Recent studies indicate that 15 to 21 percent of Canadian children and youth are affected by mental health disorders that cause some significant symptoms or impairment. A 2010 Ontario study reported that one in five Ontarians, 20 percent of the population, will experience a serious mental illness or have substance abuse issues in their lifetime.
In its 2010 report entitled Caring and Safe Schools in Ontario, the Ministry of Education noted that more than 500,000 young people in Ontario suffer from a diagnosable mental health problem, such as anxiety that may manifest itself in behaviour, such as bullying or an eating disorder.
According to Statistics Canada, teenagers and young adults aged 15 to 24 experience the highest incidence of mental disorders of any age group in Canada.
In a school context, mental health problems can significantly interfere with learning, thinking, analytical skills and communicating. System and school leaders need to be able to identify students with mental health needs and to work collaboratively with parents and school staff to identify the resources and expertise that might contribute in supporting these students. A number of questions arise. What is the role of school administration and system leaders in providing support and assistance to students with mental health needs? What strategies can be used to identify the capabilities and knowledge among school staff and outside agencies to support these students? What steps can be taken in working with parents and families to identify community structures and resources that can complement the school supports provided to the student? What steps can be taken in circumstances where parents or students are not co-operative in supporting recommended treatment or counselling?
The purpose of this article is to provide a framework for educators in assessing the capacity in the school, home and the community to respond appropriately to mental health issues and to create a school culture that is responsive and supportive of students with special education needs.
MENTAL HEALTH PROBLEMS
Mental health problems affect a person’s ability to enjoy life and deal with everyday challenges. They range from common, everyday struggles to serious mental illness.
The term “mental illness” refers to a diagnosable condition that usually requires medical treatment and emotional problems of varying degrees of intensity and duration and may recur from time-to-time. Major mental illnesses include, mood, psychotic and anxiety disorders. The Ontario Ministry of Health and Long Term Care reports that the most common mental illnesses among children and youth (to age 17) are anxiety disorder, attention deficit/hyperactivity, conduct disorder, depression and substance abuse.
Although mental illness can occur at any age, it often strikes children and youth from late adolescence to early adulthood. The Canadian Mental Health Association has set out certain warning signs in recognizing when there is a problem. The challenges that students with mental illness face include the following:
- problems concentrating, making decisions or remembering things;
- missed deadlines, delays in completing assignments, poor quality work, poor exam grades;
- low morale;
- disorganization in completing school work;
- frequent complaints or evidence of fatigue or unexplained pains;
- decreased interest or involvement in class topics or academic endeavours in general; and
- frequent absences or consistent late arrivals.
The Canadian Mental Health Association also has undertaken research on the common signs of mental illness, which include:
- marked changes in personality;
- confused thinking;
- inability to cope with problems and daily activities;
- strange ideas or delusions;
- excessive fears, worries and anxiety;
- prolonged feelings of irritability or sadness;
- significant changes in eating or sleeping patterns;
- suicidal thoughts or remarks;
- extreme highs and lows in mood;
- abuse of alcohol or drugs; and
- excessive anger or hostility.
ACCOMMODATION OF STUDENTS
Under section 265(1)(j) of the Education Act, the principal has a duty to give assiduous attention to the health and comfort of pupils under his/her care.
The Education Act and its regulations set out a structure for the identification and accommodation of special education students in Ontario’s publicly funded elementary and secondary school system.
Under the Education Act, the Ministry of Education is responsible for ensuring that all exceptional children in Ontario have access to appropriate special education programs and special education services without the payment of fees. In this regard, the Ministry is responsible for requiring school boards to implement procedures for identifying student needs and for setting standards for identification procedures.
Section 1 of the Act defines an “exceptional student” as one “whose behavioural, communicational, intellectual, physical or multiple exceptionalities are such that he or she is considered to need placement in a special education program.”
Exceptional students may be identified pursuant to Ontario Regulation 181/98, Identification and Placement of Exceptional Pupils, under the Education Act. The principal of a school may, by his or her own decision or at the request of a parent, refer a child to an Identification and Placement Review Committee (IPRC) for a decision as to whether the child is “exceptional”, and if so, whether the child should be placed in a regular classroom with support or in a special education class.
In making a determination, the IPRC will consider educational, health and psychological assessments, as well as information submitted by the parents, and can interview the student.
The IPRC also has the authority to make recommendations about special education programs and services for the student, but does not have decision-making authority in these areas.
Following the decision of the IPRC, the principal of the school is notified and he or she will prepare an Individual Education Plan (IEP) for the student. IEPs include the specific educational expectations for the student, an outline of the special education programs and services to be provided to the student and a statement of the methods by which the student’s progress will be reviewed.
The objectives of the Ontario special education legislation are: (a) to ensure that an exceptional student receives an appropriate education; and (b) to ensure that parents have a say in the decision-making process.
STRATEGIES TO SUPPORT THE MENTAL HEALTH OF STUDENTS
Educators can take a number of proactive steps to support the mental health of students. The Canadian Mental Health Association recommends the following strategies for educators:
- take steps to be informed about mental illness and the impact that mental health problems can have on learning;
- be supportive and understanding;
- take the time to listen to the student, build trust and understand his/her needs;
- initiate discussions with parents to learn more about a student’s circumstances and needs;
- work with the student and parents to determine appropriate accommodations;
- encourage peer support and friendships; and
- encourage practices that support wellness and a balanced life.
School administration needs to develop a clear picture of the professional knowledge and abilities that school staff and school board personnel bring to the task of supporting students with mental health issues. In assessing the capacity of school board personnel, school leaders should consider their training and experience in supporting students with special education needs and their ability to work collaboratively with other members of the school team.
School administration should also identify knowledge and capabilities among parents and community members, such as outside agencies and counselling services, in providing support to special needs students. Among other things, school leaders will assess the resources and expertise that parents and community members might contribute in assisting these students.
The reality is that in some cases, educators cannot, by themselves, effectively support a student who is facing a mental health problem. It is important to initiate discussions with the student’s family and work with them to determine appropriate accommodations and solutions. Medication, counselling and psychosocial rehabilitation are treatment options that can help students recover from mental health issues.
There may be circumstances where parents or students are not co-operative in supporting recommended treatment or counselling. In this regard, it may be of value to bring into the discussion a person who the student or family may trust, such as a school board professional or outside expert, to speak to them about the benefits and value of certain treatment or counselling.
Appropriate counselling or assistance from psychologists, physicians, psychiatrists, social workers or other specialists may be utilized on an individual basis depending on the needs of each child. Social skills and behaviour management programs that encourage peer support and healthy lifestyles and relationships may provide assistance to these students.
Educators, while one part of the larger community, play a significant role in the support network for students facing mental health issues. With early identification, sharing of relevant information, consultation with specialized school services, access to outside professionals and collaboration with the student’s family, school leaders can work to ensure that appropriate services and resources are provided to support students with mental health needs.