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Public school awareness programs are once again being implemented in Texas and the rest of the nation to address youth drug use, over four decades after former First Lady Nancy Reagan introduced her iconic “Just Say No” advertising campaign.
The Drug Abuse Resistance Education initiative — commonly known as D.A.R.E. — was introduced to schools in the early 1980s. It was designed to equip elementary and high school students with the skills to avoid drugs by standing up to peer pressure, but the program began to fade out of school districts across the country by the middle of the 2000s due to lack of results. This hasn’t stopped other anti-drug programs from taking its place over the years as the country constantly scrambles to figure out how to solve the problem of youth drug abuse.
Now, Texas is about to launch its latest anti-drug program in schools. Earlier this year, the state launched “One Pill Kills,” a multimedia campaign designed to warn Texans about the unlawful use of fentanyl, the synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine. Reinforcing that message is a new law passed this year — House Bill 3908 — which requires fentanyl and drug abuse prevention instruction in Texas public schools for grades six through 12.
The measure — named Tucker’s Law after Tucker Roe, a 19-year-old from Leander who died after taking a fentanyl-laced pill — went into effect in June and also requires Gov. Greg Abbott to designate a Fentanyl Poisoning Awareness Week in public schools.
After consuming what he believed to be Percocet, Roe passed away. The pill he acquired through social media turned out to be contaminated with fentanyl. Roe’s mother, Stefanie Turner, has been tirelessly advocating for fentanyl awareness among students.
“At the ‘One Pill Kills’ summit held in April, Turner shared how he was informed about his initial encounter with a pill, which unfortunately failed to rescue him. Turner emphasized that even having a caring family wasn’t sufficient to protect him. He emphasized that any family could face this predicament.”
Turner’s statement succinctly explains the core reason behind the underwhelming outcomes of past anti-drug education.
Studies on the D.A.R.E. program in the 1990s pointed out that the anti-drug curriculum failed because it didn’t acknowledge that youth drug use is often a symptom of a larger mental health problem.
Many students who have a substance abuse disorder have had a negative experience in their childhood, and being taught healthy ways to manage their emotions could prevent them from turning to drugs.
There are concerns among mental health providers in Texas that the state’s current focus on fentanyl education might lead to similar mistakes made in the past with the D.A.R.E. program.
“Kids have to understand why they are buying pills in the first place,” said Kathleen Hassenfratz, a licensed professional counselor and board member for the nonprofit mental health organization the Engage and Heal Foundation, a group that formed in 2019 to raise mental health awareness.
Youth mental health was declared a national emergency by pediatric experts across the country in 2021 as they warned that stress brought on by COVID-19 was leading to a rise in suspected suicide attempts among young people and an increase in hospital emergency room visits for mental health crises.
School counselors across the country have reported an uptick in the prevalence and severity of depression, anxiety, self-harm, suicidality and eating disorders among students.
“Students who are experiencing thoughts about self-harm are more often advancing those thoughts into action. They now have thoughts, plus a plan, plus action,” Jennifer Akins, a licensed professional counselor and president of the Texas School Counselors Association told Counseling Today in 2022.
One area of study specifically highlighted nationwide is young people’s lack of emotional regulation. Those key years when kids learn how to “monitor, evaluate and modify emotions that arise following a stimulus” happened behind computer screens as they stayed at home for online classes during the pandemic.
“A lot of it has been lumped together as an anxiety crisis. I would say we have seen a crisis in social skills, conflict resolution and self management,” Summer Rose, a Dallas-based chief clinical officer for Communities In Schools, an anti-dropout program that works with public and charter schools. “You forced everybody to only live in a digital world and then put them back in school and told them to do what they were doing but in real life, but they haven’t been taught how to do that in the real world.”
For years, researchers have been studying the correlation between mental health and substance abuse, as the connection between the two has been recognized for a significant period of time.
A 2002 study that looked at two national surveys on drug use concluded that unmet mental health care needs among those with a mental illness will most likely lead to self-medication in the future.
According to the study, it is suggested that timely screening and treatment of mental health problems may play a crucial role in preventing the occurrence of substance-use disorders in individuals with mental disorders.
