Mental Health in Schools: A Report From the Frontlines

Hello, my name is Stephanie Turner and I am a School Nurse Consultant that works within our School Health Program at Children’s Hospital Colorado. I primarily work within a public school district in the greater Denver area, and I also support a private school and several childcare sites within our community. I was asked to give a report on what the mental health crisis looks like from the frontlines.

I first want to start by focusing on those key words: the frontlines.

I appreciate our team at Children’s calling this what it is because in truth, in my nearly 12 year career, this feels like the closest I’ve ever come to fighting within a proverbial war. I find that mental health concerns among students these days is shifting by the minute and, oftentimes not playing out the way I could have predicted. For instance, when local public health authorities made the decisions to drop mask mandates and school districts soon followed, I began preparing myself for the ramifications of bullying that may surround those students who elected to still mask. Instead, I’ve seen more and more lately the confluence of what occurs when mask mandate removals meets cyberbullying.

In my high schools nowadays, there’s a trend circulating on Instagram and Tik Tok called “#maskpretty”. This occurs when someone takes a photo of another student, oftentimes a high school female, and posts that student’s picture on social media comparing it to a picture of the student in the mask with the associated #maskpretty.

I was aware of studies that had supported the notion that face masks make people look more attractive but, I never thought I’d see negative reverberations of that within my schools. Weeks after the mask mandates were dropped, I now have many students, again oftentimes females or students identifying as transgender, wearing mask to not protect themselves from COVID but instead, to shield their appearance from the harmful cyber comments of their colleagues.

Within the high school demographic, there’s been a new concern develop over recent weeks as it relates to geopolitical politics and the state of affairs occurring within the world at large. When checking in with students, I’ve heard time and time again as students express concerns over the war in Ukraine and what that may mean for them.

There’s apparently ‘rumors’ going around on cyber platforms that high school students approaching the age of 18 should prepare for the next military draft. They are afraid, unsure of what is true versus not true, and in some cases afflicted by feelings of guilt for being born in America.

I had a student tell me this week that she could feel something changing within herself in terms of guilt. She spoke of how most days, she and her classmates would complain about the food being served daily in the cafeteria. With millions of Ukrainian refugees half a world away now having no supply of food at all, she spoke of being consumed by feelings of shame and guilt that distract her from paying attention in class.

I want to mention too, the mental health ramifications we are seeing within the child care and preschool settings. Students with issues regulating their behavior has been on the rise. I have a few students who spent their first year of life interacting with one parent through a window because that parent was a healthcare provider working on the front lines battling COVID. That was 2020, flash-forward and that student is now two years old attempting to integrate within a social setting for the first time. We’re finding flares of immense separation anxiety when the parent who was once on the other side of the glass drops that student off at school leading to displaced aggression on other students.

My sites and I have been so thankful for the Mental Health Town Hall that was held in February as we’ve implemented the “Distress Tolerance Box” as a tool to help bring in comfort items for emotional regulation amongst our youngest students.

The last item to mention, is the trickle-down effect that decreased student enrollment numbers across Denver is having on school budgets, and in-turn on mental health access for students. I was surprised to learn when I entered the school health setting that each school did not have its own nurse. I was even more surprised to learn that each school does not have its own psychologist, either. In my school district, schools with the most number of IEPs and 504s take precedence over getting the token psychologist. This sometimes plays out as having a school with a low number of IEPs but a high number of students with active suicidal ideation and mental health concerns not having access to a psychologist within their school building. We don’t have enough school psychologists. Students with mental health issues are dropping out at record numbers exacerbating the decline in enrollment numbers. As enrollment numbers decline, budgets for the district are altered and the salaries for the psychologists we do have are being cut due to lack of funding. It’s a vicious cycle that keeps widening the chasm between mental health access within schools thus, leaving parents and students to wait in line for the mental health services we do have at Children’s.