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Mental health is often viewed as an adult issue, but in fact, almost half of adolescents are affected by mental disorders, and about 20% of these are categorized as “severe.” Mental health issues can pose a huge problem for students in terms of academic and social success in school. Education systems around the world treat this topic differently, both directly through official policies and indirectly through cultural views on mental health and well being.

Prevalence of Mental Health Issues in Adolescents

According to the National Institute of Mental Health, approximately 46% of American adolescents aged 13-18 will suffer from some form of mental disorder. About 21% will suffer from a disorder that is categorized as “severe,” meaning that the disorder impairs their daily functioning, but almost two-thirds of these adolescents will not receive formal mental health support. The most common types of disorders among adolescents as reported by the NIMH is anxiety disorders (including Generalized Anxiety Disorder, phobias, post-traumatic stress disorder, obsessive-compulsive disorder, and others), with a lifetime prevalence of about 25% in youth aged 13-18 and 6% of those cases being categorized as severe. Next is mood disorders (major depressive disorder, dysthymic disorder, and/or bipolar disorder), with a lifetime prevalence of 14% and 4.7% for severe cases in adolescents. An effect of this high prevalence is high suicide rates among adolescents. Suicide in the United States is the second leading cause of death for adolescents aged 10 to 24. More teenagers and young adults die from suicide than cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. There are an average of over 3,470 attempts by students in grades 9–12. Some of these suicides are because of, or in part due to the stress they are under during school. A similarly common disorder is Attention deficit hyperactivity disorder (ADHD), which is categorized as a childhood disorder but oftentimes carries through into adolescence and adulthood. The prevalence for ADHD in American adolescents is 9%, and 1.8% for severe cases.

Effects on Academics and School Life

Mental disorders can lead to many academic problems, such as poor attendance, difficulties with academic, poor social integration, trouble adjusting to school, problems with behavior regulation, and attention and concentration issues. High school students who screen positive for psychosocial dysfunction report three times as many absent and tardy days as students who do not identify dysfunction, and students with high levels of psychosocial stress are much more likely to view themselves as academically incompetent. This leads to much higher dropout rates and lower overall academic achievement, as well as specific academic and social problems associated with various disorders.

Anxiety

Students with anxiety disorders are statistically less likely to attend college than those without, and those with social phobias are nearly twice as likely to fail a grade or not finish high school as students who have never had the condition. Anxiety manifests in many of the same ways as ADHD, and so students with anxiety disorders often experience problems concentrating, filtering out distracting external stimuli, and completing multi-step or complicated tasks. Additionally, anxiety disorders can prevent students from seeking or forming social connections, which negatively affects students' sense of belonging and in turn impacts their school experience and academic performance.

Depression

According to the National Center for Mental Health Checkups at Columbia University, "High depression scores have been associated with low academic achievement, high scholastic anxiety, increased school suspensions, and decreased ability or desire to complete homework, concentrate, and attend classes." Depression symptoms can make it challenging for students to keep up with course loads, or even find the energy to make it through the full school day..

Suicide

The U.S. Bureau of Vital Statistics indicates that suicide in the Unites States exceeds 600 children aged 10 to 19 per year. Some researches estimate that for every successful suicide in adolescence, there are between 50 and 100 unsuccessful attempts. Most suicides reported in Ohio from 1963 to 1965 revealed that they tended to be social outcasts (played no sports, had no hobbies, and were not part of any clubs). They also suggested that half of these students were failing or near-failing at the time of their deaths. These periods of failure and frustration lower the individual's self-concept to a point where they have little sense of self-worth. In fact, students who perceive their academic performance as "failing" are three times more likely to attempt suicide than those who perceive their performance to be acceptable.

Attention Deficit Hyperactivity Disorder (ADHD)

Attention disorders are the principal predictors of diminished academic achievement. Students with ADHD tend to have trouble mastering behaviors and practices demanded of them by the public education system in the United States, such as the ability to sit still and quietly or to apply themselves to one focused task for extended durations. Much like anxiety, ADHD can mean that students have problems concentration, filtering out distracting external stimuli, and seeing large tasks through to completion. These students can also struggle with time management and organization.

Policies in Public Schools

United States

The United States has done a lot of data gathering and creating statistics of what can wear away at a student’s mental health, but few widely known policies have been put in place at the national level. School systems within the United States, either on the state or city/county level, seem to typically make decisions on what mental health policies should be included. There has been a growing popularity with school based mental health services in United States public school systems, in which schools have their students covered for mental health care. This concept has potential to allow students to have access to services that can help them understand and work through any stressors they may face within their schooling, as well as a better chance of intervention for those students who need it.

Bhutan

In Bhutan, efforts toward developing education began in 1961 thanks to Ugyen Wangchuck and the introduction of the First Development Plan, which provided free primary education. By 1998, 400 schools were established. Students' tuition, books, supplies, equipment, and food were all free for boarding schools in the 1980s, and some schools also provided their students with clothing. The assistance of the United Nations Food and Agriculture Organizations' World Food Programme allowed free midday meals in some primary schools. This governmental assistance is important to note in the country's Gross National Happiness (GNH), which is at the forefront of developmental policies and is the responsibility of the government.. Article 9 of the Constitution of Bhutan states that "the state shall strive to promote those conditions that will enable the pursuit of Gross National Happiness."

