Education in Ontario: Education Resources and the Mental Health of Children and Youth

Prepared by Judith A. Coulman
CMHA, Ontario Child and Youth Reference Group
March 2003

Statement of concern: The changes to education, both in funding and in policy, are not meeting the needs of children and youth in all aspects of mental health and mental illness.

In education, the areas having the greatest impact on services and support for students are special education, guidance services, and psychological services and resources. Because of escalating demands and stress in the lives of young people, there is increasing need for the support system previously offered by these services.

There is also an upsurge in mental illness and related stress disorders, manifested among the young by increasing rates of anxiety, phobias, and obsessive-compulsive disorder. More and more, younger students in elementary school (kindergarten to Grade 6) are being diagnosed with mental illness. Suicide, depression, eating disorders (such as bulimia and anorexia), drug and alcohol dependence, and self-harm (deliberately injuring the body in ways that are not life-threatening) are becoming the epidemics of adolescence (Stigma and Teens, 2002).

The immediate crisis for young people has a double cause: the decrease of resources within our communities and the dramatically increasing needs of our young citizens.

Need

Students are showing, by their behaviour and emotional anxiety, that they are affected by many causes of stress today. The following sets of facts deal with only some of the challenges facing children and youth in our education system.

• 'Some researchers believe that modern life is subjecting kids to new forms of pressure and doing it when they are younger. Chronic or severe stress in childhood may make a person more prone to stress-related problems later in life, but it isn't a guaranteed sentence to poor health. Something can be done' (McIlroy, 2002).

• In 2001, 25% of Grade 10 students in Ontario failed the pilot literacy test. Without a passing mark on the literacy test, students will not receive their graduation diploma. Increasingly, people need a graduation diploma to apply for any employment. Secondary school teachers are seeing more symptoms of anxiety within the student population now (OSSTF, 2001).

Anxiety disorders, depression and suicide are strongly associated with low self-esteem. Low self-esteem, in turn, is linked to disturbed body image and eating disorders (Yellowlees, 1997).

• One in four teenaged girls have symptoms of an eating disorder. Of girls 12 to 18 years old, 27% have disordered eating behaviours (Jones, Lawson, Daneman, and colleagues, 2000).

• Young boys and adolescent males are also showing symptoms of eating disorders, usually in a desire to bulk up their physique to meet the media model of the desired body type and because of peer pressure (Epling & David, 1996; Harrison, 2000).

• This problem with disturbed body image is starting younger and younger, in children as young as 9 to 12 years of age. Recently (1999), the Faculty of Medicine at the University of Ottawa began offering body-image programs in elementary schools (Grades 4 to 6).

• A person experiencing an eating disorder can also often experience obsessive-compulsive disorder, substance abuse, and self-injury (Thornton & Russell, 1997; Henning, 1998).

Both eating disorders and self-injury are behaviour patterns that can start in early adolescence and continue throughout a lifetime. In elementary school, special education resource teachers educated in mental health issues are often the first line of defence. In secondary school, guidance counsellors have often served this function.

Self-injury is the act of attempting to alter a mood state by inflicting physical harm serious enough to cause tissue damage to one's body. Although underlying causes must be dealt with by mental-health professionals, school personnel are often the first to identify the concern. The need for qualified, sensitive counselling personnel is critical.

• Self-mutilation and self-hatred mark the lives of many Canadian girls. There is a need for gender-specific programming in schools aimed at girls and young women to help them develop positive self-awareness (Status of Women, Canada, 1998).

• In the USA, 1% of the population has been found to use self-injury to deal with overwhelming feelings and emotional tensions (Martinson, 2001).

• Self-injury occurs much more often among those without a social support system (Favazza, 1996).

Depression in young people often occurs along with other mental disorders, most commonly involving anxiety, disruptive behaviour, or substance abuse (Pataki & Carlson, 1995; Kandel et al., 1997).

• Research in the United States found that 2.5% of children and 8.3% of adolescents suffer from depression (NIMH, 2000). Early-onset depression often persists, recurs, and continues into adulthood (Pataki & Carlson, 1995).

Depressed youth, especially females, have a higher risk of suicide. Among youths who have committed suicide, most (60% to 80%, according to research done by the Scout Association of Australia, 1996) tried to seek help in the preceding month.

• In 1997, suicide was the third-leading cause of death in 10-to-24-year-olds (NIMH, 2000).

