How to spot when something’s wrong and respond with caring confidence.

  By Gary Drevitch

THE BASICS

- Suicide Risk Factors and Signs

- Take our Depression Test

- Find a therapist near me

Key points

- Parents are uniquely positioned to recognize when their young people are in distress.

- Mental Health First Aid offers a model for talking about mental health.

- Parents play a role in encouraging college students to seek mental health support on college campuses.

As winter break approaches, college students are returning home for much-needed rest. Many will retreat to their rooms to recharge, while others may rush to reconnect with friends, even bypassing the open arms of their parents. College life is demanding, and most students develop coping skills to manage the semester’s accumulated stress. For some, however, academic, social, and independent-living pressures can feel overwhelming, triggering new mental health or substance-use concerns or exacerbating existing vulnerabilities. When distress goes unnoticed or unsupported, young people may withdraw, increasing the risk for worsening symptoms and self-harm.

Suicide is the second leading cause of death among young people ages 15–24 (CDC, 2022). Research shows that college students, who often have more access to support systems, are less likely to die by suicide than non-college-attending peers (The National Academies of Sciences, Engineering, and Medicine, 2021). Data from Penn State’s Center for Collegiate Mental Health show that the percentage of students receiving support in college counseling centers with a history of suicidal or self-injurious behavior rose from 26% in 2010–2011 to 30% in 2023–2024. The University of Michigan’s 2023–2024 Healthy Minds Report highlights the prevalence of student mental health challenges and the informal supports they seek: friends (39%) and family (39%) top the list. So loved ones play a powerful role—which underscores the importance of recognizing distress and knowing how to respond.

Findings from Healthy Minds Network Report 2023-2024

Source: The Healthy Minds Network. (2024). 2023-2024 data report.

Many college counseling centers have expanded services as needs have grown, and efforts to strengthen mental health literacy are increasing. One example is Mental Health First Aid (MHFA), a national program of the National Council for Mental Wellbeing that teaches people how to notice warning signs and start supportive conversations. More than 4.5 million individuals have been trained nationwide, with the goal of preparing one in every 15 Americans to respond to mental health or substance-use concerns and ensuring that everyone has at least one nearby friend or family member they can turn to in a time of need. Nearly 1,500 colleges now implement MHFA. At the University of North Carolina, thousands have been trained, leading to increased mental health literacy, higher confidence in responding to distress, and greater intention to use these skills to support others. These efforts go a long way toward addressing the nation’s youth mental health crisis.

Parents can be especially valuable supports for emerging adults returning home, offering stability, guidance, and help navigating resources as students prepare to return to school. Recognizing when a young person is simply recuperating versus experiencing more significant decline is essential. Understanding risk factors, warning signs, and ways to talk about mental health helps promote healthy outcomes.

Recognizing Risk

Suicide risk arises from a complex mix of individual, relational, community, and societal factors. According to NAMI and the CDC, some common risk factors include:

- history of suicidal thoughts

- previous suicide attempt

- history of self-harm

- family history of suicide

- substance misuse

- impulsivity or emotional reactivity

- hopelessness

- isolation

- exposure to violence

- access to lethal means

Concerns about potential harm should prompt immediate professional mental health or crisis-response support. Less urgent and yet important signs such as mood changes, loss of interest in usual activities, and declines in energy, functioning, or self-care should not be overlooked. It can feel uncomfortable to voice concerns, especially if your young person is signaling “leave me alone.” Many parents also worry that asking directly about suicide or self-harm may be overreacting or make things worse. In fact, research consistently shows the opposite: When caring adults approach these concerns with honesty, compassion, and curiosity, rather than avoidance, it communicates care and reduces the likelihood of tragic outcomes.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Talking About Mental Health

Parents can benefit from the guidance of the Mental Health First Aid model, which teaches a five-step action plan for responding to mental health concerns, summarized below. Reaching out, even imperfectly, is far better than remaining silent when worried about someone’s well-being.

Mental Health First Aid Steps (ALGEE)

Source: Kapil, R. (2025, September 24). Using the 5-Step MHFA Action Plan: How ALGEE Helps in Mental Health and Substance Use Challenges. Mental Health First Aid.

1. A: Approach and assess for risk of suicide or harm

Choose a private moment and ask how the person is doing. Share nonjudgmental observations such as “I’ve noticed you’ve been in your room a lot and haven’t seemed interested in seeing friends. What’s up?”Regardless of the response, the question shows you care. If they don’t want to talk, encourage them to reach out to someone they trust.

2. L: Listen nonjudgmentally

People in distress need to feel heard. Listen without interrupting. Validate their experience, even if you disagree. Limited perspective is common in depression and mood disorders. For now, simply let them know you hear them.

3. G: Give reassurance and information

Offer hope and supportive facts. When someone struggles to generate hope, they often need to borrow it. Mental health and substance-use challenges are common, rooted in both biology and lived experience, and highly treatable.

4. E: Encourage appropriate professional help

Early intervention improves outcomes. Help them learn about available options, such as primary care providers, local therapists, or directories like Psychology Today's. Familiarize yourself with campus mental health supports so they can continue care when they return to school.

