Introduction
Why is it that North American schools are such effective incubators for anxiety, depression, and a variety of other mental health issues? Outliers aside, the basic concepts of high school education have not changed that much over the past half-century or so. Yet in 2018 we find ourselves immersed in research and reporting that highlights all the now-familiar concepts: adolescents are more prone to stress, anxiety, and depression now than ever before, and our education system seems to be one of the chief causes of these conditions. In particular, I am interested in how teachers respond to the challenge of mental health issues in students, and how those responses ameliorate or exacerbate the conditions around the academic, emotional, and social well-being of that student.
Section 23
My interest in school-based stress began when I worked with a hospital-based school, with children and adolescents hospitalized for a variety of mental health concerns. I was warned off by family members and colleagues before accepting this position. They all warned me that these kinds of programs were were all the “psychopaths” were placed - which only served to pique my interest further. My work entailed creating literacy and numeracy programming for students who were housed in both the In-Patient and Out-Patient units, helping them earn high school credits, and managing the academic portion of their reintegration into life outside the hospital. This involved many meetings with principals, guidance counsellors, student success teams, parents, superintendents, mental health nurses, psychologists, psychiatrists, social workers, child and youth workers, patients’ rights advocates, police, and more.
In my four years in the program, I worked with hundreds of students whose mental health issues ran the gamut of suicidal ideation, self-harm, eating disorders, overdosing, schizophrenia, psychosis, OCD, PTSD; their social issues included expulsion, physical and sexual abuse, incest, homelessness, criminal charges, police brutality, and in one case, being put on a terrorist watch list by the RCMP. However, despite the aforementioned list, what I always found most fascinating was the commonalities between these students - the vast majority of them found school to be extremely stressful. Their reasons varied but generally centered around heightened expectations from family, teachers, administrators, or even themselves, and their perceived inability to meet those expectations. They regularly told me how their school simply did not understand their mental health needs; for many students, the most effective part of being hospitalized was simply two or three days away from school. The other half of my job was working with the school community to reintegrate these students after whatever incident brought them into the hospital. In many cases, the school was unwilling to accept these “dangerous psychos” back even though it was their legal responsibility to do so. I found the disconnect between what the student was asking for - support and acceptance - and the school’s reaction - rejection and intolerance - to be both personally and professionally frustrating.
In-School Mental Health Support
After four years I transferred into a quote-unquote “regular” high school which also has a highly stressed student population. One colleague and myself put together a “mental health club” which sought to bring the conversation around mental health to the forefront of the school community. We conducted an online survey of approximately 200 students; some of the more interesting data points were:
65% of respondents said that being at school made them “rarely” or “never” happy
45% of respondents said their current level of stress is “high” or “very high” - and this survey was given at the beginning of a new semester
30% of students reported that they slept 6 or fewer hours a night, which is generally unhealthy for a developing adolescent brain
82% said the majority of their stress was caused by homework
80% said they put “high” or “very high” amounts of pressure on themselves to succeed
90% of respondents said that they either were unsure or had no concept of where to access mental health supports at school
This data points to a school community and culture where high levels of stress are not only endemic, but expected and normalized. I am curious to see what research has been done in this area, to try and develop a data-driven approach that will help teachers craft different perspectives on their roles in causing and preventing negative mental health in students.
One interesting examination by Pope (2010) looked at the reaction of a high school to the death by suicide of one of its students, as a result of academic stress. “The Jared Project”, named after that student, used a multifaceted approach to reducing stress in the school. The one approach I found particularly interesting involved asking all staff to create a schedule where they input the amount of hours they expected students to give to that course, team, club, band, or other co-curricular area. Then, when students signed up for courses, they had to calculate how many hours per day they were signing up for and include eight hours of sleep. If they signed up for more than twenty-four hours of work in a day, or if their eight hours of sleep were reduced by more than one hour, they were not allowed to have that schedule (p. 7). This is contrasted with the other end of the self-care spectrum, which is self-harm, as detailed by Dimmock, Grieves, and Place (2008). Without the support of a school network, students who lapse into self-harm as a coping mechanism are “coping with a sense of being overburdened with insoluble problems” (p.42). The researchers held interviews with adolescents who were at the end of their psychiatric treatment for self-harm, specifically cutting; through these interviews, their respondents noted that the physical pain of self-harm was easier to deal with than the socio-emotional distress brought on by school (p.44) and that they would rather cut or speak to a teen they had never met than speak to an adult in a school setting (p.45). This suggests severely maladaptive coping strategies that are exacerbated by perceived intolerance or lack of understanding from adults within a school.
