Mentally prepared

By Jan. 9, 2018, parents, teachers and members of the community had had enough.

Over the previous 20 months, seven teens committed suicide throughout Mercer County, N.J. These acts were not isolated incidents, but part of what some continue to call a public health crisis. Just a few weeks earlier, a student at Hunterdon Central Regional High School in Flemington, N.J., took her own life during class time. So in January, hundreds of school leaders, parents and community members from Mercer County gathered at Rider University in an effort to destigmatize discussions about suicide and mental health concerns.

Suicide rates in the United States have risen nearly 30 percent since 1999, and mental health conditions are one of several factors contributing to suicide. While recent reports show a slight decline in suicides among 19-24 year olds, what's more sobering is that the rate among 10-18 year olds is on the rise. The need for mental health education and support is apparent within schools.

A change in behavior

Mental health concerns are on the minds of many, from celebrities discussing their struggles with depression and anxiety, to the #SelfCare movement on social media, to the Netflix show 13 Reasons Why, which details the events leading to a teen's suicide.

"It really came to a head when 13 Reasons Why hit," says Dr. Shauna Carter '07, principal of Community Middle School in Plainsboro, N.J. "It was a young adult novel for years, but maybe a few kids read it. Once it hit Netflix, well, everybody watches Netflix. We had to catch up quickly because our kids were in crisis."

Millions of Americans experience mental health issues each year, with one in five children experiencing a severely debilitating mental disorder, according to the Centers for Disease Control. Those in education are noticing the increase in mental health awareness and prevalence in recent years.

"There have been so many hospitalizations for suicide ideation. I’ve seen over time that stress levels have gone up in students. There’s a whole epidemic of depression and anxiety," says Dr. Christine Abrahams, supervisor of counseling services at Hopewell Valley Regional School District in New Jersey and adjunct professor in Rider's Department of Graduate Education, Leadership, and Counseling.

Defiant behavior is something Karen Abrams '88, '96 deals with daily as a first-grade teacher in the Trenton School District. During her 27 years in the district, it's not uncommon for a student to throw a chair or a desk in anger, slam a door and walk out of the classroom, or aggressively confront another student.

"There's a great need for mental health awareness for parents and teachers in schools because we have major mental health issues in the city," she says. "The students are very angry with everything and fly off the handle easily, and I teach first grade so it's pretty severe. It's definitely getting worse. Where you might have had just a few children in your room with mental health issues in the past, now there's a lot of them."

There is rarely a singular cause for a mental health concern. Some students come from unstable home situations, some are constantly surrounded by negativity, some are born with conditions like ADHD, but larger societal changes exist that are influencing children's mental health.

"Kids are dealing with things other generations didn’t have to deal with in the past. It’s that constant connection that they have to others," says Dr. Karen Gischlar '03, associate professor in Rider's Department of Graduate Education, Leadership, and Counseling. Gischlar teaches a variety of courses in the school counseling program, including ones focused on behavior, and social and emotional needs.

"When we start looking at the impact of technology beyond just being a learning tool, it’s detrimental because kids are connected 24/7," she says. "Kids have more access to things that they didn’t in the past. It can make them more informed, but it can also be hurtful. They’re hearing things that they developmentally don’t quite have the ability to make a sound judgement on. They’re exposed to tragedies in all parts of the world. They’re seeing things that other generations may have been sheltered from. The global access can be a lot for a developing mind."

Social media has particularly altered the way children interact with one another. If a group of friends decides to hang out and exclude others, none would be the wiser 15 years ago. Now, social media dictates that the hangout should be captured and shared with the world. Happy and carefree is the only mood welcome on Instagram and Snapchat.

"We all hated being a middle schooler. It was the most traumatic experience, but now it’s a traumatic experience because they're given the message through social media that everything has to be perfect. No one shows the bad side," Carter says.

While cyberbullying training is typically part of students' education, the ability of educators and experts to keep pace with the development of new social media platforms and technological growth is seemingly impossible. Gischlar once drafted a publication offering ways parents could help keep their children safe online. "By the time it was published, it was already out of date," she says.

The culture of competition within school-aged children is also noticeable. College is not a choice but a requirement. A career plan is required by age 17. Being a B student is no longer applauded. Kindergartners are expected to be able to read before entering the classroom. Schedules must be filled, first with playdates and then clubs and sports. Leisure time may be nonexistent.