• The rate of suicide for adolescents (teens) has increased dramatically over the past 30 years in Canada. Recent studies show that Canada has a greater percentage of youth suicide than other countries of similar socioeconomic, population and political structure (World Health Organization, 2001).

• The overall rate of suicide in the very young more than doubled between 1980 and 1993 – and the younger the children, the more dramatic the increase (Murray, 1994).

• Poor coping skills of already low-functioning young people can result in a sense of hopelessness and helplessness. Research shows that the incidence of such feelings tends to increase after the onset of puberty and peaks at young adulthood (Scout Association of Australia, 1996). Poor coping skills in young individuals who are already low-functioning can intensify such feelings.

• School failure has been found to be a risk factor of suicide (Son & Kirchner, 2000).

In North America, the greatest threat to the lives of children and adolescents is not disease, starvation, or abandonment, but the terrible reality of violence (Surgeon General, 2000b).

• Although any child may be subjected to random acts of hostility, children who lack a strong connection with the adults in their lives will be the victims of chronic bullying.

• Many violent adults begin their violent behaviour during adolescence (Surgeon General, 2000a).

• Youth who have a history of violent and aggressive acts are likely to repeat those behaviours, unless provided with support and counselling (Surgeon General, 2000a).

• Programs are needed to address both early-onset and late-onset violence. Prevention programs aimed solely toward younger children with problem behaviours miss over half of those who eventually will become serious violent offenders (Surgeon General, 2000a).

• There are 171 self-contained behaviour classes in elementary schools in Ontario. Almost no behaviour programs exist at the kindergarten level, and very few at the secondary level. Support and the need for it are increasing for younger children in schools. As many as 65 young children in kindergarten are receiving support for behavioural difficulties (Canadian CCBD, 2001).

It is critical for young people to have an emotionally significant person, such as a parent, teacher, friend, or youth worker, with whom they can relate (Scout Association of Australia, 1996). Increasingly, the availability of a teacher, support personnel, guidance counsellor, or special education teacher is limited: they are simply not there when the youth needs the support.

The resources available to all children and youth need a major review. We must ensure that their emotional and mental health challenges are recognized and that their mental health will have those support services that are undeniably required. Funding will have to be sufficient so that these specialized services in special education, guidance and therapy are available and accessible to all students. The lives of our children depend on immediate action.

RESOURCES

Funding resources

When the provincial funding formula for education was introduced in 1997, its stated goal was to address inequities in the public education system and make funding fair across the province. But because the formula was accompanied by massive cuts to education, the opposite has happened.

Boards around the province [of Ontario] report that the biggest problem with the funding model is that it's quite simply out of date-half a decade out of date, to be exact. The government has addressed system-wide equity by funding all [school]boards inadequately. All funding benchmarks in the funding formula are based on 1997 costs (L. Sandals, personal communication, April 2002).

Parents are being asked to supplement what is missing in the system-to pay privately for special education, for example. If we are to preserve the most important tenet of public education-that every child deserves an equal chance to succeed-growing inequities in the system must be addressed.

Some argue that money is not the solution. However, by tracking the effects of policy and funding changes, we can see where additions of funding have had a positive effect. In areas like textbooks and computers, when funding was added, there were improvements. When no funding is dedicated for specific resource support (such as guidance support staff and psychologists), however, specialist teachers and support services are being cut-as is now happening every year.

Schoolboards are spending millions of dollars' worth of employee hours in the application process for the Intensive Support Amount (ISA). This results in reduced service to those whom the ISA was meant to protect: the students who have been identified for special support within the special education services.

Some schoolboards are reluctant to put accurate needs assessments in place, for fear that they will be forced to provide a service they can't afford. But under the Education Act, every student with special needs is guaranteed an educational program to meet these needs.

The funding formula is not responsive to increases in salaries, to increases in the cost of living (and energy), nor to increased numbers of students with disabilities. It assumes growth in student enrolment, while student enrolment is static or declining in many boards.

The formula also underestimates the financial support needed for clerical support, adult education, textbooks, students of English as a second language, and students at risk: Students experiencing any mental illness, from moderate anxiety to depression or schizophrenia, are grouped into one category, 'students at risk.' Also in this group are students with moderate and severe learning disabilities, and children with physical disabilities.

The public education system continues to undergo cuts to funding, which have already produced not only fewer teachers but also fewer educational assistants, the resource staff who help with special needs students. Professional student-services personnel have also been reduced: social workers, behavioural counsellors, psychologists, attendance counsellors, and others who assist with kids with special needs, directly in the classrooms.

