Their Voices: What High School Students are Saying about School-Related Anxiety

Dr. Jenn de Lugt & Jenn Chan

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Research made possible with funding from

the Stirling McDowell Foundation of

Saskatchewan

“Schools have a profound influence on children, their families and the community. Young peoples’ ability and

motivation to stay in school to learn and utilize what they learn is affected by their mental health. Schools are

crucial in building or undermining self-esteem and a sense of confidence.”

(World Health Organization, 1995)2

What do we mean by “mental health”?

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“the state of well-being in which an individual realizes his or

her own abilities, can cope with the normal stresses of life,

can work productively and is able to make a contribution to

his or her community”

(World Health Organization, 2001)

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Mental Health is:

Mental health is not the opposite of mental illness…

• We all have mental health, as we all have physical health

• You can have a mental illness, and still have good mental health

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The Mental Health/Illness Continuum (Keyes, 2002)

Study Purpose

To further our understanding of anxiety as experienced by Grade 9, 10 and 11 students in one high school in a mid-sized city in southern Saskatchewan

Research Questions:

1. What school-related anxieties are experienced?

2. How do these anxieties affect the well-being of students?

3. What strategies and approaches do students suggest would help mitigate these school-related anxieties?

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Rationale

• 15% to 25% of Canadians under the age of 19 years have experienced at least one serious mental health concern (Butler & Pang, 2014)

• 70% of mental health problems experienced by adults begin during childhood or adolescence (Government of Canada, 2006)

• 50% of these emerge before the age of 14 years (Kessler, Berglund, Demler, Jin, & Walters, 2005)

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Rationale

It’s becoming increasingly recognised that schools are well positioned to enhance student mental health

• A reasonable assertion when considering that most children and youth spend at least 6 hours a day and more than 180 days a year in school

• Teachers agree that they are a part of the solution

• Feel they need more professional development in the areas of:• mental health in general,• in recognizing and understanding student mental health issues, and • in knowing strategies they could use to help their students

(Froese-Germain & Riel, 2012)

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Methodology

Participants

• A high school in a mid-sized city in southern Saskatchewan

• Wellness 10 class, Semester 1 (Fall 2015)

• A total of 24 participants: 7 boys and 17 girls

• Grade 9 (n=9)

• Grade 10 (n=8)

• Grade 11 (n=7)

• 24 out of 26 students consented to participating in the journal activity—some of these agreed to participate in focus groups

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Methodology

Data Collection

• Journal entries (n=24)

• 10 confidential/anonymous journal questions with prompts

• Each student was given a personal anonymous journal

• Wrote 10-15 minutes once a week for 10 weeks

• 3 Focus group sessions

• A pizza lunch incentive

• Audio-recorded

• Collected throughout the semester

– Beginning of the semester (2 groups) (n=11)

– Mid-semester (1 group) (n=5)

– End of semester (2 groups) (n=10)

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Example Journal Questions and Prompts…

➢What does anxiety mean to you?

➢When do you experience anxiety at school? Why?/When do you NOT feel anxious

at school? Why not?

➢If anxiety was a colour, what would it be, and why?

➢How does social media influence your own anxiety? Explain.

➢Describe the characteristics of an ideal teacher (one you would feel comfortable

approaching with a mental health concern, or any concern)

➢If you had a mental health concern (like anxiety or depression), would you talk to

a teacher about it?

➢What do you think teachers can do to help students with mental health

challenges? 11

Example Focus Group Questions and Prompts…

➢If you have missed school because of anxiety, describe the situation./How often have

you missed school because of anxiety?

➢Why do you think it is easier to talk about physical health than it is mental health?

➢If you had mental health concern, do you think you would talk to a teacher—why, or

why not?

➢What is the ONE most important thing teachers can do to help students who might

be struggling?

➢In many of the journals students have said that exam time (social situations;

presenting) is/are very upsetting or stressful for them./What do you think could or

should be done to reduce that stress?

➢If you had a magic wand and could change one thing about school, what would it be?12

Methodology

Data Analysis

• Journal entries and focus group interviews were transcribed verbatim

• 44 (single-spaced) pages of journal entries

• 235 minutes of focus group interview data

• Qualitative theme analysis was used to analyze the data

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What Does Anxiety Mean to You?

