Spreading First Aid for Teens’ Mental Health by Training Adults to Help

MindShift

iStock/Anna_Isaeva

During the vulnerable transition from childhood to young adulthood, many kids grapple with low self-esteem, anxiety and depression. According to the National Alliance on Mental Illness, 20 percent of adolescents between the ages of 13-18 live with a mental health condition. In fact, a recent study found that nearly 25 percent of teenage girls and almost 10 percent of teen boys suffer from depression by the age of fourteen.

When kids struggle, their emotional problems often unfold in the classroom, affecting their ability to concentrate and straining interactions with teachers and peers. Left untreated, mental health concerns can contribute to high school dropout rates. A 2001 survey conducted by the Department of Education found almost 50 percent of students age 14 and older with mental illness withdraw from school, and a recent study, published in the journal BMC Public Health discovered males with psychological disorders are five times more likely to quit attending school.

While educators often want to assist these students, many feel unsure of what to say, especially during a mental health crisis. But a community-wide intervention called Mental Health First Aid seeks to equip teachers, parents and caregivers with the information and skills they need to intervene during a mental health emergency.

MHFA training, referred to as “CPR for the mind,” teaches educators and caretakers how to recognize, understand and respond to signs of psychological distress. Educators across the country can receive “Youth” First Aid training, a unique version of MHFA teaching individuals how to recognize the psychological challenges that adolescents face.

“The course taught me how to get students the help they need, especially in an emergency,” says Tori Wardrip, an art teacher at Lewis and Clark Middle School in Billings, Montana.

Wardrip completed the training in June. The full-day course taught her several First Aid skills, including how to recognize the signs of a panic attack, psychosis and PTSD. She also learned how to assess for suicide risk by asking questions like, “Are you having thoughts of hurting yourself?” and “Are you in danger?”

Spreading the Word

Since 2013, more than 200,000 educators have been trained in Youth Mental Health First Aid, according to Betsy Schwartz, vice president of public education at the National Council for Behavioral Health; hundreds of middle schools, high schools and 27 state departments of education have implemented it. Schwartz says the results have been positive, resulting in $30 million in grant funding from the Substance Abuse and Mental Health Service Administration’s (SAMHSA) Now is the Time Project AWARE grant initiative.

The initiative also has garnered support from pop star Lady Gaga, who wants to help break silence around mental health. In 2012, the singer and her mother, Cynthia Germanotta started the “Born This Way Foundation,” a nonprofit organization committed to raising awareness about mental wellness, especially for young people. Recently, the foundation partnered with the National Council for Behavioral Health to sponsor Mental Health First Aid training across the nation.

The program trains people how to support and de-escalate an emergency crisis by using a five-step action plan, called ALGEE, according to Schwartz. “ALGEE stands for assessing for suicide risk/self-harm, listening nonjudgmentally, giving reassurance and information, encouraging professional help, and encouraging self-help and additional support strategies,” says Schwartz.

She adds that educators and caregivers who participate in the daylong YMHFA training learn how to recognize risk factors and warning signs of youth mental health challenges. Individuals are also informed about the prevalence of mental illness among adolescents, learning how protective factors, like available mental health resources, can contribute to psychological resilience.

During training, YMHFA participants practice these skills by role-playing with each other. Similar to medical First Aid training, role-play mimics realistic emergencies, allowing people to rehearse what they might “say” and “do” in an actual mental health crisis.

While the training focuses on mental wellness, instructors also discuss topics, like bullying and attention difficulties, teaching educators how these behaviors contribute to mental health concerns, like depression, suicidality and eating disorders.

At Lewis and Clark, Wardrip has put her new knowledge to good use. Since completing the training, she has become the “go to” person for the faculty’s behavioral health questions, serving as a bridge between educators and counselors.

She’s also using her new knowledge to teach students how to look out for each other.

“This year, using my First Aid training, I plan to teach my kids how to recognize the signs of a mental health emergency. If a peer is in danger, I want them to know how to get help,” she says.

Additional Resources

recent report, released by the “Born This Way Foundation,” found that even though adolescents value their psychological well-being, less than half are talking about their mental health. However, research shows teaching kids how to find psychological resources can make a world of difference, helping to break the shame and stigma that surrounds mental illness.

Schwartz says, educators and caregivers who participate in the daylong YMHFA training will learn five First Aid skills, including:

  1. Recognizing risk factors and warning signs of youth mental health challenges
  2. Understanding the prevalence of mental health conditions among young people
  3. Understanding protective factors that contribute to psychological resilience
  4. Learning the ALGEE five-step action plan
  5. Identifying community resources that can help support adolescents and their families

With support from the Born This Way Foundation, the National Council for Behavioral Health hopes to train 150,000 additional educators, parents and caregivers before the end of 2017.

Educators who are interested in setting up a YMHFA training can find courses here. See Lady Gaga and Prince William chat on FaceTime about mental health from earlier this year:

Juli Fraga is a psychologist and writer in San Francisco. You can find her @dr_fraga on Twitter.  

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Energy and Calm: Brain Breaks and Focused-Attention Practices

Edutopia

When presented with new material, standards, and complicated topics, we need to be focused and calm as we approach our assignments. We can use brain breaks and focused-attention practices to positively impact our emotional states and learning. They refocus our neural circuitry with either stimulating or quieting practices that generate increased activity in the prefrontal cortex, where problem solving and emotional regulation occur.

Brain Breaks

A brain break is a short period of time when we change up the dull routine of incoming information that arrives via predictable, tedious, well-worn roadways. Our brains are wired for novelty. We know this because we pay attention to every stimulus in our environment that feels threatening or out of the ordinary. This has always been a wonderful advantage. In fact, our survival as a species depended on this aspect of brain development.

