Student Mental Health: A Silent Crisis?

It is no exaggeration to suggest students of all ages today face a mental health crisis — whether child, adolescent, or young adult. Indeed, mounting evidence creates a compelling picture of a world in which students face the greatest levels of stress and mental health challenges than at any other time in history. Some consider this an acute crisis happening among the members of our youngest generation, with critical implications for the future.

Are our students-in-need falling through the cracks?

Promoting youth physical health in school has long been a key component of education. But mental health — a fundamental part of student health and well-being — is largely absent from the education agenda for the simple fact that there just aren’t enough resources to tackle the job. Schools already face chronically high absenteeism, low achievement, disruptive behaviour, and bullying, among other classroom problems, and school budgets are taxed for resources. Hence addressing the needs of students with mental health issues is far down the education agenda, if considered at all.

There is considerable debate as to whether the prevalence of mental health problems among youth is increasing over time and if so, why? There is clear evidence, however, that:  

• when a child is struggling, it is harder to learn,
• more students are coming forward to seek help for mental health problems,
• more students are taking psychotropic medications,
• more students with chronic mental illnesses are attending college/university, and,
• mental health issues are identified by students as having the greatest impact on their academic success.

“Kids who suffer from mental health disorders...inevitably miss out on opportunities for learning and building relationships.” David Anderson, Child Mind Institute

Why aren’t our educational systems doing more?

Schools can potentially be at the forefront of providing an environment and strategies to detect and respond to youth mental health concerns. There are many school staff who can play a big role in identifying problems, but far too often they can’t: (1) teachers see students every day and can spot emerging problems but teachers have little, if any, formal mental health training; (2) school psychologists and counsellors can help but there aren’t enough of them, and (3) school nurses, if present, can help but most lack resources and are responsible for hundreds of students. 

In the US, there are roughly 57 million students attending elementary and secondary schools including 50.7 million students in public schools and 5.9 million in private schools. The number of students attending colleges and universities is approximately 20 million. 

In Canada, there are about 6 million students attending elementary and secondary schools and the parents of over 368,000 students—one of every fifteen students in Canada—are sending their children to one of the 1,935 independent, non-government schools. The number of students attending colleges and universities about 1.7 million.

Children

•  Children’s Mental Health Ontario (cmho.org) provides these statistics:
•  70% of mental health problems have their onset during childhood or adolescence,
• 17% of children ages 2-5 years meet diagnostic criteria for mental health problems,
• 1/2 of Ontario parents report having concerns about their child’s level of anxiety,
• 1/3 of Ontario parents have had a child miss school due to anxiety,
• 62% of Ontario youth report having concerns about their level of anxiety but only 3 in 10 have spoken to a mental health care professional about anxiety.

 Most disturbing about these statistics is that 28% of students report not knowing where to turn when they want to talk to someone about mental health and are more likely to turn to friends (57%). And though 4 in 10 have sought mental health services, nearly half (42%) were unable to get the help the needed or too challenging to arrange: not the type of service needed, did not know where to go, and long wait times.

Teens 

According to the National Institute of Mental Health (NIMH):

• in 2015, about 3 million teens ages 12 to 17 had at least one major depressive episode in the past year,
• more than 2 million teens report experiencing depression that impairs their daily function, and
• about 30% of girls and 20% of boys--totalling 6.3 million teens--have had an anxiety disorder.

Post-Secondary and Undergraduate Students

A 2009 survey of the prevalence of youth mental health in Ontario post-secondary institutions found:

• 4% of students have a psychiatric condition,
• the three more common factors identified by students as affecting their academic performance were: stress (38%), sleep difficulties (26%) and anxiety (26%),
• 53% of students indicated they felt overwhelmed by anxiety and 36% felt so depressed it is difficult to function, and
• 15 to 20% of children and adolescents suffer from some form of mental disorder – one in five students in the average classroom.

A Canada-wide prevalence survey conducted by the Canadian Association of Mental Health (CAMH) had similar findings:

• one-third (29.2%) of undergraduates reported four or more symptoms indicative of elevated distress as measured by the 12-item General Health Questionnaire mental health screen, and
• the most common symptoms of distress were: feeling constantly under strain (47%), losing sleep over worry (32%), and feeling unhappy or depressed (31%).

 A 2016 Ontario University and College Health Association (OUCHA) survey of Canadian post-secondary students showed that a significant number of students experience mental health problems and illnesses: 

• 44.4% of surveyed students reported that at some point in the previous twelve months they felt “so depressed it was difficult to function”,
• 13% had seriously considered suicide,
• 2.1% had attempted suicide, and
• 18.4% reported being “diagnosed or treated by a professional” for anxiety.

