Universal Counseling in the American School System

The struggle between schools and mental health has changed drastically since Generation Z made its way into the world. The connection between the world wide web, social media, and significant population growth has affected the way children grow up, and thus their mental health. The effect this has on their education is one thing we do not need statistics to see.

            Children are evaluated for physical health, and teachers and school staff also watch for problems like lice, and schools use universal physical health screenings to check children for eyesight, hearing problems, and scoliosis. Poor mental health symptoms can cause the same effect as physical health symptoms and create a learning block for students’ education. As the CDC says, “Mental and physical health are equally important components of overall health… Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act.,” (The CDC About Mental Health, Centers for Disease Control and Prevention)

            A multi-tiered System of Supports, or MTSS, can help promote comprehensive and successful ways to approach the mental health issues seen in K12 children. With healthy approaches, correct support systems can be accessed by all students. A multi-tiered approach could help students learn core social, emotional, and behavioral skills and can have their mental health needs addressed as soon as possible to show the best results. The earlier these problems in children can be evaluated, the easier it can be for professionals to correctly diagnose, or provide guidance, to students who want or need it, (Uni. of Maryland, School of Medicine School Mental Health Quality Guide, Screening)

            Some educators argue that it is not a school’s job to treat children, so students’ mental health is simply not their problem. However, health problems are a special need for children; whether it be physical or mental, it affects their education and ability to learn. Ignoring mental health also ignores a student’s special needs and takes away from less restrictive and appropriate learning that is supposed to be provided to special need students. “The word “disability,” for instance, should have covered Tim (Paul Gionfriddos son who struggles with mental illness) and children like him. But as a friend who worked a generation ago on drafting the regulations for the federal government’s Individuals with Disabilities Education Act told me, “Paul, we were thinking of kids in wheelchairs.” Not much has changed,” Paul Gionfriddo, President and CEO of Mental Health America, (Heitz Should schools screen kids for mental health problems?)

Some schools have taken up scream rooms, or quiet rooms, to separate and contain disabled students while the schools are genuinely using silence as a form of punishment, often seen used for physic ward patients with majorly active and harmful psychotic disorders. These rooms are not meant for children. Instead of spending money and time on scream rooms, which do help truly help with any students’ problems and only create what might seem like a temporary fix, yet ignores the much larger problem, but the rooms also take away from a student’s learning time. Schools can instead put those resources to mental health screening and treatment that can help disabled students properly express their emotions and find healthy coping mechanisms. This change will allow them to have more time to learn and be social with peers. Schools say that these rooms are used as an outlet for students to let out energy and to seclude harmful students. However, an investigation over multiple schools in Illinois showed that these rooms had been used illegally thousands of times when no safety concern was at hand, (Medlin “they need to be allowed to scream.” how school districts use controversial Seclusion Rooms)

            These scream rooms are being used as a false temporary fix to a much larger issue. Approximately one in four Americans live with mental illness within a year. Half of Americans with mental illness experience the effects of their illness before they are even 14, Kita Curry, Ph.D., (Heitz Should schools screen kids for mental health problems?) Not only could universal mental health screening help students have their own healthy coping mechanisms, but screenings could also help teachers know which accommodations are needed and work best for each specific student. Mental health screenings will also allow students to be connected with the right in-school team to guide them, either through relationships, family issues that might not be physically noticeable, such as emotional incest and psychological abuse, academic issues, peer issues, and more, whether they are diagnosed with a mental illness, have poor mental health, or simply want someone to talk to. All of which can heavily affect a student’s education.

            There are multiple concerns with mental health screening in schools. One of them being a student’s peers asking why they are being pulled out of class after taking the screening, (Erika’s Lighthouse et al. 9 serious concerns about depression screening for Youth) This shows for an easy solution. Due to the global pandemic, many schools now have access to online programs. If all student’s first mental screening is done in person at school, then all students will use a designated class period, and no one would think twice to bully a student about it, as many of them would be doing it at some point, it would have the same reaction as physical examinations. After the first examination, all of the reoccurring sessions and easy to access resources can be available for students to schedule and go to at any time online. Then no students will have access to which students choose to or need to have a follow up session.

            Students will be able to grow trust in the doctors and nurses who will help them the same way they develop trust with their teachers. Their favorite teachers are there for them, they motivate them, and they help them, which is exactly what the nurses and doctor will do. A major thing all students go through is always seeing police on campus. Many students find themselves feeling safer knowing that someone who is supposed to be trained and armed is on campus, but what do they protect students from? Police are there to protect students from outside threats and major inside threats. Oftentimes, police just are not around to protect students from peers who might be harassing or physically abusing another student. While it is not the police officers’ fault, there is still more that can be done. Mental health screenings can help children process what they witness their parents or other adults do and say in a healthy way rather than mirroring the actions to other students. Nurses being present on school premises to walk around and help students the same way police officers do might have a positive outcome. Not only is it someone who can always be there to watch for students who seem to be down or struggling, but they can also help keep students on more alert before they bully or harm another student. Some students might feel more secure knowing that a psychiatric nurse who is trained to deal with disabled and mentally struggling people is watching over them and their peers rather than a law enforcement officer.

