Schools are often on the forefront in spotting mental health issues in children. But historically educators have received little training in this area. In Iowa, legislators have set aside $2 million to expand mental health training in schools. But when nearly a quarter of kids are estimated to have a psychiatric disorder, some people want the state to do more.
Just before the start of the school year in Storm Lake, several dozen teachers fill the round tables at the high school’s library. They’re learning a catchy phrase, sung like a cheer, to remember how to spot mental illness in their students.
"Assess for risk of suicide or harm. Assess for risk of suicide or harm," they shout.
Youth Mental Health First Aid is an eight-hour crash course focused on how to identify symptoms of mental illnesses, where to get help and even what to say to a student in crisis.
Trainer Marni Moody leads an activity listing common responses from teachers and writing them on a whiteboard to determine whether they're helpful or not. Like the phrase "calm down."
"'Calm down.' Helpful or not helpful?" Moody asks.
"Not helpful," the class replies.
"In the history of the world, has anyone calmed down after being told to calm down?" Moody says, laughing with the room full of teachers.
Thanks to state funding, Youth Mental Health First Aid is offered in Storm Lake and many other Iowa schools for the first time.
Jeff Herzberg, a regional school administrator, says lots of schools in his area want the training.
"We have 15 schools who have requested training already, that we've got on the calendar up through March," he says. "And you know, more gets added to that calendar everyday, almost, it seems."
Storm Lake Superintendent Stacey Cole says she signed up right away. "We have a lot of teachers that tell us that they see more and more students come through our front doors with more and more mental health needs."
About 30 or 40 staff members are taking the class, Cole says.
One of them is fourth grade teacher Kathy McCabe, who says, "I've actually had three students tell me that they thought about committing suicide."
McCabe has taught for four decades and says students today face more social and academic pressures. The training course helped her rethink old habits.
"One thing that really stuck out with me was not to give advice," she says. "I'm a mother of four. I'm a grandmother. I've taught for several years and it's just kind of my motherly instinct."
Storm Lake also has a high immigrant population. Abby Green, who helps them learn to speak English, says their background adds challenges.
"We have students who are both immigrants and refugees and have experienced trauma in leaving family and traveling through some extreme conditions," she says.
Jennifer Ulie-Wells is a former teacher who founded Please Pass the Love, a non-profit based in Des Moines that helps schools find mental health support. She says the course is helpful because most teachers don’t get any mental health training.
"Like if negative was an answer, like not just zero percent, but like negative 50 percent," she says.
Still, Ulie-Wells says “one and done” trainings often are based on getting kids outside help, which is limited – especially in rural areas.
Last year, the Iowa State Education Association and Please Pass the Love surveyed nearly 400 Iowa public and private schools, and found that less than half list mental health resources on their websites. Just 20 percent have a mental health action plan.
"We also need to be coming up with more complex legislation, a greater more comprehensive system of care so that young people and their families have access to resources, schools are better equipped to work with these young people," Ulie-Wells says.
Youth Mental Health First Aid isn’t the only training available for schools. The legislature also has required schools to provide one hour of suicide prevention training annually.
This story was produced by Side Effects Public Media, a news collaborative covering public health.