Teacher Mental Health
Another Australian study by Trudgen and Lawn (2011) examines how teachers deal with mental health issues in their classrooms, specifically depression and anxiety. Of note is the stress experienced by teachers themselves. According to the study, 40% of teachers feel their career has a large amount of stress, which is twice the national average of most professions; 71% say their stress has a deleterious impact on the quality of their teaching; 57% say they have a poor work-life balance (p.128). This study tried to find a common threshold at which teachers began to intervene in their students’ mental health, usually by making a recommendation to someone else in the school that the child receive some kind of psychiatric treatment. Trudgen and Lawn found that the majority of teachers they interviewed, regardless of years of experience, were able to easily identify behavioural signs in students that would suggest some form of mental health-related distress - however, these same teachers could not act on those signs in the moment because the rest of the class was simply too busy (p.132). Another result that I found particularly interesting was that the teachers in this study believed that teens interact differently in their social spheres now than they did ten or fifteen years ago (p.133). One possible effect of this is that the instincts or “gut feelings” that a veteran educator has honed over their career vis-a-vis rationale for student behaviour may no longer be applicable, leaving educators without a framework with which to confidently make decisions. The pervasiveness of an online life - i.e. social media - realistically leaves educators dealing with a whole other level of reality that their students occupy, which the educator may know nothing about, and where their instincts are compromised with the changing of the medium. One can understand why, later in the study, the teachers say they feel an “overwhelming sense of powerlessness” to help their students (p.134).
Trugden and Lawn conclude with an observation that I feel has become commonplace with many educators - that teachers need more training in establishing their “mental health literacy” (p.138). Yet the specifics of this training and establishing the parameters of “mental health literacy” for educators remains elusive. In my practice I have sought to include “mental health advocate” as part of my role, for both staff and students. Part of this has involved training for staff around mental health vocabulary, stigma, and understanding its relevance to their own lives and the ecosystem of the classroom; a student who is experiencing stress is more likely to cause stress for an educator, which can create something of a feedback loop of stress and anxiety between teacher and pupil. I have facilitated several workshops for staff around mental health and the ministry of care, by which I mean ministry in the ecclesiastical sense, not the governmental sense. We also brought in several guest speakers into our community for staff and students. These included Canadian Olympian athlete Sarah Wells, who speaks about resilience and endurance, and Gillian White, a Ph.D. candidate at the Human Physiology Lab at UofT who specializes in the physiological effects of stress on the human brain. Our group also organizes visits to the Centre for Addiction and Mental Health (CAMH) for staff and students to help them understand the environment a student is placed in when they are admitted to hospital for psychiatric concerns. Our hope was that these shared conversations would bridge the gap between teacher and student, adult and child, and allow both parties to understand how the other experiences stress. Once that groundwork is laid and a shared vocabulary can be used, we further hoped that we can address how staff can be complicit, explicitly or not, in the engendering of conditions ripe for poor mental health in students. This will be a difficult conversation to have as it directly addresses an educator’s pedagogy, which, in some cases, may have been established for decades. The goal of is to help staff and students understand the connection they have to one another, and how improving that connection will improve the mental health and performance of our community.
University of Ottawa B.Ed - Comprehensive School Health Cohort
My experience in my B.Ed program, at the University of Ottawa, involved mental health in my own life but not in a curricular sense. My own mental health suffered during that time; I struggled with loneliness, since I knew no one in the Ottawa area and spoke virtually no French; my grandfather and cousin both died that year; and I was acclaimed as President of the Student Federation but inherited an organization mired in debt and poor management. Yet in my classes there was no mention of mental health - nothing about teacher burnout, student anxiety, or accommodations based on mental health. Curious to see how that program had evolved since I left it ten years ago, I perused their website to see if any mental health programming had been integrated into their offerings.
Thankfully, the University of Ottawa now offers a mental health cohort in their B.Ed program. This cohort, titled Comprehensive School Health, is offered at the both the B.Ed and M.Ed levels. Its programming is based on a Ministry of Education resource titled Foundations for a Healthy School (2016), which is itself a companion to the K-12 School Effectiveness Framework document. The cohort offers an Educational Research Unit, a list of peer-reviewed mental health resources for educators, published papers by cohort members, inclusion conferences, alternative assessment databases, and more. Examining the Foundations for a Healthy School document, upon which this cohort is based, reveals only three pages related to mental health out of thirty-seven. The document suggests accessing the Ministry’s Supporting Minds (2013) document for more intensive support around mental health strategies in the classroom. Yet in the five years since the publication of Supporting Minds, I have found that it is only familiar to teachers who make mental health a priority. My hospital school mentor was one of the consultants on Supporting Minds so I was fortunate to learn of it early on; I regularly direct teachers and students to it, and have been doing so for years, but still find that a good deal of adults in my workplace - administrators, guidance, resource workers, and teachers - remain unaware of it.
This brings up another inherent tension in schools, being that of the new teacher and the established teacher. New teachers, coming from B.Ed programs with mental health-focused cohorts such as U of O’s Comprehensive School Health cohort, can graduate with pedagogy and a view of the profession that has mental health as its foundation, supported by government documents. These teachers ostensibly will approach mental health as their responsibility, equally as important as literacy and numeracy. Teachers who did not have this focus in their pre-service program could potentially be subdivided into two categories: those for whom mental health is not an issue connected to education; and those for whom it is. The former group could present as resistant to accepting their role in promoting positive mental health in the school community; the latter could be more active in promoting positive mental health, but may or may not have the resources, skills, or vocabulary to do so, depending on what resources and training they are able to access. This hypothetical latter group may also take a “scattershot” approach to integrated mental health, since they will have gleaned their philosophy from a variety of other sources as opposed to having it delivered in a standardized format through a post-secondary cohort. This approach could potentially make creating a school-wide shared vocabulary around mental health a more complicated task, since the concept of “mental health” can mean myriad things to different people. However, having a variety of mentalities and approaches could also be beneficial as it provides flexibility, diversity, and adaptability to approach a panoply of potential mental health scenarios.
