Supporting Youth with Mental Health Concerns within the School System
By Diana Romer
I came to a new job last year where I am involved with Secondary School age students who
are out of school for any number of reasons: academic failure, absenteeism, substance use,
mental health, etc. My eyes were opened WIDE when I discovered that almost every student
with whom I came into contact exhibited some symptoms of mental illness. Many of these
students are not identified by their families or the school system as experiencing mental
health concerns. The students that I see are those kids that have disciplinary problems both
at home and at school. So began this journey to find out how to support these students
within the school system BEFORE they drop out or are asked to leave.
Investigating how to promote student success in secondary schools, we know that
academic success is strongly correlated with student health. Research indicates that barriers
to academic success such as mental health disorders, substance use, and absenteeism can
be overcome most successfully within the school system. “It can be argued, on the basis of
evidence, that mental health should be a feature of all school health promotion initiatives
and that effective mental-health promotion is likely to reduce substance use and improve
other aspects of health-related lifestyles that may be driven by emotional distress.” (WHO,
2006, p.17).
The Centre for Addiction and Mental Health suggests that an integrated multiple setting
approach with a focus on schools, family and community is best practice for improving
youth mental health. Although the responsibility for the provision of formal mental health
services lies primarily with the Ministry of Health and the Ministry of Children and Family
Development - Child and Youth Mental Health division, any comprehensive process must
include the Education system. (CAMH, 2008)
Mental health problems and mental illness affect about one in seven young people, and an
estimated two-thirds of youth with mental health problems do not receive the help they
need. Suicide is the second leading cause of death among young people between the
ages of 15 and 24, and at least 90% of those who commit suicide have a diagnosable
mental illness.
TABLE 1. Prevalence of Mental Disorders in Children and Youth
Disorder Prevalence
Any anxiety disorder
Conduct disorder
Attention-deficit/hyperactivity disorder
Any depressive disorder
Substance abuse
Pervasive developmental disorder
Obsessive-compulsive disorder
Schizophrenia
Tourette.s disorder
Any eating disorder
Bipolar disorder
Any disorder
(%)
6.5
3.3
3.3
2.1
0.8
0.3
0.2
0.1
0.1
0.1
< 0.1
15
Number in BC
60,900
30,900
30,900
19,700
7,500
2,800
1,900
900
900
900
< 900
140,500
The approximate number who may be affected is based on a population estimate of
936,500 children and youth in BC (MCFD, 2002)
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As indicated in Table 1, the number of students in BC identified with a mental health concern
is approximately 15% of the total school population. These figures indicate that a significant
number of students: approximately 4 or 5 in every high school classroom are experiencing
some level of mental illness. Youth with social, emotional or behavioural problems are less
likely to experience academic success and are at increased risk of school failure.
British Columbia became a national leader in 2003 by developing the ‘MCFD Child and
Youth Mental Health Plan’ (CYMH plan) for British Columbia (MCFD 2003). In this plan, the
government of BC commits to improving resources and outcomes for the children and youth
in the province, who have mental health needs. In this report, MCFD stresses the need for
strong partnership with the schools and the health authorities, with schools being the primary
setting for identification of mental health problems among
The Canadian Mental Health
children and youth
Association published the
Schools have an opportunity to play a crucial role in detecting a
“Mental Health and High School
mental health problem at an early stage and then in providing
Curriculum Guide: Understanding
access to effective support or treatment through community
Mental Health and Mental
mental health services. Administrators, counsellors, and teachers
Illness”. This resource was
are in a prime position to pick up and act on ‘early warning
created to support educators
signals’ that students are struggling socially, emotionally, as well as
within Canadian secondary
academically. (Shortt, Fealy, & Toumbourou,2006, p2) Because
schools to address issues of
secondary schools might be without the resources or the capacity
mental health and mental illness
to detect and manage youth with mental health disorders, many
in the classroom. The guide has
disorders are not recognized until they are more critical.
been designed to help
overcome barriers such as
My experience is that most youth want to be in school, even those
stigma and fear of mental illness.
youth who are disengaged from peers, academics or athletics.
The printed guide and its webSchool is often a ‘safe’ place for students, and in terms of
based activities fit into provincial
intervention, there is the opportunity to reach students who would
secondary Planning and Health
otherwise not access treatment. Schools can provide the
curriculum and is recommended
supports for students to be successful in school, including mental
by Curriculum Services Canada.
health supports. The responsibility to provide mental health
http://www.cmha.ca/highschool
supports is ideally shared with the community resources such as
MCFD and VCH. In-service professional development can be
provided by community partners for counsellors, staff and
administrators to prepare them to recognize mental health
disorders in students and to provide initial intervention. Schools can promote mental health
by developing a supportive school culture, in which mental illness is destigmatized, and there
is support and integration of students (or staff) dealing with mental illness. District wide
adoption and implementation of comprehensive policies to support students with mental
health concerns in the school system can most successfully support students’ mental health.
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References
Canadian Mental Health Association. Mental Health and High School Curriculum Guide:
Understanding Mental Health and Mental Illness. (2007).
www.ontario.cmha.ca/mental_health_notes.asp
http://www.cmha.ca/highschool
Centre for Addiction and Mental Health: www.camh.net
Children’s Mental Health Ontario. www.kidsmentalhealth.ca
Ministry of Children and Families, Child and Youth Mental Health Plan (CYMH plan) for British
Columbia. (MCFD 2003)...www.mcf.gov.bc.ca/mentl_health/initiatives.htm
Murray, N.G., Low, B.J., Hollis, C., Cross, A.W., Davis, S.M., (2007).Coordinated School Health
Programs and Academic Achievement: A systematic review of the literature. Journal of
School Health, 77(9). 589 - 600.
Shortt, A.L., Fealy, S., & Toumbourou, J.W. (2006) The mental health risk assessment and
management process (RAMP) for schools: II. Process Evaluation. Australian e-Journal for the
Advancement of Mental Health, (AeJAMH), 5(3), 1-12.
World Health Organization. 2006. What is the evidence on school health promotion in
improving health or preventing disease and, specifically, what is the effectiveness of the
health promoting schools approach?
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