Month: April 2015

Toward more responsive campus mental health care

SoodEight years ago this month, Seung-Hui Cho, a senior at Virginia Tech, shot and killed 32 people and wounded 17 others on campus before committing suicide.
In the aftermath, Aradhana Bela Sood, senior professor for child mental health policy and professor of psychiatry and pediatrics at Virginia Commonwealth University School of Medicine, was named to an independent panel to recommend policy changes that might prevent future tragedies.
Sood’s new book, The Virginia Tech Massacre: Strategies and Challenges for Improving Mental Health Policy on Campus and Beyond (Oxford University Press, 2015), highlights what can be done to better treat people who are struggling emotionally.
“Overall, the telltale signs of a mind unraveling were observed by students and faculty,” Sood says, “but there was no coherent action from the institution to provide to Seung-Hui much-needed psychiatric attention.”

Your book includes a remarkable chart of Seung-Hui Cho’s behavioral red flags and various people at Virginia Tech who were aware of individual incidents. Yet the connections were never made.
Here we have a situation where there were so many things that were said and done by the young man, as well as picked up by his professors. Some people did sit up and pay attention, but the ones who could have done something with this information did not respond to it.
So these are opportunities for us to look at a system failure. We have to be more aware when these red flags occur and develop a better strategy of addressing them.

Cho had written dark poetry and stories about death and murder. Young people often have a fascination with dark subjects. How do you distinguish art from illness?
That’s a major issue. We certainly don’t want to stifle creativity.
I see these kids even in my practice, where a teenager might come in and be very preoccupied by Goth stuff or they might be really dark in what they are writing about, which concerns parents. Sometimes it’s just an outside veneer and there’s nothing going on that is of concern.
But I think that also needs evaluation and assessment. What does this mean in context of the person’s life?

What is the role of faculty here?
Two of Cho’s English professors were concerned enough that they weren’t really just viewing it as creative expression. They were also concerned about his ancillary behavior.
He accused classmates of being “low-life barbarians” and “despicable human beings.” He took covert photos of other students with his cell phone, among other things, which the professors were picking up correctly. One of the professors had him removed from her class.
But the role of the faculty has always been confused by the fact that educators think their job is limited to education, and that even if they identify problems, they don’t know what the university does in response to it. The information goes into a black hole and they are left wondering, “What do I do? How much should I push this with the student or the behavior?”

How do we rectify that situation?
One of the strongest outcomes of the Virginia Tech massacre has been alerting universities about threat assessment and how they can handle these issues. Virginia Commonwealth University, where I am a professor, did the same thing. I was one of the consultants to the university. We came up with multiple strategies.
One approach was to set up a code of conduct for everyone—students, faculty and staff—of what is expected behavior on a university campus. If there are aberrant behaviors occurring, there should be a mechanism wherein that is picked up and the dean of student affairs is alerted.
That student should be evaluated. It can vary from a threat assessment situation, to counseling, to seeing a psychiatrist, to seeing a substance abuse counselor—something gets done when that behavior is noticed. This way, when faculty bring up an issue, they can be assured it doesn’t go into a black hole where they have no idea what is happening.
They don’t need to know the granular details of what is happening with the student, but they should know and feel comfortable that the dean of students is responding.
We are not making the faculty counselors or therapists or interventionists. We are merely making them aware of the expected behavior. We are setting up the structure so that when these things are identified there is an appropriate intervention plan for them. That takes faculty out of the equation of making a judgment call for which they don’t feel qualified.
Of course, anyone can recognize aberrant and weird behavior. But they may think it is a private matter in which they can’t intervene.

There’s a lot of confusion over FERPA and HIPAA privacy laws.
Clearly, one of the things that is misunderstood when it comes to FERPA and HIPAA rules is that anything that is observed—that is, not written down on paper—can be communicated with peers, or with others in faculty and the administration.
You are not prohibited from doing that. Anytime there is an issue where you are worried about safety, you can immediately communicate that to anyone without danger of reprisal.

Cho’s parents were not notified that he had been hospitalized earlier for making suicidal threats.
I interviewed his folks. They took him for therapy weekly because they were concerned about him. That was one of the reasons, given his problems, he had been doing relatively well to that point.
So, there is no reason to think that, had they been told he was hospitalized or was expressing these behaviors, they wouldn’t have removed him from school. They clearly understood the need for mental health treatment.

