The new Netflix series, 13 Reasons Why, based on a novel about teen suicide, has raised awareness of teen mental health to the level of national discussion. Everyday pressures and mental health concerns are a challenge for teens; but how can parents and adults help? The locally developed TRAILS Program (Transforming Research into Action to Improve the Lives of Students) is designed to bring effective mental health practices to youth where they spend much of their time— in schools.
Training professionals to intervene
Elizabeth Koschmann, PhD, is Assistant Research Scientist with the University of Michigan Department of Psychiatry and one of the founders of the TRAILS program, described how in 2013 staff at an Ann Arbor high school approached the University of Michigan Depression Center as they were seeing a number of students with mental health concerns, such as symptoms of depression and anxiety. Koschmann met with counselors, school psychologists, social workers, and others to gather information.
Koschmann then wrote a pilot grant proposal to the Michigan Institute for Clinical and Health Research to be implemented at Skyline and Pioneer High Schools. “Skyline, Pioneer, Pathways, and Community have all been involved in the past,” said Koschmann, “and are now serving their students independently. We have now shifted our training for the time being to coach development in order to bring the program to scale statewide.”
TRAILS consists of a one-day seminar training school professionals in evidence-based mental health practices followed by 3-4 months of coaching available at the school. The focus of the training is on cognitive behavior therapy (CBT) and mindfulness. Koschmann said it is important to consider that the part of the brain that helps control impulsivity is developing during the adolescent years. This makes CBT and mindfulness strategies particularly helpful for young people to cultivate skills that delay gratification, tighten self-awareness, and become more attuned to why they are making certain decisions.
TRAILS is making an impact
According to Koschmann, students are impacted in a number of direct ways such as participating in CBT/Mindfulness groups, gaining access to evidence-based practices, completing assessment measures in conjunction with their skills, group participation that documents improvement/deterioration of symptoms, receiving assistance with referrals/recommendations for community-based treatment.
Students are also impacted indirectly, according to Koschmann, as their school professionals are better prepared to provide them with evidence-based services, their school culture is shifted to be more aware of mental illnesses and associated symptoms, and their peers are receiving earlier/more effective treatment.
Koschmann explains that the feedback received from the program has been “overwhelmingly enthusiastic.”
“Professionals tell us that they are overwhelmed by student needs and students are presenting with very serious mental health concerns: depression, anxiety, exposure to trauma, homelessness, suicidal thoughts, self-harm, sexual assault, all kinds of difficulties,” said Koschmann.
Red flags for parents
Parents and families can be involved as well. “I don’t think parents have to be frightened if their kids are moody or irritable, or go through times of withdrawal, or want to spend time in their rooms, that is actually normal,” said Koschmann. “But when it interferes with daily functioning, or goals that the kid has, or activities and responsibilities important to long-term goals, that is cause for concern. If kids stop being able to attend class, stop being able to socialize, struggle with basic self-care and hygiene, stop with physical activity or exercise—those are some of the bigger red flags.”
As a whole, parents, families, teachers, counselors, and school staff need to work together to provide a nurturing and supportive environment for each and every kid and TRAILS offers a unique opportunity for that kind of collaboration.