When we take a brain break, it refreshes our thinking and helps us discover another solution to a problem or see a situation through a different lens. During these few minutes, the brain moves away from learning, memorizing, and problem solving. The brain break actually helps to incubate and process new information. Consider trying these activities with your class:

1. The Junk Bag

I always carry a bag of household objects containing markers, scrap paper, and anything that one would find in a junk drawer — for example, a can opener or a pair of shoelaces. Pick any object out of the junk bag and ask students to come up with two ways this object could be reinvented for other uses. They can write or draw their responses. Once students have drawn or written about an invention, they can walk the room for one minute sharing and comparing.

2. Squiggle Story

On a blank sheet of paper, whiteboard, or Promethean Board, draw one squiggly line. Give students one minute to stand and draw with their opposite hand, turning the line into a picture or design of their choice.

3. Opposite Sides

Movement is critical to learning. Have students stand and blink with the right eye while snapping the fingers of their left hand. Repeat this with the left eye and right hand. Students could also face one another and tap the right foot once, left foot twice, and right foot three times, building speed they alternate toe tapping with their partner.

4. Symbolic Alphabet

Sing the alphabet with names of objects rather than the letters.

5. Other Languages

Teach sign language or make up a spoken language. In pairs, students take turns speaking or interpreting this new language for 30 seconds each.

6. Mental Math

Give a set of three instructions, counting the sequence to a partner for 30 seconds. Example: Count by two until 20, then count by three until 50, finishing with seven until 80. Switch and give the other partner another set of numbers to count.

7. Invisible Pictures

Have a student draw a picture in the air while their partner guesses what it is. You could give them categories such as foods, places, or other ways to narrow the guessing.

8. Story Starters

A student or teacher begins a story for one minute, either individually or with a partner. The students then complete or continue it with a silly ending.

9. Rock Scissors Paper Math

With the traditional game, the last call-out is “math.” With that call, students lay out one, two, three, or four fingers in the palm of their hand. The best of three wins.

Focused-Attention Practices

A focused-attention practice is a brain exercise for quieting the thousands of thoughts that distract and frustrate us each day. When the mind is quiet and focused, we are able to be present with a specific sound, sight, or taste. Research repeatedly shows that quieting our minds ignites our parasympathetic nervous system, reducing heart rate and blood pressure while enhancing our coping strategies to effectively handle the day-to-day challenges that keep coming. Our thinking improves and our emotions begin to regulate so that we can approach an experience with variable options.

For the following practices, the goal is to start with 60 to 90 seconds and build to five minutes:

1. Breathing

Use the breath as a focus point. Have students place one hand close to their nose (not touching) and one hand on their belly. As they breathe in, have them feel their bellies expand. As they exhale, they can feel the warm air hit their hand. Students will focus on this breath for only one minute. Let them know that it’s OK when thoughts sometimes come into the mind uninvited. Tell them to exhale that thought away.

2. Colors

Visualize colors while focusing on the breath. Inhale a deep green, and exhale a smoky gray. Have the students imagine the colors as swirling and alive with each inhale. If a student is de-escalating from an angry moment, the color red is a great color to exhale.

3. Movement

For younger children, direct students to stand and, as they inhale, lift an arm or leg and wiggle it, exhaling it back to its original position. For younger grades beginning these focused-attention practices, it’s good to include an inhale and exhale with any type of movement.

4. The Deep-Dive Breath

We inhale for four counts, hold for four, and exhale slowly for four counts. You can increase the holding of breath by a few seconds once the students find the rhythm of the exercise.

5. Energizing Breath

We pant like a dog with our mouths open and our tongues out for 30 seconds, continuing for another 30 seconds with our mouths closed as we take short belly breaths with one hand on the belly. We typically take three energizing pant breaths per second. After a full minute, the students return to four regular deep inhales and exhales.

6. Sound

The use of sound is very powerful for engaging a calm response. In the three classrooms where I teach, we use rain sticks, bells, chimes, and music. There are many websites that provide music for focus, relaxation, and visualization. Here is one of my favorites.

7. Rise and Fall

As we breathe in and out through our noses, we can lie on the floor and place an object on our stomachs, enhancing our focus by watching the rising and falling of our bellies.

When we are focused and paying attention to our thoughts, feelings and choices, we have a much greater opportunity to change those thoughts and feelings that are not serving us well in life and in school. When we grasp this awareness, we see and feel the difference!

How do you stimulate or quiet your students?

Get Happy: Four Well-Being Workouts

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CreditCharlie Riedel/Associated Press

Relieving stress and anxiety might help you feel better — for a bit. Martin E.P. Seligman, a professor of psychology at the University of Pennsylvania and a pioneer in the field of positive psychology, does not see alleviating negative emotions as a path to happiness.

“Psychology is generally focused on how to relieve depression, anger and worry,” he said. “Freud and Schopenhauer said the most you can ever hope for in life is not to suffer, not to be miserable, and I think that view is empirically false, morally insidious, and a political and educational dead-end.”

“What makes life worth living,” he said, “is much more than the absence of the negative.”

To Dr. Seligman, the most effective long-term strategy for happiness is to actively cultivate well-being.

In his 2012 book, “Flourish: A Visionary New Understanding of Happiness and Well-Being,” he explored how well-being consists not merely of feeling happy (an emotion that can be fleeting) but of experiencing a sense of contentment in the knowledge that your life is flourishing and has meaning beyond your own pleasure.

