This is the final article of a three-part series on mental health at the Bromfield.
“The first day of school, we drove up and he couldn’t go in the door,” recalled Jane,* a Harvard parent. Her son Mike has social anxiety disorder. One in five adolescents will experience this or another serious mental health disorder in their lifetime, according to the National Institute of Mental Health. Students at the Bromfield School are known to complain about excessive homework and pressure to achieve, and data shows these gripes are not frivolous.
Anxiety and depression are on the rise among youth in America, with 8.4% of children ages 6 to 17 reporting “ever having been diagnosed with anxiety or depression,” up from 5.4% in 2003, according to the Centers for Disease Control and Prevention. In Massachusetts, 27% of high school students reported that “they felt sad or hopeless almost every day for two or more weeks in a row so that they stopped doing some usual activities” during the 12 months before the 2017 survey was conducted.
Unfortunately, while Harvard and its surrounding towns are idyllic communities in many ways, youth in this region are not immune to mental illness. Between 2016 and 2018, the Acton-Boxborough school district lost six young people to suicide. A-B may be a different community, but the predominant challenges, said Bromfield School adjustment counselor Susan Chlapowski in an interview with the Press, are “pretty typical of students in the same demographic in that age.” These include peer, family, and relationship issues, as well as academic stress.
The suicides in Acton-Boxborough “certainly heightened our awareness of the need to have a focus on mental health,” said Bromfield Principal Scott Hoffman. While he cited communication between teachers and the school counseling team as a contributing factor to Harvard not having experienced such tragedy, “I think we’re also lucky at times,” he added.
The data regarding mental health captured by Emerson Hospital’s Youth Risk Behavior Survey (YRBS) are jarring. In 2016, 26% of Harvard students in sixth grade and 42% of those in eighth grade experienced “somewhat or very high stress as a result of academic workload.” A total of 60% of high school students said they experienced somewhat or very high levels of stress, peaking in eleventh and twelfth grades at 71% and 64%, respectively. While experiencing stress is a normal and sometimes healthy part of life (think running away from a hungry mountain lion), there is a point at which productive stress—otherwise known as eustress—becomes distress, and perhaps even a clinical disorder. At Bromfield, data indicates a high level of real distress.
The YRBS asked students whether they had seriously considered suicide in the past 12 months. Six percent of sixth-graders and 14% of eighth-graders responded in the affirmative, both figures exceeding the aggregate percentage for the study, which included students in eight school districts in the Nashoba Valley region. A total of 14% of Bromfield students in grades 9 through 12 reported they had seriously considered suicide, including nearly one in five members of the senior class. Five percent across grades 9 through 12 actually made an attempt. The aggregate figures were, on the whole, lower than Harvard’s discrete data, indicating particularly grave mental health struggles among Harvard youth.
“I think that pretty much every school should have a suicide prevention program,” Chlapowski said, and clearly Harvard need not be an exception. Bromfield currently employs the Signs of Suicide (SOS) curriculum, which an evaluation published in the American Journal of Public Health found to be “the first school-based suicide prevention program to demonstrate significant reductions in self-reported suicide attempts.” The Lifelines Prevention curriculum, another evidence-based program, is used as well.
The Bromfield administration has taken steps not only to provide the student body with coping strategies and wellness opportunities (see last week’s edition of the Press), but also to actively reduce excessive workloads and shift the dialogue surrounding student success. For the first time this year, students will not be assigned homework over Thanksgiving break, and Hoffman requested that parents refrain from contacting teachers during the vacation to allow them time to rest and recharge, too. “I know our teachers have been really thoughtful about the types of assignments that they’re giving,” he said, adding, “I would say that if you talk to any of the longtime teachers here, we’re giving less than we ever have.”
While the YRBS data indicates that academic workload is the greatest contributor to stress—followed by “events in school” and “pressure at home”—for Bromfield students, it is not the strongest connection to suicidal ideation. Bullying and cyberbullying appear to be the greatest contributors to students seriously considering suicide.
