A school nurse on why the school system is falling short with teen mental health.
May is mental health awareness month, and it’s no secret that this past year has challenged everyone’s mental wellbeing. For teenagers alone, they’ve faced their own set of challenges — from virtual college tours to Zoom classes to socially distant gatherings. The pandemic has only worsened teen mental health. Over the last decade, the number of teens with debilitating anxiety and depression has risen nationwide, with 17% of youth between the ages of 6 to 17 experiencing psychiatric illness and suicide is the second leading cause of death in this age group.
What’s the solution? We turned to school nurse Sherrie Page who recently published an article in Inside Higher Ed about why colleges are an important part of the solution.
Katie Couric Media: As a school nurse, what do you think is the biggest cause related to the increase in teen mental illness?
Sherrie Page: I think it’s a combination of factors, but technology, social media, and the pressure to meet a perceived ideal play an important role. Social media provides platforms where young people are made to feel that they aren’t good enough. That they are somehow less smart, less talented, less attractive, less popular, and less happy than all of their peers. This gets reinforced over and over again by “perfect” posts. Studies show that our brains don’t respond accurately. That, even though we know posts are contrived and don’t represent a complete picture, our brains still respond with a sense that our lives are inferior to others.
And how has the pandemic accentuated the problem?
This negative sense of self combined with excess amounts of screen time from social media, composing TikTok videos, gaming, streaming, and even internet porn can make for confused and isolated young people whose time is filled with mixed messages and little in-person interaction. Loneliness and isolation are major risk factors in teen anxiety and depression. Add a pandemic that erased in-person learning for many, decreased access to trusted adults provided by school systems, and increased isolation from friends even more, and it’s easy to understand the rise in teen mental illness.
How can the school system step in and focus on teen mental health?
With suicide now the second leading cause of death, a population-wide intervention is needed. Since all young people go to school, the education system is the best way to reach kids en masse.
The implementation of required mental health classes would assist in the prevention of psychiatric illness. If all high school students were taught evidence-based ways to reduce stress and improve overall well-being, concerning stress symptoms would be prevented or caught before turning into debilitating anxiety or depression. The earlier treatment is received, the better the outcome. So, teens need to be aware of what constitutes the need for treatment, and how to get help for themselves or a friend.
A concrete analogy is the nationally-funded school lunch program to address the widespread issue of hunger. Through funded school lunch programs, children are fed who might otherwise go hungry. Likewise, we need to nourish the mental health of our youth.
You work in a secondary school, yet the article you recently published in Inside Higher Ed expresses your opinion that the change must come from the college level. Why is that?
To wage war against declining adolescent mental health, states need to mandate classes devoted to understanding the issue, along with tools and coping strategies to empower young people to have more control over their well-being. I strongly believe that colleges must play a significant role in changing the system.
Case and point, I work in a private school that is rich in resources. Our school provides mental health awareness, has multiple school nurses and counselors, and provides opportunities for ample in-person social interaction, yet each year we see more and more students struggle with their mental health.
For our prep school population, the pressure students report to get into competitive colleges is often extreme. From my vantage point — as a nurse and wellness coordinator — students have little free time to simply be carefree. So it may seem a paradox to add another class to their workload. However, without mental health as a required course, they will never get the message that their mental health is important. This is because the perfect college resume is the prize. So if colleges reward grades, athletics, and talents above well-being, mental health will always be what is sacrificed. Suicide is the second leading cause of death on college campuses. This grim statistic is the real paradox, as that is not the college experience anyone intends. Even if a student isn’t college-bound, high school requirements won’t change until colleges insist on it.
What can parents do to help their teens manage their stress and anxiety during this time?
As this chaotic school year comes to an end, teens may worry about being academically behind. Parents should notice their own concerns and if they are being passed to children. Stress and anxiety can be “contagious.” Remind your family that everyone is in the same situation and that next year will be a catch up year for many. Give your family permission to have fun and relax. Help your teens identify something they like to do that doesn’t involve screens, and set aside time to have fun together as a family. It’s been a hard year for everyone, a little grace will go a long way.
Stress is a normal part of life, and no one is supposed to be happy all of the time. Help your teen feel more in control of disappointment by identifying his or her coping strategies. What helps them feel better when they experience negative stress? Some people like to be alone and journal, read, or work on a creative project, some like to be physically active, while others like to use a breathing strategy or mindful technique to be calm. Help your teen recognize his individual stress responses (e.g. short fuse, fatigue, upset stomach, insomnia) and applicable self-care strategies. A little anxiety is normal and can even be helpful with focus and motivation. However, when worry hijacks the brain and affects a teen’s ability to function for an extended period of time, professional treatment should be considered.
What’s the best advice you can give to parents if they are concerned that their teen is struggling with mental health?
Above all, I would advise parents to take ongoing sadness seriously. There is a difference between a bad couple of days or even a week, but if your child has symptoms of persistent sadness and loss of interest in usual activities lasting longer than two weeks, it is important to seek a professional evaluation. Your child’s pediatrician is a good place to start. Mood disorders are caused by chemical imbalances that respond well to therapy, medication, or a combination of both. The earlier someone gets help, the better the outcome. Don’t be scared to talk about your concerns. In fact, normalize conversations around mental health by making them as common and natural as conversations about physical health. Also know that you can’t make anyone suicidal by bringing up the topic, but you can save a life by talking about suicide. If you notice your teen isn’t enjoying things s/he used to, simply opening a conversation with, “I’m worried about you, you don’t seem like yourself lately, what’s going on?” is a place to start.
Sherrie Page, RN, MSN is the Health and Wellness Coordinator at St. Catherine’s School in Richmond, VA, where she has also worked as a school nurse and upper school health teacher. Her undergraduate nursing degree is from UNC-Chapel Hill and her graduate degree is in psychiatric nursing from Yale University. She is starting a doctoral program at UVA to focus on teen mental health.
