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Pressure points: Howard County schools look to address mounting mental health concerns
Columbia Flier - 2/15/2018
Feb. 15--Hammond High School senior Mandi Bhatt woke at 6:20 on a recent Wednesday morning, in time to be in class at 7:25 a.m.
She had a special guest to meet at the Columbia school.
Mandi had invited school Superintendent Michael Martirano to shadow her for a day -- from first period Italian to the dance class she helps lead, to a student government session and her Advanced Placement calculus test. She extended the invitation after they met at a student leadership conference, to give him a glimpse into the lives -- and stresses-- of students.
"I think teachers forget how much weight and pressure they're putting on students," Mandi, 17, said. "[It will be] important to show even if we're trying our hardest, it's hard with everything we've got going on. Within these eight hours it'll be clear to see there's a lot of pressure and stress."
Nearly 70 percent of Howard County high school students went on to attend a four-year college in 2016, many with merit scholarships, the kind Mandi said she's hoping to earn for one of her top choice schools, University of Maryland, College Park, or George Washington University in Washington, D.C.
All that achievement requires effort. For Mandi, it has meant four years of advanced classes and extracurricular activities, three or more hours of homework a night and running on five or six hours of sleep, a combination that she said is common.
"At least for me and my friends, there's a lot of pressure that in order to be the best you have to have the best grades and test scores," she said. "People are killing themselves over these test scores, and they're taking it out on their mental health and that's not fair."
Mental health concerns are a priority for Martirano. The issue hits close to home for the newly appointed superintendent, whose wife committed suicide in 2016.
"This is a very personal topic," he said. "I'm driving this agenda from my personal experience."
Martirano's budget proposal for next year includes three additional social workers to support students in need and more funding requests are planned in the years ahead.
The budget proposal is one of several actions the school system is taking to address mental health needs among students throughout the county.
"If any child is hurting, we need to respond with urgency. And I'm seeing that, symptomatically, you now where we've had challenges this year with our students," Martirano said. "From my vantage point, I'm seeing an increased level of emotional concerns, mental health issues in our schools. I want to take the lead in that and begin to provide a social worker to be somebody who can navigate for children who are in crisis."
The pressure to achieve is a trend among competitive school systems with highly educated parents such as Howard County, where 30 percent of residents hold a graduate degree, according to county data. Pressure can lead to overly stressed children, said Mary Alvord, a Montgomery County psychologist who specializes in teens.
While some stress can be beneficial to motivate students to work hard, Alvord said if the stress begins to interfere with sleep, work or eating habits, then it's gone too far.
"You get a pool of people who are higher achieving and they expect that of their children," Alvord said. "A lot of people who move into this area who are competitive, and there's nothing wrong with that. Seeking excellence is wonderful, but seeking perfectionism misses the mark."
Above average achievement is clear in Howard County, where last year the average SAT score was 1,161 out of 1,600 points, roughly 100 points above the national average. In 2016, more than a quarter of Howard County students took an advanced-placement test and nearly 80 percent scored a 3 or above on at least one test, often enough to earn college credit, and higher than the national rate of 22 percent.
One in five teens ages 13 to 18 have or will have a serious mental health issue, according to the National Alliance on Mental Illness. The prevalence of teens who reported major depressive episodes in the past year, defined as at least two weeks of low mood, jumped from 8.7 percent in 2005 to 12.8 percent in 2016, according to the National Institute of Mental Health.
Approximately 15 percent of Howard County high schoolers had seriously considered suicide in the past year, according to the Maryland's 2014 Youth Risk Behavioral Survey, the most recent data available. The county had the third lowest suicide consideration rate in the state, where nearly 16 percent of high schoolers seriously considered suicide. That number is lower than in 2005, the survey's first year, when 17 percent of Maryland high school students said they had seriously considered suicide in the past year; the survey from that year did not include county-level data.
Coordinator of school psychology for Howard County schools Cynthia Schulmeyer said mental health concerns among students are growing, though she declined to attribute the rise to any specific causes.
"Stress is a contributor, but it's not the only contributor," Schulmeyer said. "If a student is more vulnerable to other issues [such as] anxiety, stress could increase their vulnerability, but there's no equals sign."
Mental health crises among students also are rising. The county's crisis intervention team, Grassroots' Mobile Crisis Team, which responds to psychiatric emergencies including suicide attempts, saw a 24 percent increase in school-related calls in 2017 compared to 2016, a 40 percent spike in calls to middle schools and a 50 percent increase in calls to elementary schools.
