Middle School Mental Health: 6 Steps Educators can Take to Address Student Needs

It is a sad fact that in any classroom of thirty middle school students, approximately six might be experiencing some form of mental illness. Adolescence is a particularly important time, as physical, social, and emotional changes combined with exposure to risk factors can put young people at risk. Mental health conditions such as anxiety, depression, and substance abuse, often present by age 14 and can set adolescents on a course for any number of poor short- and long-term outcomes including low academic achievement, school dropout, strained family relationships, substance abuse, involvement with child welfare or juvenile justice systems, and engagement in risky sexual behavior (Merikangas, He, Bursteon, Swanson, Avenevoli, Cui, Benjet, Georgiades, & Swendsen, 2010; Schwarz, 2009). While teachers at all levels should have awareness of the warning signs of the most common mental illnesses, this is particularly important for teachers at the middle level as many conditions begin to develop during this transitional time.

Unfortunately, research shows that teachers’ “mental health literacy,” the knowledge and beliefs about mental disorders that aid in their recognition, management, or prevention (Jorm, Korten, Jacomb, Christensen, Rodgers, & Politt, 1997), may be insufficient. A lack of training can lead teachers to feel they are on the front lines of this crisis without enough professional education to make an impact.

What can middle school teachers do when they observe a student who is truly struggling? We propose six important steps you can take to better address the mental health needs of the middle school students in your classroom:

Recognize knowledge gaps

First, recognize your own lack of knowledge on the subject and obtain additional education, if possible. While for some that might mean taking a graduate-level course on mental health, there are now a variety of evidence-based trainings which focus either on specific mental illnesses, such as Question, Persuade, Refer (QPR) or on a range of mental illnesses, such as Youth Mental Health First Aid, and which provide teachers tools to both recognize when an individual is in crisis and intervene with language and action to assist. Mental health training and education will increase your confidence and capability.

Watch for warning signs

Second, watch for warning signs. Middle school is a challenging time for many students, and it may be difficult for a teacher to differentiate between normal development during adolescence and a true sign of concern. For example, all adolescents experience mood swings. How do you tell if this mood swing is typical or a signal of an underlying disorder? If you are a veteran teacher, you can probably tell the difference between an adolescent in crisis and a typical middle school student. If you are a novice teacher, obtaining training can help. If training is not available, consult with your more experienced colleagues, the school guidance counselor, or the school psychologist. There are also many great books available that can help you differentiate; don’t count out parenting books for this age group (for example The teenage brain: A neuroscientist’s survival guide to raising adolescents and young adults by Frances E. Jensen or Tweens: What to expect from – and how to survive – your child’s pre-teen years by Andrea Clifford-Poston). Take steps to educate yourself in whatever way you are able.

Lessen the stigma and build resilience

Third, use opportunities within your classroom to lessen the stigma around mental illness and build resilience in your students. Protective factors, like participating in sports/clubs, having an appropriate adult mentor, or familial support, build resilience and serve to reduce the chances that an adolescent will develop a mental illness. It is inevitable that all students will experience setbacks in their life, so everyone can benefit from lessons on resilience. To lessen the stigma around mental illness, watch the way you speak in front of your students. Refrain from calling people or situations crazy, insane, deranged, or unstable. When students hear this language colloquially, they form negative connotations about mental illness and may be less likely to reach out to you for help. As teachers, we should use every opportunity to model for our students.

Listen before talking

Fourth, keep in mind that listening is more important than talking. Middle school students want to be heard. Although many of us may have relevant personal or family histories, ensuring the young person feels heard is essential. That means keeping our own stories under wraps and not responding with comfortable—but unhelpful—phrases such as I know how you feel… or When I was in middle school…When unsure of how to respond, often it is best to stay quiet. That student may have taken a big risk in coming to you to help, and you want to reinforce that behavior by asking questions (How long have you been feeling this way?) and listening rather than talking.

Ask for help

Fifth, realize that as an educator, you aren’t an expert in mental health, and you can’t handle the situation alone. Regardless of how much training a well-qualified teacher has, he or she is not a credentialed mental health counselor. No one teacher should be expected to manage a student’s mental health crisis all alone. Further, school districts and buildings have specific protocols for alerting more qualified personnel to any situation where a student is in crisis. Follow these protocols and involve the district personnel who can better support the student past any initial concerns where you got involved. Adolescents experiencing mental health issues need support and counseling over the long haul, and as their teacher, you are not the appropriate one to provide it.

Practice patience and grace

Finally, be patient—with your students and with yourself. In your role as an educator, you are likely to be the trusted person a student first turns to for help, but mental health issues do not generally develop overnight, and appropriate support is likely to require extended attention from a credentialed professional. The first few times you attempt to support a student in crisis, you will likely make mistakes. You may reflect later that you didn’t respond as well as you could have or didn’t clearly demonstrate to the student that you were listening and concerned. However, just as we tell our students, try to learn from these missteps so that you can be better prepared for future encounters.

Dr. Nicole Hesson is an Assistant Professor of Education at York College of Pennsylvania whose research focuses on preservice teacher education and science education. Dr. Kimberly Kode is an Associate Professor of Education at York College of Pennsylvania whose research focuses on preservice teacher education and special education.


  • Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Politt, P. (1997).  “Mental health literacy”: a survey about the public’s ability to recognize mental disorder and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 66, 182-186.
  • Merikangas, K. R., He, J., Burstein, M., Swanson, S.A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010 October). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry.980-989, doi:10.1016/j.jaac.2010.05.017.
  • Schwarz, S. W. (2009 June). Facts for Policy Makers: Adolescent Mental Health in the United States. National Center for Children in Poverty


  1. I think these tips are going to be very helpful when I have a classroom of my own. The pandemic sure has interrupted regular teaching and the routine of many students. I have seen a growing need for educators’ knowledge of how to deal with the students’ mental health now more than ever. It can be hard to see which students are struggling with mental health and which ones are just “going through the motions” but it is important to not only prepare students for content for the future but to also help them manage their own mental health and give them the assistance they will need to deal with their place outside of the classroom and in the real-world as well.

  2. I really appreciate the importance you have placed on educating yourself about the different mental illnesses students may be dealing with. I agree that stigmas surrounding mental illnesses are prevalent, especially with this age group, and the teacher plays a large roll in lessening, if not depleting, the harmful statements made about students, or anyone else, who is struggling with mental illness.

  3. I personally have not heard of mental health literacy. After reading this article, I realize how important it is for us as teachers to learn more about this and the signs as mentioned in the article to help to continue to help our students have a safe learning environment