A record number of college students are struggling with depression and anxiety. Do we know why?
I can list multiple reasons. Number one is the stigma around mental health. I see this all the time—when you are losing your seat of reason, which is the brain, it is very scary. That’s a tough place to be for young adults. Sadly, people don’t realize that these are eminently treatable conditions.
Second is that young men and women who transition to college are suddenly taken from highly sheltered environments and put into campus life. It’s very different from the highly supervised arena they had in high school.
They have to think for themselves and be responsible for their own well-being. Stress and insomnia are major problems. There is substance abuse, which is rife within college campuses. You have the first precipitation of psychotic illness, which occurs in late adolescence.
The third thing is access. Even when these problems are identified, there are often very few providers to help a person in crisis. These kids are on waiting lists and they can’t get in to see anyone.
If they do get in to see someone, it is often a student counselor who may not be as well trained and may not be very helpful.

After a tragedy like Virginia Tech, the response is often reactive—more guards, more guns—rather than proactive.
Yes, and that doesn’t make any sense. Wouldn’t you want to know what is making these people unhappy? Unhappiness is not something that can be totally obliterated, but you can begin to look at the foundations of where it’s coming from.
You can help those people by asking, “Why is this happening? What could we do to reduce the stress so people don’t end up with these kinds of events?”

Where does that job begin at the university?
It is very important to involve key leadership. They have to empower the people below them. They have to initiate open, progressive policies around mental health. If the president or the provost doesn’t see a value in it, it’s not going to go very far.
Another problem is that many counseling centers are good at things like adjustment problems, but they often will have little experience with severe mental illness, such as schizophrenia and major depression. Counseling centers need to be able to access care for these students.
Statistically, one in five people have some sort of mental health issue that requires intervention. It’s not an uncommon thing. We need to embrace that.
Schools have generally done a very good job at the threat assessment piece, because that is low-hanging fruit. It’s the least aggressive approach when someone is exhibiting weird behavior. But the mental health piece of it still has a lot of room for improvement.
Change starts small, but you have to keep pounding away at it, just like cancer. Mental health is where cancer was 50 years ago. The more we talk openly about it the more we will remove that stigma, but we have to start that conversation.


Confronting a low-income crisis in U.S. schools

ssuitts2The number of U.S. students who come from low-income families has long been the metaphorical elephant in the room when it comes to education funding. But, according to a new report by the Atlanta-based Southern Education Foundation, it’s a problem that can no longer be ignored.
For the first time in at least 50 years, a majority of our public school students fall into that low-income category. For Steve Suitts, vice president of the foundation, the alarming trend is that the increase of low-income students is now occurring in regions where it had not been before.
“While found in large proportions throughout the United States, the numbers of low-income students attending public schools in the South and in the West are extraordinarily high,” Suitts wrote in the report. “Thirteen of the 21 states with a majority of low-income students in 2013 were located in the South, and six of the other 21 states were in the West.

Let’s begin with a definition of low-income. That doesn’t necessarily mean poverty does it?
That’s right. We found that 51 percent of students in 2013 were receiving free and reduced lunch. Now, the reduced lunch part of that means that the folks are eligible up to 185 percent of the poverty level. Those who receive free lunch are about 135 percent of the poverty level.
So, we say that these are students in and near poverty. That’s the most accurate way of expressing who these low-income students are.

The economy has improved since the 2008 recession. Are you surprised your numbers show an increase in low-income students?
The slow improvements in the economy haven’t slowed this growth. So far it doesn’t seem to have had a great deal of impact. That’s probably understandable given the fact that we’ve seen little growth or a decline in growth in lower-income job and wage earnings.

Do you expect it to get better, worse or remain stagnant?
Until we see a major increase in the wages or the other income of families and households in the bottom quartile of the economy, I don’t think we are going to see these numbers change. And there has been no real change in those numbers either from the Department of Labor or from the Census Bureau’s reports so far.
So I think this is a reflection of the economy, and also a reflection of the particular households that are in that lower quartile of the economy. These are increasingly single-parent households. They are increasingly households that are with children of color. And these are households whose incomes are just stagnant, if not declining.
That’s where it compounds the problem, generally speaking, that the students with the greatest need, these low-income students, are the ones that are provided the least resources.

When it comes to school funding, there’s a growing influence from the so-called school choice movement, but your report indicates that school choice doesn’t seem to play a role in closing learning gaps.
It really is a stunning fact in many ways. Most proposals for adopting public funding of private schools argue that it’s going to give low-income students a chance to get a better education by moving them out of “failing public schools” to successful private schools.
The best current data we have in the country—the NAEP report on student achievement—just doesn’t show that private schools do any better job at closing the gap than public schools are doing. It’s a big challenge for all schools.
So simply giving a low-income student a choice to go to private school is not going to improve their performance in relationship to higher-income students.
School choice is not about low-income students performing at higher levels. It’s about someone who wants to reshape and redefine education. School choice proponents operate on the theory that private entities can provide better education than public entities. That’s a philosophical doctrine position, not a point of evidence.