 In the “National Survey of Counseling Center Directors 2010” researchers found that over the past five years, the following percentage of directors noted increases in the following problems:

• crisis issues requiring immediate response (70.6%),
• psychiatric medication issues (68.0%),
• learning disabilities (60.0%),
• alcohol abuse (45.7%),
• illicit drug use—other than alcohol (45.1%),
• self-injury issues e.g. cutting to relieve anxiety (39.4%),
• eating disorders (24.3%), and
• problems related to earlier sexual abuse (23.1%) (Gallagher, 2010).

Graduate student

Rates of anxiety and depression have grown in the last few decades. A 2013 American College Health Association survey of college students found:

• 57% of women and 40% of men reported experiencing episodes of “overwhelming anxiety” in the past year,
• 33% of women and 27% of men reported a period in the last year of feeling so depressed it was difficult to function,
• over 30% of students met criteria for a diagnosis of alcohol abuse 6% for alcohol dependence in the past 12 months,
• among college students and other 18- to 24-year-olds, binge drinking and, driving while intoxicated (DWI), have increased from 1998 to 2006. The number of students who reported DWI increased from 2.3 million to 2.8 million and the number of alcohol-related deaths also have increased, and
• 33% of students surveyed were feeling so depressed within the previous 12 months that it was difficult to function. Almost 55% reported feeling overwhelming anxiety, while 87% reported feeling overwhelmed by their responsibilities. Almost 9% seriously considered suicide over the past year.

Suicide 

One of the most dangerous aspects of depression and mental health concerns in general is suicide. Each year, between 5 and 9% of adolescents attempt suicide and nearly 700,000 of them require medical attention. And suicide accounts for more deaths among young people ages 10 – 24 in the U.S. (approximately 10/100,000) than all natural causes combined.

According to the ACHA, the suicide rate among young adults, ages 15-24, has tripled since the 1950s and suicide is currently the second most common cause of death among college students. That study also found 9.4% of students reported seriously considering attempted suicide at least once in a 12-month period, a marked increase from several decades ago. In Ontario, the Spring 2016 NCHA indicated that depression, anxiety and suicide attempts are increasing among post-secondary students:

• 46% of students reported feeling so depressed in the previous year it was difficult to function (increased from 40% in 2013),
• 65% of students reported experiencing overwhelming anxiety in the previous year (up from 58% in 2013),
• 14% had seriously considered suicide in the previous year (up from 11% in 2013),
• 2.2% of students reported a suicide attempt within the previous year (up from 1.5% in 2013), and
• 9% had indicated that they had attempted suicide, but not in the previous year.

Why our youth are so vulnerable?

Adolescents face a tidal wave of new experiences.Youths today are reputedly more fragile, less resilient and more overwhelmed than their parents were when they were growing up.

• Poor sleep and lifestyle habits. Details in source report.
• The pressure to succeed. Details in source report.
• Recent immigrants and international students. Details in source report.
• Exams. Details in source report.
• The Internet and social media. Details in source report.

References

We are happy to share the Science Report "Student Mental Health--A Silent Crisis" available here. All references are cited in the Science Report.

About Avail

At Avail, we’re dedicted to give businesses greater control over their health benefits spend while delivering an unparalleled employee experience that maximizes health and productivity. We designed the Avail workflow to integrate with your mental health and well-being support resources (e.g. EAP, peer support, psychoeducational materials) and we have collaborated for additional integrated care support with more than 150 health plans, health systems, EAPs, disease management providers, managed and community behavioural health providers, strategic alliances, ACOs and FQHCs.

Even the most effective healthcare technologies will defy engagement if they are not easy to access. Avail ensures a smooth process for our users who are seeking healthcare and well-being services. We have vetted and aligned ourselves with top North American telecounselling networks and our users have the ability to seamlessly connect with a counsellor through the App. 

On the front-end Avail is an engaging, easy-to-use mobile and online platform that offers users insight into their mental health and well-being and how poor lifestyle choices can “knock one of one’s game”, incur stress, and lead to potentially more dire consequences (e.g., eating disorders, anxiety disorders, depression). Avail teaches self-monitoring of these lifestyle choices and, over time, helps users discover the positive, resilience-buffering impact of healthy lifestyle choices and the detrimental impact on resiliency and well-being of less healthy choices. 

On the back-end, Avail is an intelligent behaviour analytic “machine” that anonymously monitors the user’s self-reported activities and challenges over time, alerting users to potential issues that may arise if healthy action is not taken and, in turn, creating personalized recommendations for useful mental health information and tools, connection to enterprise/institution/organization resources (e.g. school counsellors, existing materials) and/or vetted external resources (e.g. counsellors, community resources).

If your enterprise is looking towards transforming your benefit plans by offering services that satisfy the expectations and desires of a tech-savvy, socially-connected workforce, Avail’s platform addresses many of the key drivers of this transformation. 

Learn more at https://avail.app