Four decades ago, when I started working with students who struggled with mental health issues, my colleagues and I were continually improvising. These were the years immediately after the federal special education regulations were first written, well before we could access the now abundant research and practice on trauma, brain development, differentiation, and inclusion. Those new regulations required for the first time that our atypical children had the unassailable right to an education. We dove into the challenge, spurred on as much by our naïveté as by our deep belief in justice and equity.
We came to work each day with an almost fanatical optimism that we could figure out every student's needs. We were trying to do the impossible, the absurd, the extraordinary, the necessary—all against the odds. We bolstered one another's capacity for empathy and creativity and turned to one another for laughs and hugs. The mental health challenges that students presented required us to be a support system for one another.
In the intervening years, we have collectively identified many strategies and resources to aid the success of all students. What has not changed are the structures to support the teachers who work with our students who have mental illnesses. That turns out to be just about all teachers, because 20 percent of youth ages 13–18 live with a mental health condition (National Institute on Mental Health, 2015). One can find many resources for self-care as a teacher, but many teachers tell me that they can barely find time to use the bathroom or get a breath of fresh air. Our baseline expectation for teachers to make time and space on their own to find support and develop coping mechanisms is troubling. And teacher self-care is ultimately an individual solution to the systemic demand of teaching every child, regardless of their mental health needs.
Changing Times, Static System
In this respect, I want to counter the implicit message that weeding out struggling teachers will solve the problems of our diverse and inclusive schools. If you feel worn down by the mental health needs of your students, if you feel despair, if you stay up late working on lesson plans because there is not enough time during the day, the current narrative is that you are somehow inadequate for the job. And one can certainly interpret the data to conclude that our new teachers just don't have the right stuff: 17 percent of them drop out during the first five years on the job (Gray, Taie, & O'Rear, 2015).
That damning narrative—which I have often heard expressed as, "Teachers aren't as good as they used to be"—infuriates me. There is a parallel narrative about the children who struggle with the pace and grind of school, perhaps because of their physical, psychological, or mental health issues: They are not resilient enough. But there hasn't been a sudden shortage of resiliency among teachers and students, as if a silent and pernicious infection is making its way through our schools.
Our schools have never been funded, structured, or resourced to be havens of resiliency, especially for students with mental health issues. There was no Golden Age of Education when all students succeeded, when teachers were so much more skilled and successful than our current staffs. One hundred years ago, approximately 20 percent of Americans earned a high school diploma. As late as 1960, only about 60 percent of students made it to high school graduation (U.S. Department of Education, 2010). In the last few years, the graduation rate has nudged over 80 percent (National Center for Education Statistics, 2017). Still, our schools, whether by default or design, have systematically failed millions of students every year. There is no reason or evidence to suggest that students with mental health illnesses have fared any better than the rest of their peers.
The "failure" that struggling students experience today was in a sense accepted and built into the system by a society in which one did not need a high school diploma to survive. Farming, small business, and manufacturing jobs allowed generations to raise families. The structures of schools and the support that teachers needed to be successful were adequate, if one were content with tens of millions of people seeking employment without a high school diploma. As a general rule, institutions give you outcomes that match their design; the design of public schools produced those tens of millions of dropouts, and 20th century society tolerated that outcome.
Then came three seismic shocks to the expectations of schools, shocks which reverberated down into every corner of our classrooms: 1) Brown v. Board of Education, the landmark Supreme Court decision that, at least in writing, required equal educational opportunities for students of any race—a problem for schools whose rituals, relationships, curricular content, and demands were, and still largely are, rooted in the dominant Anglo-European culture; 2) special education regulations, which demanded that all students, regardless of their mental health needs, must be educated—a problem for schools that had never worried about educating every nondisabled student; and 3) high-stakes testing—which narrowed the definition of success in schools, without giving them wherewithal to guarantee that success.
Amid these huge changes in education, schools could be compared to a factory that 100 years ago built the Model T but was now asked to build a Mercedes—without structural changes. Teachers now teach a more diverse, high-needs population of students than their predecessors ever worked with—a testament to democratic progress, but one that schools systems haven't caught up to organizationally. With regards to teaching students with mental illnesses, only minor adjustments have been made to such pivotal elements as class size, room size, schedule flexibility, preparation periods, nonevaluative supervision, age-based peer grouping, parent integration, and consistent consultation with mental health professionals. Under these conditions, we are testing the mental health capacity of our teachers.