To cultivate the components of well-being, which include engagement, good relationships, accomplishment and purpose, Dr. Seligman suggests these four exercises based on research at the Penn Positive Psychology Center, which he directs, and at other universities.

Identify Signature Strengths

Write down a story about a time when you were at your best. It doesn’t need to be a life-changing event but should have a clear beginning, middle and end. Reread it every day for a week, and each time ask yourself: “What personal strengths did I display when I was at my best?” Did you show a lot of creativity? Good judgment? Were you kind to other people? Loyal? Brave? Passionate? Forgiving? Honest?

Writing down your answers “puts you in touch with what you’re good at,” Dr. Seligman explained. The next step is to contemplate how to use these strengths to your advantage, intentionally organizing and structuring your life around them.

In a study by Dr. Seligman and colleagues published in American Psychologist, participants looked for an opportunity to deploy one of their signature strengths “in a new and different way” every day for one week.

“A week later, a month later, six months later, people had on average lower rates of depression and higher life satisfaction,” Dr. Seligman said. “Possible mechanisms could be more positive emotions. People like you more, relationships go better, life goes better.”

Find the Good

Set aside 10 minutes before you go to bed each night to write down three things that went really well that day. Next to each event answer the question, “Why did this good thing happen?”

Instead of focusing on life’s lows, which can increase the likelihood of depression, the exercise “turns your attention to the good things in life, so it changes what you attend to,” Dr. Seligman said. “Consciousness is like your tongue: It swirls around in the mouth looking for a cavity, and when it finds it, you focus on it. Imagine if your tongue went looking for a beautiful, healthy tooth.” Polish it.

Make a Gratitude Visit

Think of someone who has been especially kind to you but you have not properly thanked. Write a letter describing what he or she did and how it affected your life, and how you often remember the effort. Then arrange a meeting and read the letter aloud, in person.

“It’s common that when people do the gratitude visit both people weep out of joy,” Dr. Seligman said. Why is the experience so powerful? “It puts you in better touch with other people, with your place in the world.”

Respond Constructively

This exercise was inspired by the work of Shelly Gable, a social psychologist at the University of California, Santa Barbara, who has extensively studied marriages and other close relationships. The next time someone you care about shares good news, give what Dr. Gable calls an “active constructive response.”

That is, instead of saying something passive like, “Oh, that’s nice” or being dismissive, express genuine excitement. Prolong the discussion by, say, encouraging them to tell others or suggest a celebratory activity.

“Love goes better, commitment increases, and from the literature, even sex gets better after that.”

Stressed-Out High Schoolers Advised To Try A Nap Pod

NPR

Listen·3:193:19

Hannah Vanderkooy demonstrates the napping pod she uses at Las Cruces High School in Las Cruces, N.M.  Joe Suarez for NPR

 

When 18-year-old Hannah Vanderkooy feels extremely tired or anxious, she heads to a spacelike capsule for a nap — during school. Like many teens struggling to get good grades and maybe even a college scholarship, Vanderkooy doesn’t get enough sleep.

And she’s not alone. Various studies indicate that chronically sleepy and stressed-out teenagers might be the new normal among U.S. adolescents who are competing for grades, colleges and, eventually, jobs.

Studies have shown teenagers actually need between nine and 10 hours of sleep a night. But the vast majority (69 percent) aren’t getting it.

Enter “napping pods.” They’re essentially egg-shaped lounge chairs that recline, with a circular lid that can be pulled over the chest to shield against light.

“It just sort of envelops you in a really nice darkness, with soft lighting behind you,” says Vanderkooy, a frequent user of the pods. She says she typically gets only four to five hours of sleep a night.

There’s soft music playing in the pod and “you just feel extremely relaxed,” she says. The 20-minute experience is a wonderful “oasis” amid all the worry and stress of school, she says.

Las Cruces High School has one napping pod, which students use for 20 minutes when they are tired, stressed or angry.

Joe Suarez for NPR

“Being a senior, I have to apply for scholarships, do all my homework,” she says — noting that she’s taking three advanced placement courses. “So my sleep cycle has just sort of become this night-owl life, and it’s just kind of the new normal.”

A nap can’t substitute for a good night’s sleep, but it certainly can help, says Dr. Nitun Verma, a sleep specialist and spokesperson for the American Academy of Sleep Medicine.

A short nap for a teenager “can give a boost to memory and attention during the day, and it can increase school performance,” he says, adding that in a perfect world, schools would roll back their start times.

As it is now, the average school starts at 7:30 in the morning while the start time recommended by researchers at the Centers for Disease Control and Prevention is 8:30 a.m. or later. On top of that, teens’ circadian rhythms work against them — coaxing them to stay up late and then sleep late. So they are already sleep-deprived and “waking up much earlier than normal,” Verma says.

Several public schools in New Mexico are trying to tackle the problem by providing napping pods for their students.

“We know lack of sleep changes mood and makes you more anxious,” says family nurse practitioner Linda Summers, who is an associate professor at New Mexico State University’s school of nursing in Las Cruces.

Summers also works with the nearby Las Cruces High School health center, and has seen firsthand the effects of sleep deprivation on students there. So she decided to apply for a federal health grant to buy the pods, which, at the time, cost $14,000 each. They were installed in four high schools.

Vanderkooy is a senior at Las Cruces High School. She says she typically gets only four to five hours of sleep a night. Joe Suarez for NPR

 

And while the Las Cruces school napping pods were bought to remedy sleep deprivation, Summers says, “it also turns out to be good for anger and stress.”

