When the British Columbia government announced a $2-million boost to mental health supports in schools in September, it piqued DJ Gill’s interest.
Like many students forced into online classes last spring and facing restricted in-person classes since September, Gill was feeling lonely and anxious about her future.
“I didn’t want to miss out on all the Grade 10 opportunities,” said Gill, a high school student at J.N. Burnett Secondary in Richmond.
“I didn’t want this to not be a proper school year. So, I think it’s really easy to feel negatively because of these strange times.”
The $2 million is in addition to another $11.9 million in funds over three years announced in 2019 for B.C.’s Mental Health in Schools strategy, which includes integrated child and youth teams in five districts, the promotion of prevention supports in schools, new school-based supports and online mental health resources.
And federal COVID-19 relief in 2020 included $1.33 million in mental health funding for B.C. schools.
School districts received a total of $3.75 million from the province this school year for mental health, including staff training, developing new teaching resources, family information nights and student workshops.
After the pandemic funding was announced, Gill waited to see what mental health programs would be introduced in her school.
But she didn’t see any changes, she said. And despite the inclusion of “mental well-being” in B.C.’s physical and health education curriculum, Gill does not recall ever receiving a lesson on mental health.
“I’ve seen opportunities for how you can get mental support, like talking to a counsellor. But I’ve never been personally educated on this topic,” she said.
Gill wants the province to revamp its approach to mental health education in secondary schools, adding a focus on the origins of mental illnesses, their physiological impacts on the body, how to recognize signs of illness and how to seek help.
She suggests making mental health half of the physical and health education curriculum; incorporating mental health education into the existing science curriculum; or creating a standalone elective course on mental health.
“What they need to do is bring the conversation to the students, because I think a lot of students struggle with being vulnerable and taking the initiative to actually talk to people,” Gill said, adding she believes students will seek help if they’re better informed.
Josh Ogilvie, a Burnaby physical and health education teacher and president of Physical Education BC, a specialist association under the BC Teachers’ Federation, says Gill’s idea is spot on — and would work for adults, too.
If people know more about common mental health conditions and available supports, Ogilvie said, “then they’re better equipped to know how to manage life as it comes at them.”
Low treatment numbers
Elisabeth Bailey, an associate professor at UBC’s School of Nursing, said that Gill’s idea fits with recent research showing that students’ knowledge and attitudes improved with increased mental health literacy.
Bailey, who spent over a decade working as a psychiatric and a pediatric nurse, said that mental health literacy is “crucial” for everyone, especially teens so they understand what good mental health looks like and how to maintain it, as well as what mental illness looks like and how to treat it.
“It also includes reducing stigma and improving people’s awareness of where to get help if they or someone they care about needs it,” Bailey wrote.
According to research from Simon Fraser University’s Children’s Health Policy Centre, prior to the pandemic 13 per cent of people from four to 18 in B.C. were experiencing a mental disorder. That’s about 95,000 kids.
Anxiety disorders are the most common, said Dr. Charlotte Waddell, a child and adolescent psychiatrist who serves as the centre’s director.
They’re followed closely by behaviour and attention deficit and hyperactivity disorders, substance use problems and depression. Less common, but still significant, are autism, bipolar, post-traumatic stress and eating disorders, and schizophrenia.
Only 44 per cent of young people experiencing a mental disorder in B.C. are accessing treatment, however. We wouldn’t accept such low treatment numbers for physical diseases like cancer and diabetes, Waddell says.
“I don’t think young people should have to advocate for their own services, but young people saying we have needs that are not being met, maybe that’s what it takes to raise more awareness,” she said.
It’s too early to draw definitive conclusions about the mental health impacts of COVID-19 on young people.
But thanks to the centre’s research on the mental health impacts of other pandemics and natural disasters, we know to expect an increase in anxiety, depression and post-traumatic stress disorder among youth who’ve been quarantined or isolated.
Families and communities that were struggling prior to the pandemic, Waddell added, such as those who are low-income or experiencing racism, will be hit hardest hit.
Waddell would like to see Gill’s mental health education ideas expanded to encompass all students in kindergarten to Grade 1. Mental health issues can start showing up as early as the preschool years, yet many are preventable with early intervention, she said.
“Anxiety would be a fantastic teaching module that you could do with quite young kids, as well as high school kids. For example, the physiological reactions that everybody has experienced, that are in some ways evolutionary and protective when there’s a threat and you need to mobilize your brain and your body,” Waddell said.
“Then you couple that with what are healthy responses for managing that? How do you know when it starts to tip into something that’s not as helpful for you?”
Language matters, experts say
The current physical and health education curriculum does start discussing mental health in kindergarten and continues through to Grade 12.
In an email to The Tyee, an Education Ministry spokesperson said mental health education is one of four “key areas of study” in the curriculum. Students are supposed to receive age-appropriate lessons on the symptoms of stress, anxiety and depression, as well as the components of positive mental health.
But the curriculum specifically avoids using the term “mental health,” which can make it hard to recognize that mental health is covered, said Ogilvie, who helped draft the curriculum in 2013 to 2015.
“When you look in the curriculum you won’t see mental health, you see ‘mental well-being.’ And the reason for that is because a lot of people falsely associate mental health with mental illness,” said Ogilvie, adding the wording was a Health Ministry suggestion.