Are there any states or regions where the numbers of low-income students have grown dramatically?
In most cases it’s pretty much a steady march. What surprises me from our analysis of our earlier report is how widespread this trend is in all parts of every state.
Clearly, low-income students are more concentrated in the central cities. But if you look at our data from 2011, you also see that 40 percent of the students in the suburbs are low-income and 52 percent in the smaller towns.
What I think is pretty evident is that this whole problem within states cannot be simply dismissed as a big city problem or an isolated rural problem. Those are places where it often is the most striking. But when you have two out of five of your students in suburban schools who are low-income, you have a problem which is everybody’s problem.
In the late ’80s and early ’90s, one could have said that the problem was something that only parts of different states—and the school districts in those areas—would have to deal with. But if you look at the numbers in Georgia, for example, we now have two-thirds of the schools across the state with a majority of low-income students.
That pretty well means that it’s an issue that every part of the education community and every community in a state is going to have to address if it wants to be successful.

What does this mean for our economy and how we compete globally?
We can no longer look at low-income students as being a part of our student body whose performance is unfortunate for them, but is also not a major factor in where this nation will go in coming years and in future generations.
When a majority of your students are low income, and when low-income students are performing at the lower levels by almost all indicators, then what you have is a situation where a majority of the students will not perform at higher levels until low-income students become a great focus of education.
The nation is simply not going to have a well-educated citizenry for performing the kind of work that a high tech, high education economy requires. And we’re not going to have the quality of life that we want, that we want our children to have. And we’re not going to have an improvement in the standards of living either.
Unless Americans are willing to compete on the basis of cheap labor— uneducated cheap labor—then the United States has to figure out how low-income students can perform at higher levels for the national interest.

Are you optimistic about how candidates might address this in the 2016 election?
Education gets a lot of lip service but not a lot of focused attention in the electoral process at the federal and the state levels. The kind of positions that are taken and the kind of questions that are asked of candidates about education simply are uninformative in terms of the problems that schools face.
Our political system simply hasn’t yet focused on how important this issue is for the future of the country. Until it does, I don’t know that we’re going to get the kind of policies that we need.

Do you see a way that this trend can reverse?
There are two ways we can deal with this situation if we are willing to—and they probably need to be done in combination.
One is we can figure out ways in which parents can earn more money and provide their kids the kind of educational experiences in and out of school that we know that higher-income families provide for their children. Those kids are doing very well in public schools in the United States—those upper-middle-class kids.
We need to find ways to improve the income of low-income families so that they can begin to provide those kind of resources to their children’s education.
And we can try to have schools and communities provide low-income kids the kind of educational experiences that upper- middle-class kids receive. We know the advantages of early childhood education. We know that exposure to books and language—and to the kind of early learning experiences that parents and communities can provide—will help low-income kids not be so far behind.
And I think we can find ways in which to provide that to low-income kids—if we have the policies and national commitment to do so.

Teaching as it should be

OTrodriguezVanessa Rodriguez knew there was more to teaching than producing test-ready students. Feeling constricted by a system that evaluated teachers not on personal performance but on student outcomes, she had enough. In pursuing her doctoral degree, she wanted to know exactly what teaching is and how it relates to learning. The existing research, she found, was lacking. In The Teaching Brain: An Evolutionary Trait at the Heart of Education (The New Press, 2014), Rodriguez and co-author Michelle Fitzpatrick go to the intersection of education, neuroscience and daily experience to explore how the mind of a teacher works, and more important, how it can be made more effective. “No one has ever truly bothered to understand specifically how the teaching process and its corollary, the teaching brain, are separate and distinct from the learning process and the learning brain,” she says. “It’s time for that to change.”

You say commonly accepted definitions of teaching don’t match the actual practice of teaching.
Right. We’ve never actually studied it this way. I started the doctoral program thinking I’d learn the language of what teaching is. Instead, what I found is that we really haven’t explored teaching in the way we have learning.
We understand learning as a practice of cognitive development that we’re all born with. But we don’t actually understand teaching in that way. The literature on teaching is actually grounded in an understanding of learning. That means we’re actually considering teaching a tool for learning. On the surface, that seems to make sense—the whole purpose of teaching is to help someone learn. But where it falls short is that the tool that we’re using is a human being.
Unlike learning, teaching absolutely must be an interaction. When you study teaching like an interaction, it suddenly shifts everything we understand about it and have done research on.