Even if kids don’t fall asleep, but simply “zone out,” she says, they emerge saying they feel “refreshed and calm.” This led Summers to embark on a study looking at the emotional impact of pods.

She recruited students who reported feeling “agitated or upset about something,” and had them describe their feelings before and after spending 20 minutes in the pod.

“They all felt more rested, happier and more in control of their emotions,” she says, “after just 20 minutes.” Summers now writes prescriptions for the nap pod for students who are anxious, angry or just plain sleepy.

The findings haven’t been published yet, but they have been accepted for publication by a peer-reviewed journal. Summers says the teachers and school nurses she works with already see the pods as a big success. Each capsule is sort of a “therapeutic study hall,” she says, that helps students focus better when they’re in the classroom.

Vanderkooy recalls falling asleep in one of her classes and being told by her teacher that she “really, really” needed to go take a nap.

“I came back and I was awake and attentive,” she says, able to take out her notes and proceed — “just like a normal class.”

It Takes a Suburb: A Town Unites to Tackle Student Stress

Small rocks from the beaches of eastern Massachusetts began appearing at Lexington High School last fall. They were painted in pastels and inscribed with pithy advice: Be happy.… Mistakes are O.K.… Don’t worry, it will be over soon. They had appeared almost by magic, boosting spirits and spreading calm at a public high school known for its sleep-deprived student body.

Crying jags over test scores are common here. Students say getting B’s can be deeply dispiriting, dashing college dreams and profoundly disappointing parents.

The rocks, it turns out, were the work of a small group of students worried about rising anxiety and depression among their peers. They had transformed a storage area into a relaxation center with comfy chairs, an orange/peach lava lamp and a coffee table brimming with donated art supplies and lots and lots of rocks — to be painted and given to favorite teachers and friends. They called it the Rock Room.

“At first it was just us,” said Gili Grunfeld, a senior who helped with the effort. “Then everyone was coming in.”

So many rocks were piling up, they had to be stored in a display case near one of the cafeterias. The maxims seemed to call out to students as they headed to their classes in conceptual physics, computer programming, astronomy and Advanced Placement Music Theory.

And they became a visual reminder of a larger, communitywide initiative: to tackle the joy-killing, suicide-inducing performance anxiety so prevalent in turbocharged suburbs like Lexington. In recent years, the problem has spiked to tragic proportions in Colorado Springs, Palo Alto, Calif., and nearby Newton, Mass., where stress has been blamed for the loss of multiple young lives. In January, a senior at Lexington High School, who had just transferred from a local private school, took her own life.

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At a school where high achievement equals high anxiety, students posted notes on what gives them strength, like music and mom. CreditGretchen Ertl for The New York Times

Residents in this tight-knit hamlet, with its high level of civic engagement, are hoping to stem the tide. Mary Czajkowski, the district superintendent, was hired in 2015 with the mandate of “tackling the issue head on.”

Elementary school students now learn breathing exercises and study how the brain works and how tension affects it. New rules in the high school limit homework. To decrease competition, there are no class rankings and no valedictorians and salutatorians. In town, there are regular workshops on teen anxiety and college forums designed to convince parents that their children can succeed without the Ivy Leagues. Last October, more than 300 people crammed into the town hall for a screening of “Beyond Measure,” a sequel to Vicki Abeles’s documentary on youth angst, “Race to Nowhere.”

“We want to be a model,” said Jessie Steigerwald, a longtime school board member.

But it has not been easy.

Claire Sheth, a mother of four who had invited Ms. Abeles to town, describes Lexington students as “tired to the core.” Students say depression is so prevalent that it affects friendships, turning teenagers into crisis counselors. “A lot of kids are trying to manage adult anxiety,” said the principal, Laura Lasa.

The problem is not anecdotal. In a 2015 national health survey, 95 percent of Lexington High School students reported being heavily stressed over their classes and 15 percent said they had considered killing themselves in the last year. Thinking about it most often were Asian and Asian-American students — 17 percent of them, as is the case nationally.

The town’s growing Asian community has not been timid acknowledging the problem. Through college forums and chat rooms, a group of parents and leaders of the local Chinese-American and Indian-American associations have been working to lower the competitive bar and realign parental thinking. Others are pushing back. They don’t want the workload reduced — they moved here for the high-rigor schools. At association meetings, where the tension is most pronounced, discussions about academic competition in the district have brought some to tears.

Indeed, reversing the culture is complicated in a town that prides itself on sending dozens of students to the Ivy Leagues: 10 went to Harvard last year and seven to the Massachusetts Institute of Technology. Young people are lauded at school board meetings and online for having published academic papers or performed at Lincoln Center. Last year, the varsity team placed second in the 2016 History Bowl nationals and fourth in the National Science Bowl. The robotics team has qualified for the FIRST Championship, an international technology and engineering competition, for five of the last six years.

After school recently at the public library, which was packed with students poring over textbooks, calculus work sheets, lab reports and term papers, a sophomore looked up from her world history textbook and said, “You see all these people? They want the same thing — that’s really overwhelming.” What they want: Entry into a top colleges when acceptance rates are at an all-time low.

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Created by students worried about rising levels of depression among peers, the Rock Room is filled with messages encouraging visitors to decompress and with art supplies used to decorate rocks. Thus the name. CreditGretchen Ertl for The New York Times

Lexington looks and feels like a lot of other affluent suburbs: serene, stately, with a whiff of muted money. Minivans and aging Volvos are packed with violins and well-worn soccer gear. There are meticulously restored Colonials and Tudor revivals. Walk along the red brick sidewalks of Massachusetts Avenue, which cuts through the center of town, and Lexington’s Brahmin past is evident: a statue on the Battle Green of a musket-toting Captain John Parker, who led the fight against the British in 1775.

