Be Cautious—What We Don’t Know about Student Mental Health and the Pandemic
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Dear Colleagues,
Introduction
We have known for decades that between 25 and 40 percent of all students need mental health services at some point during their school careers. What we don’t know when we initially recognize the existence of “a problem” is (a) what the problem actually is, and (b) what the right services, supports, and interventions are to ameliorate the problem.
That is left to the science of psychology, the diagnostic skill of experts, and the clinical acumen of those providing the interventions or therapies—the latter when warranted by the intensity of the problem.
As we remain in the midst of the pandemic, and as more students return to school on-site, there are increasing reports on students “experiencing” higher levels of stress, anxiety, depression, and trauma.
Some of these reports are, quite frankly, published in the popular press and—while well-meaning—they are based mostly on some “expert’s” beliefs, projections, or fears—and not on objective data and fact.
Some of these reports cite epidemiological information based on group data from a specific geographical area, location, and setting. Critically, even when the mental health “diagnoses” reported are accurate, the data are often skewed to the setting involved. Thus—for those of us in education, the results do not reflect what truly exists in school.
The vast majority of the reports, relative to real students in actual schools, are non-existent.
That is because most of the mental health practitioners in our schools (e.g., counselors, school psychologists, clinical social workers) have not yet had the time (a) to identify, differentially evaluate, and provide services to their students in need; (b) to see enough of these students to get accurate incident and trend data; and (c) to compare the data now with data from the past.
Notably, the mental health practitioners in the schools are the best professionals to determine how many students have social, emotional, behavioral, or mental health challenges in our school. But they need to differentially evaluate which of their current student challenges (a) existed before the pandemic, (b) began during the pandemic (but are unrelated to the pandemic), or (c) began during the pandemic and are related to pandemic conditions or events.
Thus, on an individual student-by-student basis, school-based mental health practitioners need to first evaluate and validate.
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What We Don’t Know: An Example with Numbers
The major “take-away” above is that educators and school leaders need to “evaluate and validate” their own students and their own data before they “select and direct” the implementation of social, emotional, or behavioral services, supports, strategies, and interventions for their students.
As a case in point, this week (March 31, 2021), Education Week published an article, “Data: What We Know About Student Mental Health and the Pandemic.”
The thesis of the article was to emphasize—causally—how the pandemic has increased students’ mental health needs across the country.
Unfortunately, the article inappropriately (methodologically and statistically) used three sets of data to make its (faulty) points—points that educators and school leaders need (as above) to “evaluate and validate” for themselves using their own school-based mental health practitioners and their own student data.
- The beginning of the Education Week article quoted a clinical psychologist at Stanford Medical School who said, about the children being referred to her, “I’ve never had so many referrals than in the last six months. … Normally it’s two or three a month and now it’s maybe two a week.”
[This is the “testimonial” of one practitioner in a highly selective setting citing data that may not be related to the pandemic, and that cannot be generalize to schools across the country.]
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- The middle of the article cited information from “a nationally representative survey of more than 2,000 parents and nearly 900 teenagers this fall” that concluded that the pandemic was “causing” more anxiety for the students than “keeping up on their academics or getting ready for college.”
[This is an example of how survey data—which measures students’ perceptions and not necessarily their objectively-determined realities—are used to draw (questionable) conclusions. This passage also assumes (without validation) that the pandemic is “causing” student anxiety, and it does not discuss how many students need mental health support for their anxiety.]
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- Finally, the Education Week article presented results from a “new nationally representative EdWeek Research Center survey (completed between January 29 to February 11, 2021 that) asked both educators and students in grades 9 through 12 to talk about the mental health challenges they’ve faced and supports they’ve received during the pandemic.”
The survey results noted that a majority of the students reported experiencing more problems now than in January, 2020—with higher rates reported by Black, Latinx, low-income, and LGBTQ students.
[While this survey at least involved students and school-related issues, there were no data in the published Report that objectively validated that this was indeed a “nationally representative sample of students.”
Moreover, the survey (once again) involved students’ self-perceptions, and no data reflected the clinical severity, intensity, or duration of the “problems experienced” by the students.
Indeed, for the record, here were the “problems” cited:
Not finishing schoolwork because of procrastination
Feeling very happy and very sad during parts of the school day
Feeling too sad/down to focus on class
Problems concentrating or remembering things for school
Distracted by anxieties, worries, fears during class
Feeling tired during class
Skipping or showing up late for class
Feeling isolated from classmates
Not participating/speaking in class
Getting low grades or incompletes
In the end, none of the survey results are surprising, but they are not helpful to individual districts or schools that may need to provide strategic services or interventions to specific students in need.]