5. E: Encourage self-help and support strategies

Help identify their support network, community programs, and small, manageable self-care steps like regular meals, hygiene, movement, enjoyable activities, and connecting with others to reduce isolation.

In non-crisis situations, not every step is needed. What matters most is showing care, curiosity, and consistent presence.

When Concerns Escalate

When someone feels hopeless, they may say things like, “I don’t want to feel like this anymore,” “People would be better off without me,” or “I can’t do this.”

Instead of dismissing these statements, ask, “Are you thinking about hurting yourself?”If the response is yes, follow with, “Have you thought about acting on these thoughts?”Explore whether plans exist or steps have been taken. If the person is not in imminent danger and already has mental health supports, consult their treating therapist or psychiatrist. You can also dial 988 for the 988 Suicide & Crisis Lifeline to access help 24/7. If they are in imminent danger, have begun acting on a plan, or are behaving erratically, take them to the nearest emergency department or crisis center when it is safe and they are willing. Otherwise, call 911 and request responders trained in mental health or crisis de-escalation.

Offering Steady Support

Staying calm is essential. Your role is not to diagnose or solve the problem but to offer grounding, support, and information. More broadly, hold your young adults close. Offer love, care, and the comforts of home so you can share the holidays together and look toward a new year of growth, resilience, and meaning born from the struggles they have faced. https://standingabovethecrowd.com/?p=16282

Knowing the function of the problem behavior is the key to changing it

Writer: Gia Miller

Clinical Experts: Stephanie A. Lee, PsyD , Stephanie Ruggiero, PsyD

https://www.youtube.com/watch?v=-10S4z3sKck

What You'll Learn

- Why is it important to understand the function of problem behavior in order to change it?

- What are the four functions of problem behavior, according to Functional Behavior Analysis?

- How can parents use the techniques of Functional Behavior Analysis to help reduce problem behavior at home?

- Quick Read

- Full Article

- The four functions of behavior

- 1. Escape or delay

- 2. Access to tangibles

- 3. Need for Attention

- 4. Sensory stimulation

- Collect data to determine the function

When kids develop problem behaviors like tantrums, whining and hitting, it can be hard to for parents to get them to stop. But it can help to use strategies devised by behavior experts. An approach called Functional Behavior Analysis is based on the idea that to change any behavior the first thing you need to do is understand what function it serves. Once you know the function of the problem behavior, you can more easily change that pattern of behavior.

The FBA experts have broken down all behavior into the following four functions:

1. Escape or delay. The child wants to get away from a situation they don’t like or avoid a task they don’t want to do (homework).

2. Access to tangibles. The child wants a specific item (candy or a toy) or activity (access to an iPad).

3. Need for attention. The child wants attention, usually from a parent or teacher, any attention will do, whether it’s positive or negative.

4. Sensory stimulation. The child does something because it feels good, provides comfort, relieves pain, helps them expend energy, or calms them down. The behavior could be aimed at getting desirable stimulation, or to stop stimulation that feels bad.

Figuring out which of the four functions is driving a particular behavior can takes some detective work — for instance, it might not be obvious why a child does something even though they know that they won’t get the thing they’re begging for, or even that they will be punished. And sometimes there is more than one function. But once you have figured it out, there are specific techniques designed to reduce the behaviors associated with each different function.

For examples of each function and the techniques used to reduce the problem behaviors associated with it, see the full story below.

Tantrums, whining, hitting…all kids act out sometimes. And when they do, parents are left wondering how to get them to just stop it and behave!

The key to helping kids change problem behaviors is understanding what’s driving them in the first place. To do that, some experts use a strategy called Functional Behavior Analysis. FBA is used in therapy for kids on the autism spectrum, and to help kids whose behavior problems in school are interfering with learning. But with a little preparation, parents can use it to help kids at home, too.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

The four functions of behavior

In Functional Behavior Analysis, the function refers to the motivation or purpose behind a child’s behavior. But that function isn’t always obvious, and behaviors can have more than one function, explains Stephanie Lee, PsyD, a clinical psychologist. Parents, she says, often have to do some detective work, by thinking through what happened before and after the tantrum or outburst, to figure out what’s actually driving the behavior.

There are four functions of behavior in FBA:

- Escape or delay

- Access to tangibles

- Need for attention

- Sensory stimulation

Understanding them — and how they inform the techniques experts use to change difficult behaviors — can help you help your child curb problem behaviors more effectively.

1. Escape or delay

The child wants to get away from a situation they don’t like or avoid a task they don’t want to do.

Escape and delay is a big motivator of behavior. Kids have to do A LOT of things they don’t want to do (see eating vegetables, cleaning up, doing homework…). And, when kids don’t want to do something, they’re likely to behave poorly to get out of it, especially if acting up has worked for them in the past.

For example, Dr. Lee says, “I once observed a boy who regularly kicked a girl at school. Eventually I recognized that every time a math lesson began, he’d kick the girl next to him then look at the door.” The boy, she explains, was getting in trouble intentionally. “He was waiting for the principal to come get him, and by the time he went back to class, math was over.”

