Mental Health in Schools: The Historical Context

 Charles Ungerleider, Professor Emeritus, The University of British Columbia

[permission to reproduce granted if authorship is acknowledged]  

After reading my blog about mental health in schools, my UBC colleague, Jason Ellis, sent me two interesting articles by Catherine Gidney, a Canadian historian. Though he did not say so directly, in sending me those articles, Ellis was suggesting that the current concern among educators about student mental health fits prominently within the context of educational discussions in Canada.  

In her article, "From a 'Disciplined Intelligence' to a 'Culture of Care'," Gidney describes the shift in educational focus from developing disciplined intelligence to fostering a culture of care. The rising concern for student mental health is a contemporary manifestation of the shift Gidney describes. As education moved away from primarily focusing on intellectual development and moral character in line with Anglo-Christian values, it began to incorporate a broader understanding of student well-being, which includes mental health.  

The emphasis on empathy, diversity, and inclusivity in the later stages of the twentieth century aligns with current concerns about mental health. Educators today are increasingly aware of the importance of emotional literacy, mental resilience, and the overall emotional and psychological well-being of students.  

In Gidney’s article, “‘Breathe in… breathe out’: Contextualizing the Rise of Mindfulness in Canadian Schools,” she analyses the rise of mindfulness in Canadian schools.  Gidney describes the role of schools in addressing emotional regulation, stress management, and overall mental health. The integration of mindfulness practices into the curriculum is a response to the need for tools and approaches that support students' mental health and well-being.  

The mindfulness movement in education, as Gidney notes, is part of a broader trend towards holistic development that includes mental health. This reflects a deeper understanding of the interconnectedness of emotional, social, and intellectual development in students.  

I am writing about this because I found the two papers by Gidney of interest and thought readers of this blog might also. Her analysis of the historical shifts in educational priorities and practices provides a context for understanding the current emphasis on student mental health. It shows a trajectory from a narrow focus on academic achievement and character formation to a more inclusive and holistic approach that considers the emotional and psychological needs of students as central to their education and development. This historical perspective helps to locate the current attention to student mental health in the context of educational philosophy and practice. Thanks, Jason. 

Mental Health in Schools

 Charles Ungerleider, Professor Emeritus, The University of British Columbia

[permission to reproduce granted if authorship is acknowledged]  

Society is paying more attention to mental health issues among children and adolescents, making it hard to know whether there is an actual increase in the prevalence of mental health challenges or mainly increased attentiveness. It is probably both.  

There has been a significant increase in awareness and understanding of mental health issues in children and adolescents over the last ten years. Society is more open to talking about mental health and it is less stigmatized than in the past. This has likely led to higher rates of diagnosis and greater willingness to disclose adverse mental health conditions.  

Some of the increase in mental health challenges faced by children and youth are likely the consequence of changes in family structures, community relationships, and even the nature of childhood itself. Greater academic pressures on children and adolescents, bullying and cyberbullying, increased use of technology, and the impact of social media also play a part.  

Increased screen time and exposure to social media can lead to feelings of inadequacy, anxiety, and depression. Cyberbullying is a major problem. Sleep deprivation due to excessive screen plays a part for some.  

The pandemic has had a significant impact. Factors such as fear of the virus, disruptions to education, isolation from peers due to social distancing and school closures, and witnessing parental stress or other household difficulties no doubt had a negative impact on mental health.  

The increased prevalence of mental health issues in children and adolescents is in part due to better recognition and diagnosis, but it is also clear that sociocultural, technological, environmental factors have contributed to its increase.  

Mental health issues among children and adolescents vary widely, but certain conditions are more prevalent. Anxiety disorders are among the most common mental health issues affecting children and adolescents. The estimate is that generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias account for about a quarter of the challenges faced by school-age children and youth.  

