussion about mental health issues in a formal class setting can get kids thinking about their own issues and those of their friends, and how to address them.
“The challenges today’s generation of young people face are unprecedented and uniquely hard to navigate,” said Dr. Vivek Murthy, U.S. Surgeon General, in the introduction to the CDC’s “devastating” report on teen mental health.
As a result, we need to provide children with tools to adapt to a stressful and changing world. We need to educate about mental health itself, using all that we know about the science of behavior and resilience.
It is my hope that someday soon we might equip our kids with science-backed information about protecting their minds from disease, the same way we teach them to protect their bodies. After all, the mind is the very resource that we are trying to cultivate through our schools.