How to change escape or delay behaviors:

- Reward kids for appropriate behavior by reducing the demands. For example, if they immediately come to the table without complaint, they only have to eat half of their Brussels sprouts. Offering rewards that allow them do less of the thing they’re trying to avoid can help reduce stress and incentivize good behaviors.

- Let them know that escape is not an option. Give your child advanced warning of when something must be done. You can even set a timer. When it’s time to do the thing, there is no arguing or negotiating — it will happen, even if you need to assist them in the task. For example, if they refuse to put on their coat, you’ll put it on for them.  

- Praise them when they do what they’re asked without a fuss. Positive attention for even small, simple tasks like putting away their shoes or turning the TV off the first time they’re asked will encourage that behavior.

2. Access to tangibles

The child wants a specific item (candy or a toy) or activity (access to an iPad).

A tangible could be a treat, the toy their sibling is playing with, or time on an iPad. Sometimes the tangible is obvious; other times it’s not. For example, a child who keeps asking for things at the grocery store. “Mom, can we buy this?” “Can we buy that?” The badgering goes on until the frustrated parent offers their phone as a distraction. Sound familiar? It’s obvious the child wants something, but it’s likely the end goal is access to the phone rather than an extra bag of cookies.

Likewise, Dr. Lee recalls a parent telling her that after a tantrum over ice cream, they gave their child peanuts because they didn’t want them to go to bed hungry. In situations like this, she points out that the real tangible may actually be the peanuts, not the ice cream.

How to change behaviors when kids are seeking access to a tangible:

- Create a contract. Prevent poor behaviors tangibles by being proactive, not reactive. For example, before heading into the grocery store, make a deal with your child: If they don’t ask for anything while you’re in the store, you’ll buy them a cookie before you leave.

- Remove the tangible from the environment. Hiding tangibles can help. For example, kids will be more upset about an iPad they’re not allowed to use if it’s sitting right there on the kitchen counter. The same goes for your phone. If your child cannot play with it, then, as much as possible, be careful not use it in front of them.

- Let them know when they can, and can’t, have access to the tangible. If your child is allowed 30 minutes of iPad time when they get home from school, set a timer to let them know how much time they have. When the timer goes off, remind them of the next time they’ll have access to the iPad and for how long. Visual schedules can also help children understand that the item isn’t going away forever, it’s just for right now.

3. Need for Attention

The child wants attention, usually from a parent or teacher — and any attention will do, even getting yelled at.

When kids act out, Dr. Lee says, “they don’t actually care if the attention they get is positive or negative, they just want their attention big, bold, and immediate.” It’s about the duration, proximity, and intensity, she says. Because of this, kids often act in a way that’s likely to get them the most attention, even if that means getting in trouble.

For example, a student who’s quietly working at their desk might receive mild praise from the teacher. The praise probably won’t be for very long or very enthusiastic, and the teacher might be several desks away. But, if that same kid throws their pencil, it’s likely that the teacher will come over immediately and say, excitedly, “What are you doing! We don’t throw things in here. What’s going on?”

Similarly, just when you’re beginning a work call or engaged in cooking dinner, one of your children grabs their sibling’s toy and hits them. Or, they climb on top of the sofa…and jump. They know they’ll get in trouble, but they do it anyway, because they also know it will get your attention.

How to change attention-seeking behavior:

- Set kids up to occupy themselves. If your child often acts up when you need to do something else, being proactive can help. Set your child up with an activity that will last for the duration of your call or dinner prep. And if your child regularly craves physical touch, make sure to give them a hug before you log on to your meeting.

- Planned ignoring. The most powerful way to change a behavior that’s motivated by attention is to refuse to reward the behavior with attention, says Dr. Lee. Children won’t give up their need for attention easily, so be prepared for the behaviors to get worse before they get better — this is called an extinction burst. But eventually, the behaviors will stop. You should only use planned ignoring when you have the time, safe space, and patience to get over the hump with your kid.

- Give regular and specific positive attention for good behavior. Whenever you can, make a point of using labeled praise for behaviors you want to see. For example, “Great job sharing your crayons with your brother.”

- Help kids practice patience. Start by asking kids to be patient for short, predictable periods of time. For example, set a five-minute timer before you go to the bathroom and let them know you’ll be back by the time it goes off. Praise them for waiting patiently. Then gradually increase the time as kids get more comfortable.

4. Sensory stimulation

The child does something because it feels good, provides comfort, relieves pain, helps them expend energy, or calms them down.

Behaviors driven by a need for sensory stimulation — or to stop disturbing stimulation — are commonly seen in kids on the autism spectrum as well as other children with sensory processing issues. “These kids are seeking out sensory input because they like the way it makes them feel,” explains Stephanie Ruggiero, PsyD, a clinical psychologist at the Child Mind Institute Or, she adds,  “they’re behaving in a way that limits their access to certain things because their senses are overstimulated.”

Examples of sensory-seeking behaviors:

- Chewing on objects, like pen caps or clothing

- Spinning in circles, flapping hands, crashing into furniture

- Making repetitive sounds vocally (like clicking or humming noises) or physically (like tapping hands or feet) in places or situations where silence is expected

- Touching or smelling other people or things repeatedly, often without asking

- Self-injury to provide sensory input (such as banging their head because it feels good, skin picking to feel the skin under their nails).