Dr. Sarah Martin, division director of child and adolescent psychiatry at Texas Tech University Health Sciences Center El Paso, said poor mental health and substance abuse among young people can be considered a two-way street.
She stated that adolescents with psychiatric disorders tend to consume a higher quantity of substances, and likewise, those who consume more substances are more likely to have psychiatric disorders.
Some young people may think that they can use substances like illicit drugs or alcohol as an easier or cheaper way to find relief instead of seeking professional help, but substance abuse often makes pyschiatric symptoms worse.
According to Martin, education is the foundation of all public health improvement, and schools serve as an excellent platform to ensure children and adolescents have access to reliable information.
“According to her, substance use disorder falls under the umbrella of mental health issues, and experiencing one problem of this nature increases the likelihood of facing other related problems. Therefore, it is highly logical to provide students with education on mental health and substance abuse. As a psychiatrist, she emphasizes treating both issues concurrently as they both pose significant harm to a child’s future. It is impossible to achieve good mental health in the presence of a substance use disorder, and conversely, the disorder itself worsens mental health.”
The Engage and Heal Foundation’s Hassenfratz explained that their intention is to assess the level of interest among lawmakers regarding the inclusion of a mental health literacy component in Tucker’s Law during the upcoming special session. Their objective is to ensure that mental health literacy becomes a mandatory part of the curriculum for all public school students.
According to Hassenfratz, while teaching biology and exploring genetics and hereditary traits, it is also possible to discuss the genetic transmission of mental health issues. Essentially, promoting mental health literacy involves aiding individuals in comprehending their emotions and feelings.
The group proposes that the potential addendum, whether in the form of a separate bill or an addition to the fentanyl education program, be named after Erik Hanson. Erik was a remarkable graduate from Lake Travis High School in 2017 who unfortunately took his own life during his first year of college.
Martin, who is also an executive committee member for Texas Child Health Access Through Telemedicine, which provides telemedicine and telehealth programs to schools across the state, said she believes a mental health literacy component would be a great addition to schools.
She stated that although she could only speak for Texas Tech El Paso, TCHATT is well-equipped to provide assistance if required.
More than 1,550 students from 34 West Texas school districts have been provided care by fellows from Texas Tech University of Health Sciences Center through the telemedicine program in El Paso.
If we are unable to implement a mental health literacy program in schools, Amelia Floyd, the president and co-founder of Engage and Heal, expressed the importance of ensuring that each district’s website includes a mental health component. This component would provide information on emotions, feelings, and mental health in general.
According to Hassenfratz, feeling sad and experiencing depression are distinct phenomena. While sadness is a normal emotion, depression is a clinical condition. Hassenfratz emphasizes the importance of educating students on these differences, as many young individuals tend to incorrectly self-diagnose themselves.
A growing number of young people are turning to social media platforms such as Instagram and TikTok for guidance, resources and support for their mental health or to find a condition they think matches their feelings. This trend has alarmed therapists and school counselors as mental health diagnoses are being used almost as descriptors instead of an illness.
Hassenfratz pointed out that there is a trend where people consider it cool to claim having certain conditions, even without a proper clinical diagnosis. Words like “I have anxiety” are casually thrown around without genuine validation. She emphasized the importance for young individuals to differentiate between manageable stress and overwhelming stress.
The act of depending on the internet for self-diagnosis is not a recent phenomenon. However, mental health professionals express worry about the current trend among students, who interpret any emotion as an indication of mental illness and consequently resort to self-medicating to alleviate their issues.
Rose, a member of the Communities in Schools team in Dallas, stated that they have encountered numerous mental health inquiries from students, which appear to be triggered by content they have come across on social media.
Rose stated that a student once expressed, “I possess three or four items that were shown on a slide on TikTok or Instagram. Does this indicate that I have suicidal tendencies?” She further mentioned that she and her team, who are licensed professionals, appreciate such inquiries as they encourage seeking more information.
Rose suggested that schools possess a precious chance to educate students about emotional regulation during their early years.
She said that schools have a unique position to play a crucial role in supporting students to learn about these conditions in a way that is free from stigma.
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