Depressive disorders account for another estimated 10-15%, although this figure may underrepresent the true proportion because diagnosing depression in young people is hard. Inattention, hyperactivity, or impulsivity are referred to attention-deficit/hyperactivity disorder (ADHD). ADHD affects slightly less than 10% of children aged 2-17 in the United States. Conduct disorder and oppositional defiant disorder account for another 3-5%. Eating disorders affect about 2-3% of adolescents, mostly adolescent women. Autism Spectrum Disorder (ASD) accounts for 1-2% with the prevalence appearing to increase in recent years due to improved recognition and changing diagnostic criteria. Substance use disorders account for an estimated 15-20% typically among secondary school students.  

These are broad estimates largely based on US data and many children and adolescents who are diagnosed with one disorder might also be diagnosed with another.  

Schools have come to play a role in recognizing and addressing mental health issues given the significant amount of time children and adolescents spend there. However, the capacity of schools to effectively address these issues varies widely depending on resources, training, and policies.  

Schools can play a crucial role in early identification and intervention with students who manifest anxiety and depressive disorders. Counselors and psychologists in schools can provide initial assessment and intervention and can refer students to external services when necessary and available. Some provinces have implemented mental health education in their curriculum to promote awareness and provide coping strategies. But the reality is that not all schools have the resources to adequately provide these services, a situation that is made more difficult because there is often a shortage of trained school-based mental health professionals.  

Schools are often involved in the identification and management of ADHD through individualized education plans, which provide accommodations to help students succeed. However, teacher and staff training in recognizing and managing ADHD can vary widely.  

Schools are usually the first to notice behavioral disorders given their disruptive nature. However, managing these disorders can be challenging and may require a combination of special education services, behavioral intervention plans, and collaboration with external mental health professionals.  

Eating disorders might be less visible within a school setting unless they are severe. But schools can play a role in promoting healthy body image and eating habits, and school nurses – where they still exist - or health programs can help with early identification.  

Schools provide special education services for students with Autism to help meet their unique needs. These might include speech-language therapy, social skills training, and other interventions. However, the quality and availability of these services vary widely.  

Schools can offer support for students dealing with trauma through counseling and other mental health services. Some schools have started to implement trauma-informed care approaches that recognize and respond to the signs of trauma. However, these services and approaches are not universally available or implemented.  

Schools can help prevent substance abuse through education. Some schools have established policies and resources to support students struggling with substance use, but students who abuse often require specialized treatment beyond what schools can provide.  

A key challenge is the gap between the number of students who need mental health services and the availability of resources. This includes the lack of sufficient trained staff, funding, and comprehensive school-based mental health programs. Stigma about mental illness can prevent students from seeking help, and privacy concerns can make the communication among schools, families, and external mental health providers complicated.  

It is important to recognize that schools are primarily educational institutions and not a substitute for professional mental health services. While they can provide support for the mental health of students, collaboration with families and community mental health services is necessary to provide comprehensive care.  

There is a considerable amount of evidence supporting the value of providing  mental health services in schools. Many students who might not otherwise receive mental health services can access them in the school setting. Early identification and intervention can help prevent the escalation of mental health problems.  

Based on the accumulated evidence and expert consensus, the best practices for providing mental health services in schools include a multitiered system of supports. This includes universal prevention programs for all students, focused interventions for those at risk, and intensive services for students with significant mental health challenges. School Mental Health Ontario is leading such an approach.  

Schools should employ professionals with special preparation for providing mental health services such as school nurses, school psychologists, social workers, and counselors. Such personnel are qualified to provide individual and group counseling, crisis intervention, mental health assessments, and referrals to community mental health services when needed.  

Schools can partner with community mental health providers to deliver more intensive services in the school setting, helping to overcome barriers to access like transportation or stigma. But, if we expect schools to provide mental health services, staff need training in recognizing the signs of mental health issues, strategies for managing them in the classroom, and have an established process for referring students for mental health services.  

Incorporating mental health education into the curriculum can improve awareness, reduce stigma, and give students strategies for managing their own mental health. Increasingly schools are providing instruction in emotional regulation, stress management, and forming and maintaining healthy relationships.   