In evidence as well are signs of the burgeoning biotech industry, and the changing face of America’s elite.

Since 2000, the Asian population has ballooned from 11 percent to an estimated 22 percent of Lexington’s 32,000 or so residents, surpassing Newton (at about 13 percent) and Cambridge (15 percent). Today, more than a third of Lexington’s students are Asian or Asian-American. The demographic mirrors the migration of Asian families to suburbs across the country.

In the Crafty Yankee or the Asian bakery across the street, you are likely to bump into electrical engineers from Seoul, physicists from Beijing and biochemists from Boston. They teach at Harvard (10 miles away) and run labs at M.I.T. (11 miles). They hold top positions in the pharmaceutical companies that dot the Boston-area tech corridor. More than half of the adults in Lexington have graduate degrees. And many want their children to achieve the same.

In many ways, students in Lexington are the byproduct of the self-segregation that Enrico Moretti writes about in his book “The New Geography of Jobs,” which addresses the way well-educated, tech-minded adults cluster in brain hubs. For their children, that means ending up in schools in which everyone is super bright and hypercompetitive. It’s hard to feel special.

Best-selling authors and child psychologists have long urged parents to divest themselves from their child’s every accomplishment, thereby sending the message that mental health matters more than awards. In Lexington, the attack is more comprehensive, involving schools, neighborhoods, churches and synagogues. It is riffing off research that shows that resilience and happiness, reinforced by the entire community, can be just as contagious as stress and depression.

“You need to bring along everybody,” said Ms. Abeles, whose campaign has taken her to towns with similar communitywide efforts, including Elkins Park, Penn., San Ramon and Burbank, Calif., and New Rochelle, N.Y.

Peter Levine, associate dean for research at the Jonathan M. Tisch College of Civic Life at Tufts, says that communities that bond to promote pro-social behavior can be powerful inoculators for young people.

“Family problems are often community problems,” he said. “They need community solutions.”

No one is more aware of this than Ms. Lasa, who grew up here, earned degrees from nearby Springfield College and Lesley University, and then returned to the district — watching all the while as the population morphed from relatively laid back to Type A. She often wakes to emotional emails from parents delivered to her inbox after midnight. Most, she says, are about their children’s academic standing, and the tone is often disappointment.

Last fall, as 557 bright-eyed freshmen gathered in cushioned folding chairs in the auditorium for orientation, she gave a speech that over the last few years has come to focus more and more on stress reduction. She begged the students to make mistakes. “Do not believe that you must acquire straight A’s to be a successful student,” she said. “If you and/or your parents are caught up in society’s picture of success, let us help you change the focus.”

Students are now required to meet with counselors when choosing courses to talk about their academic loads. The practice is largely seen as a way of keeping students from overscheduling to beef up their college transcripts.

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Lexington, Mass., a tight-knit hamlet where the first shot of the Revolution was fired.CreditGretchen Ertl for The New York Times

“We are trying to change a culture that is deeply rooted here,” Ms. Lasa told me in a sunny Boston accent as she barreled through the school. She was showing off the 45-minute free period she instituted this year, allowing — or in some cases, forcing — students to take time to unwind. Some were playing basketball in the gym. Others were talking with teachers. A few hung out in classrooms, chatting with friends. An awful lot, though, were getting a head start on homework.

Ms. Lasa says she is trying to “balance all the messages” they are getting about success and happiness. The one she wants to most impart is: “Slow down.”

The paradox of Lexington High School is that while indicators of anxiety abound, so too does an obsession with happiness. A large banner from the town’s newly formed suicide prevention group, a chapter of the national organization Sources of Strength, greets students as they enter the sprawling red brick building, proclaiming: “Be a Part of Happiness.” There are close to 50 students in the group. Below the banner are remnants of their project to spread positivity. Students were asked to write down their sources of strength, which were then posted beneath the banner and on Facebook. Some named their pets or friends. One wrote: “My mom.” Another: “Trip to Israel!” A girl with green hair: “Chicken curry.”

One morning in February, students in “Positive Psychology: The Pursuit of Happiness,” a popular elective, were following up on a discussion about the psychologist Barbara Fredrickson’s “broaden and build” theory, which posits that negative emotions like anxiety and fear prompt survival-oriented behaviors, while positive emotions expand awareness, spurring new ideas, creativity and eventually building skills.

“Today, we are going to look at pretty simple ways to make it more likely that you experience positive emotions on a day-to-day basis,” Matthew Gardner told his “Happiness” students as they pulled out notebooks and pencil cases. The class discussed the benefits of exercise and eating foods that release feel-good hormones. The students also learned that smiling and being smiled at releases dopamine, which has an uplifting impact.

Mr. Gardner offered an alternative to smiling: “Our brains are not so perfect that, sometimes, if you hold a pen or pencil like this” — he held a pencil between his teeth — “you activate some of the same face muscles. You might get a little bit of a dopamine effect, too.”

Several students held pencils between their teeth to test the theory.

At one point, the class practiced laughter yoga, raising their arms slowly as they breathed in, then lowering them as they breathed out, and bursting into peels of laughter. Afterward, the students recorded changes in their pulse rate to demonstrate research from the HeartMath Institute that shows heart rates slow down and smooth out after bouts of good feeling.

“It’s not just that your heart rate goes down and you become very calm,” Mr. Gardner explained. “It’s that the shape of your heart rate is smooth and more controlled. Frustration is more jagged.”

Their homework assignment: Do laughter yoga or “smile at five people you wouldn’t normally smile at.”

