#70. Student Well-Being: Youth Mental Health First Aid

This is PART 2 in a series on student well-being. Throughout this series, I will explore what recent research reveals about ways to create an environment in which all students can thrive.

One of the reasons that I really value writing this blog is because it forces me to examine the "why" behind what I do professionally. As educators, we rarely have the time (or energy) to stop and think about why we do what we do. We are overwhelmed by the everyday demands of teaching; lesson planning, instruction, remediation, grading, etc to really take the time to dive into educational research. I have piles of books and articles and a queue of podcasts that got sidelined while life happened. For this series, I will be diving into my file of half-written articles and dust-covered books to learn more about topics like mastery learning, youth mental health, culturally responsive education, culturally proficient SEL, the psychology of learning, equity, and universal design of learning. In this post, I will be continuing this series with a look at how we help our students if they are impacted by a mental health crisis.

“One can choose to go back toward safety or forward toward growth. Growth must be chosen again and again; fear must be overcome again and again.”

― Abraham Maslow

Abraham Maslow was a pioneer in the field of humanistic psychology and self-actualization. His framework for motivation, based on fundamental physiological and psychological needs, has had a significant impact on the field of positive psychology. His hierarchy of needs is often depicted as a pyramid in which the needs lower in the hierarchy (deficiency needs) must be fulfilled before the needs at the top of the pyramid (growth needs) can be developed. Maslow argued that the need for growth and self-actualization is what drives human behavior. Research into human motivation should be an essential component of teacher training and development because… 

Educators are in the business of motivating students.

Recent research on mental health reveals that many of our students are struggling just to keep their heads above water.  In this post, I will share what I learned about helping students navigate times of crisis through my training to become certified in Youth Mental First Aid.

Before becoming an educator, I worked at the local health club. Every year we were required to complete CPR & First Aid training in order to maintain our certifications. The purpose of this training was to help keep a person experiencing a crisis safe until professional help arrived. Youth Mental First Aid is very similar. It teaches adults warning signs to look for, ways to intervene and when to seek additional help when an person is in crisis.  If you are reading this blog, I am going to assume that you probably see kids in crisis on a regular basis. Many times you are their first point of contact and the trusted adult in their life. Dealing with a teenager who is having a mental health crisis can be really scary for new and veteran teachers alike. We care deeply about our students but don't always know how to help - and we certainly don't want to do anything to make things worse!

Youth Mental Health First Aid
Youth Mental Health First Aid is a program that was developed by the National Council for Well-Being to teach adults how to help adolescents who are experiencing a mental health challenge or crisis. It is estimated that 20% of youth are affected by mental disorders during any given year. If you look around your class of 30 students, you can estimate that as many as six of your students (if not more) are being affected by a mental disorder. Common disorders affecting teens are mood disorders, anxiety disorders, ADHD, and eating disorders.

The purpose of the Youth Mental First Aid training is to (1) inform adults about common mental health concerns among youth, (2) reduce stigma surrounding mental health, (3) teach adults how to recognize signs and symptoms of mental health and substance use problems in youth, and (4) provide adults with skills to use a 5-step action plan to help a youth who may be facing a mental health problem or crisis, such as suicide.

Are you interested in learning more??

• If you would like to know more about the Youth Mental First Aid Program, click here.
• The APA has published a primer to help teachers identify behaviors in the classroom that could be indicative of a mental health issue. If you are interested in accessing these resources, click here.

Risk Factors
There are a number of risk factors related to youth mental health. A risk factor can be defined as “a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of problem outcomes" (Risk and protective factors for Youth). Some risk factors include:

Genetics: There is evidence that many disorders run in families. This suggests that there is a genetic vulnerability to certain disorders that can be passed on from parents to their children. For example, having a first degree relative with Schizophrenia increases the risk of developing the disorder from 1% to 10%. It must be noted that although genetics might indicate a predisposition, genes are not destiny. There are other factors that must be considered including environmental conditions like trauma, poverty, and toxic stress.

Trauma: One way to measure the amount of childhood trauma and stress is through measuring Adverse Childhood Experiences, or ACEs. ACEs are potentially traumatic experiences that occur between the ages of 0-17. These could include experiencing violence, abuse, or neglect, witnessing violence in the home or community, or instability in the child's environment due to substance use problems or instability due to parental separation or household members being in jail or prison just to name a few. It is estimated that 60% of adults experienced at least one ACE and 1 in 6 adults experienced 4 or more types of ACEs in their childhood. (CDC, 2021)

Here is an example of an ACE screener for adults.

