Courtney Howell is a senior at the Martha’s Vineyard Regional High School. As a freshman she loaded up her schedule with a full plate of high-level academic courses. She opted to take more difficult classes even in subjects she had little interest in because that was what colleges wanted, she thought. Her junior year, the one she remembers as the hardest, was difficult to navigate.
“School last year for me was a lot less enjoyable,” she said. “I was in classes I didn’t like to get into a good school.”
This year she did not continue with the subjects that caused her the most stress even though they may have looked good on a college application. She said it made a world of difference.
But not everyone figures out how to manage their stress like Courtney did. Educators and counselors around the Island are reporting that anxiety in many forms is on the rise these days.
John Fiorito, freshman guidance counselor at the regional high school, works with students beginning in eighth grade and continuing throughout freshman year. He said he met with one student in eighth grade who had prepared a four-year portfolio mapping out her intended route to Stanford. Students elect to take the most difficult classes freshman year to put them on track for as many advanced placement classes as possible in later years. The school recently countered this trend by limiting the number of AP classes a senior can take to three.
“I tell them, Boston College is not going to care if you took biology your freshman year,” Mr. Fiorito said. But when there is a climate of competition, students nearly always err on the side of over preparation.
College stress, while prevalent, is not the only issue though. Amy Lilavois, the social and emotional needs counselor at the regional high school, said she has noticed an upward trend in many areas, paralleling a national trend.
“The biggest issue I deal with right now, at least in the last couple years, is a huge spike in anxiety and depression which then leads to suicidal ideation and or self injury,” said Ms. Lilavois, who has more than 20 years of experience working with Island youth. At a recent all-Island school committee meeting, she reported on the school’s protocol for students in crisis.
When Ms. Lilavois thinks a student might be in danger of self harm or suicide, she turns to the clinical crisis response team at Emergency Services, a program provided by Martha’s Vineyard Community Services. Among their services, the clinicians provide emergency psychiatric evaluations and suicide risk assessments. The group completes evaluations at the appropriate loca tion including the school, hospital and homes.
In the 2014-2015 school year, 68 high school-aged students on the Vineyard were evaluated by Emergency Services. Of those, 33 evaluations resulted in placements at inpatient psychiatric or substance abuse facilities. In the first three months of the current school year, Emergency Services has done 12 evaluations of high school students that led to three off-Island placements. The students are not part of one particular group, Ms. Lilavois said.
“It’s males, it’s females, it’s top kids, it’s kids in the alternative program, vocational program, it’s across the board, it is not discriminating at all,” she said.
Recently Community Services brought in Lynn Lyons, an expert on anxiety among students, to hold workshops for kids and parents. Ms. Lyons spent four days on the Island completing workshops at the high school and a full morning workshop for middle school students. In a recent interview, she said there is a huge connection between anxiety and depression. She said the inability to manage emotions and what’s going on in the world around them can exacerbate a child’s anxiety and depression.
“So when a kid is self harming or is feeling suicidal or is feeling really unable to cope, the way that I address that and look at that, apart from diagnostic categories, is what does this kid not know how to do yet and how do we teach him,” she said. “When we see kids falling apart, that’s a sign to adults that we’ve got to help these kids develop the internal resources to manage what life throws at them.”
Ms. Lyons said the largest growing group of antidepressant users is 17 to 24-year-olds, adding that the chemical make-up of people’s brains has not changed over the years, but that there is an increased awareness and a growing culture of fear, which can create its own problems.
“In an effort to de-stigmatize mental health issues, kids and parents are ramping up the language and losing track of normal,” she said. She partially attributes the growing trend of worry to a cultural shift and a corresponding increase in parental worry. Feeling sad does not equal depression, being nervous does not equal anxiety, moodiness is not necessarily a bipolar disorder, and when kids disagree with their friends it is not always bullying, she said.
This can also lead to kids who actually need specialized care getting lost in the shuffle among kids who need to develop everyday life skills. Ms. Lyons classifies the stress that comes with applying to college as a normal life difficulty.
But anxiety and depression in all its forms does not begin with high school. Molly Cabral has been working in guidance for over 20 years on the Island and currently works with younger children at West Tisbury school.
“I see a lot more anxious kids than I did years ago, that’s my impression,” she said. “Anxiety is this free roaming thing and it gloms onto what your weaknesses are.”
For young children, Mrs. Cabral said anxiety is about “what-ifs.” What if mom doesn’t pick me up? What if my friend’s house has different rules than mine? What if I go off-Island and can’t get back on?
Graham Houghton also works as a guidance counselor at the West Tisbury School, primarily with the older students. “In the last three to four years we’re either seeing more of [anxiety], or we’re talking about it a lot more,” he said. Mr. Houghton echoed the feelings of Ms. Lyons and stressed the importance of building the emotional skills children need to deal with the uncertainties of life.
“Instead of just Band-Aiding and supporting, building skills is important,” he said. “A healthy amount of anxiety is important. We want kids to have test anxiety and be nervous for a game. It’s about the duration and intensity of the worry.”
When issues becomes serious, the schools are quick to step in, helping with the transition to a facility and also returning to school.
“One of the greatest stressors the kids have and the parents have is what happens to the school work when they’re gone,” Ms. Lilavois said. “Clearly for us the main focus should be their mental health and substance recovery, but clearly they are in high school and the academics are important.”
High school guidance director Mike McCarthy said the tutorial costs in the high school budget are directly related to the number of students placed in facilities.
“We work directly with our teachers here to provide educational opportunities to continue there,” he said. “Obviously that’s secondary to youths who are presenting problems.”
Upon the student’s return, the guidance department sits down with the child, parents, a nurse and therapist to work on reentry.
“When you’re dealing with students who could be depressed or have high anxiety, [the high school] can become part of the problem very quickly . . . . versus being part of the solution,” Mr. McCarthy said.
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