Mental Health Awareness in Schools

HI there,

Yes, parents do have the final say in deciding their child's education. There are a few things to consider in Shanthi's question-do the parents know/understand what the issues are? What kind of needs does the child have? If it is intellectual impairment, then there is a change in expectations-academically and in some children, functionally. Do the parents and teachers understand that? If it has more to do with temperament and behavior, the expectations are different.

Academic and social expectations change based on the type of disability because we are talking about interest, potential and relevance to the child's socio ecenomic and cultural situation. In an ideal world, these shouldn't matter. But we do have to keep in mind these factors when we chart the child's school career.

For example, I have know two students in Chennai, both diagnosed with AHD around 5th/6th std. They went thru' psych-ed testing and the behavior checkils, etc. Finally their respective psychiatrists recommended medication.
One parent decided not to go with the meds. She was happy for her son to get just ahigh school cert and decided she was going to have him follow in dad's footsteps and train under him. School was very tough..he had endless hrs of tuition and she would be on his case and manage everything for him. Fortunately they both had a very good relationship and she also let him be the kid he was in other ways. So he was able to go to her with his frustrations even if she was "MOM" at times.

Another parent wanted a different academic path for her son. They read up on all the risks of medication (eating, sleep, possible anxiety, etc) and learned to manage it differently. He had meds when he went to school and on holidays he went off meds...there were hitches when he went back to school but they managed to convince teachers to cut some slack (and to teach their child to tolerate some nonsense too!).

Both these kids were bright and fun loving children and they've just finished their 12th and are waiting for the results. The point is the parents made certain decisions and accepted certain boundaries as did the teachers in one case. The other set of teachers, while not exactly lily white, didn't have the same level of support.

In both cases, the teachers did identify the symptoms. Teachers can not and should not diagnose. But they should bring up issues to the parents' attention in a timely manner. And, yes, unless the parent has already seen some indications at home, most of them have a hard time accepting it. They will question it-as they should. The idea is to find the right information to help the child. It is not about who is right or wrong. Ultimately both maybe correct in some aspects and wrong in others.
But the parents have the final say in what they want for the child. In which case there are adjustments to be made even on their part.

As for schools telling parents what to do with their child, this is where following professional channels helps. As much as it seems like 'red tape' and 'hierarchy,' it does serve as a guideline for schools and parents on how to handle the whole process.

Teacher brings it to the administration of certain concerns, they put a plan together and see if alternate methods work; let the parent know at this beginning stage so there can be a follow up.
If no success, seek educational/psychological testing, and see if school can provide the neccessary services. If not...what is the procedure...

As for schools asking parents to find alternate services, sometimes it does happen that they are not able to provide services. For a while I worked in a very restricted segregated school (for kids with severe emotional and or intellectual impairments). The model was where the kids moved from class to class like a typical high school. I do remember some kids could not handle that transition and so there were aked to go to a self contained school (where the teachers moved from class to class). For 5 yrs I worked in an inclusive school for young children (up to 3rd). While it was play based (no direct instruction until 1st std even for the children with language needs as everything was done in context), some children didn't progress at the same pace. We weren't equipped to give that direct instruction for the children. Some parents understood the limitations of this approach but others wanted more. So the administration asked the parents to find different settings. Even with 2 qualified professionals coteaching in the classroom, there were limitations. The idea is to always work towards perfection-with the understanding that perfection is different for different people and hopefully there will be a meeting of minds in the middle.

I'm glad that you wrote about this because it opens up the discussion in greater detail.

 

My mother has always been curious about my work. She was a good sounding board and always asked very pertinent questions. When friends or family members first started approaching me for information, her question helped keep me on track.

"What do you mean this behavior is because of mental illness? This kind of behavior is common in all of us at some point in our lives. I can tell you things you do which would be totally weird for an outsider! Does that mean all of us are mentaly ill? Or does it mean there is an over-diagnosis, too much labeling?"

