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Breaking the silence: How youth, adults overcame cultural stigmas against depression and got help

False beliefs about mental illness can cause significant problems, experts say

Robin Thomas matriculated at Stanford University in the fall of 2008, and after a few months he was thinking about leaving.

"I was not happy. And I did not understand why," he recalled. "I made it to the greatest school in the country, it was sunny, the campus was beautiful, and yet I was sad."

Thomas knew that mental illness ran in his family; his mother was diagnosed with clinical depression and had been on a steady prescription of Prozac. Still, Thomas refused to consider that he was suffering from the same affliction.

"I felt saying I was depressed would be a cop out, that I was just making excuses. I blamed myself and believed I was the only one who could fix it."

Thomas considered himself the archetypal "Stanford Duck," a metaphor well-known to Stanford students: On the surface he looked composed and happy, but beneath the surface he was paddling furiously to stay afloat emotionally. Maintaining the image of placid contentment meant bottling up his depression.

"I felt guilty because I felt I was rejecting an awesome privilege, and I didn't feel able to open up to anyone because it would sound ungrateful," he said.

Thomas returned sophomore year thinking a fresh start would help, but his depression persisted. He checked himself into Stanford's Counseling and Psychological Services (CAPS), but he did not make much progress.

"I'm not sure if there was a whole lot CAPS could do for me because I was really good at arguing with myself and rationalizing how I felt," he said.

But it was when Thomas finally opened up to some of his fellow students that he discovered something surprising.

"I found there were lots and lots of other students going through exactly what I was going through, but were afraid to talk about it," he said. "I kept hearing that they thought they were the only ones."

Over time, and as he spoke with more and more of his peers, Thomas concluded that what Stanford needed was an open dialogue that suspended judgment about how people were feeling.

"I wrote a couple articles for the Stanford Daily, and I started sitting in the middle of White Plaza with a sign that said, 'Let's talk about anything.' I was pleased by how many people approached me to talk and was both sad and unsurprised that a lot of people were quietly suffering like I was. I thought that would be the best way for me to contribute," he said.

Thomas ultimately dropped out of Stanford.

Emily Dolph, 22, had a similar mindset as Thomas when she was a high school student in Gilroy and a college student at San Francisco State University. She was an excellent student but was constantly unhappy with herself. She wanted everything and thus never felt she was doing enough.

"I was convinced I had to be perfect, not only in school but socially. When I felt sad I convinced myself that I was a cry baby and could get over it. A lot of my depression came from me beating myself up. I really did not like myself," she said. "The people who I at the time considered my friends were particularly hurtful. There was a constant pressure to look good, be thin, get the best clothes and ace tests. I had to have it all, down to keeping my hair perfectly in place, or nothing."

The pressure continued even at San Francisco State. The summer before her junior year she attempted suicide. After recovering she was diagnosed with clinical depression and enrolled in La Selva, a mental health services clinic on California Avenue in Palo Alto that's part of the Momentum Health Group.

For too many people like Thomas and Dolph, what exacerbates their despair is not so much depression, which thanks to decades of research is treatable, but their reluctance to seek help, according to James Millsap, executive director of La Selva. Simply put, many people who should, and could, be receiving effective treatment are not.

"Something stops them. What stops them is not only their condition, which saps their energy and willingness to reach out, but also things they hear on the television set and the people around them that people with mental illnesses are crazy, dangerous, losers, weak or whatever. So then the solution is to start hiding what they feel and that ultimately leads to tragedy. That is the real enemy out there: It's stigma," he said.

Other local mental health experts agreed.

"Twenty-four percent of U.S. citizens have a mental health condition in any given year and 57 percent of citizens will suffer from a mental health condition at least once in their lives. I actually believe those numbers to be conservative estimates," said Michael Fitzgerald, executive director of behavioral health services at El Camino Hospital. Fitzgerald also helped start El Camino's After-School Program Interventions and Resiliency Education program (ASPIRE). The program is designed to provide treatment for teenage youth who are experiencing anxiety, depression or other symptoms related to a mental health condition.