According to the CDC, adverse childhood events are associated with the likelihood of mental disorders in children. Research from 2019 shows that children with three or more reported ACEs had a higher prevalence of one or more disorders (36.3%) when compared to children with zero reported ACEs (11%). It appears that experiencing adverse events early in life allows for other stressors to trigger disorders more easily later in life.

Poverty: Children who experience toxic stress early in life are at risk of long-term adverse psychological and physiological effects. Toxic stress can occur when a child experiences strong, frequent, or prolonged adversity without adequate adult support. This prolonged activation of the stress response system can disrupt the development of their brains and increase the likelihood of developmental delays, mental disorders and other health problems like heart disease. A significant contributing factor to toxic stress is poverty. In the US, children under the age of 18 account for 1/3 of all people in poverty. Poverty has been linked to poor health and the increased risk for mental health problems in both children and adults (Hodgkinson et al., 2017).

Every year in my human development unit, I show the Yahoo News documentary "Baby Brain" to address the concept of toxic stress and its intersection with public policy. "Baby Brain" takes a critical look at child poverty in the United States based on what we know about the effect of toxic stress on children . It explores solutions and interventions to target these mothers and children to raise them out of poverty and reset their life trajectory. The video and my questions are linked below.

Video Handout
1. Describe what toxic stress looks like for the individuals in the documentary.
2. How does toxic stress affect prenatal development?
3. Describe the interventions used to reduce stress in the documentary.
4. How is this an example of epigenetics?

Protective Factors
The Diathesis-Stress Model, or Stress-Vulnerability Model, describes the interaction of genetic predisposition and stressful situations and how it can trigger mental or physical disorders. Each person has a different genetic starting point, but the outcome can either be mitigated by protective factors or aggravated by environmental stressors.  In other words, our genes are not our destiny! There is more to the story.

Just like stressors can aggravate predispositions, protective factors can mitigate them. A protective factor can be defined as “a characteristic at the biological, psychological, family, or community (including peers and culture) level that is associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcome" (Risk and protective factors, n.d. ). There are three categories of protective factors: individual, family, and social. Individual factors can include high self-esteem, emotional self-regulation, strong coping skills, and engagement in two or more of the following: school, with peers, in athletics, employment, religion, and culture. Family factors can include supportive relationships, clear expectations and a predictable, structured environment. Social factors can include the presence of mentors and developmental support, engagement within the school and community, positive norms, clear expectations for behavior, and physical and psychological safety. You can be the protective factor in a child's life!

In the positive education framework, student well-being and student achievement are equally important. In fact, increases in student well-being predictably lead to increased student achievement. However, before we can focus on helping our students thrive, we really need to help them survive. We can learn to support them through robust professional developments designed to help adults identify and appropriately intervene when an adolescent is in crisis. One of the best things about education is the potential to positively impact children every single day. Embrace it. That's why we do what we do.

Be Well,
Cori

Other Posts in This Series:

#69. Student Well-Being: Leveraging Mastery Experiences to Build Student Self-Efficacy

Resources:

Centers for Disease Control and Prevention. (2022, March 4). Data and statistics on children's Mental Health. Centers for Disease Control and Prevention. Retrieved March 29, 2022, from https://www.cdc.gov/childrensmentalhealth/data.html#ref

Centers for Disease Control and Prevention. (2021, April 6). Preventing adverse childhood experiences |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved March 30, 2022, from https://www.cdc.gov/violenceprevention/aces/fastfact.html 

Frothingham, S. (2019, May 23). Is schizophrenia hereditary? genetics & other causes. Healthline. Retrieved March 29, 2022, from https://www.healthline.com/health/is-schizophrenia-hereditary

 Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017, January). Improving mental health access for low-income children and families in the Primary Care Setting. Pediatrics. Retrieved March 29, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192088/ 

Mcleod, S. (2020, December 29). Maslow's hierarchy of needs. Simply Psychology. Retrieved April 2, 2022, from https://www.simplypsychology.org/maslow.html 

Risk and protective factors for Youth. Risk and Protective Factors for Youth | Youth.gov. (n.d.). Retrieved March 29, 2022, from https://youth.gov/youth-topics/youth-mental-health/risk-and-protective-factors-youth#_ftn

Stress disrupts the architecture of the developing brain. (n.d.). Retrieved March 29, 2022, from https://developingchild.harvard.edu/wp-content/uploads/2005/05/Stress_Disrupts_Architecture_Developing_Brain-1.pdf 

Toxic stress. Center on the Developing Child at Harvard University. (2020, August 17). Retrieved March 29, 2022, from https://developingchild.harvard.edu/science/key-concepts/toxic-stress/

https://www.simplypsychology.org/maslow.html