The occurrence and severity of student mental health struggles are increasing, with 4 in 10 students reporting persistent feelings of sadness or hopelessness in 2023 and increasing rates of suicide attempts or ideation. This increase in reported mental health problems goes beyond just affecting a student’s mood or grades. Behavioral risks, health issues, and educational outcomes can all be negatively impacted when mental health suffers.
The good news, though, is that students are resilient and school professionals can have a measurable positive impact on student well-being. School nurses, in particular, are often the initial point of support for students struggling with mental health or wellness concerns. When early signs of stress, anxiety, depression, or other behavioral health challenges are identified, school nurses can respond as frontline healthcare professionals — their collaboration with school professionals, community providers, and family members can provide effective interventions in mental health support.
Read on to learn more about how school nurses can offer valuable mental health support, growing challenges faced by school nurses and students, best school-wide practices, and how to become a school nurse.
Seeing More Than Symptoms
When people think of a visit to the school nurse’s office, they might assume stomachaches or a minor playground injury, but there can often be much more to those visits.
Students with chronic stomachaches might have undiagnosed anxiety or a larger source of stress that hasn’t yet been addressed at school. Sometimes students aren’t even able to articulate or identify why they need a visit to the nurse’s office. Still, they know that they do — the National Association of School Nurses has recognized that many times students feel more comfortable verbalizing physical symptoms when they’re actually dealing with more profound issues and emotional distress.
So what role does a school nurse play when student visits reveal deeper issues? As trusted adults who interact with students often and early, school nurses can be a uniquely safe and trusted presence in school settings. Some key ways that school nurses can become more aware and sincerely supportive include:
- Participating in trauma-informed care training
- Participating in behavioral health first aid training
- Asking the right questions
- Making correct referrals
- Staying observant
School nurses are also often directly involved in developing Individualized Education Programs (IEPs) and 504 plans, which help educators and behavioral health providers assess a student’s overall wellness needs and goals. When a school nurse is involved in a student’s care plan, the care becomes more holistic and better aligned with the student’s actual needs.
Areas of Increasing Mental Stress for Students
Children and teenagers experience significant change and stress throughout their K–12 experience, but school nurses and professionals must recognize the difference between students experiencing normal amounts of change or stress students who might need extra support.
Here are a few of the issues and populations that are seeing upward trends in mental health concerns:
Bullying and Cyberbullying
Students are facing unique bullying situations in K–12 schools, and the prevalence is increasing. One in every five students reports being bullied. In a 2022 national survey by the U.S. Department of Education, 100 percent of students reported experiencing, witnessing, or being aware of acts of bullying. Cyberbullying in particular is a significant issue in recent school years, with 37 percent of middle and high school students reporting experiencing online harassment.
School nurses are in a unique position to notice, advocate for, and intervene with students before bullying escalates to levels that negatively impact a student’s well-being. School-based interventions involving nurses can detect bullying earlier, and collaboration among support teams can reduce bullying occurrences and impact.
LGBTQ+ Student Needs
School nurses have an ethical responsibility to support all student subgroups, particularly those who may face increased bullying or discrimination. Gender identity formations often take place during adolescence, and school nurses can be a free, safe, school-based source of support for LGBTQ+ students.
Some simple practices school nurses can implement to support LGBTQ+ students include using correct names and pronouns for students, implementing trans-inclusive language during conversation and education, advocating for inclusive restrooms, and being available to listen.
Academic Pressures
The pressure to perform academically is a significant source of stress for many K–12 students. According to the Pew Research Center, 68 percent of teens say they face a great deal or fair amount of pressure to get good grades. When this pressure crosses from motivating to debilitating, students may need support and intervention.
School nurses can lead wellness check-ins to assess whether academic pressures are at a healthy level in their school and watch for patterns of anxiety or stress that may be tied to academic concerns among students. They can also help students develop stress management skills to help positively affect long-term mental health and academic performance.
External Factors
Family situations, poor habits, or environmental factors are just a few of the outside forces that impact a student’s well-being at school. A school nurse may be the first professional to notice a student exhibiting consistent signs of distraction, fatigue, sadness, or other emotional or physical states that affect a student’s well-being at school.
School nurses can help students (and their families) by educating students about healthy habits, providing support when necessary, and working closely with other members of school support teams to respond to specific situations.
How Schools and Districts Can Effectively Support Mental Health
Student mental health can be improved through school- and district-wide practices, and some of those can start with advocacy from school nurses. The Centers for Disease Control and Prevention has provided an action guide to help school and district leaders build on efforts to promote students’ mental health and offer new strategies to help fill gaps in mental health care support.
The guide describes six strategies schools can implement that are proven to promote and support student well-being and mental health. These strategies are:
- Increase students’ mental health literacy
- Promote mindfulness
- Promote social, emotional, and behavioral learning
- Enhance connectedness among students, staff, and families
- Provide psychosocial skills training and cognitive behavioral interventions
- Support staff well-being
These six strategies can be supported, promoted, or initiated by school nurses if schools or districts are not currently prioritizing these efforts. When the role of a school nurse is elevated within school-based mental and behavioral health initiatives, student outcomes will improve.
The School Nurse Career Path
The path to becoming a school nurse can vary depending on state or school district requirements. The qualifications typically start with an Associate Degree in Nursing (ADN), followed by becoming a licensed practical nurse (LPN) or a licensed vocational nurse (LVN). Guidelines from The National Association of School Nurses suggest that RNs earn their Bachelor of Science in Nursing (BSN) and then pass the NCLEX-RN exam to work as a school nurse. Many school positions prefer clinical experience before working within the school system, often totalling 1,000 hours. School nurses can also become Nationally Certified School Nurses (NCSNs).
SHC Cares for Students and School Nurses
Supplemental Health Care offers staffing solutions that help school nurses connect with the right opportunities. We partner with districts to maintain a high level of support and care for nurses, which directly translates into better student outcomes. Our priority is student well-being and genuine support for school staff. Contact us today to learn more about becoming a school nurse and finding the right district position.
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