Schools must do more to help students in need

Signs of suicidal ideation include appearing withdrawn, talk about self harm, isolating from family and friends, and more.

The teen mental health crisis has been steadily increasing over the past few years. In 2019, nearly 19 percent of teens aged 15-19 in America seriously considered attempting suicide, and 9 percent actually attempted suicide.

Suicidal ideation in and of itself is a consequence of several biopsychosocial and sociocultural factors. For some teens, it can be triggered by changes in family and social life, like the death of a loved one or experiencing bullying at school. Suicide can also be the result of existing mental health problems like depression and anxiety, which are highly prevalent among this population, as well. It can also be the consequence of familial history with mental health problems and suicide.

Despite the various contextual factors that shape suicidal ideation, suicide is entirely preventable. Preventing teen suicide requires that interpersonal, institutional and structural level interventions help students identify and reappraise signs of suicidal ideation.

Teens are at a unique developmental stage in which they develop a sense of autonomy apart from their parents and begin spending a lot of time in other social circles, especially at school. Schools, then, are uniquely posited to have a positive impact on teen mental health and can reduce the burden of suicidal ideation among this population.

This largely depends on how school teachers and administrators are able to identify, address and redress signs of suicidal ideation. Signs of suicidal ideation include appearing withdrawn, talk about self harm, isolating from family and friends, and more. Below are a series of evidence based recommendations for how high schools can better address suicidal ideation among students.

Recommendation 1: Expanding mental health and suicide prevention curricula and introducing task shifted interventions

Oftentimes, conversations about mental health and wellbeing are not comprehensive. High school health and sexual education curricula in Connecticut do not include explicit components about mental health. While state policies recommend that needs of the “whole child,” including social, emotional, behavioral and physical health should be discussed, they do not include recommendations beyond managing students’ behaviors and discouraging bullying and harassment.

A wealth of stress and coping literature suggests that positive mental health outcomes in stressful situations are best fostered when adolescents have access to healthy coping mechanisms, which enable them to reappraise stressful situations and confront them. Punitive interventions, like ones that only punish bullies and other perpetrators of harm, partially help foster positive mental health outcomes. Statewide health and sexual education curricula should incorporate modules on examples of healthy coping behaviors and how adolescents can effectively build, and apply, these coping behaviors.

In Connecticut, efforts have been underway to integrate suicide prevention programming in elementary schools. The American Foundation for Suicide Prevention, in partnership with the Connecticut Department of Mental Health and Addiction Services, has implemented “Gizmo’s Pawesome Guide to Mental Health.” This therapy dog initiative in combination with health promotion activities provides elementary students with common language and strategies to talk about and protect their mental health.

The curriculum additionally includes opportunities for children to create a mental health plan and identify adults who they can trust. This intervention can be adapted for high school settings as well, especially since a recent survey indicated that nearly one-third of Connecticut high school students cannot readily identify a safe adult they can talk to about their problems.

In lower and middle income countries, where the burden of mental health problems often exceeds the capacity of public mental health infrastructure, mental health plans (or safety plans) are interventions that cater to complex mental health needs without relying on trained officials. A wealth of evidence suggests they are feasible and effective in school settings as well.

Recommendation 2: Normalizing conversations about mental health and facilitating social connectedness

Oftentimes, teens feel as though they are alone in their mental health struggles. Currently, Connecticut public schools does not have a specific system in place to facilitate social connectedness among students to make them feel less isolated in their mental health problems.

A simple university initiative that can be adapted for a high school setting is The Bandana Project. This initiative involves students pledging to support access to mental health treatment and serve as visible, approachable sources of information to other students who may be struggling. Students who pledge to fight mental health stigma tie a lime green bandana to their backpack, signaling that anyone can approach them for mental health resources.

Implementing a similar strategy at Connecticut Public Schools can help encourage healthy help seeking behaviors from an early age, normalize conversations about mental health, and raise awareness as to where and how students can seek support.

A combination of institutionalized, health promotion modules, evidence based practices, and peer to peer support to facilitate social connectedness can help address the growing mental health burden among teens. While suicidal ideation among teens has been increasing at alarming rates, it is important to acknowledge and act upon the fact that suicide is entirely preventable if ideation is handled with adeptness and sensitivity.