Every teacher has students struggling with mental health issues
Did you know that 20% of students aged 9 to 17 have a diagnosable mental health disorder that causes some degree of impairment? Even worse, 10% have a disorder that causes significant impairment. And by all measures, student mental health issues are on the rise, including anxiety, mood, attention, and behavior disorders.
Practically speaking, that means just about every teacher has students in their classes who are struggling with mental health issues. And very few of them are trained on how to work effectively with these students. That leads to frustrated teachers and frustrated students who are not getting the support they need to succeed.
Recognition is the first step in correcting this situation. Teachers need to know the warning signs associated with mental and behavioral problems. Armed with this information, they can respond more appropriately in the classroom, and they will know when to take action and when to enlist help from experts.
15 warning signs of mental & behavioral health issues
When it comes to school success, teachers tend to focus on academic measures such as grades and test scores. This is understandable because everyone from students to teachers to school districts are judged based on these metrics. However, to identify students who may be struggling with an underlying mental or behavioral condition, we need to tune in to social and emotional signals along with academic ones.
1. Social isolation
Students who never seem to engage with their peers may be suffering from anxiety, depression or other emotional issues.
2. Involved in HIB
Students on both sides of the HIB situation may need help. Perpetrators often have underlying mental health issues that lead to aggressive behavior. Students who are frequent targets may have sensitivity or anger issues that other students pick up on. Both need to be addressed with the appropriate supports.
3. Reluctance to speak in class
This behavior can come from social anxiety or fear of failure.
4. A recent drop in achievement
When a student who normally does well is suddenly failing, that’s a reason for concern. The reason may be physical, situational, or related to a mental health issue. Either way, don’t wait too long to investigate.
When a student has trouble with losing things or being unprepared for class, it might be more than forgetfulness. A cognitive processing issue may be to blame.
6. Memory issues
Students who have great difficulty remembering information and responsibilities may be suffering from depression or have cognitive processing issues.
7. Work refusal or school refusal
Refusing to complete assignments or not coming to school at all are serious issues, and are very often related to underlying anxiety, depression, or other mental health issues.
8. Frequent visits to nurse
A student who uses every excuse to get out of the classroom is trying desperately to avoid something. Very often some anxiety or fear is behind it.
9. Inattention or lack of focus
While ADHD may be the immediate suspicion, these behaviors can also indicate depression or another mental health issue.
10. Sleeping in class
While this problem can have many possible causes, don’t overlook the possibility that the student is suffering from depression.
11. Compulsive behaviors
A student who demonstrates repetitive, consistent, and rigid behaviors in specific situations should be evaluated for possible psychiatric issues, especially when the student tells you that they can’t control the behavior.
12. Irritable, angry, or oppositional mood
To a teacher who is not a mental health expert, it’s tempting to take a disciplinary approach to this type of behavior. However, anger can often mask serious depression and indicate a student who needs counseling instead of punishment.
13. Panic attacks
When a student often has breathing difficulties without a physical cause (such as asthma or a heart condition), he or she may be experiencing panic attacks due to anxiety.
14. Substance abuse
Even if you don’t see a student actually under the influence in class, a student who sleeps in class, frequently skips class, or shows a rapid decline in performance may be showing signs of alcohol or drug abuse. Furthermore, substance abuse is frequently related to an underlying mental health condition.
15. Theft, assault, and destructive behavior
When a student is engaging in illegal and dangerous actions, safety is always the primary concern (get the other students out of the room if possible). Even one incident that puts the student or other people in danger must be reported and should be evaluated by a mental health expert.
Evaluating the situation: is it mental illness?
Of course, seeing one of these warning signs does not always mean the student is struggling with a behavioral or mental health issue that needs treatment. To help decide when it’s time to refer a student for evaluation and possible mental health intervention, start by asking the following questions:
How frequent/persistent is the issue?
If someone falls asleep in class once or twice, they might be staying up too late or working on a demanding project. If you see warning signs repeatedly, it’s time to investigate what’s going on with that student. It’s important to be open to all of the possibilities so you ask the right questions. You might discover a cause that’s unrelated to mental health and be able to guide the student to a solution.
However, if your questions reveal troubling answers (or a lack of answers), that student may need to be evaluated by your child study team for possible intervention.
How extreme or severe is the issue?
Teachers spend a lot of time with their students, and might notice things that even their parents are not aware of. Things like concentration issues, social issues, and even compulsive behaviors might not be obvious to others who don’t spend extended time with the student every day.
However, it’s important to consider the severity of the issue. Is the student shy about speaking out in class but obviously interacting appropriately with peers in other ways? In that case, gentle reassurance and extra time to answer questions might be all that’s needed. But if the student seems isolated and withdrawn and also leaves class to visit the nurse regularly, that student may be suffering from anxiety and need mental health intervention.
Teachers need expert guidance to support students
It’s helpful for teachers to know the warning signs associated with student mental health issues, because being aware of the signs means more students get help sooner.
However, teachers also need a resource to turn to for guidance in specific situations. Teachers should not be expected to counsel students or to decide when a student requires evaluation. Teachers must be trained to report any concerns to the child study team.
Better yet, leading school districts are investing in mental health training for the child study team, as well as access to advice from clinical experts. Trained counselors and social workers can advise and train teachers as well as providing counseling services to students in need.
Learn more about the movement to Proactive Mental Wellness in Schools: download this informative paper that explains the concept and implementation strategies, including how to fund the effort.
Christopher J. Leonard, MSW, LCSW, M.ED.
Chris Leonard is Director of Operations for Sage Thrive and the Sage Day Schools. He is an experienced teacher, school administrator, social worker and psychotherapist with over 30 years of experience working with children, adolescents, and families. Mr. Leonard is married with two daughters and enjoys distance running, mountain and road biking, hiking, and the outdoors.