Regardless of the cause of suicidality, there was a strong connection between the presence of an adult to talk to and suicidal thoughts. In grade 8, half of students who said they have no adult to talk to seriously considered suicide, as did one-third of students with no adult to talk to in grades 9 through 12. This finding informed a new yearly survey at Bromfield in which students identify at least one “trusted adult” with whom they can speak if they need support. “I felt like I had certain teachers that I could go to when I was stressed out, and felt like I was listened to,” wrote 2019 graduate Allison Milliken in an email. “I know that this helped me feel like I had someone on my side when it felt like I had the weight of the world on my shoulders.”
Sometimes having a trusted adult is not enough, and students require more serious intervention. Hoffman declined to provide statistics regarding students who must take an extended leave due to mental illness, but “we’ve had those situations,” he acknowledged. Hoffman explained that there is a group of administrators, counseling personnel, and health staff that meets once per seven-day rotation to review the needs of students who have presented with symptoms. Hoffman and Chlapowski said that coordination efforts are made with health care providers. “We try to all be on the same page,” Chlapowski said, “so that if a student does have some kind of a treatment plan with an outside provider, that we’re not doing something different here or repeating an effort.”
Just finding treatment, however, can prove to be a struggle. While school counselors may be able to meet with students on a consistent basis for emotional support, Chlapowski noted, “As a school, we’re not set up to be an ongoing mental health counseling center.” Mike, the student with social anxiety, is an example where in-school support was simply not enough. “When he was 15, he started having panic attacks on vacation,” Jane said. After a foray into therapy failed, “we just kind of gave up on that and let it go, thinking, well, he’ll grow out of it … and he started spending more and more time in his room. He didn’t want to go to restaurants, or any place where there were people; he stopped going to the pond with his friends—all the things he used to like to do.” Each day, Jane said, Mike would get dressed and pack his backpack for school, but his social anxiety would stop him from going in every time.
At the pediatrician’s office, Jane lived out every parent’s worst nightmare as they told her, “There’s nothing we can do.” Unable to prescribe psychiatric drugs, they referred Jane to the New England Center for Healthy Minds, whose earliest opening was nearly a month away. After calling every day to check for cancelations, the center told Jane to bring Mike to the emergency room. In a stroke of luck, one of the hospital doctors discovered that Mike had previously been prescribed an anti-anxiety medication for a dental procedure, had not experienced any adverse reactions, and therefore could be prescribed that medication again. Mike took the anti-anxiety aid and was able to walk into school the next day.
Looking back, Jane believes that many of her son’s struggles could have been avoided had the condition been identified early on. “From kindergarten, he wouldn’t open up at all or talk in class … he just wouldn’t speak. And so they thought he couldn’t read.” Mike even received a 504 accommodation, provided for students with various special needs, because he had been identified not as anxious, but rather as a “slow learner.” “They never used the word ‘anxiety,’” Jane said. “I’m sure a lot of teachers knew it, but they never talked to me about it.” She conceded that it is hard for teachers to know, as they are not psychiatric professionals, but teachers are often the first line of defense against tragedy. “I think that’s part of why we brought [the documentary film] ‘Angst’ to the school,” Hoffman said. Teachers as well as students are critical recipients of information about mental health. Chlapowski described an environment in which students sometimes self-identify that they need support, but there are also multiple layers of “observers,” from friends to teachers to other staff members, who allow the counseling staff to be proactive about potential situations that “if they had gone on longer, might have been a lot worse.”
With all of the initiatives going on to promote wellness, and an effort to ease college expectations, Chlapowski was unsure of where exactly all the pressure students report feeling comes from. Milliken had an answer: “At Bromfield, there was always pressure to be the best … but that [was] always cultivated by students, fostering competition between one another and comparing ourselves to our peers.”
Changing this culture, born and bred within the student body itself, will be a difficult task at Bromfield, but one that is no less than lifesaving.
*Names have been changed to maintain the privacy of this parent and student.
