When A Stranger Calls (Part One)

Guest post from Kristina Kaiser Gehrki

Halloween Isn't the Scariest Day in US Schools

Most people don't realize the Celts brought the first Halloween tradition to America. What started out as turnip carving in Ireland, morphed into pumpkin carving in America. In typical US fashion, Americans turned Halloween into a booming business. Nearly 70% of Americans are celebrating Halloween today with retail spending reaching $9 billion. 

The American version of Halloween excess is steadily crossing back over the pond given nearly 50% of all UK residents are celebrating Halloween. But while this holiday trend isn't scary, another US trend invading the UK is cause for concern: compulsory mental health education for children. Starting in 2020, all English children will receive mental health education lessons purportedly "to tackle the rise in mental health issues." 

Last year, I spoke with an Ohio parent who shared concerns about her son's school health curriculum. It was an important topic I planned to write about for some time as it prompted reflection on my own experiences as an educator and parent. I've worked on several national programs that benefited children and taught in one of America's largest and highly-rated school districts. Helping students identify their unique talents and develop resiliency needed to live happy, productive lives was a worthy endeavour I thoroughly enjoyed. I'm all for effectively alleviating children's stress and suffering to improve their future outcomes. Why then does England's new mandatory mental health education set off alarm bells in my head? 

Identifying Students At Risk for Mental Illness

Shortly before I retired from teaching, I noticed several changes in my district's annual mandatory teacher training. There were new requirements regarding mental health and suicide prevention. Being the mother of a teen who died an akathisia-induced death, I was initially pleased to see my suburban Washington DC school district was focused on improving children's wellbeing. Regrettably, I soon learned that much of what teachers and students were being taught about mental health was woefully inadequate. Some information was misleading and false. 

During one mandatory Fairfax County Public Schools (FCPS) teacher-training session, a school social worker gave a lecture about self-harming behaviors. I raised my hand and shared it may also be important for school personnel to know what, if any, drugs children have been prescribed given that research finds an increased risk of developing self-harming behaviors among children taking SSRIs. I mentioned akathisia and some of the physical components children suffering from akathisia might exhibit in the classroom. This includes frequently getting out of their chairs to walk around the room, rocking back and forth and incessantly swinging their legs while seated. The school social worker responded that this information was "too complicated" for teachers and that, basically, once teachers made student referrals, "mental health professionals" would take it from there.  

The next school year began with more training in which critical information was omitted. Teachers were instructed to informally assess students who were "at risk" of mental illness and start an intervention by referring these students to the school counselor. The counselor could then meet with the student, call the parents, refer the student to the school psychologist, who might then refer the student for services outside the school district. During the 2016-17 school year, FCPS made 4,415 consultations with "outside providers." Specific data regarding these 4,415 referrals isn't provided, but judging from the teacher training info, it's logical to presume many of these students were referred to psychiatrists.

While I had always planned to return to my communication career after my own children went to college, my retirement from teaching came at a time when teachers were very stressed trying to successfully do more with less. Many class sizes were increasing and curriculum was expanded to meet the new state testing requirements. When discussing the subject of student mental health referrals, some teachers were worried they might miss possible signs of at-risk student behaviors. Others felt that teachers were supposed to teach subjects, not recruit subjects. 

This isn't to say teachers didn't want to do their best to help children. We chose teaching because we cared deeply about children, so much so that we didn't want to unwittingly do something that might hurt children by starting a referral process that could lead to possible misdiagnosis, a mental illness label and prescribed harm. Teachers are well aware that most parents dread receiving a phone call from their child's school. To receive such a call from a stranger might be particularly distressing, especially if it was prompted by a teacher's misperception. As a result, we sometimes found ourselves in a difficult Catch 22. 

Who's Checking the Children? 

Thinking about my previous conversation with the Ohio parent who expressed shock when her son's health class provided instruction that specifically mentioned brand-name drugs to include the SSRI Prozac (fluoxetine), I decided to attend the annual FCPS Mental Health and Wellness Conference last month. I wanted to see if what is happening in my home state of Ohio is also happening in school districts across America, and perhaps soon, across the globe. The district-wide conference provided parents and community members with an array of sessions to include:

•  "Attention-Deficit/Hyperactivity Disorder (ADHD): Signs, Symptoms and Why Testing is a  Good Idea"
•  "Educate Before You Medicate"
•  "The Neurobiology of Stress & Anxiety: What Teachers, Parents and Students Need to Know"

In addition to the break out sessions, time was built into the schedule so attendees could visit with many of the conference exhibitors and obtain their organization's information. Exhibitors included the National Alliance on Mental Illness (NAMI) and Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). 

I left the conference with many treats to include free pens, notepads and refrigerator magnets emblazoned with organizational logos similar to what doctors receive from drug companies. In the days that followed, I began thinking about a horror flick I saw as a teenager titled, "When a Stranger Calls." The storyline is about a high school girl who is traumatized during an evening of babysitting. A deranged man repeatedly calls her and asks, "Have you checked the children?" The police try to help her and soon discover the disturbing calls are actually coming from inside the house.

Part two of this blog post will discuss the scary details of the conference sessions I attended. I won't share them today because doing so might adversely impact one's ability to have a happy Halloween. 

Kristina Kaiser Gehrki is a public health and safety advocate who believes our most important knowledge stems from personal experience. She holds degrees in strategic communication, journalism and education. Her teenage daughter, Natalie, died a prescription-drug-induced death after suffering SSRI adverse drug effects that were undiagnosed by her doctor and improperly treated with SSRI dose increases.