Mental health is a continuum-on one end is a healthy child-productive (using his/her potential to the fullest), with happy and satisfying social relationships and with the ability to adapt to stress, change or other challenges. Now this is not static. It doesn't mean once you've reached this stage, you stay there for ever.

Physical health, social/environmental/academic factors are constantly changing and there is a new period of adjustment. This is a very normal process. In some children there may be adjustments to be made all through childhood. Again this is very normal. There are no clear defined tests which say you must be happy 80% of the time to be considered a wel adjusted child. (If there was, the next question will be "how do you define and measure happiness?")

Depending on the intervening factors, children respond/react very differently to the same situation or event. Their temperament, socio cultural/environmental make up all play a role.

R

 

oooooooooooooh, I typed a nice long reply and lost it...waaaaaaaaaaaah...

Now that that is out of the way ShilpaMa, hi I will try again.

First, let me clarify that I started this post asking for parents of children with mental health issues for their experiences in school. I wanted to know if schools were generally supportive, did teachers have professional knowledge in these areas and if they (and administration) made any adaptations/accommodations for their students' needs. It veered towards tantrums and behavior. As for any of those pointers on managing behaviors, methods, etc, I have to say they are just that-guidelines. Children always show a range of behaviors and that is the norm. Most of the times our instinctual responses work well. Sometimes we have to use a systematic approach. But detachment is a hard tool to develop and from a teacher's point of view, it is easier-we can ask someone to step in for a few minutes to get our thoughts together Parents have their own perspective on that.

From behavior, I switched to mental illness. Some behaviors show up as symptoms of mental illness which is why I made the leap. Perhaps that was not the way to go because it made it seem like one leads to the other. That was not my intention and I apologize if it came across that way. It may have been the wrong place to bring up this topic...in which case I am happy to move this elsewhere. The point is not to spook anyone into believing that their child has this or that condition.

Unfortunately mental illness is very real-in children and in adults. It is caused by organic/biologial processes just like any other illness. In children intervention is essential because they are still developing their social and emotional skills and academically they have their entire life open before them. It is distinctly different from intellectual impairment (which used to be referred to as mental retardation) and developmental disabilities.


Two things happened just before I started my query-At the beginning of this year, I was at home...I went to an organization which provided services for young adults with mental illness. Their work was focused on functional living skills, vocational training, social skills group and advocacy skills. Some of the students were on medication, others had therapy, etc. A young couple in their forties came their seeking admission for their pre-teen daughter. The young girl had no criterion that met mental illness but had intellectual impairment-her IQ fell within the borderline range. The person in the administrative office referred them to me and I ended up taking them home (as the building was closing).

The idea that special education services can be delivered in any kind of setting and for children with any kind of disability is generally true. But thereare always individual variations which we should be aware of and adapt our methods accordingly. In this case, the girl was atleast 6-7 years younger than the youngest of the class. Socially, it was a mismatch.

Academically, this young woman had a a lot of potential. She was also young enough that she had not hit any plateau yet. The progamme focused on vocational placement-which will come for her, after some years. It would have been a dis-service to her to not challenge her to the fullest.

Emotionally, she had occasioanl behavior issues with her parents. But no major problems with anger, impulsivity or mood swings. That was not the case with the other students. If any of their excessive moods were directed toward her, she would be at a total loss. If there was no other option, it wuold have been ok to send her to that institute. But thankfully there is more awareness now than say 15-20 yrs ago.

The other incident concerned a very good friend of mine. She was diagnosed with diabetes and had to constantly test her blood sugar, etc because they were trying to get enough data. She commented, "Thank goodness I don't have to test myself constantly for my OCD (Obsessive Compulsive Disorder). No one makes fun of my diabetes but I would have been extremely embarassed if I had to test my blood levels because of OCD." This comment really bothered me. Both conditions caused by malfunction of the endocrine system-one causes embarassment while the other meets with understanding. I had seen a lot of her struggles during our school days (with OCD) not knowing or understanding what caused these problems.