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New Federal Funding: Selecting and Directing American Rescue Plan Funds to New Interventions
Relative to students’ current academic and social, emotional, behavioral, and mental health needs—new federal funds are now available through the recently-passed American Rescue Plan (ARP) Act of 2021.
Here is the funding available (some overlaps may exist) from the ARP:
- The ARP includes a total of $169.5 billion in funding for education, with $129.6 billion for K-12 education and $39.6 billion for higher education.
Specifically, for K-12 education, the ARP provides $122 billion for new Elementary and Secondary School Emergency Relief (ESSER) Fund awards to State Education Agencies (SEAs), which must allocate 90% of their funding to local educational agencies (LEAs). LEAs must use at least 20% of their funding to address learning time loss for students. They can use the remaining 80% for other activities that address needs arising from the pandemic.
- The ARP also provides more than $3 billion for Individuals with Disabilities Education Act (IDEA) state formula grants, another $2.75 billion in Emergency Assistance for Non-Public Schools, $850 million for the nation’s Outlying Areas, $800 million to meet the pandemic-related needs of homeless children and youth, and $190 million for Tribal Education Agencies, Alaska Native Education, and Native Hawaiian Education.
- Finally, the ARP includes just under $4 billion in emergency funding for substance use and mental health programs, including:
- $1.5 billion for block grants for prevention and treatment of substance use;
- $1.5 billion for block grants for community mental health services;
- $420 million for expansion grants for certified community behavioral health clinics;
- $100 million for behavioral health workforce education and training;
- $80 million for mental health and substance use disorder training for health care professionals, paraprofessionals, and public safety officers;
- $80 million for pediatric mental health care access;
- $50 million for community based funding for local behavioral health needs;
- $40 million for grants for health care providers to promote mental health among their health professional workforce;
- $30 million for Project AWARE;
- $30 million for community based funding for local substance use disorder services;
- $20 million for education and awareness campaign encouraging healthy work conditions and use of mental health and substance use disorder services by health care professionals;
- $20 million for youth suicide prevention; and
- $10 million for the national child traumatic stress network.
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With these new funds available, districts and schools have some important decisions to make on behalf of their students.
In the section above, we emphasized the importance of having your mental health experts evaluate your students’ social, emotional, behavioral, and mental health needs so that the most strategic and needed services and interventions can be targeted for these new federal funds.
In our last Blog, we also encouraged you to critically and objectively analyze the research, outcomes, and efficacy—for your schools, staff, and students—of the frameworks and programs that will be “pitched” to you in the coming weeks.
[CLICK HERE for:
"A Consumer Alert: Student Awareness Does Not Usually Change Student Behavior--Do We Need to Dig a Moat Around CASEL's Approach to Social-Emotional Learning (SEL)?"
To assist with this critical analysis, we have integrated over 25 of our past Blogs into a new Monograph:
Trauma, Stress, Mindfulness, & SEL: Why Schools Need to Validate the Science Before Selecting their Solutions for Students’ Social, Emotional, and Behavioral Needs
This Monograph is organized in five sections:
- Differentiating Between Stress and Trauma, and Problems with Trauma-Informed Programs
- Understanding Students’ Social, Emotional, and Behavioral Challenges, and Implementing Effective Multi-Tiered Systems of Supports
- The History and Hype of Social-Emotional Learning
- Teaching Students Social, Emotional, and Behavioral Self-Management from Preschool through High School
- Being Mindful of Mindfulness
and it critiques the framework and efficacy of social-emotional learning practices and programs, while detailing the questionable research and troubling track records of trauma-sensitive or trauma-informed school programs, mindfulness interventions, and the Positive Behavioral Interventions and Supports (PBIS) framework.
For example, recent research reviewing over 7,000 school-related studies over the past decade has found that there are no Trauma-Informed School Programs that have been effectively evaluated such that they can state—with any level of evidence-based certainty—that they can demonstrate any positive impact on preventing or addressing student trauma.
Moreover, the PBIS framework has a long, near-25 year old history of “glorifying” the number of schools that are “implementing” different strategies from its menu, even as most schools only implement at the Tier 1 Prevention level and do not sustain their strategies with fidelity for more than three years.
This has left millions of school educators frustrated with the wasted time, money, and effort invested in PBIS, and millions of students with significant social, emotional, behavioral, and mental health needs untouched, unaffected, or worse off.
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Where Schools Need to Start: The Foundation for all Interventions
Despite its weaknesses, the Education Week article described earlier in this Blog does make two important points:
- School and district staff do need to help students learn to cope with conditions related to the pandemic so that they can successfully focus on their school responsibilities and interactions.
- We won’t know the full impact of the pandemic for many years, so schools need be prepared to address students’ ongoing and changing academic and social, emotional, and behavioral needs for the long haul.
