Achieving the Promise: The Significant Role of Schools in Transforming Children's Mental Health in America
Lechtenberger, DeAnn, Mullins, Frank Edward, Greenwood, Dale, Teaching Exceptional Children
According to the U.S. Department of Education (2003), during the 2001 to 2002 school year, 476,908 American children and youth attending public schools received special services under the category of serious emotional disturbance (SED), which is also referred to as emotional and/or behavioral disorders (EBD) in the research literature. It has been estimated that there are as many as 9 million children in the United States identified with SED (Friedman, Katz-Levey, Manderscied, & Sondheimer, 1996). This estimate is destined to climb within the next 50 years as the number of children and youth with mental disorders climbs from 20% to nearly 50% (U.S. Department of Health and Human Services, 1999.
In 1999, the U.S. Surgeon General's Report on Mental Health (U.S. Department of Health and Human Services, 1999) reported that in economically developed countries such as the United States, mental illness is the second leading cause of disability and premature death. According to this same report, mental health disorders are collectively responsible for more than 15% of the burden of disease from all causes and slightly more than the burden associated with all forms of cancer (see Table 1).
One year later, the U.S. Surgeon General's Report on Children's Mental Health (U.S. Department of Health and Human Services, 2000) reported that during any given year, one out of five children and adolescents in the United States experience the signs and symptoms of a diagnosable mental health disorder. This translates to roughly 4 million American young people with significant emotional and behavioral disorders that severely disrupt their daily lives and the lives of their families. This same report noted that two thirds of these young people do not receive the appropriate supports and services necessary to address their mental health needs in order to lead healthy, productive lives in their communities (U.S. Department of Health and Human Services, 2000).
Upon review of this dismal data, educators face learning environments in today's public schools that need to provide support for students with EBD. Increased academic standards, coupled with the challenge of high-stakes testing requirements, have created highly pressurized learning environments for most students and their teachers. Standardized state testing and reported outcome scores have become the priorities of school districts across the nation due to the passage of the No Child Left Behind Act, a federal initiative to improve academic outcomes for students in U.S. public schools (U.S. Department of Education, 2002). Efforts to address these priorities by school personnel is ultimately designed to decrease student dropout rates, improve school discipline and classroom behavior management, as well as to meet adequate yearly progress (AYP) requirements for student performance. Unfortunately, the additional pressure on students may lead to more acting out behavior and an increase in some students becoming depressed or overwhelmed as they work to keep pace with these current educational demands. These stressors may be especially taxing for students with EBD.
Mental health disorders do not discriminate, and their accompanying challenges can be found in families across all ethnic, socioeconomic, and educational backgrounds. Students identified as EBD are also more likely to be from a nontraditional home environment, such as a single parent household or a foster care placement (Wagner, 1995). Also, White and African American students, as well as students from lower socioeconomic standings, are all noted to be overrepresented in the percentage of students labeled as having EBD (U.S. Department of Education, 1994). Several effective behavioral, psychosocial, and pharmacological treatments exist for many mental health disorders such as attention deficit hyperactivity disorder, depression, and anxiety disorders; however, families and school personnel are often unaware of these treatments. …