Back to school: Expert advice on anxiety, bullying, stress for students, teachers, parents

With more and more reports of bullying, suicide and violence, as well as lingering repercussions from the COVID pandemic, the mental health of students – and teachers – has become a primary focus of schools as a new academic year begins.

At the same time, schools are facing a critical shortage of counselors and teachers. Many districts are struggling to provide the necessary resources to respond to increased mental health concerns.

“The mental health of our students and staff is a top priority," said Edward Aldarelli, superintendent of the Edison school district. "Our comprehensive support system is designed with layers of care."

Aldarelli said the district is fortunate to have a dedicated in-district team "with an unwavering commitment to nurturing the wellness of our students."

“As educators, we hold a deep awareness that the well-being of our staff is paramount and has a profound impact on our students, resonating throughout their educational journeys," he said.

Schools are facing a daunting challenge because there has been a sharp increase in adolescent mental health issues.

According to 2022 study by the Centers for Disease Control and Prevention, more than 37% of high school students reported experiencing poor mental health during the pandemic, with an additional 44% reporting they felt persistently sad or hopeless over the previous year. And, as reported by Mental Health America, about 60% of youth with major depression don’t receive treatment.

"Talking about mental health can seem daunting or confusing, especially for kids," said Dr. Greg Carnevale, chief medical officer at UnitedHealthcare, New Jersey. "If left untreated, adolescent mental health issues can carry into adulthood. Mental health during adolescence has a greater bearing on one’s adult life than many people realize."

The COVID pandemic continues to impact mental health

Stephanie Marcello, assistant vice president of Academics, Integration and Innovation at the Behavioral Research and Training Institute at Rutgers University, said in raising children, "social emotional learning is their foundation." And the children of the COVID pandemic can have delays in their social emotional learning.

"Children need to be evaluated to see if they're delayed or underdeveloped because they didn't have similar opportunities to develop these social and emotional skills which are essential in terms of prevention for any kind of mental health challenges," said Marcello, chief psychologist at Rutgers University Behavioral Health Care.

Students and school staff should have more access to mental health care, said Karen Smith, assistant professor of psychology at Rutgers University-Newark.

It’s no secret that the pandemic was a source of stress because loneliness or perceived social isolation can affect mental health, she said.

“The pandemic is still at the forefront of people's minds and at the same time, it does seem like we're moving toward a more general discussion of these things,” Smith said. “It is more societally acceptable to talk about mental health and how we can cope with mental health. We are normalizing that. Things like stress and loneliness are things everyone experiences at some point.”

Smith said teachers and parents can help by recognizing that stress is normal.

"We all experience stress on a regular basis, and it doesn't necessarily have to be a bad thing," she said. "Students learning that stress is actually a good thing helps motivate them to deal with perceived challenges and threats in the environment. It helps them reframe how they think about stress and implement better coping techniques to help them use that stress in a more positive manner."

It is important for parents and children to have discussions about stress, Smith said.

"We can talk about stress, how it can be a good thing and what kind of coping strategies can be implemented to help children across development cope with stress they might be feeling," she said. "And help them to be able to verbalize it, acknowledge it and maybe gain some understanding where those emotions might be coming from. And I think parents have the potential to make a difference because they are the ones who will interact with their children every day.”

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Communication is key, Smith emphasized.

"A problem for a school is that it is hard to be so personalized in dealing with stress, and that's why some students and some teachers need more support than others and they need a different kind of support," she said. "Creating an environment where children feel safe and able to communicate with their teachers and parents is important to facilitating that goal."

Two factors in generating stress, Smith said, are "a lack of control" and "a lack of predictability" which came to the forefront in the pandemic.

“Even just implementing small strategies aimed at giving yourself back some of that control or some of that predictability can be very helpful," she said

"For parents, talk with your child when both of you are calm about what is causing stress and how it shifts your attention to negative thoughts," she said. "Even recognizing that can help you break that cycle. Parents, if you are feeling anxious, give yourself time to step away from it. That makes for a more productive conversation."

Meditation, breathing and exercise and a good night's sleep have been proven to build wellness. Many schools have begun introducing students to these coping tools to help reduce stress and anxiety and encourage self-care.

But, it is a very personalized thing, Smith added.

"Stress is so dependent on our perceptions − of what we feel are challenges or threats," she said. "That also means that coping tools are very individualized as well. So one thing that works for one person doesn't necessarily work for another person.”

Coping with anxiety

Anxiety may be one of the most common feelings challenging students and teachers at the beginning of a new school year.

The first thing that those experiencing anxiety need to know is "you aren't your anxiety."

"Anxiety is a feeling − a very normal feeling," Marcello said. "The problem is when you're experiencing anxiety in a situation and it's taking you away from doing something you would normally do − when it's interfering with your quality of life. I think having those open conversations with our kids about what is everyday anxiety and what is an anxiety disorder helps. Educating ourselves on what is the difference between everyday anxiety and then anxiety that has become a problem in need of professional help."

