Our schools are filled with too many students who are lonely, isolated, and disengaged. These students are often inhibited and shy, and lacking skills in social interaction. Many of them were timid and quiet in elementary school, and became socially anxious as teenagers. Some have significant depression. Some have felt suicidal. Suicide is now the 2nd leading cause of death in teenagers. For these isolated students, attending school can be painful. Their situation is analogous to working at a job for which they have no skills. They look around and everyone seems to know what to do, except for them. They see other students in the hallways and the cafeteria talking, laughing, and don’t know how to do what they are doing. They sit in class and barely speak, because they do not want others to see them. They sit alone at lunch, or escape to the library to avoid the stares of peers. Being socially inept as a teenager in school is extremely painful. They suffer in silence. They may be ostracized by their peers, or sometimes cruelly teased. They may become angry and vengeful and feel as if it is impossible to tolerate their despair. And occasionally they feel they want others to suffer as they do.
Usually after a school shooting, politicians cry out for more mental health treatment. But what exactly do they mean by “mental health treatment”?’ After all, in the findings of the Safe School Initiative published in 2004 by the United States Secret Service and the United States Department of Education, only one-third of school shooters had ever received a mental health evaluation (34 %) and fewer than one-fifth had been diagnosed with a mental health or a behavior disorder prior to the attack (17 %). Two thirds of the attackers had never been in trouble at school, and one third had been characterized as loners. These are not children who are easily identified as needing mental health treatment. These are not students who are displaying obvious psychiatric symptoms such as delusions or hallucinations, and they would most likely never get admitted to a psychiatric hospital. So how can politicians call for more mental health treatment when these students have no apparent mental health issues?
In my years working as a school psychiatrist, I have often wished that politicians would cry out for more funding and resources for our schools. During the 2014-2015 school year, the ratio of students per school psychologist in the United States was 1,381 to 1. The ratio recommended by the National Association of School Psychologists is 500-700:1. There are some states in which the ratio is 3,000 to 1. When money is tight and school budgets face shortfalls, often the first positions to be eliminated are those in counseling and psychology. Many psychologists do not have the time to perform important services for which they are trained, as they are by necessity overextended. Often the first services in schools to be eliminated are those dealing with prevention and the early identification of students who may be struggling with a mental health problem. School psychologists and social workers are critical stakeholders in providing mental health services for students. Virtually no school district has a psychiatrist on staff. It seems quite hypocritical for politicians to advocate in public for more mental health services when in reality funding for these services in our schools is in constant jeopardy.
Our schools need more personnel who can spend time identifying students who are marginalized and isolated. We need more psychologists, social workers, and counselors in schools. We need as a community to identify students at risk, and work with these students on social skills and social engagement to decrease their sense of isolation. Schools need personnel to develop programs for students who are struggling with mental health problems, so that school becomes a less onerous place for them. Schools need funding and resources, because those students who may one day commit egregious acts are sitting in our classrooms, feeling desperate and alone. They are in our schools, and we need to find them and help them. And we, as a society, must insure that those students who suffer in silence never have access to a firearm as a means of expressing their despair.
Caryl Oris (caryloris.com) is a child and adolescent psychiatrist working in school districts across Long Island.
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