"This is a huge concern. Kids aren't getting help oftentimes because of stigma: Mental health concerns are portrayed very negatively in our society. Kids, particularly in regions such as the Silicon Valley, can feel enormous pressure to get into Stanford or a similar university. The pressure of being a kid seems worse now, on top of adolescence being inherently stressful," he said.

That pressure is felt among both young people and working adults.

"A lot of stigma comes from the expectations set by the people around us," said Annie DiTiberio, who was associate director of La Selva and now works at another mental health provider in Palo Alto that partners with La Selva. "What is the theme of this place? It's wealth, it's stories of extraordinary success at a rapid pace, it's hyper competitive both in school and work."

Setting extraordinary expectations can be a mental burden that can both aggravate a mental illness like depression and make stigma even harder to overcome, DiTiberio said. The strongest evidence of this cultural phenomenon is who does not come in for help, rather than who does. The demographic patterns are surprisingly specific.

"I have noticed that males who are successful lawyers, or work at startups, and are typically in their 40s really struggle with coming in. The few who do come in I can almost see a physical battle in their faces because they are so apt to blame themselves and eager to convince themselves they do not have to be here. Their self-stigmatization is incredibly powerful," she said.

"Stigma is pervasive throughout," said Dr. Laurie Leung, associate director of mental health programming at the San Jose nonprofit Asian Americans for Community Involvement (AACI). "The general perception is that mental health services are for people who have severe psychotic episodes or other extreme conditions."

Counseling and mental health services cover a large spectrum of problems and levels of severity. Targeted, time-limited consultations can address a specific issue, while longer term care is used to stabilize and return someone to baseline level of functioning. Inpatient care is needed when the individual could no longer provide for his or her own well-being, Leung said.

In short, says Julie Lythcott-Haims — former dean of freshmen at Stanford, Gunn High School parent and author of the upcoming book, "How to Raise an Adult: Break Free of the Overparenting Trap and Prepare Your Kid for Success" — Palo Alto, as well as the broader society, is facing a cultural problem.

"Confronting stigma necessitates confronting our habits, values and culture," she said. "Our kids are adopting the exceedingly high, narrow and rigid definitions of success endemic in the Palo Alto community, which undermines their mental health and wellness. We need to drop the facade that everyone is doing amazingly well, broaden our definition of success, and at the same time make it easier for people to talk about their mental health problems."

Dealing with stigma in mental health treatment is at least as challenging as treating the symptoms of mental illness, Millsap said.

"Depression and other mental illnesses are as real as any physical affliction," he said, "but they are easy to dismiss or ignore because it is not as dramatically physical as say a broken limb, and it can easily be mistaken as an attitude problem." (See sidebar.)

Stigma is even more invisible because it manifests in language, entertainment and sometimes people's most basic internal assumptions and instincts. These create barriers that can be more difficult to overcome than any mental illness.

Stigmas exacerbate depression

Eight years ago Kristin Dawson, 47, was convinced there was something physically wrong with her.

"I kept checking myself into emergency rooms. I was breathing quickly, had trouble swallowing and was rapidly losing weight. Every time doctors said I was likely suffering from a mental illness I rejected what they said. It turned out they were right," said Dawson, a Redwood City resident.

Dawson worked in Silicon Valley and was afraid her company would find out. She feared having a reputation at work as being mentally ill and therefore unstable, and possibly even seen as unemployable at any job in her industry.

Dawson was so self-stigmatized that she initially refused to see a psychologist and was terrified of getting diagnosed and being put on medication.

"I thought being on medication meant losing control over myself. I thought I would be numb to my life," she said.

Dawson also didn't like the connotations she associated with people who have mental health problems.

"In movies and television the villains are all suffering from mental illnesses. It's the go-to explanation when a tragedy happens like a mass shooting or the recent plane crash in the Alps. I did not want to be put in the same category as those people. Ironically, I was as much of a participant in creating stigma as everyone else," she said.

Dawson was finally diagnosed with bipolar disorder and depression and received treatment including medication and therapy training, but only after she became intensely suicidal. She credits La Selva for saving her life. Today, she's no longer afraid of her illness.