Grassroots Executive Director Ayesha Holmes said the crises, whether suicide or another form of imminent self harm, could be caused by a variety of factors including anxiety, academic stress, social issues or family upheaval such as divorce. Calls for student emergency services have become significant enough, she said, that the school system is in need of a designated psychiatric crisis team.
"What we know is that the data tells us that there is something going on, but we don't know what it is," she said.
Martirano said that while he is open to exploring all options to help students, including a school-specific crisis team, funding for such a program would likely need to be in collaboration with the county. He has not had conversations with Grassroots about adding a school team.
One of Martirano's first steps has been to add three social workers in his proposed operating budget for next year. He would like to hire three social workers a year for the next four years. The 57,000-student school system employs five people in social worker roles, as well as 67 school psychologists, 158 guidance counselors and 22 pupil personnel workers.
Martirano proposed $183,000 for the three new positions.
Working with students and families, social workers act as a "bridge" to connect them with community resources, such as the county's Local Children's Board or Mental Health Authority, said the school system's Executive Director of Community, Parent and School Outreach James LeMon.
LeMon said the social workers will help the school district's ability to connect families to community services for issues ranging from mental health to food access.
"There's a gap in the middle where we could better utilize the social worker to provide outreach services to kids," LeMon said.
Steps to help kids before they're in crisis also are vital, said Sharon Hoover, co-director for the Center for School Mental Health at the University of Maryland.
One strategy, Hoover said, is to screen students for mental health concerns, just as schools screen for physical health issues, a practice recommended by the National Association of School Psychologists.
Howard County does not mandate "universal screenings" for mental health, but the school system's mental health task force, made up of staff from the school system, county health department and community agencies, is researching the practice to consider recommending its use, according to Schulmeyer.
The other major component, Hoover said, at helping to prevent mental health issues is to incorporate social and emotional well being education in the classroom, including lessons on self care, responsible decision-making and positive interactions with others.
"One of the real challenges in mental health promotion and prevention is finding the time, especially in communities with so much focus on academic performance," Hoover said. "Even though there's tremendous evidence to show social emotional learning improves academic success, it can be a battle to get it into curriculum."
Those lessons are something Mandi's father, Vyomesh Bhatt, said he'd like to see. While Bhatt, a software engineer, said he discusses mental health with his daughter, he'd like schools to talk about it and ways to manage academic and social pressures "that lets them know there is support out there, that other people are going through the same thing."
Director of Program Innovation Caroline Walker said Howard County school officials are in the early stages of crafting curriculum for social and emotional learning at each grade level. School administrators hope to have curriculum written by the end of the school year.
The final piece of the school system's multi-pronged approach to address mental health is to begin to shift the tone of conversations schools, parents and students have about what it means to be successful, said Chief Academic Officer Bill Barnes.
Barnes said school officials, under the encouragement of Martirano, are working to highlight paths to professional success beyond a four-year college, such as technical institutes and other career training. This includes a proposal in the new operating budget to expand the county's Jumpstart program, which allows students to earn college credit and industry certificates through Howard Community College
"I think for a while, we were running everybody on that getting ready for a four-year institution [mindset]," Barnes said. "And that level of stress, we were finding that kids were competing with themselves."
Beginning next year, Barnes said he wants to better educate families about what colleges are looking for in students and bring in college representatives for more outreach events.
"There's so much pressure to get every A, to get in the most advanced class, to get the highest grade," Barnes said. "And it's not all parents putting pressure on kids, but kids feel that and if we're aiming at the highest level of college learning and their parents are buying into that, that puts the kid into the middle of thinking, 'hey I've only got one way to be successful in the eyes of society and my family.'"
Talking about school pressures on a day when she's shuttling from school to mock trial before three hours of homework, Mandi said this shift in focus and priorities is something she'd like to see.
"Not everyone is going to perceive things in the same way. Not everyone can think about school 24/7, can talk about test scores on a Saturday night," Mandi said. "Adults are the ones who have the wisdom to talk it out with you. It doesn't have to be guidance counselors, but just more emphasis on 'hey it's OK, don't put all this pressure on yourself.'"
"A lot of us ge caught up in the little things-- a test grade, an assignment. It's not the end of the world, and that's something I have to tell myself a lot," she said. "Calculus is supposed to be hard. We forget the big picture a lot."
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