Why Starting School Later Is a Social Work Issue

start school later
Via Unhelpful Teacher Memes

On Aug 25th the American Academy of Pediatrics (AAP) released a highly publicized position statement recommending middle and high schools start after 8:30am.  Adopting later school start times is an effective way to increase adolescent sleep and thus improve adolescent health and safety – primarily because of a later shift in sleep cycle that occurs during puberty.  The statement by the AAP follows numerous statements from health and education experts calling for attention to the matter.  Now is the time for those of us in the trenches, social workers, to join the conversation. Why do social workers need to speak?

Research conducted over the last several decades has shown that chronic sleep loss is associated with a host of negative outcomes, and adolescents are our most sleep-deprived age group in America.  Social workers see the repercussions of teen sleep debt in the form of increased substance abuse, depression, anxiety, auto accidents, sports injuries, bullying, crime, learning difficulties, and health problems.

Social workers honor clinical research and evidence-based practice, we recognize the unique stages of human development, and we understand the vital role of prevention in well-being.  Given the broad impact of sleep deprivation on functioning – and the strong presence of social workers in mental health, substance abuse, education, forensics and medicine – we are the perfect profession to speak on this topic.

Media advisories from the Centers for Disease Control and position statements from the American Academy of Pediatrics carry more weight when they are complimented by the voices of local social workers who know the sleep-deprived kids by name.

Most importantly, social workers are well-versed in dealing with one of the biggest barriers to adopting later school start times which is people don’t like change.  Even when familiar with the research, school boards and superintendents often feel pressured to maintain the status quo out of a real or imagined fear that change will be uncomfortable.

Fear of change?  Discomfort?  Those are the legs upon which we stand.  We have eased individuals and communities through successful growth and change since the inception of the social work profession.

Social worker Mandi Mader in Montgomery County, Maryland is an excellent example of advocacy from the trenches in the start school later movement.  Having witnessed the effects of chronic sleep deprivation in her clinical counseling practice she chose to act and has, in true social work fashion, effectively rocked the boat and opened eyes to the research – raising awareness in Maryland and setting the foundation for possible state-wide reform.

I have also seen the fallout from sleep loss in my counseling office.  In order to catch a 6:30am bus, many Ohio teens are waking in the 5 o’clock hour despite the biochemical barriers to falling asleep before 11pm the night before.  Adolescents require 8.5 to 9.5 hours of sleep for optimum health, and it doesn’t take long to do the math and realize why our teens are so sleep-deprived.  I am now active with the national non-profit Start School Later along with Mandi Mader and other impressive advocates, and I am proud to serve as chair of the sleep committee for the Ohio Adolescent Health Partnership.

However we need more voices – especially from the front lines.  We need social workers to talk to teens, talk to parents, talk to colleagues, talk to schools, and talk to legislators about sleep and school start times.  It’s about health, it’s about safety, and it’s about time.

For a good overview of the research visit the websites of the National Sleep Foundation http://www.sleepfoundation.org/, the non-profit Start School Later http://www.startschoollater.net/, or a slide show created by the author: Adolescent Sleep Research: School Start Times .net/ssimera/adolescent-sleep-research-for-linked-in-6584580.

Standardized Testing – Words a Therapist Shouldn’t Hear

Mental health professionals learn to expect and recognize additions to the common words and phrases we hear. ‘Facebook Feud’ and ‘emotional affair’ have been added to the lexicon of couples and family therapy. When working with teens ‘cyber bullying’ and ‘sexting’ are sad additions to the counseling vocabulary. In substance abuse treatment we strive to keep up with the latest slang for the various drugs and their methods of use, from ‘huffing’ to ‘spice’ and ‘Special K’. Listening for repeated words and phrases tells us much about local and societal trends and where we need to focus our clinical attention.

standardized testingI am stunned and saddened, therefore, by how often my colleagues and I are hearing ‘Standardized Testing’ coming from the mouths of anxious children. Whether the anxiety initiates within the student or is picked up vicariously from school personnel doesn’t matter – the distress makes a comfortable home within the brains and bellies of children and stays there.

Students tell me stories of how standardized testing is discussed on the first day of school, and that ‘intervention’ periods are hijacked for endless practice tests. Children hear their favorite teachers talking in the hallway – or even at the front of the class – about how their jobs are on the line and it is understood – covertly or overtly – that the kids must save the adults.

Rumors get started, and are not corrected, that 50% of a child’s grade is based on testing results and that ever-dreaded summer school could be in the child’s future if they don’t score well. Kids hear the urgent message on the home answering machine telling parents to insure their child gets plenty of sleep and a well-balanced breakfast before testing days – as if sleep and good nutrition are not important on learning days – and as if we aren’t fully aware that these messages paradoxically result in difficulty eating and sleeping. Children know that the stakes are high, and they feel the burden of the American educational system on their shoulders.

