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Originally published October 17, 2013 at 4:14 PM | Page modified October 18, 2013 at 4:52 PM

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A holistic approach to mental health for students is needed

Better understanding about mental-health challenges in young people rightly starts in elementary school.

Times editorial columnist

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A small mental-health effort could produce huge improvements in school academic performance and, more generally, build better understanding about mental-health challenges faced by young people.

A $651,000 Bill & Melinda Gates Foundation grant will pay for training teachers and other staff at Beacon Hill International and Olympic Hills Elementary School in Seattle.

The schools’ partnership with Public Health — Seattle & King County, Washington State University and the Odessa Brown Children’s Clinic — provides the clinical expertise.

Social workers, teachers and public-health providers are familiar with kids in crisis coming to school. Some students are dealing with common social anxieties or, say, problems with parents or a boyfriend. Other students confront tougher demons, including family breakups, criminal activity and abuse.

The grant is meant to address these traumas. Doing so early can mitigate mental-health problems in the future.

One-third of American adults suffer from mental-health disorders. That makes mental illness one of the leading causes of disability in the United States. Treatment efforts ought to broaden to include prevention efforts. Studies suggest that one in five children has some kind of mental health disorder. Many of those cases often go untreated into adulthood.

Children from immigrant and refugee families are at higher risk for conditions that include depression, anxiety, social isolation, lack of self-esteem or social integration, and undiagnosed mental-health disorders. They are more likely to have limited access to mental-health care, and often come from cultures where getting help for mental-health problems carries a stigma.

About a third of college students have sought mental-health counseling, according to the “Consortium Mental Health and Counseling Study,” which surveyed more than 25,000 students. These students were more likely to name anxiety and stress as culprits rather than more severe problems like violence or substance abuse.

Although some students in the study were in treatment, most were not. Nine percent reported seriously considering suicide before college, with a smaller percentage saying they had attempted to kill themselves.

So what’s needed? A hierarchy of support is needed, starting with families and ending with a durable safety net built with plenty of supportive housing, community-treatment programs and crisis beds.

The great thing about the end of the government shutdown, which was partly fueled by right-wing battiness over the Affordable Care Act, is that attention now returns to helping an estimated 32 million Americans access mental-health or substance-abuse benefits. Parity rules require mental-health coverage to be comparable to that provided for, say, general medical or surgical care.

Keeping young adults on their parents’ health insurance until age 26 means that mental-health problems missed at a younger age can still be caught later on.

The other part of a holistic approach to mental health involves law enforcement. Many families coping with a loved one suffering a mental-health crisis are hesitant to call 911 out of fear that police will not know how to deal with a person who is visibly anxious, upset or threatening to hurt themselves.

That concern is well known to former King County Sheriff Sue Rahr. As the new director of the Washington State Criminal Justice Training Commission, Rahr is leading a cultural shift in police training from a “military model” to one that trains police to engage and de-escalate tense situations involving someone with mental-health problems.

“It is extremely easy to confuse adolescent acting out with behavior that might indicate something more serious,” Rahr says. Officers do not have to become social workers to be able to defuse a tense situation and steer a family toward a clinic or other help. Rahr gets this.

We’re headed toward a holistic approach to mental health. At one end, schools are working proactively to find and address problems. At the opposite end, law enforcement is looking to change how it views abnormal behavior. All are fledgling efforts, in part because of lingering shame and embarrassment about mental health. But those involved ought to keep at it, because this strikes close to home for many.

Lynne K. Varner's column appears regularly on editorial pages of The Times. Her email address is Follow her on Twitter @lkvarner

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