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Anxiety is…

FEAR NERVOUS

INCREASED HEART RATE

HEAVY BREATHING

LOTS OF PEOPLE

SWEATY HANDS

FEELING THAT TAKES OVER

GOING TO PASS OUT

CONSTANT WORRY

KNOT IN YOUR STOMACH WANT TO CRY

FEELING HELPLESS

SCARED

ANGER

WORST FEELING IN THE WORLD

IT HURTS

EXCITED

STRESSED

OVERTHINKING

MENTAL ILLNESS

INTENSE FEELING

PANIC ATTACK

UPSET

MILD, MODERATE, SEVERE

UNCOMFORTABLE

TREMBLING BODY

SHAKING

FIDGETING UNCONTROLLABLE

AFRAID WORRY

CONSTANTLY UNSETTLEDCANNOT RELAX

A BURDEN EVERYTHING IS WRONG

NOT SAFEAGAINST YOU

ROBBED OF MY AIR

DIZZY

CAN’T BREATHE

HOPELESS

LOST ALL WILL

FEAR OF FAILURE

FEAR OF JUDGEMENT

PAIN IN CHEST

TAKING OVER MY MIND

DEPRESSION

A TRAP TAKES ALL THOUGHTS

BIGGER WORRIES

AVOIDANCE

TUNNEL VISION

INTERFERES WITH DAILY LIFE

BREAKDOWN

OVERWHELMING

DROWNING

If Anxiety was a Colour...

“I think anxiety would be a very deep, dark blue because anxiety reminds me of the feeling I get when I’ve been underwater for too long and the ocean get’s darker the deeper you get. The worse [the] anxiety, the deeper you are. The

deeper you get, the more suffocating it is.”

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The GAD–7 Survey

• General Anxiety Disorder

(GAD–7) self-test screening

tool

• 7 questions

• 4 point Likert scale from “not at

all” to “nearly every day”

• Over half of the class (54%) had

moderately severe to severe

anxiety

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“For me, there isn’t one single thing that gives me more anxiety than the other. Nearly every aspect of school causes me anxiety.”

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Findings: Top 5

• Final Exams/Tests 92%

• Social Situations 67%

• Class Presentations 63%

• Homework 17%

• Pressure from Parents 13% 0

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90

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Final

Exams/Tests

Social

Situations

Class

Presentations

Homework Pressure from

Parents

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“There really aren’t times that I don’t experience anxiety. For me personally, it’s a constant issue when I’m at school. I’m not even 100% sure why. The only time that I feel calm is when I’m with my friends at lunch.”

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Final Exams/Tests

• Students identified test anxiety as

the number one reason they

experience anxiety at school• fear of failure

• high stakes nature of testing and final

exams in high school

• the amount of time spent studying

• additional pressures like other classes,

homework, and maintaining a job

• Students also felt underprepared

for exams and said their teachers

did not teach them how to study or

take a test

22 of 24 students identified having anxiety during final exam week, or before writing other tests throughout the semester.

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Final Exams/Tests

• “I don’t like being tested on a bunch of stuff at once so it really stresses me out which makes me space out.”

• “The tests give me anxiety because I fear that I wont succeed.”

• “I find that that's a lot more stressful, having to memorize something as opposed to actually learning, getting taught, and fully understanding what it’s all about”

22 of 24 students identified having anxiety during final exam week, or before writing other tests throughout the semester.

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“Anything involving other people is pretty much a nightmare for me.”

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Social Situations

• Students identified the main reason

for social anxiety as fear of

judgement from others, or “what

people will think of me”16 out of 24 students identified having anxiety while being in front of large groups of people, during school assemblies, when meeting new people, while playing sports in front of peers, and performing at the musical.

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Social Situations

• “I experience anxiety at school on a

daily basis I would say… walking into

class late… the hallways are stressful,

as are school bathrooms. There’s

almost always this knot I feel in my

stomach when I’m at school.”

• “Just knowing you could fail in front of

a group or the thought of people

judging you for something you might

do.”

16 out of 24 students identified having anxiety while being in front of large groups of people, during school assemblies, when meeting new people, while playing sports in front of peers, and performing at the musical.

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“I don’t like being around a lot of people, especially when I have to share my thoughts… I hate presenting projects to the class –especially when I’m being marked on the way I speak… but I always think that it’s the end of the world when I have to present my project. I become a nervous wreck. I start stuttering, my hands and legs shake, and my face goes red. I don’t like it.”

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Class Presentations

• Students said they do not like

speaking in front of their peers

• fear of failure

• fear of judgement

• are uneasy when their peers are

watching them

• experience anxiety when speaking in

front of crowds

15 out of 24 students identified having anxiety while presenting to a group.

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Class Presentations

• “The thought of someone judging you

is scary and nerve wracking.”

• “I experience anxiety at school when I

have to do presentations in front of the

class. I miss half of what I wrote for

the presentation, [and] end up getting

a really low mark.”

• “I’m scared people will make mean

comments, or say everything that I did

wrong”.

15 out of 24 students identified having anxiety while presenting to a group.

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“It’s like well I just [worked] five hours last night, I was exhausted. I need to sleep, I need to eat, I can’t be doing math homework at 12 every night. It’s ridiculous.”

