PolicyLab

A typical day for a high schooler may involve balancing chemistry equations, analyzing classic novels and memorizing key facts and figures from American history. Beyond their normal school work, students also learn how to maintain positive relationships with their friends and families, prepare for the increased responsibilities of adulthood, and balance their academic work with part-time jobs and extra-curricular activities. This is a lot for anyone, but may be particularly challenging for those experiencing multiple stressors — such as poverty, poor access to health care, and exposure to community violence — and students with unidentified mental health problems.

Mental Health and Academic Achievement

Recent estimates show that approximately 20 percent of adolescents ages 12-20 have a seriously debilitating mental health disorder, such as anxiety or depression. The same study found that an even larger percentage of adolescents experience mental health symptoms that may impair their daily activities and which place these youths at risk for more significant mental health problems. A wealth of research shows that youth who develop a mental health disorder as a teenager are at increased risk for continued mental health difficulties as adults. These concerning facts speak to the need to find innovative ways to expand mental health services at every possible touchpoint, from the doctor’s office to the classroom.

Though many students suffer with these conditions in silence, we can see the implications of an untreated mental health condition on a high schooler’s transcript. For example:

• One study found that students who report having some type of emotional difficulty are three times as likely to be tardy or absent from school compared to those without these disorders.
• Another showed that 83 percent of students with emotional and behavioral disorders scored below the average student in reading, writing and math compared to the general population.
• Finally, a report from the Centers for Disease Control and Prevention shows that mental illness and emotional disturbance accounts for 31 percent of high school dropouts.

Despite the well-known facts that mental health conditions are both highly prevalent and have a great impact on student well-being and performance, between 60 to 90 percent of adolescents with mental health conditions don’t receive treatment. A number of barriers lead to these unmet mental health needs, including stigma, lack of identification, inadequate insurance coverage and a shortage of mental health care providers.

Integrating Mental Health into a School Day

Considering that adolescents spend the majority of their waking hours in school, people across the country, including myself, have explored opportunities to integrate mental health services into a student’s school day. For example, many have developed school-based health clinics that provide health and mental health services to students. My specific interests lie in school-based mental health prevention programs, so we can intervene before students’ emotional problems become more significant and concerns about stigma influence their willingness to receive treatment. 

My past research has demonstrated the efficacy of a group depression prevention program that I developed called Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST). IPT-AST is an adaptation of interpersonal psychotherapy, an evidence-based treatment for depression, and is built on the idea that things that happen in our relationships affect how we feel, which in turn impacts how we act in our relationships. For instance, getting into a fight with a friend makes us feel sad or angry, and when we are in bad mood, we may lash out at others or become withdrawn from our relationships.

IPT-AST teaches students skills to promote positive relationships and address problematic relationships with friends and family to prevent these youth from developing more significant depression. We have conducted three different studies of IPT-AST in schools and have found that the program positively impacts depression and anxiety symptoms. We also saw a decrease in the number of depression diagnoses that students experienced. Our preliminary findings also suggest that IPT-AST and other mental health prevention programs have a positive impact on students’ academic functioning. Researchers will need to further examine this finding to justify a continued focus on mental health prevention in schools.

We recently submitted a grant application to the Institute of Education Sciences to train school counselors in the Philadelphia School District in delivering IPT-AST. If funded, this study will examine the effects of counselor-delivered IPT-AST on a variety of outcomes including social, emotional, and academic functioning.

The education system is in a unique position to ensure that students’ minds are both sharp and healthy, but this requires a continued, and increasing, commitment to providing these types of services in schools. Addressing mental health conditions may be just as important for student success as any essay or geography lesson.