Running head: MENTAL HEALTH IN EARLY COLLEGE HIGH SCHOOLS 1

Student’s Mental health in Early College High School

AP Research

Word Count: 4969

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Introduction

Every 1 in 5 teenagers suffers from at least one mental health disorder (Polaris Teen

Center, 2018). That means at least 6 students in a regular classroom could be struggling with

their mental health and this number is significantly large school. Additionally, if a student has a

severe mental illness it can come to affect others. Mental health can affect students’ academic

performance, behavior, and even put other students in danger (Center, 2015). Because of all the

negative, there is clear evidence that there is an urgent need for a change. There is a gap in the

way school administration deals with mental health. With my research, I want to provide

information on resources that could potentially help any early college high school. This led to my

research question, “What changes need to be made in early college high school counseling when

dealing with students’ mental health?”

There have been changes in points of view regarding mental health but there still isn’t

much being done. Even though this a topic has been recently discussed, there has been evidence

that some schools have been decreasing the amount of mental health help students need. The

most important thing for mental health problems is to first bring awareness to the issue and seek

solutions that can be implemented in schools.

Yet, despite recent attention to the topic, we still need to find solutions for American early

college high school students with mental health problems. The goal of my research is to bring

awareness to the problem and find programs or services that could be implemented in American

high schools.

Literature Review

Mental Health Stigma

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Teachers need to be able to understand the signals students show that hint they have a

mental health issue. Mental health includes “our emotional, psychological and social well-

being… [this can affect] how we think, feel and act, [and it] is important … from childhood and

adolescence through adulthood,” (What is mental health? 2020). Teachers and school

administrators must get over the stigma that surrounds mental illnesses. Stigma is “a negative

and often unfair social attitude attached to a person or group.” Mental health stigma can include

the social shame that is put on those who have it or who might even try to seek help. According

to the Mental Health Foundation, 90% of those with mental health issues feel that the stigma and

discrimination surrounding this topic can negatively impact their lives (Zoppi, 2020).

Furthermore, schools play an important role in mental health education so they need to get rid of

the stigma by educating their leaders, teachers, and students.

Staying Informed

Dismissing signs of mental illnesses can affect one negatively. Firstly, mental illness is “a

disorder of brain function.” Everyone who experiences a mental illness will have different

symptoms and have significant impacts on people (Polaris Teen Center, 2018). Mental illnesses

do not discriminate and can affect all ages. Mental health is more common in teenagers of ages

12 to 18. The reason for this is believed to be the brain changes we experience as adolescents.

The most known forms of mental illnesses are depression and anxiety. Furthermore, mental

health and illnesses are important and so is looking out for them. It would be helpful if teachers

learned about the different signs that mental illnesses show so that they could help their students.

Henderson, a special education teacher at Manchester HS, discusses her experience when dealing

with mental health concerns. She discusses that although teachers might notice the red flags
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hinting at mental health concerns, teachers are pushed to the max, so it is hard for them to help

sometimes (Walker, 2018).

Mental Health & COVID-19

Students all over the country struggle with temporary challenges, chronic stressors, or

mental health issues. In a school of 750 students, approximately 150 of those will experience a

mental health problem, and only a few of those will receive the help they need. For some

students, school is the only place where they could only receive mental help, so schools need to

try to help them the best they can. It is estimated that 70-80% of students with a mental health

illness receive their initial mental health service in school (Cowan and Rossen, 2014).

Furthermore, COVID-19 hit the United States in March of 2020. The lack of contact with other

people might have benefited some who had social anxiety, but the disadvantages of the pandemic

outweigh the benefits. For example, people who had issues at home like domestic violence and

child maltreatment had to deal with these problems at home every day. As discussed previously,

the only access to mental health services might only be at school with counselors. Since schools

have reopened this semester, they must focus on their student’s mental health now (Fegert,

2020). Before the pandemic, there was evidence showing that mental health problems in young

students were on a rise. Sharon Hoover states that researchers were expecting an increase in

anxiety, depression, and trauma. Because school closures and social distancing have drastically

changed teenagers' routines, the pandemic made some students’ mental health worse.