To begin this process, we remind our colleagues of the benefits of the following strategies:
- Listen to students with your full attention.
Students need to feel that they are the “most important” thing in your life when you are interacting with them. If you are not modeling listening with your full attention, then you really cannot expect them to learn or demonstrate the same courtesy with you and others.
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- Acknowledge and label students’ feelings, while teaching and reinforcing their emotional control skills.
Help students to recognize how emotions link to interpersonal, social problem-solving, conflict prevention and resolution, and emotional coping skills.
Students are always learning about different emotions and how to handle them. At the elementary level, we teach the student how to recognize different emotions, how they feel—physiologically—under different emotional conditions, and how to control mild to moderate emotional situations. At the secondary level, the focus is on teaching students how to control more extreme emotional situations, and how to analyze and solve their own social and interpersonal problems.
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- Talk with your students using a problem-solving approach, and teach and model effective problem-solving in different situations.
When talking with students during actual or potential conflict situations, teachers can strategically model the language and process that we use in our Stop & Think Social Skills process:
“Let’s Stop and Think about this together. We need to make a good choice and think about what is happening here, and what we want to happen next. What choices or steps do we have or need to resolve this situation? Let’s get ready to follow these steps, and. . . just do it! How did it go. . . Can we reinforce ourselves for a good job?”
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- Talk with students using an appropriate volume, tone of voice, and level of respect—even under “emotional” conditions.
Remember, even when students are not demonstrating appropriate behavior, you need to model your own social, emotional, and behavioral control. For example, if you are irritated with your students and talk with them in an excessively angry, critical, demeaning, or loud voice, your students might react negatively to the emotionality or disrespect in your voice, refuse to listen to you (now and in the future), and “write you off” as someone who “talks the talk, but does not walk the walk.”
Even though it is challenging, it is important to maintain an appropriate volume, tone of voice, and level of respect when talking and interacting with students in all situations. If you “blow” it, step back, let the air clear, and come back later to discuss the situation with your students and even (gasp!) apologize if your behavior was inappropriate.
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- Give students time to process their feelings, thoughts, issues, and responses. In other words, when needed, be patient, don’t talk too much, and give your students a chance to work things out on their own.
When students approach you with a problem, give them the time, place, structure, and guidance to process it on their own. Indeed, once you have taught students the problem-solving process, every problem-solving opportunity become a “teachable moment” where students learn how to apply the original instruction.
While you may need to provide more help—from a skill perspective—to younger students during these teachable moments, you may also need to provide more help—on an emotional level—to older students who are sometimes confronted by some highly emotional situations and dilemmas.
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- Remember to reinforce your students for Good Choices, while teaching and prompting them to self-management and self-reinforce themselves.
From kindergarten through middle school and high school, students increase their self-awareness, and learn how to depend on themselves as they plan, implement, monitor, evaluate, correct, and reinforce their own emotions, thoughts, and behavior. All of these processes increase students’ self-confidence, self-management, as well as their self-accountability. Self-monitoring, self-evaluation, and self-reinforcement are particularly important parts of students’ developing self-management skill sets, because students are often too dependent on what others’ think about, believe, or respond to in different situations.
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- Finally, give students hope.
Students need encouragement for their growth, progress, and effort—even if they are not always “perfect.” Help them expect and belief that they can improve and succeed over time. Give them opportunities to see different situations in different ways. Critically: give them a chance to see themselves as positive, productive, valued, and valuable individuals.
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Summary
While we know a lot about students’ social, emotional, behavioral, and mental health needs, we are learning more given the unique circumstances of the pandemic.
And while it is important to anticipate that more students will need more services, supports, and—potentially—interventions, we need to approach this process in clinically valid, strategic, and efficacious ways.
And thus, we want to emphasize the primary message of this Blog:
Educators and school leaders need to “evaluate and validate” their own students and their own data before they “select and direct” the implementation of social, emotional, or behavioral services, supports, strategies, and interventions for their students.
With the new funding from the American Rescue Plan Act, we need to be sure that proven practices based on sound science are chosen to support students in our schools.
In the rush to help our students, let’s not fall prey to the “old” stories (some from our federal and state departments of education) of programs and frameworks “that work”. . . or the “new” stories of “innovation” and “technological advances” that simply will not result in demonstrable and sustained student outcomes.
In the midst of the tragedies and losses, frustrations and roadblocks of the pandemic, we have an opportunity to have real impact. Let’s do our homework so that we can make the critical decisions to “seize the moment and win the day.”
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We hope that this information has been useful to you, and that it will help you plan your next steps so that we can help and support our students both in the next phases of the pandemic and thereafter.
If there is anything that I can do to guide you through this process, please feel free to contact me with your questions, or to set up a free, one-hour consultation with me and your team.
Best,
Howie
