Congress must act now to address mental illness in schoolchildren

The raft of school shootings across the country is dramatic evidence of the need to provide a better support system for children with mental illness. As schools have focused more and more narrowly on academic performance, early warning signs of mental and behavioral health disorders have been all too frequently overlooked. The Mental Health in Schools Act of 2013 (S. 195) has placed a spotlight on children’s mental health, now at increasingly greater risk given cuts to state education budgets. These cuts threaten to further reduce already limited numbers of school counselors and other support personnel. In a time of “big data,” we cannot ignore the fact that one in five children in the United States suffers from mental illness. Over the past 20 years, suicide rates have nearly doubled among children between ages 10 and 14.

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A recent report by the Center for Children’s Advocacy in Hartford, Conn., identified red flags in school records as early as kindergarten and first grade. More than 70 percent of students in the sample who were diagnosed with mental illness and behavioral health problems by middle school had exhibited warning signs by second grade. Of these, almost 25 percent exhibited risk factors during pre-kindergarten years. Red flags included an array of developmental and health issues, adverse social factors and exposure to trauma that had been clearly documented. Yet many of these same children, now anxious, depressed, alienated and failing in school, had been described by kindergarten teachers as engaged, social and motivated to learn.

School records painted a disturbing picture. Report cards, test scores, notes for parents and teacher comments were often optimistic in the early years of schooling, describing children as “eager to learn” and “very motivated” and “likes to help others.” Unfortunately, that sense of individual potential faded rapidly for some. The impact of prenatal exposure to drugs, lead poisoning, histories of head trauma, complicated and stressful family circumstances, parental loss, abuse and domestic violence took a toll. Like 70 percent of adolescents with mental health problems, the struggles of these teenagers were often unrecognized and untreated until symptoms became too severe to ignore. Teen depression, anxiety disorders, post-traumatic stress disorders and suicidal and self-injurious behaviors began to overwhelm the potential for success.

Many of the school records showed poor or failing grades led to social promotions and retentions in grade, disciplinary incidents, school suspensions and school failure. Language and learning disabilities, often masked by behavior problems, further challenge student success.

Services for mental health and behavior disorders are scarce and getting more so as social safety nets become increasingly frayed. Educational, behavioral and social outcomes for children classified as having emotional and behavioral disorders continue to be the worst of any disability group, according to national studies.

Some students express their pain through disruptive behavior, leading to suspensions, expulsions and dropping out of school. Involvement with the juvenile justice system often follows, too frequently a prelude to prison and wasted lives. For others, equally troubled, social and emotional withdrawal and dependency also destroy opportunities for successful, productive participation in the community.

School is where children spend a major part of their early years. It must become a nexus for providing quality mental health services for those in need. With appropriate support, schools can bring educational, mental health and community-based resources together to address early warning signs and interrupt patterns of failure. Early screening, prevention and intervention are essential to nurture emotional and social development and avoid lifelong negative consequences of societal blind spots.

The Mental Health in Schools Act of 2013, introduced recently by Sen. Al Franken (D-Minn.) and co-sponsored by Sens. Dick Durbin (D-Ill.) and Max Baucus (D-Mont.), Ben Cardin (D-Md.), Mazie Hirono (D-Hawaii), Sherrod Brown (D-Ohio), Mary Ladrieu (D-La.), Richard Blumenthal (D-Conn.) and Jon Tester (D-Mont.), brings welcome national attention to the problem of mental illness in children. The bill proposes a grant program that expands access to mental health services in schools; supports schools that work with community-based organizations; promotes assistance to schools to train staff, volunteers, families and other members of the community to recognize signs of behavioral health problems in students and to initiate appropriate referrals for needed services. The measure has been endorsed by more than 70 professional and community-based organizations and now deserves bipartisan support and immediate action by Congress.

The problem is urgent and the need is great. We cannot afford to turn a blind eye to the needs of our children. They deserve the best of educational, social, medical and therapeutic interventions. 

Andrea Spencer is dean of Pace University’s School of Education and educational consultant to the Center for Children’s Advocacy.