I understand this is an emotionally charged topic. It is not relevant to everyone but it would be nice for everyone to know a little bit about it. At some point in their lives they may be able to direct someone else to find assistance. I don't know all the answers but I am interested in hearing from others about their points of view...maybe it will support or negate what I know.

Why do I write about children instead of adults? Because I've seen what severe anxiety, depression and anger does to children and to their families. In an ideal world we should be able to eliminate the conditions which cause them so much stress and sadness. The next best step is to provide the necessary support so that a crisis in their lives doesn't mean they can't start again. I write to the parents because no matter what we professionals know or do, you are your children's best advocate.

I hope I answered your doubts. If it is still upsetting please let me know and I will stop/change. As for the second part of your query...I will post separately as this post is way too long

R

 

HI Anitha,
Thank you for the vote of confidence. ShilpaMa, it is definitely not my intent to force my professional view upon others.

Mental illness (yes together) is the technical/clinical/medical/colloquial term for a group of disorders which have a biological basis- It shows up as abnormalities in

• Behavior
• Mood
• Cognitive function
• By themselves or as a combination, and they result in pain (physical, emotional) and affect successful day to day functioning.

There maybe several triggers for this-genetics, environment, hormonal imbalance, socio-cultural factors, trauma (physical or emotional) but the underlying factor is that there is a biological reason just like in diabetes, bp, etc. We notice it because of behavioral symptoms.

As of now, NAMI (National Alliance for the Mentally Ill) uses the term ‘mental illness.’ They may decide to change it somewhere along the line and the rest of the world may follow (just as mental retardation was changed to intellectual disability or impairment). As far as I know that is still the terminology used. The stigma is not in the term but in our fear of what the term means. It is prevalent in adults and yes, some children also do have mental illness. This term includes disorders like OCD (Obsessive Compulsive Disorder), Bipolar Disorder, depression, Borderline personality Disorder, etc. Some fall under anxiety disorders, others under mood disorders and still other personality disorders.

The reason to talk about this is to remove the stigma. Too many children keep quiet when they first start noticing the changes. They don’t know why their bodies and minds react/respond the way they do and are afraid of being ridiculed. Popular movies and fiction don’t help either. A lot of them are good at hiding their symptoms. It takes a crisis to bring it out in the open. Then the adults begin to fear the stigma. For some children it is too late.

One of the kids I know was taken to a psychiatrist (in India) when he was 12. The parents were told he was “arrogant” and nothing was wrong with him. Much later as I got to know him better he mentioned that he had first attempted suicide when he was 11! He continued to go through several attempts. On one such hospital visit he said, “I wish I either didn’t have the ability to understand the consequences of my actions or remember the look on my mom’s face before my impulses take over!” Denial hurts children the most.

Mental illness takes time to evolve into a full blown disorder. That is the reason to talk about mental health awareness. We can provide support and teach coping skills from the beginning. Treatments and therapies are varied-what works for one doesn’t necessarily work for another. As for what a teacher can do, there are so many things which can be adapted or modified. Teaching organization (one of the most difficult things for a student with mental illness) and time management skills, how to prioritize their work load, reducing anxiety, improving self esteem and motivation…the list is quite long. These are skills that need to be taught from the get go but they are life long skills. It is not about parents versus teachers as much as parents and teachers working together as a team.

It is a difficult topic to discuss but there are lots to be learned from each others’ experiences. There is a general tendency to name famous people with different disorders. But there are lots of ordinary people with mental illnesses who lead productive, happy lives. I like the idea of everyday people because children can meet them, talk to them and see how they don't let the illness define their lives.

R

 

Correction:
NAMI is the National Alliance on Mental Illness-an organization which comprises of families and friends of, and people with mental illness.
They lead a lot of the research in to social, medical, therapeutic and academic issues for children and adults with mental illness in the US.

There are comparable organizations in other countries but as the US funds a lot of research into mental health care and rehab, they have a far reaching effect with regard to legislation and rights of those with mental illness.
R