Mental health support in public schools

Crosses bearing the name of of the victims killed in a shooting at Santa Fe High School are seen in Santa Fe, Texas, U.S., May 21, 2018. Photo by REUTERS/Jonathan Bachman

More than any other time in history, children and adolescents are exposed to a wide range of serious life adversities including trauma (e.g., sexual abuse, physical abuse, witnessing domestic violence), bereavement (the death of a loved one) and social aggression. 

For example, using data from a nationally-representative sample of over 10,000 teens (ages 13 to 18), research shows that bereavement is the most prevalent lifetime stressor among U.S. adolescents, with over 30% reporting that they had experienced the sudden death of a loved one at some point during their lives. Such youth are significantly more likely to fail a grade, be suspended, skip school, perform poorly on measures of academic achievement and endorse low levels of school connectedness, when compared to non-bereaved youthand after accounting for the effects of other traumas. 

With regard to social aggression, it is not uncommon to observe students instigating and disseminating rumors, sharing demeaning and hurtful remarks about their peers and negatively impacting others’ self-perceptions through social media, which can lead to high levels of depression and/or suicide risk. In fact, a recent national survey found that approximately 5% of male and 9% of female high school students reported a suicide attempt in the last year. In order for schools to meet the essential emotional and mental health needs of today’s students, a systemic push for student on-campus access to licensed professional mental health providers is a fundamental funding requirement for public education. 

Educational leaders agree that school counselors play a vital role in daily campus function. They serve students through academic advising, course selection, career planning, post-secondary education elections and more. In addition, they provide lessons in social-emotional health on topics such as developing healthy relationships, prevention of drug and alcohol abuse, appropriate use of social media and suicide awareness and prevention. However, while emotional support topics are included in the school counselor program of study, their training in such areas is minimal as compared to that of licensed mental health professionals who are trained to provide counseling services.

Ideally, those counselors should work in tandem with licensed professionals to effectively support students on campus with more symptomatic mental health issues. This best practice, tiered model of support has been implemented as part of the Santa Fe Coordinated Response,­ resulting from the mass shooting a year ago, during which a 17-year-old Santa Fe High School student entered the campus and shot and killed 10 people and wounded 13 others. The impact on the lives of families whose loved ones were murdered in this event is unfathomable. For those injured, their outward wounds were visible. However, the invisible emotional wounds of all who were involved are long-lasting and often require effective, ongoing mental health support in order to ensure that impacted students resume a normal developmental trajectory and go on to lead healthy, happy, productive lives. To best meet students’ mental health needs, Santa Fe ISD provides both school counselors and licensed mental health professionals on every campus.

As noted by Dr. Julie Kaplow, chief of psychology and director of the Trauma and Grief Center at Texas Children’s Hospital, following a traumatic loss, the vast majority of students will grieve in a normal, adaptive manner. In other words, over time, most students will be resilient, and although they will continue to miss those who died, they will find healthy ways of feeling connected to their deceased peers and even to live out their lives in ways that help to carry on the legacies of the deceased. However, we also know that a significant minority of youth exposed to a mass shooting will require a higher level of assistance from a mental health professional and/or require referral for more specialized intervention. 

Because mental health support is readily available on each campus through the Santa Fe Coordinated Response, district and campus personnel have become acutely aware of students in need of support —  not just in response to the shooting, but also in response to other traumatic childhood events, depression, self-harm, or suicidal ideation. Because students have on-campus access to licensed professional counselors, many are now able to address issues that could otherwise lead to future risk-taking behaviors or destructive lifestyles. 

Other benefits of licensed professional counselors include training for school counselors, staff and students with a focus on emotional health; communication between students, parents, community services and specialized service providers; training for parents on recognizing unhealthy child behaviors and providing tools and appropriate referral mechanisms to address identified issues. Professional mental health providers have proven invaluable in the Santa Fe ISD response to the horrific shooting. Their presence has also fostered a deeper understanding and appreciation of the value of mental health providers and the critical need for this type of support on campuses throughout Texas. 

It is critical that funding for licensed mental health professionals be provided for districts throughout the state. Students with readily accessible emotional and mental health support are more likely to be better prepared for life after high school and become productive citizens. Our students deserve it, and ultimately, our society will greatly benefit from early identification and mental health support for our most at-risk youth and emotional health support for all students on campus.

This is one of a pair of op-eds on emotional and mental health in public schools. The other is at this link.

Disclosure: Texas Children’s Hospital has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

Jacqueline Shuman

Assistant superintendent, Santa Fe ISD

Julie Kaplow

Chief of Psychology, Texas Children’s Hospital

B. Glenn Wilkerson

President, ARKGroup

Robert Brooks

Clinical psychologist, Harvard Medical School (part-time)