Student Performance & Behavior

Furthermore, mental health and student performance go hand in hand. As Houri and

Kincade stated, “Mental health challenges, such as anxiety and depression, distract from learning

and interfere with the cognitive process associated with learning.” (Houri & Kincade, 2021).
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Mental health issues like anxiety and depression can get to a point in which it does not allow a

student to perform in school at their best. One great example that is mentioned in this article is

that “20-40% of students with… ADHD also has reading disabilities.” Similarly, students that

struggle to learn in school are more likely to experience symptoms of anxiety. Additionally,

students who experience depression are more likely to have a hard time learning and vice versa;

students that struggle to read are likely to show depression symptoms (Houri & Kincade, 2021).

Many symptoms can affect a student’s academic performance like lack of motivation, irritability,

fatigue, loss of concentration, and the need to eat (Lesser, 2021). To add, mental health problems

can also be so serious that they can affect whether students show up to school. Students who

struggle with mental health problems are more likely to have the worst graduation rate and

highest dropout rates compared to other students. For instance, “over 50% of students with

emotional and behavioral disabilities ages 14 and older, drop out of high school.” (Problems at

school, 2019).

Furthermore, mental health can also have a connection with a student’s behavior. The

causes of these might be difficulties with concentration, self-control, and problem-solving skills.

Some examples of behavior problems that undiagnosed or untreated mental health issues can

bring are “delinquency, disciplinary actions, office referrals, suspensions, dropping out … and

lower rates of employment.” Some signs that parents and teachers can look after are difficulties

in concentration, lack of self-worth, low mood, joylessness, a loss of interest, social withdrawal,

and sleep disruption (Schilte-Korne, 2016). Because schools all around the country lack mental

health services, it can be a cause of the increased risk of behavioral problems in high school

students (Shelton & Owens, 2020). Teachers and parents need to look out after their

child/student and look out for signs and symptoms. One can encourage communication so that
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their child is open to talking about their mental health problems and thus they can receive the

help they need either at school or by going to therapy. The most important tip is to be open to

hearing advice from other parents who have dealt with the same thing (Helping at Home, n. d.).

Additionally, schools can also do a few things to look out for their student's mental health and

behavior problems. By providing a healthy climate, students will have better or healthier mental

health. Furthermore, one thing that both teachers and parents can both do is network. This means

that teachers and parents would cooperate in the educational and healthcare sectors (Schulte-

Korne, 2016). Moreover, mental health problems can lead a teenager to have behavior problems

in school thus they must be given the help they need to prevent this from happening.

School Approaches

To move towards a school with mentally healthy students, schools could adopt a

technique that will benefit the whole school. Sarah Adams discusses the “Whole School

Approach.” This approach is about making schools informed about mental health topics so that

they can provide help. She mentions that schools should “require school leaders to ensure all

staff are appropriately trained, have the resources required, monitor the effectiveness and impact

and act upon areas of improvement.” In simple words, the approach wants to ensure that schools

aretrained correctly so that they can act when needed. By including all the schools in the

approach, nobody will feel hopeless or stressed when dealing with mental health needs (Adams,

2019).

Furthermore, social-emotional learning is like the trauma-informed approach. SEL is “a

methodology that helps students of all ages to better comprehend their emotions, help students

make decisions, help achieve their goals and build positive relationships with others,” (Social

Emotional Learning (SEL), 2020).” SEL helps prevent mental health issues in school by teaching
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how to understand emotions in school thus promoting safer and more caring environments.

Students are taught things like mindfulness, coping, communication, relaxation skills, etc.