For example, the kindergarten phys-ed curriculum covers learning the causes and effects of emotions, “caring behaviours” with family and friends and activities that boost mental well-being.
By Grade 10, students are learning about the symptoms and signs of stress, anxiety and depression; exploring factors that help shape identity; and describing the relationship between mental well-being and physical activity.
There was an emphasis on including more mental-health education when redrafting the curriculum, Ogilvie said.
But how much mental well-being education is actually covered in class is up to the teacher, and available teaching resources often aren’t created with the B.C. curriculum requirements in mind.
“For a lot of teachers, I think it’s fair to say that they’re much more comfortable with the physical portion than the mental well-being portion at this current time,” he said.
Mental well-being doesn’t have to be solely covered in physical and health education, says Ogilvie.
Prior to the curriculum update, mental health was covered in Health and Career Education and Planning 10. But it’s included in physical and health education today because “it needs to belong somewhere,” Ogilvie said, adding it’s up to the school, not just the teacher, to ensure it delivers the full curriculum to the students.
Mental health could be addressed in almost any subject, for example, by encouraging students to self-monitor, Ogilvie added.
“Every day [my students] come in, they’ll do a self-monitoring check: how am I feeling at the beginning of class? How am I feeling in the middle? How am I feeling at the end?” Ogilvie said of his classes. “And then ask, ‘With what we did physically today, do you think there’s any connection?’”
Most students, he said, know someone who has experienced mental illness, and silence about the topic just deepens the pain. Ogilvie’s own mother suffered from bipolar disorder, though a diagnosis took a long time.
“When we found out about it, it just really clarified things,” he said, adding he’d blamed himself for his mother’s behaviour, because she often did.
Sharing his story with students led to one reaching out to share that they were going through their own struggles with a mentally ill parent.
That’s why it’s important that physical health and education teachers don’t solely focus on the physical aspect of a healthy lifestyle, Ogilvie said.
“Physicality has a direct influence on our mental well-being and vice versa. And the more we can learn and understand that, the more we can be equipped to make informed decisions for ourselves,” he said.
‘Your grades are your self-worth’
Gill is not alone among B.C. teenagers with her concerns about mental health education and in-school resources.
Tasneet Suri, a Grade 12 student at R.C. Palmer Secondary in Richmond, started a mental health club with a friend at school called Living Beyond the Horizon after pressure to achieve academically started affecting her mental health in Grade 11.
“Especially for high achievers, your grades are your self-worth. And I feel like that’s something that runs among a lot of students as you get into higher grades and you’re going to university,” Suri said.
“While we’re racing to get the best grades, we forget about our well-being completely.”
The club discusses several aspects of mental health, including various mental illnesses, the Diagnostic and Statistical Manual of Mental Disorders, and media glamorization of mental illness. They recently started a podcast and run events at school.
Suri is also one of 18 youth participating in the Agenda Gap, a mental health policy intervention research program run through UBC in partnership with the Richmond school board, the province and others.
The program is piloting an engagement tool to be used by community groups or schools to help young people and adults create mental health policies together based on young people’s needs.
“Part of the process is identifying, from young people’s perspective, the types of issues or challenges that shape mental health for them in their community and that are responsive to policy change,” said Emily Jenkins, an assistant professor of nursing at UBC and one of the researchers behind the Agenda Gap.
“Then working to identify and build a network of folks who can support that kind of change and go directly to policymakers or decision-makers to work to create some of that change.”
Young people using the tool gain mental health literacy and skills, as well as an understanding of how policymaking works, she said.
“Historically, we have a challenge where researchers can work in silos, and they can develop evidence often stripped of context. And then they go to have it implemented. And in practice, there’s a lack of uptake or a sense that it doesn’t really reflect the needs of the populations that it was intended to serve,” said Jenkins.
“This is particularly true when working around issues of child and youth health or mental health, where well-meaning adults create programs, but then there’s either low uptake or in some cases they can be harmful when they don’t actually reflect the needs, expertise and desires of youth themselves.”
Last fall, Gill created an Instagram page, Teach Mental Health BC, to engage with young people on what mental health education they’ve received and what they want to receive. The page now has over 1,000 followers.
In January, Gill conducted an unscientific poll on the app, asking B.C. students what mental health education they’ve received and whether they’d feel comfortable going to their school counsellor for a mental health issue.
Most respondents said they hadn’t received any mental health education, and they didn’t feel comfortable approaching the school counsellor.
Suri said this tracks with what she’s heard from her friends about school counsellors.
“Students are definitely less motivated to go to them, because they’re scared of what they might say, or they’re scared of what other people might say or their parents,” she said.
“A lot of my friends, they will go to the counsellor, but not tell their parents. So there’s a lot of disconnect of mental health between students and their family or other adults in their lives.”
Gill said she’s contacted the Education Ministry with her mental health education suggestion and received a response similar to that sent to The Tyee: mental well-being is in the curriculum, the ministry is funding school resources, and students have access to school counsellors, online resources or one of 11 Foundry centres — one-stop shops for youth physical and mental health programs and referrals (another eight centres will open by 2023).
Gill felt dismissed by the response. “I guess a reason why the ministry didn’t take me seriously is because it’s just one person,” she said.
“But if there’s a lot of students thinking we need a change, we want to be taught how to deal with our negative emotions, I think they’ll recognize that, appreciate it and make a solution.”