The Village Dispatch: CMHRC's September 2024 Newsletter
Topic: More Punishment Won’t Fix the Behavior Crisis in Schools 
Giving Corner: Be Part of the Solution

Wednesday Webinars: Therapy 101: Why We Go To Therapy, And What To Expect

Clinical Seminar for Professionals: How & Why the DSM Fails Providers and their Patients

By Elizabeth Errico

As millions of families head back to school this fall, it is imperative we raise awareness of a growing movement across the United States to make it easier for schools to suspend and expel “disruptive” students.¹ State legislatures in Florida, Nebraska, Nevada, Texas, and at least three other states are crafting laws to allow stricter discipline for students, as young as kindergarteners. My colleagues and I at the Children’s Mental Health Resource Center (CMHRC) challenge the foundational premise of this legislative movement. Punitive responses to challenging behaviors will not make schools safer or end the “behavioral crisis.”

What’s required is a committed focus to meet the social and emotional needs of students. According to the CDC, 1 in 6 US children aged 2-8 years has a diagnosed mental, behavioral, or developmental disorder.² In 2022, the Child and Adolescent Psychiatric Clinics of North America reported that 21.8% of US children aged 3-17 have one or more of the most common mental, emotional, and/or behavioral health conditions.³ That’s 3-6 students in every classroom, from preschool through high school. 

Worse, the CDC reports that from 2007-2017 suicide rates among 10-24 year olds climbed by 56%.⁴

We cannot separate children's capacity to learn from their social and emotional needs, and we cannot separate the rise in difficult classroom behaviors from the rise in mental health challenges in children and teens.

The impulse to strengthen discipline often stems from confusion over what is “misbehavior” and what is a symptom of a mental health disorder. This misunderstanding is exacerbated when adults don’t know what symptoms look like in children and teens. Childhood onset symptoms often appear as:

• Irritability

• Oppositional behavior

• Difficulty making transitions

• Refusal to try new things 

• Intense and unpredictable temper outbursts 

• Social difficulty

• Ineffective communication skills

These behaviors can be problematic at home and in the classroom. Adults see them as “misbehavior” or disrespect, and as willful and intentional. But, these “behaviors” are actually symptoms of legitimate disorders.

In our work we often hear words like, “chose,” “refused,” and “decided”, as in “the child decided to misbehave”. This is not an appropriate characterization. In many cases, the child in question is dealing with symptoms over which they have no control. They also lack the coping skills necessary to manage them. When involuntary symptoms are met with punishment, the message is that these are “bad” kids and that they are causing problems for their peers. This damages self-esteem and humiliates the child. Most importantly, discipline doesn't teach any of the skills needed to manage symptoms. 

Psychologists understand that punishment doesn't work to change behavior. Punishment attempts to stop something undesirable. But a behavior can't change without first looking at:

1. What is causing the behavior to happen in the first place
2. What new behavior should replace the undesirable behavior?
3. How to replace the old with the new behavior

Lifeguards learned long ago that saying, “walk, please” is more effective than saying, “don’t run.” This gives children a replacement behavior they already know how to do.

Punishment doesn’t teach how to use a replacement behavior. Desired behaviors often involve skills the child either hasn’t yet developed (such as self-control and self-monitoring), or skills they can’t access because symptoms are overwhelming them.

A child who calls out in class, doesn’t stay on topic or follow instructions, is vulgar, or unable to stay in their own space may actually be experiencing a manic or hypomanic episode. They know the teacher wants them to sit down, quiet down, and behave “appropriately”. But they’re being driven by involuntary symptoms, and even though they want to, are unable to stop. This child is no different from a child who wants to breathe but can’t because they’re having an asthma attack. Only one of these children will be punished for their behavior. The other will be given an inhaler. Disciplining the expression of emotional need improves nothing, and teachers are left without the tools needed to stop the cycle of classroom “misbehavior” and punishment.

As part of my mental health advocacy work I go into Individual Education Plan (IEP) meetings, Behavior Plan (504) meetings, parent/teacher conferences, disciplinary hearings, and even mediation sessions with families all across the country. Teachers and special education professionals are eager to learn new approaches to help students regulate and de-escalate. They can be trained on how to identify symptoms, differentiate them from misbehavior, and use simple straightforward interventions to help symptomatic students get back on track. Yet despite teachers asking us to provide it, overburdened schools say, “we don’t have either the time or the budget to pay for it.”