Marcello said that anxiety can often be eased with coping skills.

"If you have a child who deals with anxiety and they're starting high school or something new, for instance, you may start to notice that they're having more anxiety symptoms − their stomach is hurting more or they are getting more headaches or having trouble sleeping or however they express anxieties, more is coming out," she said. "Normalize that this is pretty common and ask what we need to do to help them feel supported during these transitions.”

Marcello said the anxiety can be eased by having predictable routines at home, like regular times to go to bed and wake.

“Educating our children and our teens about that and then making sure that those are the boundaries and the rules of expectations in the day. I think the more that the parents can stay calm and reassuring to their children − using a calm voice, having a very relaxed posture and other nonverbals − can also be really helpful,” she said. “Go back to those everyday things − back to the basics of sleeping, drinking water, eating healthy meals and model that ourselves as parents."

Marcello added that identifying a "safe person" at school can be very powerful for a child.

"For my daughter, it was the guidance counselor and then her backup was the vice principal,” Marcello said. “She knew that if she was having a really stressful day that she could go to that person, and they understood her."

But people can develop anxiety that limits or stops them from doing the things they may want to do. In these cases, professionals can help, she said.

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Marcello said she focuses on three key areas − physiological, thoughts and behaviors.

First, she addresses if there are physiological symptoms, such as headaches and stomach aches with no medical cause.

She then looks at different ways of thinking and what those thoughts are, such as "I'm going to fail this test," "What if my mom or dad dies?" "What if I have no friends?" or "Are kids going to make fun of me?"

She pays attention to extremely negative thoughts that can also be a sign that anxiety is worsening.

Third, she examines behaviors, with the most common being avoidance.

"A kid who is struggling with anxiety − and there are adults too − they begin to avoid this thing they're afraid of,” she said. “They're afraid of having nightmares, so they try to stay up all night until they just pass out. They're afraid of no one talking to them so they don't go to the party. They're afraid of taking a test so they try to make up a reason why they don't have to go to school every day.”

Those are the signs that parents should pay attention to, she said.

“When we start to see they are not hanging out, they're missing that party or they're missing some days of school because their stomach hurts so bad or they can't get out of bed,” Marcello said. “That's when we want to have them evaluated to see what else is going on."

Bullying has increased

Bullying is a growing problem, said Alice Lee, a senior vice president at EVERFI, a provider of free educational programs and resources for mental health awareness and bullying prevention.

"We are in a mental health crisis," she said. "And we're seeing bullying increase as well − 23% of students reported that they’ve said or done something mean or cruel to another person online, while 27% reported that they’ve been the target of mean or cruel comments online. Bullying is the reason why 160,000 kids stay home from school every day, and young people who experience cyberbullying are at a greater risk for both self-harm and suicidal behaviors."

According to Lee, it is important at the start of the school year to build and maintain a safe school culture.

"It needs to be an entire community-wide strategy to ensure that our students are safe, both physically and virtually,” Lee said. “It's especially important at the start of the school year to set the tone from the beginning that not only will bullying not be tolerated, but to educate students on what it looks like and how to report if they see it. I think what's important is setting that tone at the beginning of the year and creating a positive school culture where people respect one another and respect each other's differences."

Students should be empowered and encouraged to think about their mental health, she said.

“The first step is you have to arm your students to understand what their own mental health is and how to take action on it,” Lee said. “But you also want students − maybe they don't have the issue themselves − to support each other. You do see students turning to one another when folks are experiencing stress or emotional challenges. And ideally, they're reaching out to each other or a trusted adult."

Lee said mental health education has a collective effort.

"It's not just the educators and teachers that have to be trained on how to work with students that are struggling with mental health," Lee said. "They have to be trained. Then, there is the staff, school counselors, principals. And parents. Our children spend half of their days at school and so it all needs to be reinforced both at school and at home. I also think we need to lean on external organizations, partners, community partnerships because it takes a village."

What can we do for our teachers?

The entire country is experiencing a teacher shortage. The pandemic placed teachers under tremendous pressure and burnout has become a common complaint. A recent survey found that 55% of educators say they plan to leave the profession sooner than they originally thought.

"There is a lack of support for teachers at a societal level right now that's contributing to this issue of burnout and loss of teachers in schools and classrooms," Smith, the psychology professor at Rutgers-Newark, said. "I think the biggest thing that could happen to help support teachers is at a policy by making sure they have the resources to be able to effectively teach and manage the classroom. And also take care of themselves in terms of managing their own stress levels."

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The community should recognize that teachers are under a lot of stress.

"Teachers are in a classroom where they're teaching a large number of students and that makes it difficult for them to be working with every child at this very individualized level," she said. "When you have conversations with teachers, recognize they are under stress and try to have that constant communication in a respectful way – one that doesn't contribute to exacerbated stress on either side of that conversation."

