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Taking Attendance: The Absence of Mental Health Curricula in American Classrooms

Opinion | April 11, 2016

Mental health education is not given the same attention as physical education, yet mental illness is as deadly and widespread as physical illness. 1 in 5 children will have a serious mental disorder at some point in their life. Given the lack of dialogue about mental health, the number is likely an underestimate. In 2013, suicide was the third leading cause of death in the US for ages 10-14 and the second leading cause of death for those aged 15-34. At universities, conversations about mental health seem to be on people’s minds. A multitude of articles shed light on the issue, from reporting on its staggering prevalence to criticizing the way universities handle the mentally ill. At Tufts, students readily voice their experiences and advocate for others to fight stigma. Posters around campus, organizations such as Active Minds and Balance Your Life, and orientation activities consistently remind incoming freshman what services are available. There are numerous resources such as counseling centers and health services available that the university encourages, but it’s too late for high school teenagers who experience the intense adolescent emotions that they’re too afraid to speak up about.

Health classes in general remain at the edge of importance in relation to the core classes of science, math, English, and social studies. According to the National Association of State Boards of Education, the policies vary state by state, from being fully mandatory each year, to requiring just one credit to graduate. The Center for Disease Control provides nine guidelines for schools’ health curriculums, only two of which reference mental health. These two guidelines do not even call for including mental health education in the curriculum, but focus on providing proper counseling and mental health services for students.

A 2011 study by the University of Southampton in the UK looked at the effects of mental health promotion and problem prevention in schools and found a range of beneficial effects on children, families, and communities in both social-emotional and education outcomes. Although the numbers showed at most moderate improvement, the implications of the interventions lay down foundations for long-term influence. The more effective interventions involved focusing on positive mental health with changes in curriculum, relations with the parents, the community, and outside service agencies. Simply establishing mental health as an important topic begins to peel away society’s underlying negative attitudes. Another study examined the methods of integration of mental health into school education, advocating for using the built-in resources of the school in order to sustain mental health support in the school infrastructure. However, the current requirements for mental healthcare are so few and unclear that the education that is provided right now in schools is futile in long-term prevention of illness and promotion of awareness. A larger overhaul on mental health education is needed, not just putting up anti-stigma posters around the school.

Mountains of petitions urging legislative action to address this problem have resulted in the federal Mental Health in Schools Act of 2015, which would require a comprehensive mental health services and education in schools. However, the act remains at the committee level. Given the lack of response to this problem, many have scaled back on their petitioning efforts to focus solely on mandating some semblance of mental health services by requiring that a school official be educated in mental health issues.

Psychologists and professionals have also advocated for mental health screenings in schools, similar to the annual physical checkup the school nurse already does. “If we made mental health part of the usual health system of a school, then it becomes more normal…and hopefully it will then be easier to access it,” Dr. Mina Fazel said in an interview with Time magazine. “We need to think about how to embed mental health services so they become part of the culture in schools,” Fazel said, a child psychiatrist at the University of Oxford. Lack of access to mental health services, and hesitancy to take advantage of those that are available has resulted in low treatment rates among youth populations. 80 percent of youth with diagnosable anxiety disorder, 60 percent of those with depression, and 40 percent of those with ADHD remain untreated. With mental health incorporated in the school system, Fazel’s belief is that treatment can be issued earlier and prevent them from worsening as students age.

Outside of education, the mental health professionals continually seek to break down the stigma by associating it with physical health. Comics and infographics continue to be shared locally between individuals on social media, slowly picking at the stigma that stands in society. According to The Atlantic, the National Council for Behavioral Health has attempted to fight the stigma against mental health since 2001 by compiling a Mental Health First Aid program. Just like learning CPR or remembering the steps in case of a heart attack, they provide training for helping others in mental health crises, like panic attacks or intense suicidal thoughts. In addition, the US Preventive Services Task Force has now recommended screening for depression in the general adult population during routine medical check ups. They place it at equal importance to yearly mammograms and diabetes screening in overweight patients. The goal is to make the public understand that both physical and mental health are equally urgent, equally treatable, and equally worth talking about.

For long lasting and widespread change to occur, larger structural changes need to be implemented in terms of health policy and educational reform. Most importantly, it seems that a social change must take place before any real impact can be made. Providing services is an improvement, but not if students are too afraid to use them. The crippling stigma that debilitates society is an issue that requires much more than a policy change, and perhaps little by little these triumphs in mental health advocacy will chip away at the unrelenting social attitudes with time. As Peer Health Exchange says, “Let’s get comfortable with being uncomfortable.”