Examples of sensory-avoidant behaviors:

- Refusing to eat certain foods or wear certain clothing

- Covering ears when they believe sounds are too loud

- Avoiding certain people or things due to their scent

- Self-injury to avoid something (such as banging their head to avoid hearing a bothersome sound, skin picking to soothe their anxiety).

How to change sensory-seeking or sensory-avoidant problem behaviors:

- Replace a harmful behavior with a safe alternative. For example, if a child constantly picks at their skin to ease their anxiety, occupying their hands with a fidget toy or something else they can “pick” at, like putty or stickers, can help prevent the behavior.

- Set limits around the behavior. Some behaviors, like making sounds or spinning around are okay in some settings, but problematic in others. Help your child become aware of their behavior, learn when and where it’s appropriate, and work together to find an appropriate replacement behavior for when they need sensory stimulation.

- Find solutions to help your child cope with the loud noise, uncomfortable clothing, bad smell, etc. You can minimize or eliminate your child’s sensory-avoidant behaviors by making accommodations that meet their needs. For example, purchase noise-cancelling headphones, prioritize comfort over style when it comes clothing or suggest a family member not wear a certain fragrance when around your child.

Collect data to determine the function

Dr. Ruggiero says the best way to determine the function of the problem behavior is to collect data.

“I’m a big proponent of what we call ABC data, which stands for antecedent, behavior, consequence,” she explains. “That means you should track what’s happening right before the behavior, what the behavior entailed, the duration, and your response to the behavior.” This allows you to find the pattern, leading you to the function.

Ruggerio says that if the behavior happens several times a day, you may be able to see the pattern within a week, but if it occurs only once or twice a week, it could take a month or more.

Once you’ve determined the function of a problem behavior and implement a plan to change it, continue to track the behavior for at least two weeks to see if there’s any improvement. “It can take longer if you need to teach a replacement behavior or a new skill,” says Dr. Ruggerio. “And, it’s also possible that your child may go through an extinction burst where the frequency and intensity increases before you begin to see a change.”

If nothing changes, you might have misidentified their motivation or there is more than one reason for their behavior.

Once you’ve successfully eliminated a behavior, if it returns at a later point, begin the process again. Children do change over time, which means that the function of their behavior can also change.

Frequently Asked Questions

Why do kids act out?

Kids often act out because they want to escape or delay a task they don’t like, because they want a specific item (like a toy, candy, etc.), or because they want attention. Kids with sensory issues might also act out because they need more or less sensory stimulation. https://standingabovethecrowd.com/?p=16279

James Donaldson on Mental Health - People with mental health conditions face higher injury risk

by U. Michigan

People with mental health conditions face a significantly higher risk of physical injuries, according to a new study.

These include unintentional injuries, such as falls and traffic accidents, and also injuries from self-harm and assault.

The newly published findings, which received US federal funding, indicate an urgent need to integrate injury prevention into mental health care.

While previous research has established that individuals with mental health conditions are at greater risk for chronic physical diseases as they age, less attention has been paid to their vulnerability to physical injuries. Existing studies have largely focused on intentional injuries, including self-harm and suicide attempts, and in some cases assault victimization.

Until now, the role of mental health in unintentional injuries—the most common type of injury in the population—has remained poorly understood, says study lead author Leah Richmond-Rakerd, assistant professor of psychology.

Injuries are an important public health concern, she notes. They are a leading cause of premature mortality in the United States and worldwide, and are a major source of pain, disability, and lost productivity. Unintentional injuries account for the majority of injuries, yet they have rarely been examined as a potential consequence of poor mental health.

To address this gap, researchers analyzed population-wide administrative data from nearly 5 million individuals in Norway and New Zealand. Mental health conditions were identified through primary care records and inpatient hospital records. Injuries were identified through primary care records, inpatient hospital records and injury insurance claims. Participants were followed over periods ranging from 14 to 30 years.

Individuals with mental health conditions had an elevated risk of subsequent self-harm injuries and injuries resulting from assault, the study indicated. However, they also had a significantly increased risk of unintentional injuries. These associations were observed across a range of mental health conditions and injury types, with particularly strong links to injuries affecting the brain and head. Importantly, the increased risks could not be explained by preexisting injuries or by socioeconomic background.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

“These findings indicate that individuals with mental health conditions are vulnerable to a broad range of injuries,” the researchers say. “People with mental health conditions are an important and underrecognized population for injury prevention efforts.”

The study reinforces the importance of continued assessment and prevention of self-harm among individuals with mental health conditions, as well as the use of evidence-based strategies to reduce their risk of victimization. At the same time, it points to new directions for health care and policy.

Researchers call for more integrated health care services, such as embedding psychoeducation about injury risk into mental health treatment and identifying opportunities to intervene during acute-care encounters, including mental health-related hospital admissions. The findings also underscore the need for enhanced public health surveillance to better track and prevent injuries among people with mental health conditions.