            “… you’re more likely to walk away with a prescription than a mental health referral…” says Erika’s Lighthouse, (Erika’s Lighthouse et al. 9 serious concerns about depression screening for Youth); but what if there was another option? Anyone has a right to decline medication. Instead of school based mental health services and screenings in K12 schools focusing on solely diagnosing and medicating, they will focus on diagnosing, if needed, and finding the root of the problem. Finding the root of the problem allows the mental health professional to show students healthy ways to cope and move past what is causing their mental discomfort. By providing better coping mechanisms and resources, not only could this help students achieve better academic success, but also help with the fight of teenage substance abuse, and potentially even school shootings.

78% of American school shooters had a history of suicide attempts prior to their attack, 87% of school shooting executors have left behind evidence that they were victims of severe bullying. Healthy coping mechanisms, accurate evaluation and diagnosis through mental health screenings, and psychiatric nurses being in schools to stop bullying and be in a direct path of all students suffering as a comforting person could all help the constantly increasing amount of school shootings, (School shootings and Student Mental Health: Role of the School Counselor in Mitigating Violence)

Starting mental and behavioral health screenings in schools across America will not be easy. However, the children these screenings will help are the future of the United States, and without financial help, a strong plan, and good execution through schools and educators, mental illness in students will continue to rise. As will child suicide, uncaring and harming behaviors in children, and thankfully, many high quality universal screening tools have been, and are being, developed to help schools tackle these issues.

The first step schools would need to take is addressing anything they do not currently have the capacity to do. This could include a thorough review of resources they already have, resources their city or community has, and seeing how many students might need a follow up session after their first screening, (Hoover, PhD. Associate Professor and Connors, PhD. Assistant Professor Making school mental health screening and early …) This could also be a time for schools to reach out to any local universities to directly hire and support local psychiatric nurses to straightforwardly evaluate and watch children within the school interact.

            Financial needs are also an important part of helping students with mental and behavioral health. According to the Texas Mental Health Task Force Report, which are to help schools fund mental health services in Texas school districts and communities, they provided a total budget of $104,080,111 to be used across multiple services which could have been utilized by schools and communities to better the availability to mental health services for students and local communities in 2019. Only $78,586 of the total funding provided was spent. The separate categories for which funding is provided to enact are state funded public mental health services to priority population, some provided in schools, Medicaid and other funding also used, state funded comprehensive social services to support student retention and achievement, state funding provided to Texas Health and Human Services Commission to be used for community grants to urban and rural regions, Texas Health Access Through Telehealth, or TCHATT, to create or help existing telemedicine or telehealth programs to assist school districts with identifying mental health care needs and accessing services, funding to support school safety, which includes mental health supports and reporting systems, educator and other training in mental health first aid training program, and non-physician mental health professionals in Education Service Centers. The general revenue funding for the fiscal years of 2020 and 2021 provided a total of $393,993,880 to go to previously said services. Which is $92,916,829 more in state provided funds for the individual years of 2020 and 2021 compared to 2019, (Independent Task Force and Texas Education Agency The Collaborative Task Force on Public School Mental Health Services Year 1 Report)

            Creating consent and an easy way for students and parents to opt out of services is another way that could help parents and students feel more secure in utilizing any available services. Schools should gather information about how the local communities to the school feel about the screenings. This includes information about how they think it could benefit students, whether they would be okay with their children or dependents utilizing the school’s mental and behavioral health services, and what they think about psychiatric nurses being in schools to help students.

            Then, schools need to create their mental and behavioral healthcare team. This includes the professional psychiatrist who will perform the mental health screening of students and the registered psychiatric nurses who will work at the school for follow up visits, handle online resources, and any communication to help students.

            The school districts and their mental and behavioral health teams must also figure out what type of screening would be most beneficial for each school. It is very important to remember that while choosing a screening style, the developmental age of students, as well as the style of school district, should be taken into account. Some tools need students to submit self-reports, while others require instructors, parents, or guardians to do them. This is especially helpful when screening younger students, as it might be better for parents or educators to do the screenings with them. It is also crucial to talk about the significance of certain results for each screening style before gathering and analyzing information, (Betters-Bubon et al. The case for Universal Mental Health Screening In Schools)

Cultural differences may impact the screening process. If the screening method has not been normalized for or educated on cultural differences in child-raising patterns and what is considered typical development, issues may arise. The screening may be repeatedly misinterpreted by the population served, or it may fail to discriminate between students who are developing normally and those who are not. Different cultural groups should be contacted, and they should be asked to suggest areas where there may be misconceptions. If required, an alternative tool can be used, or a current tool can be customized by rephrasing a question or weighing specific replies differently than recommended. Therefore, due to modifications to the screening tool or how the findings are interpreted may have an impact on the screening’s validity, it is best to check with the screening tool’s creators before making any final changes. Tool developers may have collaborated with other groups on tool changes, or they may have unpublished research results. The developers can, at the very least, give insight into how the suggested modifications could influence the screening findings, (SAMHSA Ready, set, go, review: Screening for Behavioral Health …)

