May is Mental Health Awareness Month. In recognition of mental health as one of the most important pieces of school safety today, we asked Safe and Sound advisors, Dr. Melissa Reeves and Dr. Stephen Brock to weigh in on what they see in our K-12 schools today.
Safe and Sound Schools: Drs. Reeves and Brock, what are the top 5 mental health issues and themes you see in our K-12 schools currently?
Drs. Reeves and Brock: It’s difficult to pick just 5, but these make up a great deal of the mental health work we are seeing in the field of K-12 School Safety today.
Two key mental health challenges our schools are facing are:
1. Suicidal ideation and behavior among students.
According to the Youth Risk Behavior Survey and the CDC, rates have significantly increased since 2008 (after over a decade of decline). Nineteen states have passed laws requiring suicide prevention education for educators, the most recent being California. On September 26, 2016, Governor Jerry Brown signed into law AB 2246 which requires all schools serving students from grades 7 to 12 to adopt comprehensive suicide prevention policies (that address suicide prevention, intervention, and postvention).
2. Increased anxiety due to demands and social pressures.
Academic demands continue to increase and students are feeling the pressures to take more challenging classes. Social pressures, the constant comparisons to others via social media, and readily available access to information for which children and youth may not be ready to comprehend and process, are all contributing to higher levels of anxiety. Schools are beginning to teach students anxiety management strategies to better cope with these stressors.
On the positive side, these are three trends we see schools taking to address mental health in schools:
1. Integration of mental wellness into the curriculum.
Social emotional learning (SEL) programs not only help to keep our young people psychologically well, they have been shown to improve academic performance and decrease referrals for negative behaviors.
2. Prompt identification and treatment of mental illness.
Half of all lifetime cases of mental illnesses emerge during the school years (by age 14). The school environment is the perfect setting for early identification. Universal mental wellness screenings should become as common as vision and hearing screenings.
3. Increasing mental health services and staffing in schools.
Research shows that mental health treatment compliance increases 21 times when it is provided in a school vs. in a community setting. School-employed mental health professionals can work directly with students to learn social-emotional skills that increase social competence and academic achievement, and decrease mental health challenges.
Dr. Reeves is President of the National Association of School Psychologists (NASP) and speaker and advisor for Safe and Sound Schools. Dr. Brock is the former President of NASP and speaker and advisor for Safe and Sound Schools.
In the hours, days, and weeks after an act of school violence, our nation predictably turns its focus to the mental health of the perpetrator. We often assume that the attacker’s behavior was caused by mental illness. This belief provides something of an explanation for us to hold onto in our shock and grief. Believing that the perpetrator suffered from mental illness allows us to distance ourselves just a bit from the individuals who would commit this type of violence. While this explanation may serve as comfort for our wounded psyches, is it valid? What does the research tell us about the connection between mental health and violence?
The majority of people with mental illness do not commit violent acts. A number of studies support the finding that a mere 4% of violence toward others in the U.S. can be attributed to people diagnosed with mental illness. There are, however, specific severe mental illness diagnoses linked to slightly higher rates of violence – schizophrenia, which is characterized by disorganized thoughts and behavior and perhaps a loss of touch with reality, along with the major mood disorders, bipolar disorder and major depression. The truth is, persons with mental illness are more likely to be victims than perpetrators of violence. Mental illness does, however, carry an increased risk of violence toward oneself – suicide.
We also know that alcohol and drug use and abuse significantly increase risk for violence toward self and others in both mentally ill and non-mentally ill populations.
Mental illness, then, is not the sole cause of school violence. Roughly 1 in 4 people in the U. S. have a diagnosable mental illness and most of them do not feel compelled to act violently. Mental illness is just one risk factor, and the presence of risk factors does not necessarily result in a specific outcome. Many factors are involved in this process.
How can we reliably determine which individuals are at risk for perpetrating violence in our schools?
The practice of threat assessment, developed over the past twenty years, is the tool we use to investigate and determine the level of risk posed by a given individual. Its focus is not on predicting, but on preventing violence.
Quite simply, we can get a glimpse into someone’s mind by observing precisely what the individual says and does. We review all risk factors, behavioral warning signs, and violence inhibitors, to obtain a more complete picture of whether the individual is heading toward violence. Then, we can intervene, get help for the person, and manage the possible threat in a way that will keep others safe. If we find that we do have concerns about the individual’s mental health, this is the time to summon the person’s support system and refer him or her for assistance.
This discussion would not be complete without acknowledging that in the aftermath of a number of school shooting attacks, previously overlooked indicators of undiagnosed mental illness were uncovered. While the incidence of school shooting is rare, and the link between mental illness and violence is tenuous, we always want to watch for signs of possible mental health issues, and attend to them swiftly.
Other risk factors and warning signs of violence include access to weapons, substance use/abuse, noncompliance with psychiatric medication or treatment, fascination/preoccupation with weapons and violence, a commando mentality, holding onto grievances, a model or script for using violence to solve problems, feelings of envy, anger, rage and hopelessness, a sense of being entitled to revenge for a perceived wrong, and a feeling of marginalization from peers. Can a distorted sense of reality or skewed thought patterns be behind some of these factors? Absolutely!
There are also specific protective factors shown to inhibit violence. These may or may not be present in a given individual’s life. It is the totality of the situation that ultimately determines the outcome.