"I feel more in control of my life than I ever have in the past eight years. It's disturbing to think that the hardest part was getting over my own perceived stigma about mental illness and medication. I still go through episodes of anxiety and depression, but now I know how to handle them. My relationship with my spouse and family is stronger than ever," she said.

Stigma doesn't just come from people's self-perception, which in any case is usually adopted from the culture around them, but also from cultural stereotypes.

"There's particular stigma directed toward the Asian community that is perpetuated by the 'model-minority' stereotype," said Leung of AACI. Roughly, the stereotype advances the notion that Asians are perfect, they strive for the top schools and the highest-earning industries, she says.

Partially as a result there are a lot of students of Asian heritage who are going day-to-day unaware that they have a mental health issue or unwilling to seek treatment because that means admitting to a fault or needing help, she said.

Leung notes that within the Asian community, as is the case with other immigrant groups, more recent immigrants are more likely to be unaware of mental health issues than their more Americanized counterparts.

"The Asian community is still battling stigma against seeking help for physical health, never mind mental health. There remains a belief among some members of the Asian community that you should not visit a doctor unless you are very, very sick."

The stigma created by a culture of extraordinarily high expectations is neither an Asian construct nor does it exclusively affect Asians, however.

Sammy Kotmel, a 17-year-old Caucasian female, was a sophomore at Burlingame High School when she got a B in a class, her first ever.

"The 'B' shattered what was so important to her, which was her straight-A identity," said Maja Nelson, her mother.

Kotmel had been diagnosed with obsessive-compulsive disorder as a freshman, which contributed to her sterling academic record. Since as early as middle school Kotmel was fixated on getting admitted to colleges like Harvard, Yale and Stanford. She insisted on studying for the SAT in the 8th grade, a full three years before she was due to take the test. But what drove her to excel also put her at risk. The "B" threw her into a deep, severe depression. She attempted suicide.

Kotmel's parents never applied pressure on her to get straight A's or even take all the advanced courses she enrolled in, Kotmel said. They both went to relatively average colleges and have good jobs.

"The pressure came from the culture I grew up in," said Kotmel, now a junior attending Mercy-Burlingame, a private high school. "Certainly a lot of my pressure was self-created, but it was all based from what I was exposed to. There seemed to me a rigid, inflexible logic that getting straight A's was the only way I could get into an elite college, which was the only way I could get a good job, which was the only way I could hope to have a good life. My neighbors were evidence to me: They attended Ivy League schools; they have a huge house with four seemingly perfect kids. That had to be me."

"It was tricky for us to find good resources," Nelson said. "There's a lack of willingness in the community to open up, and even as a parent I felt stigma against reaching out. Burlingame is a lot like Palo Alto in that families work to perpetuate an image of high success and that everything is fine. We were lost, and we didn't know where to go."

What Nelson did find, though, was an "underground" network of parents who had kids who were suffering from mental health illnesses and able to discreetly connect parents to therapists and other caregivers.

It was when Kotmel was hospitalized that they learned of the ASPIRE program in Mountain View's El Camino Hospital.

"A lot of our program is to talk and think about what success really means and to get a bigger picture of what life is about. We want to equip young people with skills they'll need to get through life," Fitzgerald said.

Students enrolled in the ASPIRE program can receive credits that go toward their high school diplomas.

"We are trying to destigmatize mental health by treating it as something you have to learn and practice. It is real work; the course lasts eight weeks. And we sponsor the kids in the rare event that insurance does not want to pay," Fitzgerald said.

Today, Kotmel is doing and feeling a lot better, even though she got two B's this past semester. She's lightened her course load, only taking one AP class in her favorite subject, biology. She's no longer as concerned about the SAT or college admissions as she once was; she knows she is a good student and will excel no matter where she decides to attend.

Sadly, like Emily Dolph, she's had to shed friendships with peers who were either sources of anxiety or could not bring themselves to understand Kotmel's condition. But the friendships that survived are stronger than they were before, Kotmel said. Moreover, with the skills she gained at ASPIRE she feels psychologically robust. She has taken up painting again, a creative outlet she abandoned during her years of obsessing about grades and college admissions.