Families play an important role in supporting students' mental health. Schools should involve families in planning and delivering mental health services and should also provide resources to help families support their children's mental health. But they will need preparation and resources for doing so. If schools provide mental health services, the services provided should be sensitive to the cultural and linguistic needs of students and families.  

Instead of an exclusive emphasis on addressing mental health issues when they arise, schools should focus on promoting overall well-being and resilience. This should include fostering a positive school climate, promoting social-emotional learning, and providing opportunities for physical activity and creative expression. In an earlier blog I lamented the loss of school-based nurses. Were they reinstated, nurses could be very helpful in early identification of the broad ranges of mental health issues.  

School mental health is a rapidly evolving field. Best practices continue to be refined based on research and experience. The challenge remains in ensuring these best practices are widely adopted and adequately resourced, and that there is policy support, professional development, and funding to ensure all students get the mental health services they need. 

“P.E. teachers are going to love this blog!”

 Charles Ungerleider, Professor Emeritus, The University of British Columbia

[permission to reproduce granted if authorship is acknowledged]  

“P.E. teachers are going to love this blog,” my wife said when I told her that I had read a meta-analysis confirming the positive relationship between physical activity and cognitive functions in children and youth. The article systematically searched and analyzed studies to confirm that being active and engaging in physical exercise is good for improving children’s thinking abilities. These thinking abilities include basic cognitive functions like processing speed, core executive functions like paying attention and remembering instructions, and higher-level executive functions like problem-solving and planning.  

The study points out that physical activities that are part of the school curriculum are especially effective. These activities don’t just make kids sharper thinkers; previous studies have also shown that they keep kids physically healthier.  

Given these positive effects, the study suggests that the information could be valuable for those who make policies or decisions about children’s health and education. It implies that encouraging physical activity could lead to better performance in school, improve mental health by reducing issues like anxiety and depression, and even prevent heart disease.  

However, some schools in recent years seem to be reducing curricular opportunities for physical activity. The review argues that, if educational and public health guidelines take these findings into account, they could help reverse this trend. But to have high quality curriculum in physical activity, you need professionals who really know how to design physical activities that are both fun and developmentally useful for kids.  

The study suggests that future research should look into how the environment, like playgrounds and general surroundings, can be designed to encourage kids to be more active and how this, in turn, could help in their brain development.  

Not everyone will be pleased with the findings of this meta-analysis. Current research suggests that different kinds of exercise do not all affect brain functions in the same way. Exercises that involve complex thinking and controlled, adaptable movements (for example, dance, juggling, games requiring strategies) seem to have a more significant positive effect on executive functions, which are the mental skills that help us manage time, pay attention, switch focus, plan and organize, and remember details.  

The authors of the study also indicate that physical activity done in the classroom doesn't seem to boost children’s thinking skills. This conclusion comes from combining results from classroom-based activities with results from other physical activities that aren't part of the curriculum, like what children do during recess. When they compared this mixed bag of school-time physical activities to structured physical education classes that are part of the curriculum, the latter seems to have a more substantial benefit for children’s cognitive development.  

It is affirmation of the benefit of structured physical education classes, carefully planned and executed, that will please the P.E. teachers.

_______ 

Álvarez-Bueno, C., Pesce, C., Cavero-Redondo, I. , Sánchez-López, M., Martínez-Hortelano, J.A., and V. Martínez-Vizcaíno (2017) The Effect of Physical Activity Interventions on Children’s Cognition and Metacognition: A Systematic Review and Meta-Analysis, Journal of the American Academy of Child & Adolescent Psychiatry, 56 (9), 729-738, https://doi.org/10.1016/j.jaac.2017.06.012.

The Role of School Boards in Guiding Student Achievement, Equity, and Trust

 Charles Ungerleider, Professor Emeritus, The University of British Columbia

[permission to reproduce granted if authorship is acknowledged]  

The cyclical nature of the school year, coupled with the consistent influx of students embodying a diverse array of backgrounds and abilities makes the educational goals of enhancing student achievement, fostering equity, and reinforcing public confidence in the educational system ones that endure over time. Each incoming cohort of students brings with it a unique blend of strengths, challenges, and needs. The variety of these needs - cognitive, socio-emotional, cultural, linguistic, physical, among others - reinforces the persistent nature of improving student achievement and success, ensuring equity among different groups of students, and instilling confidence in the school system.  