Small steps we can take each day to keep our schools safe include making vital personal connections with our students, fostering a positive, equitable school climate, educating others and ourselves about the risk factors and warning signs of mental illness, suicide, and violence, and keeping a watchful eye on students. We can develop a process in our schools for referral, assessment, and intervention to provide the help our students need. With all of these preventive measures in place, we can trust that we’ve made our schools a much safer place to learn.
– Susan Sibole, B.A. Psychology, M.S. Counseling Psychology, Youth Risk Prevention Specialists
Founder of Youth Risk Prevention Specialists and creator of the SafeAware program, Suzanne Sibole works with school districts nationwide to significantly increase their levels of safety. With the SafeAware program, schools receive step-by-step assistance developing safety and crisis response plans and setting up violence threat assessment teams. Suzanne trains all staff on everyday school safety, detecting the warning signs of suicide and violence, and the importance of reporting and following up. She then works with key staff members until they are confident assessing individual cases and managing potential school threats. She also speaks to parents about their critical role in school safety and violence prevention. Suzanne has trained at the Gavin de Becker Academy, is a member of ATAP (Association of Threat Assessment Professionals), and works with with national school safety and threat assessment experts.
 Friedman, Richard A., M.D. The New York Times, December 17, 2012.
 Brekke JS, Prindle C, Bae SW, Long JD. Risks for individuals with schizophrenia who are living in the community. Psychiatric Services. 2001; 52(10):1358–1366. [PubMed]
 University of Washington School of Social Work http://depts.washington.edu/mhreport/facts_suicide.php
 Singh, Pavita, MPH. Huffpost Media, Jan 28, 2016
 Langman, Peter. School Shooters: Understanding High School, College, and Adult Perpetrators, Rowan & Littlefield, January 2015
I dealt with school violence before it was front-page news. To me, any child killed anywhere, anytime, is a huge tragedy; but, decades ago, when children were killed in the inner city of Cleveland, you probably never heard about them. The Newtown shootings shocked this country like no other school violence. Working in school safety for over 30 years, I have tried to help schools and communities keep our youth safe and healthy so that they can learn more and live better. I offer several lessons that I have learned.
School violence can happen anywhere, but not here.
After school shootings, it is often heard, “I cannot believe that it can happen here.” As we have learned, school violence can happen anywhere. Don’t be surprised after the next tragedy if someone says, “I cannot believe that it can happen here.” Denial is human but, denial allows violence and danger to grow unseen.
Be prepared, not scared.
Schools are not powerless. Awareness, education, and advocacy can help break down this attitude that it can’t happen here. Schools and districts need to have a school-community emergency plan of action in place for students, staff, and parents. It should be both practiced and proactive. Practice drills are crucial. Preparation allows violence and potential danger to be dealt with before it unfolds.
Social media has changed how we communicate.
Texts, tweets, and Facebook posts, which were not around at the time of the Columbine shootings, now offer instant information–and misinformation. Before problems occur, students need to be part of a dialogue with parents and educators to make schools safer. Social media may prove to be one of the best new tools to help keep our schools safe and parents informed, and to encourage students to take ownership of their schools and education.
Bullying is a symptom, and mental health is the issue.
Bullying is a hot topic and often is blamed for school violence. Bullying is serious and must be addressed but, bullying is often referred to as a cause for school violence even when it is not, as in Columbine. Issues such as mental illness, depression, suicidal ideation, anxiety, anger, family violence and substance abuse are often at the root of bullying behaviors and require immediate attention.
Treat the illness: not the symptom.
Many experts advocate for a comprehensive mental-health approach for the schools, families, and community. Some suggest that teachers be taught mental health first aid to assist those in crisis. As we often see, hurt people, hurt people; and the use of mental health and wellness professionals, such as, school counselors, school social workers, school nurses, school psychologists, as well as, school resource officers may enable us to help people, help people.
Building relationships is key.
The Secret Service found that school shooters usually tell other kids, but not adults. Adults trusted by kids may be given life saving information. Teaching to the heart, as well as to the head to reach the whole child, not only academically, but also to the social, mental, emotional, physical and spiritual dimensions, will help build a school and community of respect and trust.
When emergency occurs, you need to be aggressive, forceful, and effective.
An emergency plan of action needs to be in place, practiced and proactive. Teachers and students should be trained and practiced in emergency protocols. Parents need low tech and high tech communication systems for responding to school emergencies. Gone are the days of Columbine when police waited for hours to enter the school. Today police and community emergency response teams are trained for rapid response. School communities must prepare with responders in order to address emergencies.
Healing is personal.
Schools need to be prepared to deal with the consequences of violence immediately and long after the incident. Individuals react to trauma and grief in a wide a range of ways, and there is no best way or timeline for these processes.
There are no guarantees, only intelligent alternatives.
Today, we are better prepared to deal with and prevent school violence than we were in the earlier days in Cleveland and Columbine. There still is no 100% guarantee that our schools will be violence-free. There are no easy solutions, but there are intelligent alternatives to reduce the risks. It’s time for all schools to explore these alternatives. For some, tomorrow may be too late.
Dr. Stephen Sroka, Safe and Sound Advisor and Professional Contributor.
© 2013 Stephen R. Sroka, PhD, Lakewood, Ohio. Used with permission.
Stephen Sroka, PhD, is an adjunct assistant professor at the Case Western Reserve University School of Medicine and the president of Health Education Consultants. He is an award-winning educator, author and internationally recognized speaker. He has worked with school violence issues worldwide for more than 30 years. Connect with Sroka on his website www.DrStephenSroka.com or by e-mail at email@example.com