Our crisis in children's mental health: frameworks for understanding and action.

The widespread deterioration of our children's mental health is a little known and poorly understood societal condition that has far-reaching implications for educators at every level. The genesis of this theme issue precedes both the U.S. Surgeon General's proclamation above and the world-changing events of September 11th. The authors whose work is highlighted here continue a discussion that began at the January 2000 meeting of ACEI's Publications Committee. At that meeting, the committee affirmed once again ACEI's holistic perspective that all intra- and interpersonal dimensions of a child must be acknowledged, valued, and responded to in a caring and competent manner. Such a holistic perspective incorporates physical, mental, emotional, social, and spiritual dimensions of personhood. This perspective also incorporates the multiple, intersecting influences on a child's life: prenatal development; home and family life, from birth to the present; academic and other educational history; idiosyncratic features of personal growth and development; and the child's, family's, and community's cultures, attitudes, and aspirations.

For the past dozen or so years, the U.S. education agenda has become simultaneously politically charged and narrowed in scope to the current preoccupation with academic standards and high-stakes standardized tests. Serving as Co-Editors of this issue has provided impetus for intensive reflection, as well as extensive dialogue, about the potential of perceiving and serving children from an integrated, coherent, and holistic framework. While we support the academic mission and mandates of public education in the United States, we are troubled by the fact that other critical human needs have become perilously marginalized in many schools. In contrast to the contemporary, politically driven preoccupation with students' mastery of academic subject matter, the contributors to this special issue employ a variety of perspectives to inform educators about appropriate, essential engagement with their students'--as well as their own--mental health and psychosocial development.

Following the January 2000 Publications Committee meeting, we thoughtfully considered whom we might ask to submit articles that would examine mental health and public education from systemic, classroom, and interpersonal perspectives. We also strove to ensure that the theme issue would accentuate the healthy socio-emotional development of young children, elementary age children, and middle school children. We are extremely pleased to offer contributions from individuals we have identified as leaders on the cutting edges of these perspectives.

Howard Adelman and Linda Taylor are clinical psychologists who serve as the Co-Directors of the federally funded Center for Mental Health in Schools (CMHS), which is based in the Department of Psychology at the University of California at Los Angeles. Although the range of initiatives and products generated by the CMHS is broad, Adelman and Taylor have devoted many years to the creation of a conceptual framework in which they articulate the essence of the school mental health field. Their articles bring a much-needed understanding of the challenges of systemic change in public education, and provide a detailed description of their multifaceted framework.

Mark Weist and his colleagues also bring a systemic perspective to issues of mental health and public education. Weist is the Director of the federally funded Center for School Mental Health Assistance (CSMHA), based at the University of Maryland School of Medicine, Department of Psychiatry, in Baltimore. CSMHA staff psychologists Weist, Sander, Lowie, and Christodulu delineate their "Principles for Expanded School Mental Health." As described in their article, the ESMH framework is structured to ensure that mental health services are provided for students, families, and school staff in a coherent and comprehensive manner.

Angela Oddone serves as the Mental Wellness Program Coordinator in the National Education Association's Health Information Network (NEA-HIN), based at NEA Headquarters in Washington, D.C. Licensed as a clinical social worker, Oddone has grounded her work in a human ecology perspective. Her article discusses the notion of resilience as a helpful--and even necessary--tool for successful coping by individuals, school staff, and entire communities.

Ernie Dettore brings many years of experience in program development on the preschool and the college undergraduate and graduate levels to his position as Director of the Early Childhood Initiative Demonstration Project of the Office of Child Development at the University of Pittsburgh. His work is grounded in fostering healthy growth and development in our youngest children. In this theme issue, Dettore takes us into the world of his 5-year-old granddaughter as she, with the support of her family, creatively copes with her initial experiences with death. Dettore provides insights into the complex emotional and social dimensions of young children's lives, and offers strategies for promoting mental health through quality preschool programs.

Shelley Terzian, a public elementary school teacher, takes the reader through a year of demystifying standardized testing with her 4th-grade students during her first year of teaching in a Chicago public school. What emerges is a rich description of life within an inner-city school classroom as a teacher and her students strive to address the stress generated by such tests, within the social context of a school under intense district and state pressure to meet mandated standards.

Christopher Murray, a member of the education department faculty of DePaul University, builds on his work with early adolescents with disabilities, preservice and inservice teachers, administrators, and public policymakers. Murray presents a conceptual framework for the building of teacher-student relationships in the middle years of public school education. He provides guidelines for teachers of children and youth with disabilities, along with a clear directive for the importance of emotional and social dynamics in relation to what he terms "academic health."

At the University of Missouri-Columbia, psychologist James Koller and doctoral program student Sara Svoboda have been engaged with others in the creation and implementation of the Center for the Advancement of Mental Health Practices in Schools. This new center is noteworthy because it is the only university-based interdisciplinary professional preparation program in the United States to be mandated and fully funded by a state legislature. Koller and Svoboda describe systemic features of the center's operation as well as initial research projects.