The research highlights a critical but overlooked intersection between mental health and physical safety—one that could inform more holistic approaches to care and ultimately save lives, the researchers say.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-people-with-mental-health-conditions-face-higher-injury-risk/

by U. Michigan

People with mental health conditions face a significantly higher risk of physical injuries, according to a new study.

These include unintentional injuries, such as falls and traffic accidents, and also injuries from self-harm and assault.

The newly published findings, which received US federal funding, indicate an urgent need to integrate injury prevention into mental health care.

While previous research has established that individuals with mental health conditions are at greater risk for chronic physical diseases as they age, less attention has been paid to their vulnerability to physical injuries. Existing studies have largely focused on intentional injuries, including self-harm and suicide attempts, and in some cases assault victimization.

Until now, the role of mental health in unintentional injuries—the most common type of injury in the population—has remained poorly understood, says study lead author Leah Richmond-Rakerd, assistant professor of psychology.

Injuries are an important public health concern, she notes. They are a leading cause of premature mortality in the United States and worldwide, and are a major source of pain, disability, and lost productivity. Unintentional injuries account for the majority of injuries, yet they have rarely been examined as a potential consequence of poor mental health.

To address this gap, researchers analyzed population-wide administrative data from nearly 5 million individuals in Norway and New Zealand. Mental health conditions were identified through primary care records and inpatient hospital records. Injuries were identified through primary care records, inpatient hospital records and injury insurance claims. Participants were followed over periods ranging from 14 to 30 years.

Individuals with mental health conditions had an elevated risk of subsequent self-harm injuries and injuries resulting from assault, the study indicated. However, they also had a significantly increased risk of unintentional injuries. These associations were observed across a range of mental health conditions and injury types, with particularly strong links to injuries affecting the brain and head. Importantly, the increased risks could not be explained by preexisting injuries or by socioeconomic background.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

“These findings indicate that individuals with mental health conditions are vulnerable to a broad range of injuries,” the researchers say. “People with mental health conditions are an important and underrecognized population for injury prevention efforts.”

The study reinforces the importance of continued assessment and prevention of self-harm among individuals with mental health conditions, as well as the use of evidence-based strategies to reduce their risk of victimization. At the same time, it points to new directions for health care and policy.

Researchers call for more integrated health care services, such as embedding psychoeducation about injury risk into mental health treatment and identifying opportunities to intervene during acute-care encounters, including mental health-related hospital admissions. The findings also underscore the need for enhanced public health surveillance to better track and prevent injuries among people with mental health conditions.

The research highlights a critical but overlooked intersection between mental health and physical safety—one that could inform more holistic approaches to care and ultimately save lives, the researchers say. https://standingabovethecrowd.com/?p=16276

James Donaldson on Mental Health - How Anxiety Affects Kids in School

What it looks like, and why it's often mistaken for something else

Writer: Rachel Ehmke

Clinical Expert: Ken Schuster, PsyD

What You'll Learn

- What might anxiety look like at school?
- Why is anxiety sometimes confused with other problems like ADHD or learning disorders?
- What physical symptoms do anxious kids get?
- Quick Read
- Full Article
- Inattention and restlessness
- Attendance problems and clingy kids
- Disruptive behavior
- Trouble answering questions in class
- Frequent trips to the nurse
- Problems in certain subjects
- Not turning in homework
- Avoiding socializing or group work
Downloadable Resources
- How Anxiety Affects Kids in School

Quick Read

Anxiety makes school hard for kids. It might also be hard to notice. Anxiety can be confused with upset stomachs, acting out, ADHD or even learning disorders. And there are different kinds of anxiety that might come up at school. Kids may worry about everything from separating from parents at drop-off to speaking up in class to feeling like their work has to be perfect.

Teachers may think a kid has ADHD when they’re restless or aren’t able to focus on the lesson. But it could be anxiety. Some kids don’t want to go to school especially after a summer or holiday break. This can also be anxiety. Throwing tantrums in the classroom or asking the same questions over and over are other ways anxiety can show up at school.

Some kids really want to participate, but when they’re called on they just freeze up. Other kids want their work to be so perfect that they don’t end up turning in their homework at all. Teachers may think those kids don’t care or have a learning disorder. To make things more confusing, kids with learning disorders may also have a lot of anxiety before they are diagnosed if they are falling behind at school.

Anxiety can also take the form of physical problems. Kids with anxiety get headaches and stomach aches a lot. Sometimes when they get really anxious, they have trouble breathing or feel their heart racing. Anxious kids end up in the nurse’s office a lot.

Sometimes anxiety is easy to identify — like when a child is feeling nervous before a test at school. Other times anxiety in the classroom can look like something else entirely — an upset stomach, disruptive or angry behavior,ADHD, or even a learning disorder.

There are many different kinds of anxiety, which is one of the reasons it can be hard to detect in the classroom. What they all have in common, says neurologist and former teacher Ken Schuster, PsyD, is that anxiety “tends to lock up the brain,” making school hard for anxious kids.

