Researchers Investigate Aggressive Students' Mental Health

Aggression and violence in schools is a persistent problem that teachers and communities face. One team of mental health professionals is testing whether they can provide a way of dealing with aggressive kids that helps these youngsters, and keeps schools safe.

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STEVE INSKEEP, host:

Today is the first day of school for some kids in the United States, and it is also the day that we're learning of a new effort to fight aggression and violence in schools.

Some mental health professionals are testing whether they can provide a way of dealing with aggressive kids that helps these youngsters and keeps schools safe.

Michelle Trudeau reports.

MICHELLE TRUDEAU reporting:

The Columbine school shootings was like a 9/11 for educators, says researcher Nancy Rappaport, a child psychiatrist at Harvard Medical School. Following that 1999 attack, schools went on high alert trying to identify and understand violence in students.

Rappaport believes it's the responsibility of mental health professionals to help schools in this effort. To find out how, a team from the Cambridge Health Alliance went into a dozen public schools in the greater Boston area to analyze their problems.

Ms. NANCY RAPPAPORT (Child Psychiatrist, Harvard University): This is a study of 33 students who were referred by an urban school district for aggressive and violent behavior.

TRUDEAU: The 33 students were mostly boys, average age 13, but ranging from five to 18 years old with a variety of aggressive behaviors.

Ms. RAPPAPORT: It could be taking a desk and shoving it across the room and having it fall on a teacher, or a kindergartener that rips off all the drawings in a classroom, kicks her peers, runs out of the classroom; or a sixth grader that may make a threat under their breath about a hit list, and a teacher may overhear it.

TRUDEAU: Not the level of aggression where law enforcement gets involved, and not assaultive enough to get expelled, but the kinds of aggressive kids where the schools had exhausted their repertoire of how to deal with them.

Rappaport believes that a full psychiatric assessment and intervention might make the difference. So her team evaluated these students, making home visits, interviewing the students, their parents, teachers, analyzing reports of the violent incidents.

Then, with the psychiatric and medical workups of the kids and the family profiles, the researchers began to unearth what lay beneath the aggression in these youngsters.

Ms. RAPPAPORT: Many of these students were facing major challenges. The aggression was an expression of compelling pain, either of a parent dying or a sibling with a major medical or mental illness, or a trauma where they might have seen a father smash a bottle over a head of their mother, or a learning disorder where school could be a lesson in frustration every day.

TRUDEAU: Most faced multiple problems at home, Rappaport found. The majority lived without a father. Many had a medical condition, such as asthma. Many struggled with family troubles.

Ms. RAPPAPORT: Students may have had very difficult stressors at home, and when they come into school what you see is the ballistic kid. Trying to place that within context is really important.

TRUDEAU: Rappaport also found that nearly all of these very aggressive students had serious underlying psychiatric illnesses, such as depression, PTSD, bipolar disorder, ADD, yet few were receiving help. The researchers assisted the schools in coordinating mental health services for these youngsters. All this cost up to $2,000 per student.

Christopher Thomas, a child psychiatrist at the University of Texas Medical Branch at Galveston and an expert in youth violence, says it's worth spending that money.

Professor CHRISTOPHER THOMAS (University of Texas at Galveston): When you consider the potential savings in both assuring school attendance and reducing violent incidents and what they cost in a community, the benefits are quite obvious.

TRUDEAU: A report of Rappaport's work appears in the August issue of the Journal of Pediatrics. Her team is currently evaluating their mental health intervention to see if aggressive behaviors have diminished in these students. She says early results are promising.

For NPR News, I'm Michelle Trudeau.

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