Additionally, “Research shows SEL is associated with a positive impact … that increases

children’s attachment to school and motivation to learn and reduce risky behaviors.” (Committee

for Children, 2015). This goes back to making changes so that students have fewer behavioral

problems. Similarly, the trauma-informed approach is when someone understands what trauma is

and the impacts that it can have on a person physically and mentally. When a teacher is trauma-

informed, they recognize and understand that they judge a student’s behavior but question what

might be happening that might be causing them to act like that. Trauma is when someone goes

through an event that might have intensely threatened them. According to the National Survey of

Children’s Health, 35 million children in the U.S. have experienced at least one type of

childhood trauma. Trauma can have short and long-term effects on someone's health. Examples

of ways it affects one's body and trauma are body and brain development, emotions, and

behavior. These triggers might lead to mental health problems by interfering with someone's

everyday life (The Editorial Team, 2021).

Parent Involvement

Involvement is when someone participates in an issue or activity. Having more parent

involvement would benefit a student’s achievement and mental health in high school. Parent

involvement would include the “parent’s interaction with schools and with their children to

benefit their children’s educational success.” Based on the research I did, there is no specific

type of involvement has been identified that would be the most successful. This is a limitation

for researchers and programs that are trying to include more parent involvement. Some of the

types of involvement that have been looked at include the parents having communication with
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teachers, attendance, and volunteering in a school. Based on a study done with 10th-grade

students and parents, parent involvement improves the teenager's academic and emotional

performance compared to the 11th grade. This research goes more into detail about the different

types of parent involvement, depression, and academic performance. Overall, the varied types of

involvement had different results but, in the end, most of them showed an improvement in their

child’s overall performance (Wang & Sheikh-Khalil, 2014).

Sleep & Mental Health

Sleep and mental health have an essential relationship; “sleep is essential for the physical

upkeep of the body.” For the brain to help maintain its cognitive skills, getting a good rest is

required. Having a bad sleep schedule could be a risk factor for d eveloping mental health issues.

The lack of sleep can lead to insomnia, and this could develop into depression, bipolar disorder,

anxiety, and an increased risk of suicide. Additionally, lack of sleep is also a symptom of some

illnesses like anxiety and schizophrenia (Kingsland, 2020). Sleep is a key factor as “each [sleep]

stage plays a role in brain health, allowing activity in different parts of the brain… enabling

better thinking, learning and memory.” Getting enough sleep allows the brain to process

emotional information. On the other hand, not getting it harms the brain as it is “especially

harmful to the consolidation of positive emotional content.” The reason that this is bad is that it

can influence one’s mood and emotional reactions, thus it is linked to mental health problems.

As a result, researchers state that there is a clear relationship between sleep and mental health

(Suni, 2020).

Sleeping in School

Because sleep has a strong relationship with mental health, schools must make sure that

students are getting enough sleep. Schools can help students get enough sleep by providing them
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with “sleep pods" or “calm corners.” A sleep pod, or nap pod, is an “egg-shaped lounge chair that

reclines, with a circular lid that can be pulled over the chest to shield against the light.” The

purpose of these pods is to provide students with a room in which they can sleep and relax.

Students who do not get enough sleep or feel anxious are welcome to use them. Hannah

Vanderkooy states that during school she felt tired and anxious and when she tried the pod, she

felt extremely relaxed (Neighmond, 2017). If schools provide this it would benefit students as

“The National Institutes of Health recommends 9-10 hours every night, but only a third of teens

are sleeping even 8 hours.” (Beck, 2017). The lack of sleep causes students to zone out and not

pay attention; by providing them, students would be more comfortable taking a nap without

getting in trouble. A study in New Mexico found that students who used the sleeping pod “felt

more rested, happier and more in control of their emotions.” (Morning Edition, 2017).