Gross National Happiness

GNH in Bhutan is based on four principles: sustainable and equitable economic development, conservation of the environment, preservation and promotion of culture, and good governance. Their constitution prescribes that the state will provide free access to public health services through a three-tiered health system which provides preventative, promotive, and curative services. Because of this policy, Bhutan was able to eliminate iodine deficiency disorder in 2003, leprosy in 1997, and achieved childhood immunization for all children in 1991. It became the first country to ban tobacco in 2004, and cases of malaria decreased from 12,591 cases in 1999 to 972 cases in 2009. The elimination of these diseases and the strong push for GNH allows for all people (including adolescents who are provided with many necessary items and free education) to live happier lives than they otherwise may have had.

United Kingdom

The Department for EducationinUnited Kingdom is working on developing a whole organizational approach to support mental health and character education. A joint report published in October of 2017 from the Departments for Education and Health outline this approach with regards to staff training, raising awareness of mental health challenges that children face, and involvement of parents and families in students' mental health.

Singapore

REACH is a program in Singapore that looks to provide interventions for students struggling with mental illness. A quote from the REACH website reads, "The majority of children and adolescents do not suffer from mental illness. However, when a student has been identified, the school counselor, with consultation from the school’s case management team, will look into managing the care of the student. When necessary, guidance specialists and educational psychologists from the Ministry of Education will render additional support.

In 2010, the Voluntary Welfare Organisations (VWOs), in collaboration with National Council of Social Service (NCSS), have also been invited to join this network to provide community and clinical support to at-risk children. Students/children with severe emotional and behavioural problems may need more help. The REACH team collaborates with school counsellors/VWOs to provide suitable school-based interventions to help these students. Such school/VWO based interventions often provide the requisite, timely help that these students/children need. Further specialised assessment or treatment may be necessary for more severe cases. The student/child may be referred to the Child Guidance Clinic after assessment by the REACH team for further psychiatric evaluation and intervention. These interventions may include medications, psychotherapy, group or family work and further assessments."

Mexico

Traditionally, mental health was not considered a part of public health in Mexico because of other health priorities, lack of knowledge about the true magnitude of mental health problems, and a complex approach involving the intervention of other sectors in addition to the public health sector. Among the key documents anticipating the policy change was a report presented by the Mexican Health Foundation in 1995, which opened a very constructive debate. It introduced basic tenets for health improvement, elements for an analysis of the health situation related to the burden of disease approach, and a strategic proposal with concurrent recommendations for reforming the system. Mexico has an extensive legal frame of reference dealing with health and mental health. The objectives are to promote a healthy psychosocial development of different population groups, and reduce the effects of behavioural and psychiatric disorders. This should be achieved through graded and complementary interventions, according to the level of care, and with the coordinated participation of the public, social, and private sectors in municipal, state, and national settings. The strategic lines consider training and qualification of human resources, growth, rehabilitation, and regionalization of mental health service networks, formulation of guidelines and evaluation. All age groups as well as specific sub-populations (indigenous groups, women, street children, populations in disaster areas), and other state and regional priorities are considered.

Japan and China

In Japan and China, the approach to mental health is focused on the collective of students, much like the national aims of these Asian countries. Much like in the US, there is much research done in the realm of student mental health, but not many national policies in place to prevent and aid mental health problems students face. Japanese students face considerable academic pressure as imposed by society and school systems. In 2006, Japanese police gathered notes left from students who had committed suicide that year and noted overarching school pressures as the primary source of their problems . Additionally, the dynamic of collective thinking—the centripetal force of Japan’s society, wherein individual identity is sacrificed for the functioning benefit of a greater collective—results in the stigmatization of uniqueness. As child psychiatrist Dr. Ken Takaoka explained to CNN, schools prioritize this collectivism, and “children who do not get along in a group will suffer.”

Alleviation and Fostering Adjustment

Prevention

A school must recognize that they are not just an institution, but need to help shape the lives of students and allow them to participate meaningfully in a social aspect of this environment. Psychologically, this overshadows the academic aspect, yet little heed is given. Athletics, faculty-student relationships, clubs, and other social activities are important so that no student is left in a "social limbo year after year." Educators also may need to pay less attention to the academic aspect of school and evaluate in a more realistic manner. Some standards are unattainable for students, resulting in a built-in academic failure that may produce frustration, resentment, and anger. The Use of letter grades has an extremely detrimental effect on students who are being compared to each other. The concept that learning takes place when students are rewarded for realistic achievement and not punished for unrealistic non-achievement would be better implemented in some school systems.

Belongingness

Belongingness in the school environment may be the most important and relevant factors affecting students' performance in an academic setting. School-related stress and an increase in academic expectations may increase school-related stress and in turn negatively affect their academic performance. The absence of social acceptance have been shown to lead lowered interest and engagement because students have difficulty sustaining engagement in environments where they do not feel valued and welcome.

See Also

• Mental Health
• Education
• Learning disability