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Homework

• Students identified they were

overwhelmed with the amount of

homework given by teachers and

felt their teachers held unrealistic

expectations of them

• Students said they had a hard time

managing school, homework, part-

time jobs, saving money for

university, and sleep

4 out of 24 students identified having anxiety when given too much homework.

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Homework • “I’m busy, and rarely have time or

energy to finish all of my

homework. Before Christmas

break and Easter break I

experience a lot less anxiety,

because I know that I will have

time over the breaks to finish any

homework I need to.”

4 out of 24 students identified having anxiety when given too much homework.

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“I’m overwhelmed. Stop, please.”

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Pressure from Parents

• Students identified their parents as

an added pressure

• Students said their anxiety was

sometimes rooted in stressful

situations at home, making it

harder for them to focus at school

3 out of 24 students identified having anxiety as a direct result from parental pressure.

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Pressure from Parents

• “…Afraid of failure I guess… and

parents seem to put lots of pressure

on kids to do well. Even receiving

like a 70% to a 85% they bug you

about not doing as good as you

could’ve.”

• “I’m most anxious near a test or

exam and when I’m in a highly

stressful situation at home.”

3 out of 24 students identified having anxiety as a direct result from parental pressure.

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Overall Results

• One student identified as having no

anxiety related to the top five

• Four students identified as having one of

the top five anxieties

• Four students identified as having two of

the top five anxieties

• Twelve students identified as having three

of the top five anxieties

• Three students identified as having four of

the top five anxieties

• No students identified as having all five of

the top five anxieties12 had 3

anxieties

4 had 2

anxieties

4 had 1

anxieties

3 had 4

anxieties

1 had 0

anxieties

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“I really don’t think teachers understand people who have anxiety.”

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Would you talk to a teacher?

• 11 students said they would NOT

talk to their teacher if they were

experiencing anxiety at school

• 6 students said they MIGHT talk to

a teacher• “only certain ones”

• “if there was no one else to talk to”

• “only if it affected my school work”

• “depends on the teacher”

• “only as a last resort”

• 1 student said they WOULD talk to

a teacher

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• “Noooo!!!”

• “I definitely would not… they probably wouldn’t care very much”

• “Teachers can’t really help, most people aren’t comfortable enough with teachers to tell them their problems. Even if they do, teachers don’t care or have the resources to help… teachers can’t help in any way”

• “Teachers don’t care. They won’t do anything”

• “They would see me differently or judge me”

Would you talk to a teacher?

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Characteristics of an Ideal Teacher

• respectful

• reassuring

• trustworthy

• nice

• understanding

• cool

• comfortable

• knowledgeable

• humorous

• confident

• responsible

• good relationship

• easy to talk to

• relatable

• inspiring

• open

• caring

• friendly

• realistic

• approachable

• willing to listen

• confidential

• has their own kids

• down to earth

• genuine interest in

students

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Conclusions

P3 anxieties

• Relationships are key• Peer more influential than teacher

• Can help or hinder

• Stigma remains around mental health• Education around mental health is too little, too brief, not engaging, not

memorable

• Parents don’t understand anxieties experienced by their teenagers

PresentationJudgement

PerformanceSuccess/failure

PressureSocial/parental/time

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Student Recommendations for the Top 3 Anxieties

Final Exams and Tests

• Make time to review in class

• Consider alternate formats such as open-book finals – focuses on learning not memorization

• Provide a weekly catch-up period

• Provide an anonymous “please review” box

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Social Situations

• School-wide BBQ or other events

• Connect older students with younger students through relationship building

• Reduce cliques through school-wide community building

• Get to know classmates better by playing games (etc.)

• Find a balance between students choosing groups and the teacher choosing the groups

Student Recommendations for the Top 3 Anxieties

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Presentations

• Provide choices or options for presentation and audience

• 1 on 1 with a teacher

• to their friends

• stand at the back with PPT at front

• to younger students (builds confidence)

• Present in groups instead of alone

• Give more time to prepare and practice

• Start slowly and build expectations

Student Recommendations for the Top 3 Anxieties

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Top Ten Recommendations

1. Build a caring school/classroom culture

2. Build strong, genuine, caring relationships with students

3. Talk about mental health, provide resources, teach students skills to

manage their mental health

4. Be sensitive to students’ needs – observe/respond/check-in

5. Provide an anonymous option for communication e.g.

question/conversation box, journal

6. Reconsider assessment methods e.g. don’t give culminating exams,

incorporate final projects, provide open book exams

7. Teach students study strategies, give time to review in class

8. Provide instruction not instructions; re-teach in a different way

9. Provide choices for presentation method/audience and ensure

expectations match outcomes

10. Reconsider homework44

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