We have all kinds of technology to help kids learn on their own, so why do we even need teachers?
Right now we are trying to replace the human model of teaching with computers. It’s not the first time that this has been attempted. B.F. Skinner came up with a teaching machine in the 1950s and argued that it helped students learn more efficiently. It used reward and punishment to influence behaviors and learning. There are many things that machines can do more efficiently than humans, but no machine to date is able understand the complexity of the mind. It is forever changing, and it’s different for every individual. Humans are best at understanding other humans. But the way that we’ve designed the school system is not to take that into account. If we shift how we define teaching, then we find there is a completely different way of understanding that process of development. We can design ways to better prepare teachers in a classroom to help learners—who are also human, That’s different from being effective at helping children score high on exams that we don’t even know matter in the end.

Give us an overview of what the teaching brain is.
It’s a way to understand other people and to interact more effectively in relationships. The teaching brain is something we all have, but it’s not something we’re born with, which is fascinating. We’re not born with the ability to understand that other people have different minds than our own. We are born believing that everyone knows exactly what we know.
Somewhere around the age of 1 or 2 we realize, “I think one thing, but the people around me have different knowledge bases.” That’s where we’re then able to begin teaching. It starts simply and then develops various other cognitive skills. But there is a point at which that natural development stops. That’s the shift into professional intentional teaching.

Much of your focus is on five “awarenesses”—awareness of context, of the learner, of yourself as teacher, interaction, and of teaching practice.
You may be doing some of these things, but if you aren’t aware you are doing them, you can’t really affect how you are changing. For example, an awareness of my learner means I understand that the learner has a cultural background that affects the way they learn. They have a certain capacity for memory. They have certain emotions and their own cognition, how they process information. All of that is how I understand that learner.
But if I’m not aware that I’m forming this theory about who my learner is, then I’m not going to recognize it as a theory. Instead, I’m going to teach as if that is who that child is. But we never know who a person is. We only have our perspective of who that person is. If I form the incorrect theory, then I’m continually teaching to a misguided notion of who my learner is.
That’s where you start to get frustrated and feel like the child is not trying. But then you realize, “I must have formed an incorrect theory of who this learner is. Let me reevaluate that theory and let me shift it until I find the one that works.”
To be able to do that, you need to have an awareness that you’ve even formed a theory of that learner. And you also need to have an awareness of yourself. Because in a sense, it’s your fault that you formed the theory in the first place. To illustrate, I always had trouble with shy students. One of my “ah-ha” moments was when a student told me, “I’m not shy. I’m actually very outgoing.” I thought, “Wow. In my definition she’s shy. But in her view of herself, she’s not.”

You studied a group of master teachers in your research, some of whom experienced revelations about themselves in the process. Can you give an example?
We did a specific type of interview. For instance, we asked them to talk about how important culture is to their process of teaching. Oftentimes they’d say, “It’s extremely important to understand where my children come from, what families they have.”
I’d remind them that the interview was about themselves, not about their students. I was trying to find out more about what was happening in the mind of teachers when they are teaching.
And they’d say, “My culture? That doesn’t matter.”
Later, when the study was over I’d ask them if they really thought their culture didn’t matter. They’d say, “It does. I just never had anyone ask me about myself when I’ve been asked to talk about teaching. They want me to talk about my learners, not about myself.”
That’s an interesting phenomenon that doesn’t happen in other professions. When you talk about how you do your work, you talk about yourself. But in teaching, we really have been trained that we don’t exist. You don’t bring who you are into the classroom. You don’t bring your politics or your culture into the classroom. You are just there to serve the learners.
We need to recognize that both the teacher and the student have perspective. And it’s the teacher’s responsibility to be thoughtful about how their perspective affects everything that occurs in the classroom.

What practical applications can an administrator draw from this? Does it impact the hiring process?
Yes. At the university level, we need to help prepare teachers to understand just as much about teaching development as they do learning development. At the school level, principals can begin to evaluate teachers on a scale that really is about teaching and not just about learning. A school administrator could work with teachers in breaking down where they are and where they need to be in these areas of awareness. Then a teacher would know what areas they need to work on.

Not to sound flippant, but can you teach an old dog new tricks? Many teachers are just concerned with keeping their jobs.
That’s a tough one. I had this conversation not long ago. Someone asked, “What do you do with teachers who just want to keep their job and wants to bring home their paycheck and is terrified to change?”
I said, “What’s unfortunate is that we’re talking about several decades of teachers being blamed for absolutely everything that’s wrong in education. That’s turned into real consequences where their paychecks are tied to measures that every researcher and most of the public understands are not a measure of teaching, but of the learner answering questions right.”
Inevitably, what we’ve done is threatened teachers by threatening their families, because once you tie it to a paycheck that means you’re tying it to whether I can feed my children at home, and whether I can keep paying my mortgage, and whether my children have shelter.
I think anyone would argue that while teachers are supposed to care about the learners in the classroom, their first priority is their children over your children.
So I am honestly not sure how to change that. I think that is a level of trust that just has been broken. Rebuilding trust takes a long time, and it has to be intentional.