Student Poetry

As part of the Student Publishing Program, a literary arts curriculum, all 10th graders at Lexington High School write a poem, sharing what inspires, worries or matters most to them. A poem by Eric Sirkovich, class of 2017:

STRESS
Clammy hands,
And a tap-tap-tapping foot.
Even lying there in bed,
The tests and projects and quizzes,
And quizzes and projects and tests
Cannot be forgotten.
The endless list of deadlines
Seems to never stop growing
And the pressure builds up.
It builds and builds and builds.
But the release valve
Is nearly within reach.
There is a pause;
A pause used to fantasize
About a burden-free life.
And during this pause,
The pressure swiftly, silently
Envelops the dreamer
To ensure that this dreamer,
This naïve, hopeful student
Will never cease working…
Working towards
Some perverted portrayal
Of success.

The effects of smiling are also taught in the A.P. Psychology class that Gili Grunfeld is taking, and it has informed her thoughts on stress. On a winter afternoon, she and several classmates were uncoiling in the Rock Room, making friendship bracelets and sketching in fat coloring books. A Post-it that read “Unplug” was taped to the wall clock. The students were bemoaning how so many of their peers develop “tunnel vision,” in Gili’s words, about schoolwork and extracurricular activities, sacrificing sleep and time with friends.

“They isolate for academics,” she said glumly.

Soon the students had changed topics, and were discussing the ice that had caked the school parking lot that morning and how to balance on it. The subtext, once again, was well-being: How much can friends support each other if both feel overwhelmed?

“Are we more likely to fall or are we more steady if we hold onto each other?” asked Jocelyn Geller, a junior.

“I feel like if you have a friend with you, you feel safer,” said Millie Landis, a sophomore, pulling Jocelyn up and wobbling on the floor with her to demonstrate. “But you could pull each other down.”

The district has increased the number of counselors and social workers, including those working in the district’s elementary schools, and expanded the training they receive in identifying and supporting at-risk students.

Slide Show

CreditGretchen Ertl for The New York Times

Cynthia Tang, whose parents emigrated from Taiwan, has been a counselor at Lexington High for 12 years. Warm and well-liked, she organizes workshops addressing the pressure on Asian students to succeed, borrowing insights from the childhood discord she experienced with her own parents as well as research on biculturalism. Studies show that the less assimilated parents are to American culture, the more stressed the children.

Adding to the pressure, she says, are cultural differences in how parents, raised abroad, and their offspring, raised in the United States, are expected to process setbacks and strife: American educators routinely encourage students to share their feelings; not so in Asia.

“I really see a lot of this being bicultural conflict,” Ms. Tang said. “When you have one side of the family holding one set of values and the other embracing a new set of values, that inherently creates a lot of misunderstanding and a lot of tension.”

Ms. Tang says that the disconnect is compounded by a lack of knowledge about the various routes to success available in the United States. Last year, she was brought in by the vice president of the local Chinese-American Association, Hua Wang, to help plan the college forum, a three-hour event on Father’s Day. Dr. Wang, an engineering professor at Boston University, wanted to shift the focus away from a guide on applying to top colleges.

Despite resistance from the organizers, he and Ms. Tang prevailed. At the forum, she presented a slide show celebrating the academic trajectories of respected Chinese-Americans: the fashion designer Vera Wang went to Sarah Lawrence College; Andrew Cherng, the founder of the fast-food chain Panda Express, went to Baker University in Kansas; the best-selling author Amy Tan, San José State University. Parents were surprised. But, Ms. Tang said, “I think a lot of parents felt like: ‘What do I do with that information?’”

This year, organizers will delve deeper into the differences between the Chinese and American systems, and are planning to add another new element: a panel discussion on combating stress. Dr. Wang said they want to showcase families who have adopted a more “holistic view” of education. Selected parents of graduating seniors will be asked to talk about how they encouraged their children to get enough sleep, comforted them when they came home with B’s and discouraged them from skipping ahead in math to be eligible for higher level classes earlier.

This would not be the only time that Dr. Wang has engaged in this kind of dialogue. Using the Mandarin words “danding,” which means to keep calm and steady, and “ruizhi,” which means wise and farsighted, he has initiated conversations on WeChat, an online chat room popular among Chinese parents. Recently, he told them: “Calmness and wisdom from the parents are the Asian child’s greatest blessings.”

But the message was not well received by everyone. Among the posted responses: “If your child gets a C, how do you get to a point of calm? You think we should be satisfied because at least he didn’t get a D?” And: “But my heart still whispers: Am I not just letting my child lose at the starting line?”

One parent, Melanie Lin, found herself, too, in a heated conversation on WeChat after early-admissions decisions arrived last school year. She urged the other parents to stop bragging on the site about acceptance letters to top-tier schools: “If it’s only those students who are attending the big-name schools that are being congratulated, then the idea being passed on is that only those students are successful, and attending a big-name school is the only way to become the pride of your parents.”

Dr. Lin, who works at a pharmaceutical company, emigrated in the 1990s from Beijing to get a Ph.D. in biochemistry from Arizona State University. She says her rebuttal annoyed even close friends, whose online responses accused her of trying to deny parents and their children their moments in the spotlight.

Recounting the conversation with me brought Dr. Lin to tears. “There is just so much pressure,” she said. For her, the struggles are not theoretical. On the home front, she too can be just as obsessed as her peers, she says.

Her daughter, Emily, would agree. During junior year, she dreaded car rides and family dinners — any time, really, that she was alone with her parents — because conversations routinely veered back to college. Now a senior, Emily has eight A.P. and 13 honors classes under her belt. She is also a violinist, choral singer, competitive swimmer and class vice president.