Improving student achievement and success is a constant because, with each new group of students, there is a renewed need to ensure they acquire the knowledge, skills, and attitudes necessary for their success in school and beyond. Every year, schools welcome students with diverse abilities, ethnicities, socio-economic statuses, and more. Equity in education means ensuring that all students achieve outcomes unimpeded by their backgrounds or circumstances. Given the diversity in any school population, the pursuit of equity is an ongoing task that must be addressed anew with each incoming cohort.  

The credibility of the school system is dependent on its ability to adapt to the changing needs of the student population and the broader community. It must strive to improve, to foster an environment of trust and respect, and to deliver on its commitments to the citizens who rely on the school system to prepare the young to take their role as citizens. As societal expectations and contexts evolve, so too does the need for the school system to demonstrate its relevance, effectiveness, and reliability.  

The rapid pace of technological change requires schools to modify teaching strategies to prepare students for a world increasingly dependent on technology. This constant need for adaptation underscores the enduring nature of the goal of improving student achievement and success. As societal values and norms shift, so too do the expectations placed on schools. Schools are places where students are prepared for their participation in a democratic society that values respect for diversity, civic responsibility, and social justice. Schools have a responsibility to prepare students to engage with diverse cultures and perspectives. The goal of promoting equity must therefore extend to include intercultural understanding and competence.  

The persistence of these goals — enhancing student achievement, fostering equity, and building public confidence in the education system — highlights their importance, and there is an argument to be made that they should be at the core of a school board's strategic focus. The essential role these goals play in shaping an effective and inclusive educational environment is undeniable, and their achievement can be seen as a critical indicator of the success of an educational institution.  

Reducing the strategic goals of a school board exclusively to these objectives may not encapsulate the multifaceted nature of education, nor address the complexity and variety of students' needs. Education isn't merely about academic achievement, but also about holistic development, including social, emotional, and physical wellbeing. Similarly, equity extends beyond academic equity to include providing a safe, inclusive, and supportive environment for all students, regardless of their background, abilities, or identity. These important dimensions of schooling should be reflected in board policies and, if they are not expressed in policy, school boards should have as a strategic objective for their development.  

Matters such as teacher recruitment and retention, budgeting, and facilities management are operational matters that are necessary to achieve the broader goals of education. How these operational tasks are managed and executed to effectively support these broader goals depends on the Superintendent that the Board hires.  

The Superintendent sets priorities for hiring teachers with specific skill sets or experiences, establishes and implements programs to support teacher development and job satisfaction, and allocates resources towards competitive compensation packages. The superintendent’s budgeting decisions should prioritize programs and resources that have been shown to be effective, efficient, and economical.  

While these areas are indeed operational in nature, they require planning and decision-making to ensure they align with and support the broader educational goals. School board oversight can ensure their operations not only address the day-to-day functions of the schools but also contribute to the long-term vision and goals of the education system.  

The role of the school board extends beyond just hiring a superintendent to manage operations. School boards are responsible for setting the strategic direction of the district, establishing policies, and holding the superintendent accountable for implementing these policies and achieving the set goals.  

While the superintendent handles the day-to-day operational aspects of running the school district, the school board is responsible for ensuring that these operations align with the larger strategic goals. So, even though operational tasks like teacher recruitment, budgeting, and facilities management might be handled primarily by the superintendent, the school board still has a crucial role in overseeing the performance of the superintendent.  

While the tactics and methods employed by the school board’s leadership may change over time, the underlying goals of improving student achievement, ensuring equity, and instilling confidence in the school system are constant because of the changing nature of the student population and the broader social, economic, and technological context in which schools operate. 

