Believe in Fate No Longer

A former school district leader’s up-close parental perspective on five ways for educators to consciously address student depression

The day I woke up in the hospital where my teenage daughter lay in intensive care after a suicide attempt was a day that changed the trajectory of life for my family and me. That was a hard week. But harder still was planning for my daughter’s re-entry into a world I hoped would support her.

As a former assistant superintendent in a large, urban school district in California, I was no stranger to mental health crises among adolescents. But this was something entirely new. I was not the provider of services and support as I had been when I was a principal. I was the distraught and numb parent still trying to comprehend the magnitude of what had happened and how life was now changed for the future.

Being on the other side of the table, as the parent, was a perspective that taught me a few things about what schools can and need to do to support adolescents’ mental health.

My family’s and my own understanding of how to provide love, care and support had to change. We were frightened.

It was difficult to call the school and reveal to the counselor that my younger daughter was hospitalized and in a coma. For a split second, I worried about how my daughter would be judged as deficient or how I might be judged (a successful school leader who had missed the signs of her own daughter’s depression). Thankfully, the school responded with support, understanding and a loving attitude that yielded no judgment. I needed that caring response just as my daughter needed it during her months of recovery and re-entry into school life.

We were lucky in one respect. Our daughter attended a small charter high school that was highly in tune with the needs of its students. Our family did not have to ask for accommodations or for help. The school readily offered assistance and guidance for the following 18 months after the suicide attempt.

Empathy First

School personnel need to face their prejudices about students’ mental health conditions and symptoms and show empathy. I can still recall the stinging remark of one educator who said to me, “Well, you never did get used to having a daughter who was depressed, did you?” The comment left me speechless.

Many others showed compassion by sharing their stories of a family member with mental health issues, squeezing my hand or arm and sharing a look of knowing that went beyond words.

Through my experiences, I have come to formulate five considerations for school personnel for improving the mental health support they provide students.

 No. 1: Stop believing in fate. Educators must formulate a plan to address depression in students.

I no longer serve as a school administrator, but I coach administrators. I have heard administrators respond to mental health conditions and tragedy with these words, “Well, these things just happen.” Actually, they don’t.

School leaders should work closely with school counselors and faculty to understand suicide can be prevented.

Paying attention and having a plan for what to do if a staff member detects possible depression in a student may save someone’s life. The plan should include, minimally, a staff member who can conduct an at-risk assessment, advice for parents and efforts to connect the student and family to social services in the community.

Additionally, a plan should include written policies that formally make student suicide prevention a priority. Clearly describe the procedures to take when a student threatens, attempts or shows warning signs for suicide. This plan also should describe steps to take the day after a student suicide attempt and how to help the student with re-entry into life.

 No. 2: Be open about saying, “It’s OK to not be OK.”

Students and their parents often will not ask for help because of the stigma surrounding mental illness. Open and honest discussion must occur if a student is displaying signs of depression.

The stigmatization and decreased support for mental health education and mental wellness guidance is alarming, especially among adolescents. One in 13 adolescents suffers from a severe mental disorder, according to the Centers for Disease Control and Prevention. Suicide is the leading cause of death for young people between 10 and 24.

Educators see things. They notice students’ behavioral changes but may not realize what is happening. This puts faculty, staff and administrators in a central position to help students.

 No. 3: Show compassion for students who are depressed or whom you suspect may be depressed.

When they act out or break rules, do not shame them. Offer alternatives to discipline, perhaps using restorative practices that help students see that, while the transgression committed is not acceptable, it is OK to admit the reason for rule breaking may be emotionally related.

Sometimes dispiritedness drives these students to break school rules. Perhaps the student is nonresponsive in class, sleeping or showing up unprepared to learn. These are also signs of depression, and punishment will not help students admit their feelings.

However, due to the shrouded nature of mental health and the intense stigma that accompanies it, adults may use punishment to get a student to “snap out of it.” Punishment aimed at invoking shame will not help a student overcome depression, which is not a choice.

Restorative discussion skills can help focus on logical outcomes to emotional situations. Preparing to use restorative practices can give educators time to observe the student and consider what support services may be needed. Restorative practices can forge connectedness between adults and students.

A restorative approach also means helping students who have misbehaved acknowledge their contribution to what happened and make amends. In addition, depression comingles with other mental health issues. Openly discussing the student’s behavior with parents, without a focus on punishment, can help the parents develop understanding of their child’s mental health needs and share the behavioral issues with doctors and other support providers consulted by the family.

 No. 4: Develop mental health awareness competence among faculty and staff.

Mental health issues should not be placed solely upon school counselors. The maximum recommended number of students for a high school counselor’s caseload is 250, but nationally the average is 470, according to the American Counseling Association. All staff members need to become competent in understanding mental health issues in students. At a minimum they need to become aware of depression in youth.

Do not allow the depressed student to fade away or hide behind inappropriate anger or behavioral outbursts. Adolescents and teens who are depressed may become apathetic and try to minimize their presence at school in a variety of ways, essentially slipping away. Students who are angry often are depressed.

Anger is not what school personnel usually look for in students. Depression can be masked by anger, leaving adults to blame the anger and irritability on adolescent behavior or feel helpless facing sullen and withdrawn behaviors that adolescents sometimes exhibit. Depressed students may display an array of behaviors that can be dismissed in our heads by describing them as something else. Rather, educators should be up front about depression, letting students know it is healthy to share their feelings without shame or worry they will be labeled.

Mental health awareness competence can be developed over time, just as cultural competence is developed over time. It is the awareness that people with mental health is-sues are dealing with an illness that does not just “go away” and that students may need different supports at different times during the evolution of the ongoing care they experience.

It also means being aware of how faculty and staff interact with students even if students appear to be fine or are not experiencing a crisis. Teachers can check in with students to see how they are dealing with their depression and can offer ongoing support, which could include offering the students more time for completion of work, giving choice in situations that seem stressful and alerting others if a student’s mood is worsening.

 No. 5: Be proactive.

Schools can show proactiveness in various ways, including the establishment of mental health awareness clubs, where talk about mental health issues is open and honest. Being proactive is important. Although half of those with mental illness develop it by age 14, it takes another 8 to 10 years typically for the student to receive services, according to the National Alliance of Mental Illness.

Schools can host programs where students develop a “personal toolbox” that helps them learn about mental health and learn that people are different, feel different and perceive the world differently. A personal toolbox might include three curricular components: a supportive peer group, education about health signs and symptoms and individualized plans for personal improvement developed by students.

A Way of Life

My daughter has learned to manage her depression now that she is out of high school and attending college. This has not been an easy road for her. She daily must manage her symptoms. She has learned her depression is a chronic illness and must be treated like any other chronic illness — without stigma attached.

My daughter does this by practicing self-care, such as positive self-talk, balancing sleep and activity and meeting with medical practitioners as necessary. These steps are helping her during her college career. Acceptance has helped her become resilient, and every day she ventures into the world knowing that understanding herself is how she can accomplish anything she chooses despite her illness.

NANCY AKHAVAN is associate professor of educational leadership at Fresno State University in Fresno, Calif.
 @nancyakhavan

Sayeh Akhavan, the author’s older daughter, contributed to this article.