In high-performing school districts, such as Carter's and Abrahams', the pressure is accelerated and the thought of failure is crushing.

"We had third graders testing into our honors math program who were breaking down because they felt like they didn’t do well," Carter says. "Their definition of what failure is, is different. A 'B' in a high-performing district is failing and that’s just unacceptable. It’s irrational. Now, how do we shift that?"

"There’s a lot of pressure on kids because everyone feels like you have to go to college, and it doesn’t need to be an immediate step right after high school. The little ones have anxiety and they haven’t even heard the word college," Abrahams says. "School-aged children are like tuning forks. They can really pick up what’s around them and vibrate it back with intensity. So if there’s anxiety in their home life, at school or within their peers, the kids feel it, and it becomes generalized."

All of these stressors can accumulate, leading to anxiety and depression. Society is asking a lot of children today, things they may not be developmentally prepared to handle.

"As much as the world has changed, child development has not," Gischlar says. "In terms of development, it hasn't changed what ages kids are ready for certain things. I think the world has tried to make them ready before they are. We’re expecting them to be able to handle this adult world because they have so much exposure to it."

Everyone's responsibility

Sometimes, it's just a moment to breathe that can make a difference.

At Community Middle School, Carter's students are encouraged to take a break when things are just too much. She created a wellness center within the school where they can use their Chromebooks to download an app to walk them through a guided meditation or a breathing sequence.

"It’s part of the culture now. We rebranded it to be named after our mascot so it's the Panther Pause. We also have a featured activity every month for the students, so one month could be mindful coloring and another therapy dogs,” she says.

These efforts are in response not only to the evident need for mental health practices within the classroom, but also to a movement from the New Jersey Department of Education. In 2017, the Department implemented social/emotional learning competencies, which aim to promote positive school climates. They outline five categories for social-emotional learning educators are expected to implement in the classroom — self-awareness, self-management, social awareness, responsible decision-making and relationship skills.

There is no prescribed way to implement the competencies, rather it is left up to the schools' interpretations.

Some schools begin the day with a mindfulness activity or yoga. In the Hopewell School District, students have access to a biofeedback machine that educates them about their emotional reactions. They will also be introduced to a psychosensory technique called Havening that provides a calming effect. It teaches children to touch certain points on their upper arms, cheeks or hands to create delta waves.

There's an increased emphasis for mental health education among teachers, parents and students. Trainings on suicide warning signs, PTSD and other mental health issues are becoming more common.

"When we talk about mental health, it is everyone’s responsibility. It's how we help our friends who express that they want to kill themselves on Snapchat. When a child is in crisis, you hope the child goes to the first person they can and that person needs to be able to react appropriately," Carter says. Though, a stigma still prevails among certain groups.

"There's a lot of people who don't want their children labeled," Abrams says. "Mental health shouldn’t be viewed as a bad thing. If a child had an illness, you’d give them medicine. If they have a mental illness, they need help, it’s the same thing. It’s not different. Help could be life changing for the child."

A lack of resources can also be a challenge in certain schools. In Abrams' school, there is one counselor and one behavioral specialist for the approximately 500 children enrolled. Some districts are partnering with outside organizations to bring psychologists to the school to provide therapy to students.

"In the past, we were sending out kids for psychological evaluations. The approach was to send them away and they can come back when they’re ready. Now it’s being more proactive than reactive," Carter says.

Therapy shouldn't be an isolated event though, Abrahams says. It needs to be a holistic experience involving an entire family unit.

"Parents are OK with sending kids to therapy, but not getting the whole family there. Sometimes the parents blame themselves if their child is having an issue, but it’s so much more than that," she says.

Paying attention is the most basic way to help students in need, Abrams says.

"I’m always checking in on some of my current and former students so they know someone is looking out for them. You never know which kids you’ll make the difference with and you may prevent something from happening," she says. "Everyone has to look out for everyone."

Many times, the responsibility falls to those in the school system, teachers, counselors, the school nurse, even other students.

"I tell my teachers all the time, a stressed brain can't learn. It’s about recognizing those changes in behaviors," Carter says. "We want teachers noticing that the jovial kid who’s always saying 'hi' isn’t anymore. We need to create spaces and time within our instructional time for mindfulness. Students' lives may be so regimented that they don’t have the time to create the space on their own to deal with their feelings. We need to let them know that it’s OK not to be OK, to know that you don’t have to do this alone."