The $13.85 billion in elementary and secondary funding announced in the 2001 Ontario budget represents a cut, in real per-student terms, of $325 million this school year compared with last year. In total, education funding has dropped by $2.4 billion on a real per-student basis over the last five years. Some schoolboards and parent-school councils estimate that this is a cut of more than $1,000 per student in student-focused funding (OSSTF, 2002).

'We feel as a group we no longer have the funds to run our programs. All schoolboards are suffering-English, French, public, Catholic, east, west, north, south' (Michael Sherre, personal communication, March 2002).

The funding process for education in Ontario must be revised.

• An assessment of specialized funding requirements based on practical input and data from those involved with the system-teachers, resource support workers, students and parents-should be ensured.

• The capacity and sustainability of the public education system in Ontario needs immediate review.

• An educational system in Ontario must be developed to provide those guaranteed rights of the children of Ontario for an education for each according to his/her needs.

Education system resources

Classroom teachers alone cannot provide the individualized support that many students require. These are some of the services that provide those supports within our education system.

Special education

The needs of special education students vary widely. Many students have mild or moderate needs that require some extra support. Some students have severe needs that require intensive supports every day.

Students who are experiencing mental health issues from moderate to severe usually will need access to these services. Students who, because of their actions or conduct, need additional behaviour-oriented programming support are served within special education.

• The funding allocated to schoolboards through the Special Education Grant is protected; the money may be used only for special education. In 2001-2, the grant will be over $1.37 billion.

• Ontario's Ministry of Education (MoE, 2001a) developed a three-year plan to improve the quality of special education services, Special Education: A Guide for Educators.

• The Minister's Advisory Council on Special Education (appointed by Order-in-Council) submits an annual report including a review of the previous year's plan and recommendations about future priorities and planning. Reports from the special education sector show an increasing discrepancy between policy/planning and actual school experience. Of the 37,000 students waiting for special education services:
  • 58% are waiting for assessment by the Identification Placement Review Committee (IPRC)
  • 28% are waiting for their IPRC reports
  • 14% are waiting for placement in an appropriate special-education program.

• To be legally entitled to special education services in Ontario, a student must go through the IPRC process and be assessed by a professional (psychologist, psychometrist or psychiatrist). There has been a 41% decline in schools reporting regular access to a board psychologist; in 2002, 9% of schools reported that they have none. Half of the boards with no access to a board psychologist are in northern Ontario.

• Some families are now paying $1,000 or more to have assessments done privately. The guaranteed provision by a public education system of equality and access for all is in fact converting into a two-tiered system.

• Teachers in special education are reporting a frustration with the required reporting and the complexity of the IPRC identification process. Many schoolboards are finding that the cost of special education is increasing because of the time that teachers spend on this part of the process. Some families are waiting as long as three years to receive identification services (CBC, 2002).

• A number of schools express concern that congregated special education classes and self-contained behaviour classes are being cut. These students are then integrated into regular classes accompanied by educational assistants, who usually work less than full time and often are not trained to work specifically with special needs students. In fact, with the increasing cuts by schoolboards as they try to balance their budgets, additional cuts come to the special education, behaviour education and guidance education areas; thus, students with special needs are placed into regular classrooms with no additional resource staffing at all (reported by several sources: CBC radio, the Toronto Star, The Globe and Mail, and Maclean's, summer 2002).

• Many parents are reporting concern over loss of staff, allocated time and programs.

• The Individual Education Plan (IEP) is a critical and required programming tool showing what accommodations will be made to meet the specific needs of each student. In fact some schoolboards are not identifying students as often, a decision based on the cost of providing programming for identified students rather than on need. Schoolboards are spending millions of dollars' worth of employee hours in the funding application process, and in the more stringent qualifying process for Intensive Support Amount (ISA) funding.

Guidance education

• The funding formula for staffing assigned to guidance education and services is not protected: Secondary schools have 2.6 teachers per 1,000 students.

• Elementary schools often have 0.1 guidance teacher to meet the needs of 5,000 students. Many schoolboards have decided to eliminate elementary guidance positions entirely because the level of staffing that could be provided (by the formula) was so low as to be seen to be of no value at all (Canadian CCBD, 2001).