Ego Formation and Teacher Identity
Examining the mental health connections in pre-service programs led me to consider teacher ego formation and how it relates to my subject. Many times I have been told that once a teacher is placed within a staff environment, it takes an average of three years for them to acclimatize that that environment and cast off whatever their previous concepts of education were. Thus, to create a climate where staff acknowledge and work through their role in student mental health, it is vital that the majority of that staff have enough similarities in their self-concepts as educators that they can bridge the gap between other differences that may impede progress in this area. Clarke, et al. (2018), draw on Lacan to discuss the formation of teacher identity as a dialectic between the ideal ego, or hypothetical perfect self, and the ego ideal, or practical required self (p. 116). This “lack of fit” between the two Lacanian concepts results in cognitive dissonance, which is exacerbated by “conflict arising from the space between the psyche and the social (...) becoming a teacher requires openness to knowledge of the self and to knowledge originating in the other.” (p. 116) It could be argued that for educators, students are often this “other” - a vast unknown, safely homogenized into broad stereotypes that fit our preconceived notions. The authors also connect this conflict between ego ideal and ideal ego to the use of an inside out model of ego formation as opposed to an outside in model. They postulate than an outside in model uses extrinsic factors to shape a teacher’s identity, namely: curricular documents; ministerial publications, “best practices” courses, and universal standards. The inside out model, conversely, begins with the identity of the teacher at the core and creates the teaching model built around that unique identity (p. 117). Rather than positioning one or the other of these modes of ego formation as ideal, Clarke, et al., reflect the Lacanian postmodern approach by positioning the genesis of teacher ego as an ongoing process that exists in flux between these two poles; here, the teacher-as-subject is eximate, or existing neither inside nor outside, but in both simultaneously (p. 119).
The eximate model works well in helping me understand how teachers process new information and responsibilities, such as that of mental health advocacy. If mental health is not personally important to you - if it is not part of your inside out model - and it is not theoretically or professionally relevant to you - if it is also not part of your outside in model - then you could struggle to integrate it into both your ego ideal and ideal ego. The relatively recent emphasis on mental health in education could clash with what many educators have “learned”, “known”, and “felt” their entire careers. This new emphasis could cause these teachers to question both their ego ideal and ideal ego as teachers, particularly if mental health in schools fits into neither the inside out or outside in models of ego formation. Thus, one potential solution for them to avoid this cognitive dissonance is to avoid the concept of mental health in education all together. This allows them to still feel like competent, caring teachers, in the same way that they have expressed this for years prior to the emphasis on mental health in education, and prevents them from feeling as though they are unprofessional. Once the mentality of avoidance has taken hold writ large amongst a staff, any new staff coming in will struggle to implement their own ideation around mental health, since they too will experience this same eximatic conflict and potentially choose to go with the path of least resistance to maintain their ego ideal and ideal ego. If the phrases “I am a good teacher” and “I am a teacher who cares about mental health” do not overlap for an educator, then it is easiest to eliminate the latter in favour of maintaining one’s self-perception of the former. Perhaps this is why, in part, some teachers find it difficult to integrate concepts of mental health into their pedagogy - particularly if they cannot recognize that they themselves can be the source of poor mental health in their students.
REFERENCE LIST
Andrews, J. and Feurer, D. (2009). School-Related Stress and Depression in Adolescents With and Without Learning Disabilities: An Exploratory Study. Alberta Journal of Educational Research, v. 55, n. 1, pp. 92-108.
Clarke, M., Michell, M., and Neville, J. (2017). Dialectics of development: teacher identity formation in the interplay of ideal ego and ego ideal. Teaching Education, v. 28, n. 2, pp. 115-130.
Dimmock, M., Grieves, S. and Place, M. (2008). Young people who cut themselves - a growing challenge for educational settings. British Journal of Special Education, v. 5, n. 1, pp. 42 - 28.
Ontario Ministry of Education. (2014) Foundations for a healthy school. Ottawa, ON: Queen’s Printer for Ontario.
Pope, D. (2010). Beyond “Doing School”: From “Stressed-Out” to “Engaged in Learning”. Canadian Education Association, v. 50, n. 1, pp. 4-8
Trudgen, M. and Lawn, S. (2011) What is the Threshold of Teachers’ Recognition and Report of Concerns About Anxiety and Depression in Students?: An Exploratory Study With Teachers of Adolescents in Regional Australia. Australian Journal of Guidance and Counselling, v. 21, n. 2, pp. 126 - 141.
University of Ottawa, Bachelor of Education Program. Comprehensive School Health. Retrieved from http://uottawa-comprehensive-school-health.ca/. Accessed Monday, April 23rd, 2017.