Schools should also take a student’s perspective of screenings and the process of helping mental and behavioral health into deep consideration. It is widely believed that screening measures with optimistic wording have a lower emotional impact on kids. While this may make the process of completing the assessment better for students who are not having trouble, this could not be the case for students who are having mental or behavioral trouble. Students might find that giving a negative response to optimistically phrased questions or situational examples can be stressful or upsetting. Which could lead to the students not answering honestly. It is crucial to consider students who may want adult support to complete the screening so that they can answer honestly and freely without as much stress and anxiety. Schools must also think about if the student should have a say in who supports them through the screening. The psychiatric nurses are already educated in the best way to handle said situations to calm younger children and teenagers so they can answer freely. Some students may need someone else there to tell them it is okay to be open and honest, (SAMHSA Ready, set, go, review: Screening for Behavioral Health …)

Concerns regarding warning signals or positive test findings must be communicated to the students’ parents or guardians. Since a student’s parents or guardians must consent to their child’s evaluation and treatment, as well as determine how to proceed, they should be reached as soon as possible by phone or in person by the school’s psychiatrist to address the student’s mental health. Only the warning signals should be discussed, as well as an explanation of what the screen can discover or has discovered, (SAMHSA Ready, set, go, review: Screening for Behavioral Health …)

Mental health and behavioral health screenings can be so impactful to help America fight the rising number of students with poor mental health or a mental illness. Most mental illnesses go undiagnosed and untreated until they are well formed into adulthood. Poor mental health and mental illness can have a heavy effect on academic success and treating students’ poor mental health from an early age can help students see a better outcome in their education and have more resources and better opportunities. Early detection of mental illness can allow professionals and schools to correctly help each individual student while their brain is still developing. It can allow students to work better in teams and overcome fear of large social settings, which will help them when they get a job or live in highly populated areas. By helping students overcome poor mental health and mental illness, we are preparing them to healthily identify and cope with anything that comes up in their life. While mental health and behavioral screenings might not give sudden results or receive totally favorable reactions from parents and students, they can and will change the future of students and parents who choose to utilize the resources and counseling provided. The screenings are a small step to better the education and lives of future generations to come.

Works Cited

Betters-Bubon, Jennifer, et al. “The Case for Universal Mental Health Screening In Schools.” Counseling Today, 5 Sept. 2019, https://ct.counseling.org/2019/09/the-case-for-universal-mental-health-screening-in-schools/.

 The CDC. “About Mental Health, Centers for Disease Control and Prevention.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 June 2021, https://www.cdc.gov/mentalhealth/learn/index.htm.

 Erika’s Lighthouse, and Name *. “9 Serious Concerns about Depression Screening for Youth.” Erika’s Lighthouse, 3 Jan. 2020, https://www.erikaslighthouse.org/blog/9-concerns-depression-screening-youth/.

 Heitz, David. “Should Schools Screen Kids for Mental Health Problems?” Healthline, Healthline Media, 29 Aug. 2015, https://www.healthline.com/health-news/should-schools-screen-kids-for-mental-health-problems-082915.

 Hoover, PhD. Associate Professor, Sharon, and Elizabeth Connors, PhD. Assistant Professor. Making School Mental Health Screening and Early … Child and Adolescent Psychiatry, University of Maryland School of Medicine , Center for School Mental Health , 2018, https://www.ssw.umaryland.edu/media/ssw/institute/training-institutes-2018/presentation-notes/Workshop-No-45-notes-2.pdf.

 Independent Task Force, and Texas Education Agency . The Collaborative Task Force on Public School Mental Health Services Year 1 Report. 2 Nov. 2020, https://tea.texas.gov/sites/default/files/HB-906-Mental-Health-Task-Force-Year-1-Report.pdf.

 Medlin, Peter. “‘They Need to Be Allowed to Scream.” How School Districts Use Controversial Seclusion Rooms.” Tri States Public Radio, https://www.tspr.org/post/they-need-be-allowed-scream-how-school-districts-use-controversial-seclusion-rooms-0.

 SAMHSA. Ready, Set, Go, Review: Screening for Behavioral Health … Substance Abuse and Mental Health Services Administration , https://www.samhsa.gov/sites/default/files/ready_set_go_review_mh_screening_in_schools_508.pdf.

 School Shootings and Student Mental Health: Role of the School Counselor in Mitigating Violence. https://www.counseling.org/docs/default-source/vistas/school-shootings-and-student-mental-health.p.

Uni. of Maryland, School of Medicine . “School Mental Health Quality Guide, Screening.” University of Maryland, School of Medicine .

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