Thursday, May 9, 2013

Teachers to watch out for mental health “symptoms”

The NIMH will no longer fund the bible of Mental Health Diagnosis, the DSM. And yet the problems associated with symptom-based diagnosis will be perpetuated in the government initiative to have teachers on the lookout for mental health disorders.*

To ask teachers to watch for Mental Health symptoms, when they are already seriously overtaxed after 6 years of decreasing budgets, is a recipe for disaster. Teachers already threaten the parents of creative and occasionally non-compliant students with “your child’s (drawings, behavior, comments, etc.) are disturbing and inappropriate”. In reality, every creative child’s drawings could be construed as “disturbing” or “inappropriate” – in particular by an over-stressed and over-worked teacher. Not only is it an unreasonable expectation, it allows teachers to control children with the threat of a mental health assessment or diagnosis.

As a teacher, I completely understand how frustrating it can be in an over-crowded classroom to have agitated, bored young people exercise their individuality and creativity. But it would be unfair to ask teachers to make an assessment about an individual’s mental health condition. Even under the best conditions this task is difficult for doctors. It is also an inappropriate expectation. It skews the teacher’s role toward surveillance, and will breed mistrust between students and their teachers.

We could more accurately predict mental health conditions through software that analyses an individual's computing and online habits. I am not advocating the use of such software, but in fact mental health disorders are in many ways very predictable, and one’s online and computing activity do reflect behavioral patterns and mental shifts. The question is: What is the goal of this "early alert" program, and what negative impacts may it have? If schools or our government want a tip-off regarding potentially dangerous conditions, there are more accurate ways to accomplish this task. There are also more humane steps we can take without undermining the trust essential for a healthy and productive teacher-student relationship.

Claudia M Gold on her blog Child in Mind advocates for a more holistic approach to understanding mental health ( http://claudiamgoldmd.blogspot.com/2013/05/dsm-nimh-on-mental-illness-both-miss.html ). The discipline of Infant Mental Health engages a process that is, according to her blog, “characterized by four key components. First and foremost, it is relational, recognizing that humans (and that includes their genes and brains) develop in the context of caregiving relationships. Second, it is multidisciplinary.. Experts in infant mental health offer different perspectives.  They come from many fields, including, among many others, developmental psychology, pediatrics, nursing, and occupational therapy.  Third, it encompasses research, clinical work and public policy.  The field looks at mental health within the context of culture and society. And last, it is reflective, looking at the meaning of behavior, not simply the behavior itself. The ability to attribute motivations and intentions to behavior is uniquely human, and research has shown that this capacity is closely linked with mental health.”

Let’s hope that instead of policing for false “signs” of mental health disturbance, we can proceed with intelligence, engaging the wide range of existing and evolving tools.

* “According to a January report the Obama administration planned to spend $50 million to fund Project AWARE (Advancing Wellness and Resilience in Education), which would train teachers to identify signs of mental illness or provide "Mental Health First Aid" and ensure that students have access to mental health care. According to the report, Project AWARE would reach 750,000 young people” – http://abcnews.go.com/Health/obama-budget-includes-235-million-mental-health-initiatives/story?id=18922699#.UYxPjoLb_-U

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