• Choices Into Action is an all-inclusive development program for all students in Ontario schools from Grades 1 to 12 (1999). This program covers students' personal, interpersonal and career development. This was mandated as policy to be carried out at the same time as the funding formula for public education was applied. Because of the loss of staff and resources in both elementary and secondary schools, the program has never been fully implemented. Thus, valuable age-appropriate curriculum has not been put into use for self-awareness and mental health issues for all of the children and youth population (Hedges, 2002).

• Guidance counsellors have traditionally been the people most likely to provide initial counselling for students experiencing anxiety disorders, eating disorders, and other stress-related concerns, particularly in secondary school. These guidance counsellors have also helped to link students and their families to resources within the community. They have also facilitated mental health promotion in secondary schools, providing speakers and facilitating workshops with trained professionals from the community – for example, suicide intervention workshops, eating disorder awareness workshops, and Breaking the Mask (Gordon, 2001), a video used in a community education forum to develop an awareness of the stigma associated with mental illness in adolescents.

• The presence of an important person in a young person's life-an emotionally significant person to whom the youth can relate (maybe a parent, a teacher, a close friend or a youth worker)-is critical. The person becomes the lifeline to the teenager. The presence of a good supportive network is particularly important to those youths who have little or no family support (Scout Association of Australia, 1996).

Staffing must more realistically represent the present climate and needs of children and youth in both secondary and elementary schools.

• Careful consideration must be given to requests and proposals for effective implementation of policy and programming from those who are working with the students.

• Communication processes for policy development and implementation must be continued and enhanced so that policy decisions will better reflect the needs of children, youth and families.

Community support resources

Service providers for children and youth must improve the system of support within our communities (including the entire province and within Canada). In times of increasing disparity of income, decreased funding to the social support network, and increasing needs of children, youth and their families, all services need to enhance their systems of support so that the individual does not get 'lost' in the process.

This cannot be done with present funding and staffing. New and creative ideas for connecting services require germination, careful application, and clear review of effectiveness from all of the stakeholders. Practical approaches include developing an inventory of those processes and models of service that are working, and increased sharing of ideas and processes among stakeholders.

• Better Beginnings, Better Futures was implemented by the Ministry of Community and Social Services in 1991. This program was designed to help families with preschool children improve their lives by tailoring social programs offered in their neighbourhoods. The review process has been expanded to include families, older children, and services within the community (Peters, 2003).

• The National Children's Agenda addresses the need for a national, systemic approach for services to families with young children (Friendly, 2002).

• Recently, $2.2 billion went into a five-year federal-provincial initiative on early childhood development (Ferguson, 2002).

• In Ontario, the Early Years program is attempting to coordinate resources for children, from birth to six years of age, and their families.

• High-quality childcare has proven to be essential for the day-to-day monitoring of children who may be at risk of developmental delays, emotional difficulties, or child abuse (Ontario Coalition for Better Child Care, 2001).

• The stated mandate of the Ministry of Education for special education includes:
  • setting standards for individual education plans and schoolboards' overall special education programs, and monitoring individual education plans
  • developing program standards that will set province-wide criteria for special education programs
  • simplifying parent access to coordinated services such as social, health, speech and language, and psychological services for children with special needs

• There is increasing need for a community-based model for integration of services.

• Of students expelled from Ontario schools, 50% had behavioural problems among their exceptionalities. Often these students have problems in daily school life, resulting in expulsion. Thus, other community agencies become involved (such as the police, the court system, family and children's services, and community mental-health services).

• Service concerns listed in an Ontario study of behavioural issues and education (OCCB, 2001) include a scarcity of mental health services and long waiting lists for them.

• Access to the services of psychiatric and social workers has decreased steadily in the last 4 years (People for Education, 2001a). In 2000-1:
  • 9% of schools had no access to a schoolboard-appointed psychiatrist
  • 20% of schools had no access to board social workers
  • 40% of schools had no access to board youth workers

• Resilience is greater for youth who have positive experiences under the care of Children's Aid Societies. Young people in care are far more likely to succeed when they feel that someone cares deeply for them, whether that person is a social worker, foster parent, teacher or school counsellor (Brubacher, 2002).

With the continuing cutbacks to resources in our communities, children with emotional and behavioural problems have become very vulnerable.

In our communities (and in our province) we need an integrated, accessible, supportive model of service in order to provide a continuous, seamless focus on the individual. We need to develop greater capacities for early intervention and prevention, and thus cut considerably the costs associated with a rehabilitation-and-treatment model of care.

There is a crisis in education. The need of our children and youth for mental health resources far exceeds the resources and services available. The future strength and health of our society depends on our resolution to solve this problem immediately.

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