Teachers must be able to teach. But when one student is struggling, it can impact the other students’ learning. The most direct line from a disrupted classroom to a constructive learning environment is to address the needs of the struggling student. This is what IEPs are designed to do. The creation and implementation of an Individualized Education Plan (IEP) is supposed to give the struggling child the support, accommodations, and tools they need to succeed in school. When used properly, a constructive learning environment can be achieved for all students in the class because when the needs of the individual student are met, the whole class benefits.

To access education, kids living with mental health conditions often must be homeschooled, or families turn to private schools that can provide smaller classrooms, with fewer students, more teacher’s aides, and better access to “special” classes like art, music, and physical education. This strategy can work for an individual student or an individual family, but there are larger systemic concerns about privilege and access. We can’t ignore that socio-economics dictate who gets access to education that addresses mental health needs and who doesn’t.

Organizations like ours have programs in place to support teachers and school systems in addressing students’ mental health needs. But we can’t provide those resources while our society's collective focus is only on stopping problematic behavior. We must recognize that “misbehavior” is actually the communication of needs. When we finally decide to put our time, money, and energy into meeting and resolving those needs, then we’ll be able to get those children, and the rest of the class, back to learning.

Elizabeth Errico is a licensed mental health counselor, a parent, and the executive director of the Children’s Mental Health Resource Center.

1. https://www.chalkbeat.org/2023/3/28/23658974/school-discipline-violence-safety-state-law-suspensions-restorative-justice?fbclid=IwAR0u_56FLV8IcRaj79X_kVkyNV9E2YXCt6YxEUUitf4LWyhN_vfCvSSLrKU

2. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2–8 years — United States, 2016. MMWR, 2018;67(5):1377-1383. [Read article]

2.  https://publichealth.jhu.edu/2022/study-reveals-fourfold-range-in-rates-of-mental-health-problems-among-us-children-based-on-relational-and-social-risks#:~:text=The study appears online in,and behavioral health conditions assessed.

3. https://thehill.com/policy/healthcare/mental-health/466294-suicide-rates-for-young-people-jumped-between-2007-to-2017/

Everything we do at CMHRC, from working with educators to meet children's mental health needs in school, to providing IEP and 504 plan support to families, to developing new school-to-home communication strategies is focused on working towards solutions to this society-wide problem. 

Our donors make this work possible. Make a gift today and be a part of the solution. 

Therapy 101: Why We Go To Therapy,

And What To Expect

September 18th, 7:30pm Eastern Time

There's still a lot of stigma around psychotherapy, psychiatry, and mental health. That stigma often means that people might not understand what the therapy process is really about, might feel intimidated by it, or just think to themselves, "That's not

for me." Come learn from professionals and families about what psychotherapy actually is, how it can help, and why it should be accessible to everyone.

September 25th, 5:00pm Eastern Time

During this clinical seminar for mental healthcare providers we'll take a look at the history of the Diagnostic & Statistical Manual of Mental Disorders (DSM). We'll explore how it was developed and designed, why it has evolved to be the authoritative source for diagnosing mental illness, and how and why it fails not only practitioners who rely on it,

but their patients as well. Join us as we take a deep dive into a resource that's so taken for granted its dangerous flaws have been forgotten.

Thursday September 19th, 8:30pm Eastern Time

Too many times neurodivergent children focus on their differences and forget their strengths. This book helps parents and caretakers understand their neurodivergent children, and gives them tools to help understand and accept their gifts. 

“Maintaining the Truth is a book that parents will not stop reading. It masterfully helps recognize that emotional and academic struggles in children require parents and other to not lose sight of the child’s strengths. Each chapter highlights that mental health or academic issues are complex, which is why it is important to maintain a positive mindset in heling the children and parent and to avoid critical or devaluing comments. The author’s ultimate goal is to teach others, step by step, how to help improve self-esteem and confidence in children. A must read.” 

– Sergio V Delgado, MD, Professor of Psychiatry and Child Psychiatry 

Sent by CMHRC

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