Children can struggle with:

- Separation anxiety: When children are worried about being separated from caregivers. These kids can have a hard time at school drop-offs and throughout the day.
- Social anxiety: When children are excessively self-conscious, making it difficult for them to participate in class and socialize with peers.
- Selective mutism: When children have a hard time speaking in some settings, like at school around the teacher.
- Generalized anxiety: When children worry about a wide variety of everyday things. Kids with generalized anxiety often worry particularly about school performance and can struggle with perfectionism.
- Obsessive-compulsive disorder: When children’s minds are filled with unwanted and stressful thoughts. Kids with OCD try to alleviate their anxiety by performing compulsive rituals like counting or washing their hands.
- Specific phobias: When children have an excessive and irrational fear of particular things, like being afraid of animals or storms.

Here are some tips for recognizing anxiety in kids at school, and what might be causing it.

Inattention and restlessness

When a child is squirming in their seat and not paying attention, we tend to think of ADHD, but anxiety could also be the cause. When kids are anxious in the classroom, they might have a hard time focusing on the lesson and ignoring the worried thoughts overtaking their brains. “Some kids might appear really ‘on’ at one point but then they can suddenly drift away, depending on what they’re feeling anxious about,” says Dr. Schuster. “That looks like inattention, and it is, but it’s triggered by anxiety.”

Attendance problems and clingy kids

It might look like truancy, but for kids for whom school is a big source of anxiety, refusing to go to school is also pretty common. School refusal rates tend to be higher after vacations or sick days, because kids have a harder time coming back after a few days away.

Going to school can also be a problem for kids who have trouble separating from their parents. Some amount of separation anxiety is normal, but when kids don’t adjust to separation over time and their anxiety makes going to school difficult or even impossible, it becomes a real problem. Kids with separation anxiety may also feel compelled to use their phones throughout the day to check in with their parents.

Disruptive behavior

Acting out is another thing we might not associate with anxiety. But when a student is compulsively kicking the chair of the kid in front of him, or throws a tantrum whenever the schedule is ignored or a classmate isn’t following the rules, anxiety may well be the cause. Similarly, kids who are feeling anxious might ask a lot of questions, including repetitive ones, because they are feeling worried and want reassurance.

Anxiety can also make kids aggressive. When children are feeling upset or threatened and don’t know how to handle their feelings, their fight or flight response to protect themselves can kick in — and some kids are more likely to fight. They might attack another child or a teacher, throw things, or push over a desk because they’re feeling out of control.

Trouble answering questions in class

Sometimes kids will do perfectly well on tests and homework, but when they’re called on in class teachers hit a wall. There are several different reasons why this might happen.

“Back when I was teaching, I would notice that when I had to call on someone, or had to figure out who’s turn it was to speak, it was like the anxious kid always tended to disappear,” says Dr. Schuster. “The eager child is making eye contact, they’re giving you some kind of physical presence in the room like ‘Call on me, call on me!’ ” But when kids are anxious about answering questions in class, “they’re going to break eye contact, they might look down, they might start writing something even though they’re not really writing something. They’re trying to break the connection with the teacher in order to avoid what’s making them feel anxious.”

If they do get called on, sometimes kids get so anxious that they freeze. They might have been paying attention to the lesson and they might even know the answer, but when they’re called on their anxiety level becomes so heightened that they can’t respond.

Frequent trips to the nurse

Anxiety can manifest in physical complaints, too. If a student is having unexplained headaches, nausea, stomachaches, or even vomiting, those could be symptoms of anxiety. So can a racing heart, sweaty palms, tense muscles, and being out of breath.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Problems in certain subjects

When a child starts doubting their abilities in a subject, anxiety can become a factor that gets in the way of her learning or showing what they know. Sometimes this can be mistaken for a learning disorder when it’s really just anxiety.

However anxiety can also go hand in hand with learning disorders. When kids start noticing that something is harder for them than the other kids, and that they are falling behind, they can understandably get anxious. The period before a learning disorder is diagnosed can be particularly stressful for kids.

Not turning in homework

When a student doesn’t turn in their homework, it could be because they didn’t do it, but it could also be because they are worried that it isn’t good enough. Likewise, anxiety can lead to second-guessing — an anxious child might erase their work over and over until there’s a hole in the paper — and spending so much time on something that it never gets finished. We tend to think of perfectionism as a good thing, but when children are overly self-critical it can sabotage even the things they are trying their hardest at, like school work.

You might also notice that some anxious kids will start worrying about tests much earlier than their classmates and may begin dreading certain assignments, subjects, or even school itself.

Avoiding socializing or group work

Some kids will avoid or even refuse to participate in the things that make them anxious. This includes obvious anxiety triggers like giving presentations, but also things like gym class, eating in the cafeteria, and doing group work.

When kids start skipping things it might look to their teachers and peers like they are uninterested or underachieving, but the opposite might be true. Sometimes kids avoid things because they are afraid of making a mistake or being judged.

Dr. Schuster notes that when kids get anxious in social situations, sometimes they have a much easier time showing what they know when teachers engage them one-to-one, away from the group.

Frequently Asked Questions

What does anxiety look like in the classroom?

Anxiety can look different in the classroom depending on the child. An anxious child could be restless and disruptive, have trouble answering questions in class, be unable to finish work, or make frequent trips to the nurse.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-how-anxiety-affects-kids-in-school/

What it looks like, and why it's often mistaken for something else

Writer: Rachel Ehmke

Clinical Expert: Ken Schuster, PsyD

What You'll Learn

- What might anxiety look like at school?

