Opinion, School Community, Well-being

What should you do if you suspect mental illness in a student?

Don’t shoulder the burden alone – get help, go slowly, and involve the parents.

One in five youth under the age of 18 has a diagnosable mental disorder. So in a classroom of 25 children, you can expect five to be struggling with significant emotional problems. How can you recognize the signs? What should you do if you see them?

Kids develop along different dimensions: physical, social, familial, emotional, cultural, psychological. And there’s a continuum between “normal” and “abnormal”. Most mental illnesses represent an interaction between nature and nurture, and result in a failure of that child to be able to meet their “developmental tasks” (age-appropriate expectations) in the dimensions just mentioned.

So, recent changes in behaviour that are unusually intense, frequent, and persistent for that child, should catch your attention. The definition of mental illness is basically subjective distress (“I don’t feel happy”) plus functional impairment (“I just can’t do what I used to do, or what my parents/friends expect me to do.”). A combination of these features is highly suggestive that the student is in trouble.

Practically speaking, this can look like:

  • changes in sleep, appetite, or energy level;
  • social withdrawal or aggression;
  • new conflict with parents;
  • sadness, worry, or irritability and lack of self-esteem. 

In the classroom, concentration, memory, organization, and participation can all be affected, with the net result being assignments not handed in and marks going down.

Risk factors for mental illness include: 

  • recent physical illness in the student or a family member;
  • a family history of mental illness;
  • insult to the student’s brain (e.g. concussion);
  • lack of stable attachment figures (e.g. high conflict divorce, death of a loved one, or frequent moves);
  • single parenthood and poverty; neglect, abuse, or being the victim of bullying;
  • standing out as “different” for any reason (height, weight, intellectual capacity);
  • and difficult temperament (poor self-regulation, prone to hyper-sensitivity and hyper-reactivity).

What should you do if you suspect mental illness in a student?

  1. Get help – don’t shoulder the burden alone! 
  2. Go slowly – talk to the student directly, and enquire about how things are going for him/her. Then voice your concerns, describing them in a neutral, non-judgmental, and behaviourally verifiable way (“I’ve noticed that lately you’ve stopped playing with your friends at recess, you’re more quiet than usual, and you’re not at the soccer games as much as before.  Is anything going on that you’d like to talk about?”) 
  3. Involve the parents – no student is an island, and often comparing your notes with the parents in extremely informative. If the parents share your concerns, suggest that they contact their family doctor or pediatrician to make sure there isn’t a physical illness. Once that is ruled out, together you can talk about whether a referral to a mental health specialist is warranted.

The good news in all this is that when mental illness is identified and treated early, the prognosis is excellent. Seventy-five per cent of mental illnesses begin before the age of 20, but because the brains and environments of children are still changeable (“plastic”), the vast majority of youth can overcome their struggles and resume their course of normal development, flourishing, and reaching their natural potential.

PS: A great resource for parents and teachers is The ABC’s of Mental Health, a free, on-line resource developed by the Hincks-Dellcrest Centre for Children and Families.

This blog post is part of CEA’s focus on student mental health, which is also connected to Education Canada Magazine’s student mental health theme issue and a Facts on Education fact sheet on what the research says about effective approaches to improving students’ mental well-being. Please contact info@cea-ace.ca if you would like to contribute a blog post to this series.

Meet the Expert(s)

Marshall Korenblum

Marshall Korenblum

Dr. Marshall Korenblum is Psychiatrist-in-Chief at the Hincks-Dellcrest Centre for Children and Families in Toronto and Associate Professor in the Department of Psychiatry, University of Toronto. He has been practising child psychiatry for over 25 years. Dr. Korenblum was Director of Postgraduate Education for the Division of Child Psychiatry at the University of Toronto for over 10 years, and Chairman of the Education Committee of the Canadian Academy of Child Psychiatry for 2 years. He consults to a number of children's mental health centres, and is on staff at Sunnybrook Health Sciences Centre, Hospital for Sick Children, and the Center for Addiction and Mental Health. Dr. Korenblum has a special interest in mood disorder in adolescence, and has published widely in the area of personality development in adolescence. He is an award-winning teacher, and a staunch advocate of public education.

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