The State of Mental Health Education in Public Schools

There are plenty of articles on the web that address the issue of mental health and stigma. I’ve read many of them (certainly not all). Rather than pile on, I’d like to share with you a slightly different approach. Let’s first consider how information about one’s health care is distributed to an individual. For example, a baby is born in a hospital, let’s call her Emma. Baby Emma’s health is monitored and she is seen by a pediatrician for all of her check-ups. Emma happens to be born into a family in which the members get their annual physicals and bi-annual dental cleanings. Emma is being socialized in part by her family to see that her health is important.

However, Emma was born in the United States, so at age 11 she has a pretty good chance of being overweight or obese. Certainly, her parents are doing right by her, by modeling going to the doctor and dentist. How about exploring what her parents typically shop for at the grocery store? Is Emma eating a “healthy” diet? What is Emma learning in school about nutrition? Furthermore, what is she learning about her overall health in school? They cover that sort of thing in P.E. right?

Suppose Emma will be attending a public middle school in Montgomery County. How does the county’s middle school curriculum address physical and mental health education? The Physical Education Content Standards and Expectations document (which applies to grades K-12 and was last updated in 1999, presumably based on the latest research on child development and exercise science) does a fabulous job outlining various standards for fitness, injury, balance, motor skills, teamwork, goal setting, etc. But the closest thing to mental health education is illustrated in Standard 3.0:

Expressing Empathy – Students will strive to understand others and develop the ability to demonstrate empathy toward another’s situation. They will acquire a positive efficacy about themselves and social skills necessary to work effectively with others essential to communication, caring, healthy decision making, and a sense of community for all individuals.

Self-Control – Students will participate in a variety of individual and group tasks to increase their ability to control and modify their own thoughts, feelings, and emotions.

Granted, expressing empathy and self-control are two extremely important skills that I teach adolescents and adults working in couple and family therapy sessions. But this does not resemble anything close to a sufficient education on mental health.

For the record, I think that MCPS does provide a more than sufficient education of physical health. Where else would a student like Emma learn about mental health? As a 1st grader she would have learned the following topics:

• Define ways to communicate with friends and family; describe emotions; identify what makes a good decision (safe, respectful, legal, and parent approved).

As a 5th grader she would have learned the following topics:

• Demonstrate healthy communication skills.
• Analyze how one of the six components of personal well-being can be applied to develop goals for positive self-change.
• Dramatize using the 5 steps in decision making to address personal issues and problems.
• Demonstrate using time management to reduce stress in a variety of situations.

Since Emma is a middle schooler, her mental health education will be lumped into a comprehensive health education including family life and human sexuality, safety and injury prevention, nutrition and fitness, among others. Back in 2003 MCPS tried a pilot program called the Red Flags Program aimed to help teach students, parents, and staff how to identify signs of adolescent depression. Because it was a pilot program and because it relied on non-profit funding, it was only implemented in 5 schools. Today, it seems to only exist as a supplemental resource page.

If Emma happens to be a student who is at risk or if she is showing behavioral symptoms successfully identified by a staff member, she may earn a visit with a school counselor, a school psychologist, a pupil personnel worker, and/or a school nurse. I get it, I know that because I am a mental health professional, I am going to have a skewed bias for favoring higher quality educational standards around my own field. And I also know that there are only so many hours in the school day, only so many school days in the academic year. But we must do better.

One of the reasons I believe stigma around mental health is still so prevalent in our society is because of how it is incorporated in the educational system. If mental health education were treated as equally important as physical health education I believe that our society would have different mental health outcomes. Some might make the case that we do a good job with teaching kids about exercise and nutrition and yet still 1 in 3 youth are overweight or obese. Doesn’t that undercut my argument?

We need to look at how youth are socialized in a system. Even if the standards of mental health education were to be dramatically improved, we would still be overlooking one crucial component, the family. We marriage and family therapists know that the deepest change comes about when more members of the family system are involved. To help serve students like Emma, we need to think about generating new and effective ways of incorporating and sustaining parental and guardian involvement in the educational paradigm. Free access to a good public education that informs our youth and their families on the basic fundamentals of what it takes to live a mentally healthy lifestyle is what I am advocating for. At present, I sincerely think we are missing the mark.