Furthermore, a calm corner is similar in theory to a sleeping pod. A calm room corner of a small

corner that is designed to help students when they feel overwhelmed. When comparing a calm

corner and a sleeping pod, a calm corner would be easier to create and cheaper. Teachers could

create calm corners with things they have in their classroom already while sleeping pods are

about $14,000. (Morning Edition, 2017). These would include comfortable seating, fidgets,

noise-canceling headphones, journals, etc. (Kalahar, 2020). The purpose of both services would

essentially be the same: to provide students with a space in which they can sleep when they

cannot get enough sleep at home. By providing a space in which students can get the sleep they

need, schools would be moving toward a healthier school.

Therapy Apps

Over the last decade, the use and development of technology have increased; it is said

that it has replaced “face-to-face mental health services.” (Kretzschmar, Tyroll, etc., 2019). This
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replacement of interaction simply consists of automated responses that reply to users in search of

a mental health service, these are usually called chatbots. Chatbots are “a conversational assistant

that allows businesses to communicate with their audiences in a way that is both automatized and

personalized” (Owings-Finner, 2021). These chatbots have been included in some mental health

service apps. They would consist of having 24/7 support for a user, creating a conversation that

seems real with a person through instant messages. Adding on, they consist of “guiding users

through how they are feeling, helping users challenge negative thoughts, suggesting tools and

resources, and engaging them in evidence-based therapy techniques, including mood tracking

and mindfulness.” People who do not want to go through face-to-face interaction are likely to use

these types of services. Moreover, it is hard and expensive for schools to provide services like

therapists for everyone, thus providing chatbots for students would be a good option. Having

chatbots would benefit those and even the ones who don't mind the real-life interaction. By using

these types of services, Dr. Camille Crittenden says would show a progression of a student's

mental health (Kelliher, 2021).

Music & Mental Health

An additional intervention that schools can include in their mental health services can be

listening to music or including music in their counseling system. Music has been linked to

having psychological benefits on a person’s brain. Many people listen to music to be entertained,

but research suggests that it might make a person healthier: “Music can relax the mind, energize

the body, and even help people better manage pain.” Because music has shown positive effects

on the brain, music therapy could be implemented in schools to help students with their mental

health. This type of intervention is used to help a person’s “emotional health, help patients cope

with stress, and boost psychological well-being.” (Cherry, 2019). It can be used in schools to
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help improve cognitive performance, reduce stress, help with sleep, etc. There are different types

of music therapies, including analytical, benenzon, etc. The difference between all the types of

music therapy is the approaches that are taken to include music. For example, analytical music

therapy is when a person sings or plays an instrument to express their thoughts unconsciously.

On the other hand, Benenzon music therapy is when a person looks for a musical sound that

describes how they feel. Regardless of the approach, research has found that music therapy helps

anyone who might be struggling with depression, anxiety, and other mental health issues (Wong,

2021).

Methodology

Participants

All the participants were 14-19 years old, and no parent consent form was needed as it

was not an experiment on the students. The study was conducted in a Texas early college high

school. The school consists of about 490 students and has a 25:1 student-teacher ratio. The

population of the school consists of mostly Hispanic and/or Latino origin with a small section of

African American and Caucasian students and teachers. Since the school lacks a wide variety of

ethnicities, the results might be different from other studies related.

Survey

The survey consisted of ten questions regarding the mental health topics discussed

previously. All the questions were written in the simplest form and terms were explained. The

survey started with questions that would categorize the students who took the survey. Each term

was given a definition.

The Questions
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The questions were created by me and were made in the simplest way possible. The

questions of the survey are listed below:

1. What grade are you in?

2. How would you rate your mental health? 1-5, 1 being the worst and 5 being the best.

3. Have you ever been to one of our school counselors in the past?

4. Based on your experience, or what you have heard, how would you rate the counseling

administration in this school? 1-5, 1 being the worst and 5 being the best.

5. How well do you think having more parent involvement would help our student's mental

health? 1-5, 1 being the worst and 5 being the best.

6. How well do you think having a calm room/ corner would help our student's mental

health? (This would allow kids to have a break, take naps, read a book, etc. to help them

relax). 1-5, 1 being the worst and 5 being the best.