For both teachers and parents, Smith recommends taking the time to develop coping strategies and figure out how to handle stress.

"One of the best ways you can help the children in your classroom or your own children is by also making sure you're taking care of yourself," she said. "It becomes much harder to effectively help a child regulate their own stress and have those conversations with children when you're feeling very stressed or burnt out."

Marcello, the chief psychologist at Rutgers Behavioral Health, said teachers and schools are "being asked to do more than they've ever done."

"We all know that they have certainly have a ton to do already," she said. "At the same time, this is where the kids are. These are the people that they feel safe with and the people who have an eye on them. The more we can do to support teachers so that they can support our youth the better. They have their eyes on these kids. Sometimes more than the parents do − they notice when someone's acting different or doesn't seem themselves or are sitting alone. They have so much power to be able to get the change in behavior and engage the families.”

Teachers also need more support because they are such a powerful resource for children, Marcello said.

"I think we need ongoing training and coaching to support behavioral health clinicians in providing trauma-focused treatments," she said. "So much of the core of what we do and what we see is grounded in trauma, in childhood stressors."

Experts encourage mental health screenings at back-to-school physicals

The children going off to college or entering high school are children of the pandemic, Marcello said, so they have had experiences like no other generation.

"They all have had transitions in times of extreme stress," she said. "And we know that can be really challenging, and I think these are the kids that we are probably the most worried about in terms of the increases in anxiety and depression and substance use.”

Marcello said Rutgers has universal mental health screenings for all incoming students, like a physical.

"This is to gauge where they are at in terms of anxiety and depression," she said. "Many schools do this − they build in screening for depression, anxiety and substance abuse into a wellness check."

If something surfaces in the screening that warrants more attention, the student can immediately access a behavioral health professional.

"Someone can come in and talk with them about that, maybe some brief interventions are necessary, or they can be referred to a professional who can work with them for a longer term," she said. "Sometimes, they are experiencing things that are very normal things to be happening, but when it comes to a point where it's impacting their day-to-day, that's when we really need to have those supports."

Marcello also is an advocate for universal screenings at pediatricians' offices.

"I think that is a way to really engage communities that may not feel safe, or just culturally don't go to behavioral health providers,” she said, “but they will go see their pediatrician."

Carnevale, the chief medical officer at UnitedHealthcare, New Jersey, agreed, saying that well-child visits are the perfect time to ensure a child’s holistic development is progressing. And with back-to-school season ready to begin, it is an ideal time to discuss a child’s physical and mental health with their pediatrician or family doctor.

"Just as children can learn to understand medical problems that affect their bodies − like how asthma can make their lungs tighten and it can be helpful to use an inhaler to help them breathe more easily − parents and doctors can help them understand that mental health concerns are just as important has physical concerns," Carnavale said.

"School is a challenging enough environment as it is, so be sure to talk to your child’s doctor about changes in mood, behavior, academic performance or disposition to better ensure their needs are addressed and their concerns are heard, giving your child the skills to excel both inside and outside the classroom," he continued

Marcello believes that "one thing that this generation is so good about, is talking about things."

"We can definitely continue to improve on that, but this can really remove that stigma. Anxiety is a very healthy, normal emotion that all of us have. It's actually there to protect us," she said.

Challenges for college students and their parents

Parents of college students may find themselves with an extra set of mental health challenges.

Marcello said it is important to have conversations with college students about boundaries and rules whether living at home or on campus.

"They should be very clear to all involved," she said. "Families can sit down and have a conversation about what this next phase looks like. Since they are older, a great first step is to just stop talking and interrupting them while they speak. In turn, ask them to do the same.”

Students may become homesick. Some may call more, want to come home while other college-age children "ghost" their families. Marcello suggests following a student's social media but do not post or be active on their pages.

"It’s important that you and your college student establish how much communication works for all of you," she said. "A student may not call or text because they are having a wonderful experience. However, we do want to check in if we haven’t heard from them. If they are living in a residence hall, you can check with the staff, and they can do a wellness check."

Going to college is not only a transition for the student but for parents as well. Feelings of loss, nostalgia and missing a child go hand-in-hand with the excitement of transition These are feelings are normal, Marcello said.

"Let yourself feel it," she said. "We want to avoid projecting these feelings on our college students. Typically, within a month or two, you will notice adjusting to this transition. It is time to prioritize yourself again, and that’s okay if you don’t know what that means.”

But the relationship with the student is still important.

“Remember that secure parental attachment and healthy levels of separation have consistently been linked to greater college student adjustment and strengthens students’ psychological well-being," Marcello said.

email: cmakin@gannettnj.com

Cheryl Makin is an award-winning features and education reporter for MyCentralJersey.com, part of the USA Today Network. Contact: Cmakin@gannettnj.com or @CherylMakin. To get unlimited access, please subscribe or activate your digital account today.

This article originally appeared on MyCentralJersey.com: Back to school: Mental health advice on anxiety, bullying, stress