- Why is anxiety sometimes confused with other problems like ADHD or learning disorders?

- What physical symptoms do anxious kids get?

- Quick Read

- Full Article

- Inattention and restlessness

- Attendance problems and clingy kids

- Disruptive behavior

- Trouble answering questions in class

- Frequent trips to the nurse

- Problems in certain subjects

- Not turning in homework

- Avoiding socializing or group work

Downloadable Resources

- How Anxiety Affects Kids in School

Quick Read

Anxiety makes school hard for kids. It might also be hard to notice. Anxiety can be confused with upset stomachs, acting out, ADHD or even learning disorders. And there are different kinds of anxiety that might come up at school. Kids may worry about everything from separating from parents at drop-off to speaking up in class to feeling like their work has to be perfect.

Teachers may think a kid has ADHD when they’re restless or aren’t able to focus on the lesson. But it could be anxiety. Some kids don’t want to go to school especially after a summer or holiday break. This can also be anxiety. Throwing tantrums in the classroom or asking the same questions over and over are other ways anxiety can show up at school.

Some kids really want to participate, but when they’re called on they just freeze up. Other kids want their work to be so perfect that they don’t end up turning in their homework at all. Teachers may think those kids don’t care or have a learning disorder. To make things more confusing, kids with learning disorders may also have a lot of anxiety before they are diagnosed if they are falling behind at school.

Anxiety can also take the form of physical problems. Kids with anxiety get headaches and stomach aches a lot. Sometimes when they get really anxious, they have trouble breathing or feel their heart racing. Anxious kids end up in the nurse’s office a lot.

Sometimes anxiety is easy to identify — like when a child is feeling nervous before a test at school. Other times anxiety in the classroom can look like something else entirely — an upset stomach, disruptive or angry behavior,ADHD, or even a learning disorder.

There are many different kinds of anxiety, which is one of the reasons it can be hard to detect in the classroom. What they all have in common, says neurologist and former teacher Ken Schuster, PsyD, is that anxiety “tends to lock up the brain,” making school hard for anxious kids.

Children can struggle with:

- Separation anxiety: When children are worried about being separated from caregivers. These kids can have a hard time at school drop-offs and throughout the day.

- Social anxiety: When children are excessively self-conscious, making it difficult for them to participate in class and socialize with peers.

- Selective mutism: When children have a hard time speaking in some settings, like at school around the teacher.

- Generalized anxiety: When children worry about a wide variety of everyday things. Kids with generalized anxiety often worry particularly about school performance and can struggle with perfectionism.

- Obsessive-compulsive disorder: When children’s minds are filled with unwanted and stressful thoughts. Kids with OCD try to alleviate their anxiety by performing compulsive rituals like counting or washing their hands.

- Specific phobias: When children have an excessive and irrational fear of particular things, like being afraid of animals or storms.

Here are some tips for recognizing anxiety in kids at school, and what might be causing it.

Inattention and restlessness

When a child is squirming in their seat and not paying attention, we tend to think of ADHD, but anxiety could also be the cause. When kids are anxious in the classroom, they might have a hard time focusing on the lesson and ignoring the worried thoughts overtaking their brains. “Some kids might appear really ‘on’ at one point but then they can suddenly drift away, depending on what they’re feeling anxious about,” says Dr. Schuster. “That looks like inattention, and it is, but it’s triggered by anxiety.”

Attendance problems and clingy kids

It might look like truancy, but for kids for whom school is a big source of anxiety, refusing to go to school is also pretty common. School refusal rates tend to be higher after vacations or sick days, because kids have a harder time coming back after a few days away.

Going to school can also be a problem for kids who have trouble separating from their parents. Some amount of separation anxiety is normal, but when kids don’t adjust to separation over time and their anxiety makes going to school difficult or even impossible, it becomes a real problem. Kids with separation anxiety may also feel compelled to use their phones throughout the day to check in with their parents.

Disruptive behavior

Acting out is another thing we might not associate with anxiety. But when a student is compulsively kicking the chair of the kid in front of him, or throws a tantrum whenever the schedule is ignored or a classmate isn’t following the rules, anxiety may well be the cause. Similarly, kids who are feeling anxious might ask a lot of questions, including repetitive ones, because they are feeling worried and want reassurance.

Anxiety can also make kids aggressive. When children are feeling upset or threatened and don’t know how to handle their feelings, their fight or flight response to protect themselves can kick in — and some kids are more likely to fight. They might attack another child or a teacher, throw things, or push over a desk because they’re feeling out of control.

Trouble answering questions in class

Sometimes kids will do perfectly well on tests and homework, but when they’re called on in class teachers hit a wall. There are several different reasons why this might happen.

“Back when I was teaching, I would notice that when I had to call on someone, or had to figure out who’s turn it was to speak, it was like the anxious kid always tended to disappear,” says Dr. Schuster. “The eager child is making eye contact, they’re giving you some kind of physical presence in the room like ‘Call on me, call on me!’ ” But when kids are anxious about answering questions in class, “they’re going to break eye contact, they might look down, they might start writing something even though they’re not really writing something. They’re trying to break the connection with the teacher in order to avoid what’s making them feel anxious.”