7. How well do you think online therapy apps/ websites would help our student's mental

health? 1-5, 1 being the worst and 5 being the best.

8. How well do you think having music therapy in this school would help our students'

mental health? (Music therapy would be a "therapeutic approach that uses properties of

music to help people improve their mental health." 1-5, 1 being the worst and 5 being the

best.

9. Out of all these services, which one would you say is the best one for you personally?

10. If you have any other mental health service that you would prefer over this type it here.

Research Fair

The survey took place at a school event organized by our AP Research teacher. The

school event was organized for the AP Research students who had surveys and other studies/
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experiments that needed other students' participation. All the students had the opportunity to

participate in the survey. Students were released by grade level into the event, lower classmen

were dismissed first, and upperclassmen came last.

When students arrived at the fair there were tables set up for all the AP Research students'

booths. Each booth had information about their research and study. My booth included a poster

of my information including a QR code that directed students to the survey. Each of the students

responded to a Microsoft form and each of the answers was anonymous. Results were recorded

in Microsoft Forms and the results were transferred into a Microsoft Excel spreadsheet.

Hypothesis

I initially hypothesized that students who have experienced high school counseling did

not find it useful; therefore, changes need to be made. This hypothesis was made based on

previous knowledge of mental health in schools and on conversations I would hear about school

counseling. The study showed that students did not believe that the mental health counseling

services in school were useful.

Data & Analysis

Mental Health Rating & Counseling (Table 1)

To analyze whether students with lower mental health were most likely to attend school

counseling, I looked at questions 2 and 3 (methodology section). I analyzed the data in two ways:

those who said no and those who said yes. Those who said no were those who have not attended

school counseling and those who said yes were those who have attended school counseling. The

option “prefer not to say” was provided but not included in the data analysis. After categorizing

the information, I conducted a two-sample t-test. A two-sample t-test is used when studying two
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groups to know if there is a difference. I analyzed the p-value and the test statistic ‘t’. The p-

value is the “probability that a random chance generated the data or something else that is equal

or rarer.” Thus, if a p-value is less than 0.05 then I can reject the null hypothesis (H0), and a p-

value greater than 0.5 means that the null hypothesis is true. The purpose of a null hypothesis in

statistics is to prove whether a test will be supported. My null hypothesis was that the average

number of those who said no was equal to those who said yes. This was my hypothesis assuming

that those who have never been to school counseling have the same mental health issues as those

who have attended counseling. For this small study, a p-value greater than 0.05 means that the

average mean of the mental health of those who said no and those who said yes was equal.

Attending Counseling & Rating (Table 2)

To analyze whether students who took the survey believed that school counseling was

helpful, I looked at questions 1-5. For this section, I categorized the data in two ways. The first

was those who have gone to counseling and rated their experience. The second was those who

have not gone to counseling and rated what they have heard about the counseling system in

school. I then calculated the average for both categories. The option “prefer not to say” was

provided but not included in the data analysis. A good counseling system would be rated a 3 and

above, and a bad one would be anything less than that. To compare the answers, I used a two-

sample t-test. In this case, the null hypothesis was that the average of those who said no’s

population is equal to the average of those who said yes. The null hypothesis (Ho) in this case,

was that the mean of those who said no was equal to those that said yes. Traditionally in

statistics, a p-value greater than 0.05 means that the null hypothesis is true. For this small study,

a p-value greater than 0.05 means that the average mean of those who said no and those who said

yes was equal.

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Grade Level & Mental Health Services (Table 3-6)

To analyze how each grade level rated each mental health service discussed, I used a one-

sample t-test. I decided to use a two-sided sample t-test so that I could compare a known smaller

population of high schoolers to an unknown bigger population. I used the information from

question 1 to sort the information into 4 categories: 9th, 10th, 11th, & 12th graders. Then I used

questions 5-8 to analyze the average rating (1-5, 1 being the worst and 5 being the best) of each

of the services. The services analyzed were parent involvement, calm room/ corners, online

therapy apps/ websites, and music therapy. A good counseling service would score an average

rate greater than three.

