Identify and Refer Concerns

One-half of all lifetime cases of mental illness begin by age 14; three-fourths by age 24. Researchers in the Adverse Childhood Experiences Study (ACEs), found sufficient data to support their claim that children exposed to four or more types of abuse, neglect, and household dysfunction are significantly more likely to have health risks for alcoholism, drug abuse, depression, and suicide. When child behavior signifies an underlying problem, early intervention and assistance is crucial to their short- and long-term mental health and health outcomes—and ultimately their academic performance.

Signs and Symptoms of Mental Illness in Children

According to the Mayo Clinic children can experience a range of mental health conditions, including:

  • Anxiety disorders. Children who have anxiety disorders — such as obsessive compulsive disorder, post-traumatic stress disorder, social phobia and generalized anxiety disorder — experience anxiety as a persistent problem that interferes with their daily activities.
  • Attention-deficit/hyperactivity disorder (ADHD). This condition typically includes a combination of issues, such as difficulty sustaining attention, hyperactivity and impulsive behavior.
  • Autism. Autism is one of a group of serious developmental problems called autism spectrum disorders that appear in early childhood — usually before age 3. Though symptoms and severity vary, all autism disorders affect a child's ability to communicate and interact with others.
  • Eating disorders. Eating disorders — such as anorexia nervosa, bulimia nervosa and binge-eating disorder — are serious conditions. Children can become so preoccupied with food and weight that they focus on little else.
  • Mood disorders. Mood disorders — such as depression and bipolar disorder — can cause a child to feel persistent feelings of sadness or extreme mood swings.

On their website, the Mayo Clinic lists the following warning signs or signals that a student might have a mental health condition:

  • Schizophrenia. This chronic mental illness causes a child to lose touch with reality (psychosis). 
  • Mood changes. Look for feelings of sadness or withdrawal that last at least two weeks or severe mood swings that cause problems in relationships at home or school.
  • Intense feelings. Be aware of feelings of overwhelming fear for no reason — sometimes with a racing heart or fast breathing — or worries or fears intense enough to interfere with daily activities.
  • Behavior changes. This includes drastic changes in behavior or personality, as well as dangerous or out-of-control behavior. Fighting frequently, using weapons or expressing a desire to badly hurt others also are warning signs.
  • Difficulty concentrating. Look for signs of trouble focusing or sitting still, both of which might lead to poor performance in school.
  • Unexplained weight loss. A sudden loss of appetite, frequent vomiting or use of laxatives might indicate an eating disorder.
  • Physical harm. Sometimes a mental health condition leads to suicidal thoughts or actual attempts at self-harm or suicide.
  • Substance abuse. Some kids use drugs or alcohol to try to cope with their feelings.

When a teacher observes changes in school performance, poor grades despite strong efforts, excessive worry or anxiety, hyperactivity, persistent disobedience and/or aggressive behavior and temper tantrums, it is important to seek the assistance of staff within the school qualified to assess and support students.

Nutrition and Health Concerns

Health-related factors such as hunger, physical and emotional abuse, and chronic illness can lead to poor school performance. The Coordinated School Health Program at the Ohio Department of Education works in collaboration with the Ohio Department of Health to help schools and communities integrate best practice wellness strategies into current initiatives in eight related areas: health education, physical education, health services, nutrition services, counseling and psychological services, healthy school environment, healthy promotion for staff, and family/community involvement.

Nutrition affects students’ physical health, growth and development, readiness to learn and risk of disease. Research shows that when students participate in a school breakfast program, it enhances their daily nutrient intake, improves their academic performance and behavior. Inadequate nutrition is a major cause of impaired cognitive development and is associated with increased educational failure among children. Due to this research, a guideline on nutrition was included in the Ohio School Climate Guidelines.

Working Cooperatively with Staff

In order to address the whole child, schools have set up processes and teams of professionals to develop procedures and resources for students and families. Often the school has established partnerships with community agencies to provide needed health, mental health, and social services. Classroom teachers can now collaborate with school mental health providers (school psychologists, social workers, and counselors), reading specialists, occupational therapists, physical therapists, learning disabilities specialists, and other specialized instructional support personnel (related/pupil services personnel) to improve:

  • The student's academic performance;
  • The student's behavior, or
  • Assist the classroom teacher in teaching students with diverse educational needs.

When you experience a concern about a student, ask for help. Consult with your school counselor, assistant principal, instructional coach or other designated staff to find solutions to help all your students.