If they do get called on, sometimes kids get so anxious that they freeze. They might have been paying attention to the lesson and they might even know the answer, but when they’re called on their anxiety level becomes so heightened that they can’t respond.

Frequent trips to the nurse

Anxiety can manifest in physical complaints, too. If a student is having unexplained headaches, nausea, stomachaches, or even vomiting, those could be symptoms of anxiety. So can a racing heart, sweaty palms, tense muscles, and being out of breath.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Problems in certain subjects

When a child starts doubting their abilities in a subject, anxiety can become a factor that gets in the way of her learning or showing what they know. Sometimes this can be mistaken for a learning disorder when it’s really just anxiety.

However anxiety can also go hand in hand with learning disorders. When kids start noticing that something is harder for them than the other kids, and that they are falling behind, they can understandably get anxious. The period before a learning disorder is diagnosed can be particularly stressful for kids.

Not turning in homework

When a student doesn’t turn in their homework, it could be because they didn’t do it, but it could also be because they are worried that it isn’t good enough. Likewise, anxiety can lead to second-guessing — an anxious child might erase their work over and over until there’s a hole in the paper — and spending so much time on something that it never gets finished. We tend to think of perfectionism as a good thing, but when children are overly self-critical it can sabotage even the things they are trying their hardest at, like school work.

You might also notice that some anxious kids will start worrying about tests much earlier than their classmates and may begin dreading certain assignments, subjects, or even school itself.

Avoiding socializing or group work

Some kids will avoid or even refuse to participate in the things that make them anxious. This includes obvious anxiety triggers like giving presentations, but also things like gym class, eating in the cafeteria, and doing group work.

When kids start skipping things it might look to their teachers and peers like they are uninterested or underachieving, but the opposite might be true. Sometimes kids avoid things because they are afraid of making a mistake or being judged.

Dr. Schuster notes that when kids get anxious in social situations, sometimes they have a much easier time showing what they know when teachers engage them one-to-one, away from the group.

Frequently Asked Questions

What does anxiety look like in the classroom?

Anxiety can look different in the classroom depending on the child. An anxious child could be restless and disruptive, have trouble answering questions in class, be unable to finish work, or make frequent trips to the nurse. https://standingabovethecrowd.com/?p=16270

James Donaldson on Mental Health - National Nonprofit Helps Rural Youths Prevent Suicide

Photo by Pixabay on Pexels.com
- By Dan Sullivan

A national nonprofit is launching a program to help rural youths talk with each other about mental health struggles.

Rural Minds will pilot the Rural Youth Mental Wellness program starting in October in New York and Pennsylvania.

It is expected to roll out nationwide in fall 2026.

The program will focus on the particular challenges of young people who live in rural areas.

Youths age 15 to 19 are 74% more likely to commit suicide than their urban peers, according to the Rural Health Information Hub.

The new program focuses on developing and normalizing peer-to-peer communication about mental health.

Young people are often more comfortable talking with each other about personal struggles than with an adult, said Chuck Strand, the executive director of Rural Minds.

The biggest step is often having the courage and sensitivity to ask someone if they are thinking of harming themselves, Strand said.

“Those are tough conversations to have, and one of the printable program pieces that we have already in that resilience program is how to have that conversation,” he said.

National Grange and other partners are supporting the Rural Youth Mental Wellness program.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Matt Espenshade, the president of Pennsylvania State Grange, said rural life can come with burdens such as preserving a generational farm.

“Nobody in my position wants to be the final generation,” said Espenshade, a seventh-generation dairy farmer in Lancaster County.

Social media presents its own challenges.

Espenshade said rural youths could get discouraged by comparing their real lives, full of mundane struggles, with the selective highlight reels posted by urban kids.

“It’s a real challenge separating what is real from just glorified fantasy,” he said.

Espenshade first encountered Rural Minds two years ago, when the group’s founder, Jeff Winton, spoke at the National Grange Convention. Last year, Strand spoke to the Pennsylvania State Grange.

Over the past few years, Espenshade said, he has noticed that rural people have begun to talk more freely about mental illness.

Strand thinks the historical reluctance is cultural.

“A lot of people in rural communities grow up with this mindset of celebrating being able to do things themselves, which is often necessary,” he said. “You’ve got to learn to be independent and self-reliant.”

But people can’t always sort out mental health challenges on their own, and care can be hard to access in rural areas, he said.

Advisory committee members on the new peer-to-peer project include NY FarmNet and Cornell University, as well as teens and young adults from FFA, 4-H and the National Grange.

Rural Minds’ services are available at ruralminds.org and by calling 800-226-8113.

If you or someone you know is having thoughts of suicide or is in emotional distress, dial 988 for 24/7 support. If it is a life-threatening emergency, call 911 or go to the nearest emergency room.

Photo by Pixabay on Pexels.com https://standingabovethecrowd.com/james-donaldson-on-mental-health-national-nonprofit-helps-rural-youths-prevent-suicide/