I analyzed each grade level in order, and I analyzed the data per service. The null

hypothesis for Table 3-6 was that the average rating is expected to be equal to the average rating

of the whole population of local high school students. For each grade level, I analyzed and

compared the sample averages and p-values. Sample averages above 3.75 would let me know

that students believed that service would be very helpful. I used 3.75 to see if the service rated

high instead of a 3 because the rating range was small, and outliers could have affected the

average. A p-value below 0.05 meant that the null hypothesis was rejected. For these smaller

samples, it was easier to analyze the p-values of each grade level and each service as they all

equal 0.000 (information from tables 3-6). After I analyzed each grade level and what they rated

each service, I compared the sample averages. This helped me determine which service scored as

better within each grade level and overall.

Results
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The hypothesis was that the average of those who said no was equal to those who said

yes. Based on the information from the table, the difference between the average of those who

said no and yes is big enough to be statistically significant. Since the p-value is smaller than

0.05, I come to say that my null hypothesis was incorrect. The average mental health of those

who said no was higher than those who said yes. A higher average meant that the students

answered that their mental health was "healthier."

The null hypothesis was that the average of those who said no' is equal to those who said

yes' population. After doing the test, I concluded that the difference between the average of those

who said no and those who said yes is not big enough to be statistically significant. Thus, making

my hypothesis true; the students who have not gone to school counseling and the students who

have both rated the school counseling about the same.

The following tables 3-6 have the same null hypothesis. The H0 was that the average

mean of the smaller population was going to be equal to a larger population. Because all p-values

in the tables (Table 3-6) were below 0.05, the null hypotheses were rejected. The information
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was not big enough to be statistically significant. Thus, the average mean of the smaller

population and larger population cannot be said to be equal.

Mental Health Service Comparison Results

For the following information, I used the average rating of each mental health service per

grade level and compared them. I compared each service per individual grade. Then, I compared

the highest and lowest-rated services from all grade levels. Lastly, I assumed which service

would be the most helpful by looking at the service that scored the highest overall. The data was
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analyzed and observed from the tables above. On average, 9th-grade students rated music

therapy as the best service and online apps/ therapy and parent involvement were rated as the

worst (Table 3). Secondly, 10th-grade students rated calm room as the best service and online

apps/ therapy as the worst (Table 4). Third, 11th graders rated calm room as the best service and

online/apps as the worst (Table 5). Lastly, 12th grades rated a calm room as the best and online

apps as the worst (Table 6). Overall, the surveyed early college high school students preferred a

calm room over all the other services. Additionally, a calm room scored an average rating of

4.12. The service that scored the second highest was music therapy with an average rating of

3.91 among the students. The service that scored the least overall was online therapy and apps,

with an average rate of 3.20.

Lastly, I reviewed the answers to the last two questions. Students selected a calm

room/corner as the service that would work for them the best. When I asked if they had any other

suggested methods, talking to someone and mental health breaks were two of the good

suggestions.

Conclusion

The original research question was regarding what changes could be made in early

college high school when dealing with mental health. The purpose of the research was that

mental health problems in teenagers are increasing. The goal of this study is to reach other early

college high schools, bring awareness to the problem, and inform them about what students feel.

The strength of my research is that my survey had enough responses to run statistical tests and

make statistical conclusions. A limit to my research is that some students decided not to take the

survey, so the sample size was not big enough to make an overall conclusion on early college

high school students.

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The result of this study suggests that the mental health of students is not at its best and

that they want a change. Although there is more information available about the topic of mental

health, schools only teach broad information. Further research, with larger sample size, would

show more specific data regarding which service is more preferred over the other.
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