The last few years have seen a sharp increase in mental health issues for teenagers. As students return to school for the new year, it’s important for school nurses and health staff to familiarize themselves with this topic. We recently spoke with D&G Wellness Consulting to learn how nurses can better prepare for back-to-school season and care for their students year-round.

What is Mental Health 

The phrase ‘mental health’ is often used as an umbrella term to describe anxiety and depression — but what does it actually mean?  

The World Health Organization defines mental health as the state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community.  

Mental health exists on a spectrum and affects everyone. There are four layers to mental health: 

• Thriving 
• Managing 
• Struggling 
• Distress 

When an individual is struggling with their mental health or in distress, this can be a sign of mental illness. Changes in emotion, thinking, or behavior that negate your ability to function are classified as mental illness and should be managed with professional help if possible.  

Mental Health Trends 

A March 2021 report from FAIR Health shows that mental illness is increasing for children ages 13 – 19: 

• 93.6% increase in anxiety 
• 83.9% increase in depression 
• 333.93% increase in self-harm 
• 62.7% increase in substance abuse 

There are many factors that influence mental health and illness. Certain things (genetics, medical history, access to care) are out of our immediate control; things like coping strategies, self-care routine, support networks, and willingness to share are items in our control that can help us process and heal.  

For many, the isolation created by COVID-19 negatively impacted their mental health. The prevalence of digital platforms and social media networks have also been proven to cause anxiety and depression, especially for young adults.  

Even more, research shows that students at high-achieving schools are three to six times more likely to have symptoms of clinical depression and anxiety than other children their age. Academic and societal pressures have a large impact on students’ feelings of self-worth and achievement. 

As a school nurse, you are in the perfect position to educate your community and normalize conversations around these important topics. 

Warning Signs and Emotions 

Poor mental health and mental illness reside below the surface but can display in numerous ways. Here are a few warning signs to look out for: 

• Frequent stomachaches 
• Poor hygiene 
• Fatigue 
• Bad behavior 
• Withdrawn attitude 

These physical symptoms signal that something is affecting our emotions. For example, if a student comes to your office with a stomachache, they might feel worried, anxious, or tense. It’s important to break the stigma around emotions and encourage students to share how they’re feeling.  

Ask the student, “If I’m feeling worried, what do I need? If I’m feeling angry, what do I need?” Encourage the child to confront their emotions and feel their feelings instead of shutting them down. 

Creating a Safe Space 

Unfortunately, students don’t always know or want to ask for help. They might feel embarrassed, judged, or imperfect for feeling the way they do — all of which can stop them from reaching out and seeking help. 

As a school nurse, you can create a safe and open environment for students to share.  

Observe: look for warning signs. If you see a scar on a student’s arm, take notice and keep an eye out for more. If you see a fresh wound, step in and ask to treat the injury. Do not shame the student; ask them what’s going on and if they’re okay. 

Listen: if a student opens up, be patient and be present. Don’t interrupt or speak over them, maintain eye contact, and provide non-verbal feedback so they know you are actively listening. Validate their feelings and be compassionate with what they’re going through. 

Share: there are many great resources available for individuals struggling with their mental health. Create a handout for students that includes hotline numbers to resources like the National Suicide Prevention Lifeline, Crisis Text Line, The Trevor Project, and the Substance Abuse and Mental Health Services Administration’s Disaster Distress Helpline.  

Stay: be sure to follow up with the student after your conversation and keep in touch. They might not want to come back to your office, but make sure they know you didn’t forget about them.  

Caring for Yourself 

The start of a new school year is a busy time, especially for school nurses. It’s normal to feel overwhelmed and it can be difficult to care for yourself when you have a community relying on you. 

Your mental health and wellness matter, too. Keep these strategies in mind and make time for yourself! You can’t pour from an empty cup — caring for yourself will allow you to better support and care for those around you. 

For more information on this topic, watch our webinar with D&G Wellness Consulting.