A teacher must do a lot of self-care to bear witness to the structurally designed failures of our most needy students, including the approximately 50 percent of students with mental illnesses who drop out of high school (U.S. Department of Education, 2001). Test data get more publicity than do images of teachers sitting to comfort a student who is suffering through a personal crisis. The tens of thousands of good teachers who fill our schools feel the pain of failure for students with mental illnesses. They know that failure happens student by student by student, not merely as statistics.
Confronting Secondary Trauma
In the alternative schools and public school programs I've worked in that taught students with mental illnesses, we knew that pain intimately. We talked about how we felt like sponges, all day soaking in our students' emotions. There is a term for this: secondary trauma. That term defines the feelings experienced professionals must bear to work with people who are diagnosed with mental and emotional illnesses. We are at risk of feeling overwhelmed, ineffectual, confused, withdrawn, and hopeless. That is a professional hazard of caring for those with mental illnesses, and teachers cannot care for their students without running those risks.
Given the millions of students with mental illnesses in our schools and the ethical imperative that every child succeeds, schools as systems must robustly support their teachers. The following practices can be initiated at the district level, or within a given school. I urge administrators to consider these improvements as the first steps to creating more supportive working conditions for educators; in addition to their practicality, they are significantly less expensive than the cost of hiring and training new staff or funding out-of-district school placements. I urge teachers to come together to demand that such practices become part of their work environments. Advocacy and affiliation with your peers can even help mitigate the impact of secondary trauma. "Teachers who are comfortable expressing honest opinions and concerns are four times more likely to be excited about their future careers in education," write Russell J. Quaglia and Lisa L. Lande (2017, p. 2).
Create opportunities for work with experienced mentors. When it comes to supporting students with mental illnesses, there are few better guides than veteran teachers. Provide stipends for veteran teachers to add this responsibility into their already crowded schedules. For instance, a mentor may be a special educator who has been following a student for several years.
Provide clinical consultation. Schools can contract with community agencies to provide individual and team support for understanding the idiosyncratic ways a mental illness manifests in a student. Support can take many forms, including individual meetings at the school, in-class observations, phone calls, case studies, and professional development. Often, teachers need the trained eye and ear of a mental health professional to affirm their strategies, which can empower teachers to not give up in the face of long-standing and significant student need.
Identify confidential places for staff to talk. Teachers need to vent their worries and confusion. The staff lunchroom or hallways are not the right places; neither are IEP meetings. School leaders can post reminders in the office and staff rooms that suggest where such necessary conversations should take place: in offices and classrooms with the doors shut.
Walk through the school with an occupational therapist. I was truly astounded when I listened to our occupational therapist identify all the sights, sounds, smells, and textures of our building and classrooms, and the ways we could modify that stimulation to support the calm functioning of students with disabilities. After walking through the building, teaching teams can apply that knowledge in their classrooms, such as by sitting a student away from the heater or by placing a student's chair on a soft carpet square.
Remind teachers they're not expected to cure students. There are no cures. There are no predictable timetables. Support, celebrate, evaluate, and disseminate the ways teachers maintain a calm and consistent environment within which students grow. Among other resources, read the article "100 Repetitions" (Benson, 2012) to underscore for everyone the patience needed to see long-term growth in students with mental illnesses.
Provide one-page summaries of IEPs. IEPs are legal, financial, and pedagogical documents, often far too wordy to be easily referenced. The special education team can design a one-page template, filled out by the IEP team chair, that communicates the student's strengths and learning style. The template can also outline specific strategies that previous teachers found successful with this student and situations that have proven most difficult.
Provide five-minute substitutes. Students with mental illnesses can temporarily exhaust even the most veteran teacher who is on the front lines of helping students cope. Develop a list of available staff each hour of the day who can step in for five minutes to give the teacher a needed break.
Highlight nonacademic accomplishments. Report cards should allow teachers the opportunity to provide families documentation and anecdotes about the whole student. Not only does this provide the family with a richer picture of their child's growth, but it also supports the teacher's hard work. Publicize school data on such accomplishments as student attendance; decreased critical incidents, such as suspensions; collaborations with parents and community providers; and student and staff satisfaction surveys. Bolster the spirits of the staff by driving the narrative that our inclusive schools are providing a much greater public service than annual increases in standardized test scores.
Building a Better System
Quite simply, the status quo demands too much of students with mental health illnesses when the structures of school do not reflect their needs. We also demand too much of teachers who want to do the right thing without the preparation or support for compassionately managing mental illness in their students. If we expect better outcomes for both students and teachers, we must change the system, not the individuals in it.