Whether standardized testing improves education, or whether it is an adequate assessment of teacher effectiveness or what a child actually knows, are arguments I will leave to others. My concern is that I should not be hearing about the ‘OAAs’ within the walls of my Ohio counseling office. I and countless colleagues beseech educational policy-makers to find other ways to accomplish whatever it is that the high number of standardized tests are meant to accomplish. Children already have enough reasons for stress, anxiety and depression.

Duty to Expel: Zero-Tolerance Policies in Schools

Go At It All Alone Poster  Emily & Kaley, 2011.
Go At It All Alone Poster Emily & Kaley, 2011.

Many people have heard of Tarasoff “Duty to Warn” laws, although the back story and subsequent legislative rollercoaster isn’t as well-known. Given the number of states that continue to mandate zero tolerance policies in schools, it is time to remind our lawmakers of the risks of legislative reactions to tragic events.

In 1968, University of California student Prosenjit Poddar pursued Tatiana Tarasoff and was rebuffed. When Mr. Poddar voiced intent to harm his romantic interest, his roommate encouraged him to seek therapy at the campus counseling center. Clinicians at the counseling center, concerned about the threats, eventually decided to call the police and recommended that Mr. Poddar be involuntarily hospitalized. When law enforcement officials investigated they determined that there was no risk and did not follow through on initiating hospital admission. Mr. Poddar tragically killed Ms. Tarasoff.

In 1974, the Supreme Court of California issued its first decision in the case of Tarasoff v. the Regents of the University of California and determined that mental health clinicians have a ‘duty to warn’ potential victims. While well-intentioned, the strict and limiting wording used in this decision prompted criticism from the National Association of Social Workers, the American Psychiatric Association, and other professional groups. The court vacated, i.e. erased, its decision and rescheduled the case for hearing. In 1976, the Supreme Court of California issued its official Tarasoff decision that determined that mental health professionals instead have a ‘duty to protect’ potential victims.

While this may seem to be semantic hair-splitting, the differences between ‘duty to warn’ and ‘duty to protect’ are legally and clinically profound – and serve as a good comparison to zero-tolerance policies in schools.

Following the Tarasoff case, a host of state legislative bodies across the nation focused on the wording of the vacated 1974 decision and imposed upon mental health professionals a legal ‘duty to warn’. While these legislative efforts appeared as well-intentioned as the 1974 Tarasoff wording, they were also just as misguided. Such laws were widely viewed as knee-jerk reactions to an unfortunate event that unnecessarily tied the hands of front-line professionals and, paradoxically, did not increase public safety.

The same can be said for secondary school ‘zero-tolerance’ mandates. In reaction to school violence many states enacted these policies which are, in effect, ‘duty to expel’ laws that undermine education, safety, civil rights, and the clinical expertise of the ground-level professionals serving our children.

Initial post-Tarasoff ‘duty to warn’ laws required a clinician to warn a potential victim – even if the threat was vague or temporary, even if better options existed, even if warning a potential victim wouldn’t necessarily protect anyone, and even if making such phone calls carried its own, possibly worse, burdens and risks by reversing clinical progress and eroding client and public confidence in the mental health system.  

While most people agree that reaching out to Ms. Tarasoff would have been clinically appropriate in the afore-mentioned case, there are many instances in which calling a potential victim is not appropriate when other options are available.  If a woman whose schizophrenia is typically well-managed contracts the flu and forgets her medication and makes vague threats to the Pope, our best option in protecting the Pope is to arrange for hospitalization, not make a phone call to Rome.

Zero-tolerance policies in schools carry similar limitations and burdens.  We are well-familiar with the stories of children suspended or expelled because school administrators’ hands are tied by zero-tolerance policies: the 1st grader who plays cops and robbers on the playground and makes a gun with his hand; the bullied child who eventually pushes his tormentor; the little girl who went off her medication after a bout of the flu and her ADHD is topsy-turvy for several weeks. These children, removed from their learning environment, then carry the additional burdens of stigma, shame, and compromised educational opportunities.

Wisely, most states have since rescinded post-Tarasoff ‘duty to warn’ laws and replaced them with ‘duty to protect’ mandates. For example current Ohio law recognizes that mental health clinicians should be able to utilize their professional knowledge and familiarity with each individual case to determine the best course of action – whether hospitalization, increasing level of care, notifying police, and/or warning a potential victim (Ohio Revised Code 2305.51).

Ohio and other states need to similarly replace zero-tolerance mandates.  Doing so does not mean that schools no longer have the option to suspend or expel a child when warranted, rather it allows schools to determine, on a case-by-case basis and with input from trained professionals, what is the best course of action for the child and society.   As of this writing Ohio Senate Bill 167, introduced by Senator Tavares and Co-Sponsored by Senators Schiavoni, Brown and Sawyer to rescind existing zero-tolerance mandates in the states, will most likely die from inattention.  Social workers and other professionals need to encourage all states to evacuate ‘duty to expel’ laws and replace them with ‘duty to serve and educate’ laws.

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