As Co-Editors, we bring our own experiences and perspectives to the compilation of the multi-level frameworks provided here. Bob Burke brings both personal history and professional experience to strengthen his emergent national role as a teacher educator committed to facilitating interdisciplinary collaboration and training designed to enhance the practice of both education and mental health professionals. Himself the survivor of an abusive, alcoholic home environment, Burke has an intimate knowledge of the confusion, pain, and fear typically generated within dysfunctional families, schools, and communities. For the past 30 years, he has explored an array of traditional and experiential learning opportunities in both education and mental health settings. In addition, his career in human services includes work as a milieu therapist, juvenile probation officer, and teacher in K-5 general education classrooms.

Barbara Kimes Myers brings considerable experience in public and private education as a teacher, administrator, early childhood teacher educator, and consultant to public policymakers. She is committed to better understanding and sharing of what she is learning about the ways that adults, individually and collectively, nurture the spirit of the child. A frequent contributor to early childhood-related publications, Myers welcomes both written and spoken conversations with those who work with young children and their families, persons who prepare early childhood professionals, and those who wade into the often tumultuous waters of social change.

While all of the authors introduced above bring a variety of frameworks for understanding and action in relation to the crisis in child and adolescent mental health in the United States, we continue to be challenged to provide resources for all of our children. In September 2000, U.S. Surgeon General Dr. David Satcher convened the first-ever national conference on child and adolescent mental health. In the Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda (2001), published after that conference, it was reported that:

* Estimates of U.S. prevalence rates for all mental disorders and psychosocial problems among children (ages 1-19) range from 16 to 22 percent; furthermore, mental disorders persist into adulthood, as indicated in one study, which found that 74 percent of 21-year-olds with mental disorders had prior mental health problems

* Childhood emotional and behavioral problems [and related impairments] produce deleterious effects of greater magnitude than any other set of conditions in a child's life

* One in 10 U.S. children and adolescents suffer from mental illness severe enough to cause some level of impairment; however, only one in five receives specialty mental health services [including special education]

* The World Health Organization indicates that by the year 2020, childhood neuropsychiatric disorders will rise by over 50 percent internationally; these disorders will become one of the five most common causes of morbidity, mortality, and disability among children.

Researchers and practitioners in the fields of education and mental health have a wealth of knowledge that must be shared as we work together for children. We do, however, wish to be clear about our shared position regarding one important issue: Teachers in general education or other classroom settings are not psychologists, and they should not attempt to conduct psychotherapy with their students and family members. At the same time, we believe that the essence of both classroom teaching and counseling can be captured in a single word: relationship. Noted child and adolescent psychiatrist Harold Koplewicz (1996) states that children typically identify three adults as "most important": 1) biological mother, 2) biological father, and 3) current classroom teacher. Thus, if a teacher sincerely seeks to practice what Donna Kerr (1996) calls a "nurturing pedagogy," then he/she must not eschew professionally appropriate attention and engagement in matters related to student mental health.

We consider the accurate "translation" of mental health knowledge, contextualized via examples of classroom application, to be a crucial initial task in the long overdue building of bridges between the fields of mental health and education. It is important for educators to realize that the various sub-disciplines constituting the field of mental health (e.g., psychiatry, psychology, and social work) have evolved from over 100 years of theoretical development and practical application in a variety of human service settings. In parallel fashion, the sub-disciplines constituting the field of education (e.g., general, special, and early childhood education) encompass a vast universe of human thought and action. Education and mental health professionals collaboratively engaged in the translation and contextualization process can do so in a manner that enables all researchers and practitioners to access, understand, and appropriately apply each field's knowledge base.

What we in ACEI know well is that young children develop within the complexities of their social worlds--and so do adults. Human development, including childhood education, is an interactive process engaging all of us in the events and issues of a dynamic global community. This understanding flows throughout our association's policies and publications. The current issue provides a variety of topics and perspectives about school mental health that we hope will serve as an impetus to move beyond the current fixation on academic learning and the exclusive reliance on standardized tests as the only acceptable measure of student and teacher success.

At this dawn of the 21st century, we discern an undeniable, desperate need for the integration of information between education and mental health. Our hope is that such a cross-disciplinary synthesis will stimulate new language, theory, and practice for education and mental health professionals ... including tools and procedures that can be readily understood and used by classroom teachers, school administrators, and those engaged in public policy decisions. We believe this Annual Theme Issue of Childhood Education represents a major contribution toward that end.

References

Kerr, D. H. (1996). Democracy, nurturance, and community. In R. Soder (Ed.), Democracy, education, and the schools (pp. 37-68). San Francisco: Jossey-Bass.

Koplewicz, H. (1996). It's nobody's fault: New hope and help for difficult children and their parents. New York: Random House.

Surgeon General of the United States. (2001). Report of the Surgeon General's conference on children's mental health: A national action agenda. Available online at: www.surgeongeneral.gov/topics/cmh/default.htm

Robert W. Burke is Associate Professor, Department of Elementary Education, Ball State University, Muncie, Indiana. Barbara Kimes Myers is Professor, Early Childhood Education, DePaul University, Chicago, Illinois.