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“There is just so much pressure,” said Melanie Lin, whose daughter, Emily, applied to 14 colleges. Dr. Lin has spoken out against competition among parents over where their children go to college.CreditGretchen Ertl for The New York Times

For a chunk of her high school career, Emily was one of those who “isolated for academics,” working into the early morning hours on homework and waking up, sometimes before dawn, after only five or so hours of sleep. She skipped birthday parties and lunch to squeeze in more studying. “I was never doing anything for pure fun,” she said. “I put my head down and I was always running somewhere with some purpose.”

But as a member of a youth board for a teen counseling center in town, she realized that her study habits were unhealthy. To get support for herself and others, she helped launch the town’s Sources of Strength chapter. She has assisted in planning student outreach events and spoke up at a town meeting about “the dog-eat-dog” competition that still persists at the high school.

Homework remains heavy, students say, particularly in high-level classes. Class rankings may be gone but students have a pretty good sense of where they stand. And while there has been talk of a later start time to the day so students can get more sleep, the idea is on hold.

In December, when early decisions came in, Emily found out she was deferred to the regular admissions pool by Yale, her top choice. Parents on WeChat were more sensitive this time around, but accepted seniors still bragged on Facebook.

Since then, Emily has been admitted to nine universities; rejected by three, including Yale; and waitllisted by Harvard and the University of Chicago. She is deciding between Columbia and Duke.

Through it all, she has wondered if it’s worth it.

“I lost out on a lot of high school,” she had told me as she waited for college decisions. What she hopes is that students who come after her find some balance before their time at Lexington is up.

Why Kids Shouldn’t Sit Still in Class

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Third- and fourth-graders at Breakthrough Magnet School in Hartford, Conn., participating in a BrainErgizer movement break during the school day. CreditBrainErgizer

Sit still. It’s the mantra of every classroom.

But that is changing as evidence builds that taking brief activity breaks during the day helps children learn and be more attentive in class, and a growing number of programs designed to promote movement are being adopted in schools.

“We need to recognize that children are movement-based,” said Brian Gatens, the superintendent of schools in Emerson, N.J. “In schools, we sometimes are pushing against human nature in asking them to sit still and be quiet all the time.”

“We fall into this trap that if kids are at their desks with their heads down and are silent and writing, we think they are learning,” Mr. Gatens added. “But what we have found is that the active time used to energize your brain makes all those still moments better,” or more productive.

A 2013 report from the Institute of Medicine concluded that children who are more active “show greater attention, have faster cognitive processing speed and perform better on standardized academic tests than children who are less active.” And a study released in January by Lund University in Sweden shows that students, especially boys, who had daily physical education, did better in school.

“Daily physical activity is an opportunity for the average school to become a high-performing school,” said Jesper Fritz, a doctoral student at Lund University and physician at the Skane University Hospital in Malmo who was the study’s lead author.

“Activity helps the brain in so many ways,” said James F. Sallis, a professor of family medicine and public health at the University of California, San Diego, who has done research on the association between activity breaks and classroom behavior. “Activity stimulates more blood vessels in the brain to support more brain cells. And there is evidence that active kids do better on standardized tests and pay attention more in school.”

John Ratey, an associate professor of psychiatry at Harvard Medical School and the author of “Spark: The Revolutionary New Science of Exercise and the Brain,” said: “Movement activates all the brain cells kids are using to learn, it wakes up the brain.”

“Plus,” he added, “it makes kids want to come to school more — it’s fun to do these activities.”

But not all districts are embracing the trend of movement breaks.

“The bottom line is that with only six and a half hours during the day, our priority is academics,” said Tom Hernandez, the director of community relations for the Plainfield School District in Illinois, about 40 miles southwest of Chicago. He said that under state law, the schools provide daily physical education classes and that teachers in the district find ways to give students time during the day to refresh and recharge.

“Kids aren’t meant to sit still all day and take in information,” said Steve Boyle, one of the co-founders of the National Association of Physical Literacy, which aims to bring movement into schools. “Adults aren’t wired that way either.”

Mr. Boyle’s association has introduced a series of three- to five-minute videos called “BrainErgizers” that are being used in schools and Boys and Girls Clubs in 15 states and in Canada, Mexico, Ireland and Australia, he said. A version of the program is available to schools at no charge.

The program is designed so that three to five times a day, teachers can set aside a few minutes for their students to watch a video and follow the cues given by the instructors. In one typical video, the instructors are college students of all shapes and sizes at the University of Connecticut who do a quick warm-up and then lead kids through a mini workout involving movements from several sports: baseball, basketball and a triathlon. That’s followed by a cool-down.

“At the end of the week, kids have gotten an hour or more worth of movement, and it’s all done in the classroom with no special equipment,” Mr. Boyle said. “We’re not looking to replace gym classes, we’re aiming to give kids more minutes of movement per week. And by introducing sports into the videos, giving kids a chance to try sports they may not have ever tried before.”

Julie Goldstein, principal of the Breakthrough Magnet School in Hartford, Conn., said her school has been using BrainErgizers since the spring of 2015.

It’s easy for the teachers to implement, and “easy for the students to follow,” Mrs. Goldstein said. She said the program has “helped them focus and bring up their energy level in the classroom.”

Scott McQuigg, chief executive and a co-founder of GoNoodle, a classroom movement program used in more than 60,000 elementary schools in the United States credits Michelle Obama’s “Let’s Move” initiative with helping to bring movement and the health of children into the public consciousness.