Some mistakes are too important to ignore

 Charles Ungerleider, Professor Emeritus, The University of British Columbia

[permission to reproduce granted if authorship is acknowledged]  

There are mistakes in Geoff Johnson’s article “FSA not a good way of assessing Indigenous students” in the Times Colonist posted on October 29^th that deserve correction for several reasons. One is that the Times Colonist is widely read. The other is that the designation of “former superintendent” adds authority to the errors he has made.  

As noted in his article, “the Foundations Skills Assessment is administered to all Grade 4 and Grade 7 students, both Indigenous and non-Indigenous.” The mistakes arise from his claim that the Foundation Skills Assessment is not a good way of assessing Indigenous students. One of them is the logical fallacy in his statement. He writes, “turns out that the four ‘lowest performing’ elementary schools on the FSA, according to the Fraser Institute’s one-shot ranking system, have significant populations of First Nations students.”  

In making that statement Johnson is committing the logical fallacy “after this, therefore because of this.” The logical fallacy occurs when someone assumes that because one event or set of conditions preceded another, the first event must have caused the second. In saying that the lowest performing elementary schools have significant populations of First Nations students, he is implying that the poor performance is attributable to the student composition of those schools.  

Another mistake deserving correction is drawing the connection between the performance of those schools and the assertion that “assessing a child in a way that does not seem meaningful or relevant to their life and culture is inauthentic and therefore meaningless, because it does not respect the learning of the whole child.” Indigenous children live in a society in which and literacy in the dominant language and numeracy figure prominently and where both have been used to deny Indigenous peoples their rights. Knowing how well Indigenous students perform on such assessments is essential to ensuring that they are being educated to the same standard as their non-Indigenous peers and from equipping them with the knowledge they need to defend their rights.  

I agree with Johnson that ensuring that the measures used to assess Indigenous youngsters are fair is essential. Johnson strongly asserts that “a central problem with the lack of validity of the FSA, as far as Indigenous students are concerned, is that the tests often contain items expressed in a way not obvious to an Indigenous student who might have a worldview and experiences that differ from the dominant Western culture.”  

This is something about which evidence can be brought to bear. Differential Item Functioning (DIF) is a technique used in assessment to determine if a question is fair to different groups of people. Imagine, for example, a math assessment, and you find out that for some reason, boys are more likely to get Question 5 right than girls, even when both groups are equally good at math. If that's the case, then Question 5 has "differential item functioning." Question 5 is not measuring math skills equally for boys and girls. DIF helps us figure out if a particular question on a test is easier or harder for one group of people compared to another, helping to ensure that tests are fair and unbiased.  

Before strongly asserting that the FSA is inappropriate for Indigenous students, one should consider the evidence. Johnson’s reference to the 2013 article by Jane P. Preston and Tim R. Claypool and the invocation of the imprimatur of The Canadian Council on Learning does not substitute for evidence about the Foundation Skills Assessment.  

Johnson quotes a B.C. government media release saying, “the redesign of curriculum maintains a focus on sound foundations of literacy and numeracy while supporting the development of citizens who are capable thinkers and communicators, and who are personally and socially competent in all areas of their lives.” He follows the quotation with the claim that the government statement ignores research about Indigenous ways of learning and is “dangerously close to being as colonial as you can get.”  

Could it not be argued that Johnson’s assertion is colonial? Johnson seems to imply that Indigenous students are by reason of ancestry or circumstance unable to demonstrate that they are capable thinkers and communicators. I doubt that was his intention. However, it seems very similar to the incorrect inferences drawn about women; namely that they are by constitution incapable of being pilots, surgeons, entrepreneurs, etc.  

There are three crucial omissions from Johnson’s article. One is the fact that the First Nations Leadership Council supports the use of the Foundation Skills Assessment as “. . . one among many tools necessary to address the ‘racism of low expectations’ experienced by First Nations learners as identified by the BC Auditor General in their 2015 report.” The second is that Indigenous educators are involved in item development for the assessment. The third is that the assessments contain First Peoples content written by and about First Peoples, and their development is guided by the First Peoples Principles of Learning.  

It is for these reasons that I hope Johnson will revise his article in the Times Colonist.