“We call this the Movement movement,” Mr. McQuigg said. “If we invest three to five minutes for our kids to move in the classroom, we are actually going to optimize the next 45 minutes for learning. That small investment in time has such a big yield for teachers.”

GoNoodle, which offers free and paid videos, aims to entertain kids while they are moving, Mr. McQuigg said. GoNoodle and other “brain break” videos can be found on the website for “Let’s Move! Active Schools,” part of Mrs. Obama’s “Let’s Move!” initiative.

“We have purposely not gone after this as an exercise program,” Mr. McQuigg said. “This is a digital generation that expects to be entertained, and we think we can do more good around getting them to move if they are entertained.”

For example, GoNoodle videos have kids running alongside their desks through a virtual obstacle course or following along with dance moves.

Joseph E. Donnelly, professor of medicine and director of the Center for Physical Activity and Weight Management at the University of Kansas Medical Center, said one of the good things about kids being more physically active in classrooms is that everyone is moving at the same time.

“In physical education classes, there is a lot of standing around, a lot of minutes of kids waiting to do an activity, and sometimes kids are only moving for about 15 minutes during a 50-minute class,” said Dr. Donnelly, who co-authored a statement on the effects of physical activity and academic achievement in children that was published last year by the American College of Sports Medicine. “If you do movement in class a few times a day, that can add up to at least an extra 60 minutes more of movement per week.”

Lindsay DiStefano, an associate professor in the department of kinesiology at the University of Connecticut, said the country is due for a major shift toward appreciating the benefits of physical activity in the classroom.

“In 1961, President Kennedy said school kids needed physical activity to thrive, but in the past 20 years, the pendulum has totally shifted the opposite way because schools are feeling the pressure to have students do well on standardized tests,” Ms. DiStefano said. “We are not thinking about the child as an entire person, how physical activity helps them cope with the stresses of school and actually benefits them in the classroom.”

Technology and Teen Sleep Deprivation

Independent School Management

Vol. 16 No. 2 1/24/17

PSN eletter vol15 no2 slee

For the past few years, there has been notable research on how technology (e.g., digital devices, laptops, television) disrupts student sleep patterns—and student success (or not) in school. A recent meta-analysis of 20 studies, Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes, published by JAMA Pediatrics, sheds more light on this “major public-health concern” for students. Attention-stealing devices like televisions, computers, MP3 players, and cell phones are largely to blame.

The study, covering more than 125,000 children, determined there was a “strong and consistent association between bedtime media-device use and inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness.” Almost 90% of teens have at least one device in their bedrooms, and most use those devices in the hour before going to bed. Such children are twice as likely to not sleep enough and 40% report poor sleep quality, compared to children who have no access to those devices at bedtime. Students who had access or used media devices before bedtime were also more than twice as likely to experience excessive sleepiness in school.

According to another study from the National Sleep Foundation (NSF), 95% of those surveyed reported using electronic devices just before sleep. People under the age of 30 are the worst offenders—especially teenagers aged 13 to 18. Texting an hour before sleeping is prevalent, for example. While Baby Boomers on average read, send, or receive five texts in the hour before sleep, Gen-Zers typically text 56 times in that hour. Many students feel a sense of attachment to their phones and other digital devices, and view technology as a lifeline that they can’t live without. Unfortunately, when using such devices disrupts their sleep, this leads to anxiety, depression, and other maladies.

Another problem reported by researches is that exposure late at night to the “blue light” created by computer and other screens causes sleep-phase delay. The lit screens impact (via the retina) the portion of the brain that controls the body’s circadian cycle, sending the message that it’s not time for sleep yet. A study in the Journal of Applied Physiology suggested that performing “exciting” computer activities, like a playing a video game, may suppress melatonin production, the so-called “sleep hormone.”

The NSF recommends that teens get 8.5 to 9.25 hours of sleep every night of the week. However, the average teen gets about 7.5 hours of sleep each night; 62% of 9th–12th graders report inadequate amounts of sleep.

Sleep deprivation is of particular concern to schools. As mentioned above, research shows that a lack of sleep leads to:

  • poorer school performance (lower grades),
  • inattention,
  • negative moods,
  • health risk behaviors (e.g., substance abuse, thoughts of suicide), and
  • increased incidents of adolescent-related car accidents.

Academic leaders must be aware of these problems and educate parents about the impact of sleep deprivation on their children.

The NSF and other sleep experts make the following recommendations for parents.

  • Take technology out of the bedroom. For example, mandate that all cell phones in the house are recharged at night in a room other than the bedroom. Don’t allow a TV, laptop, or other device in a teenager’s bedroom after a certain hour.
  • Reserve the last hour before bed for nighttime rituals like brushing teeth, showering, etc. Pleasure reading is also a wonderful way to unwind as well.
  • Make your child understand that the lack of sleep can cause them to be less creative, forgetful, do poorly on assignments, and fall asleep in the classroom. Sleep deprivation has also shown to cause acne, weight gain, and other health problems.
  • Establish a consistent sleep schedule, every day of the week. Don’t let teenagers stay up late nights or “sleep in” on the weekends.
  • Make sure your child gets enough exercise. An hour of playing tennis, for example, is far better than an hour in bed playing video games.
  • Monitor your child’s schedule. Is he or she overwhelmed with school responsibilities, sports, clubs, perhaps a part-time job at the expense of sleep? Perhaps lessening the number of these activities can rectify the situation.

The dynamics around sleep, student performance, student well-being, and the student’s evening time are complex. Talk with parents to ensure that your students receive an adequate amount of quality sleep—and a better experience at your school.