"I'm no longer afraid of setbacks and feel comfortable in my own skin. I'm open about my illness, and I've made some changes, but I own it, it's a part of who I am and it won't stop me from living a good life. The ASPIRE program helped me because I started asking bigger, more important questions about what life is about," she said.

For Nelson, as soon as she and Kotmel became comfortable discussing mental health, an interesting phenomenon began to occur.

"So many parents have come out of the woodwork asking me where they can find help for their son or daughter," Nelson said. "People were breaking their silence as soon as they knew someone that has gone through it themselves."

Efforts to combat stigmas

ASPIRE, AACI and La Selva are all conducting outreach and debriefing programs at Palo Alto Unified School District (PAUSD) high schools.

"We are working with PAUSD to create new programs that train parents and teachers to look out for signs and symptoms," AACI's Leung said. "We've been very active in collaborating with the schools. Parents and children have a lot of resources around, and we're hoping they can utilize these resources and know that there is support out there."

Fitzgerald applauded the district for taking decisive steps toward providing more resources for youth as well as for the parents who have been proactive enough to seek consultation at ASPIRE, though he wishes more parents would come in.

"Palo Alto is doing more than a lot of places to provide resources to young people, and we're seeing a lot of kids overcome their conditions and leading healthier, more fulfilled lives. We want kids to know they can make it, but that it requires support and help. Reaching out for help is an act of courage, not weakness," he said.

In addition to the ASPIRE program, the HEARD Alliance — which is a group consisting of organizational leaders including Fitzgerald from El Camino Hospital as well as leaders from Stanford Hospital, PAMF, Sutter-Mills Hospital, local schools and others — is working collaboratively to address concerns about adolescent treatment in the region. The group has created a website with resources for families and others to access: heardalliance.org.

For Millsap, he hopes that the spate of tragedies will spur people to face and overcome their prejudices against mental illnesses. La Selva is offering without fee a family support group for those with family members struggling with a mental illness. It meets the first and third Wednesday of each month at the California Avenue campus.

"We've seen discussions of the stigmatization of physical ailments like AIDS and breast cancer enter the mainstream and be overcome, and we in the mental health field feel like it's our time now. The tragic irony is that we are only now starting to see some positive movement after it's been too late for some of our kids," Millsap said.

After Thomas left Stanford he was finally diagnosed with clinical depression and prescribed Prozac, which Thomas said has substantially improved his quality of life.

"Getting diagnosed was actually a relief. It showed me that my thoughts about the world, my devaluing of my own life, is not really true. I have a disease that is shifting my perception of the world. The world doesn't suck; it's that I have a sickness that makes me think that way," he said. "I actually felt empowered. The most important thing a depressed person can do is to remind themselves that they have this sickness called depression and that it can be combated. It is not you; it is something inside of you. I'm now fully functional and I feel in control."

Dolph enrolled at La Selva and worked with DiTiberio. She said she initially felt ashamed.

"I would tell myself that I have no reason to feel like this. Nothing has happened to me that would lead me to depression. I do not have an abusive relationship or come from a broken home. But after enrolling in therapy, learning about depression and seeing other people there going through the exact same thing I was going through, I felt empowered," she said.

Today, Dolph still visits La Selva and regularly speaks on alumni panels. She's also taken up the arts as an outlet; she is the dance director at the Children's Musical Theater Company, where she teaches dance.

"I think if I were given the chance to talk to someone who is going through depression now and is too ashamed, embarrassed or scared to come out with it, I would tell them that depression is a disease," Dolph said. "You wouldn't be ashamed to go to the doctor for a virus or broken arm or any other ailment, so why be ashamed of getting help for this?"

ABOUT DEPRESSION

What is depression?

Depression is a mental illness. There are a variety of causes for depression. It can be situational: Something has happened in a person's life and he or she is struggling to effectively cope (e.g., the death of a loved one). Depression can also be clinical, meaning there is not an apparent cause to the depressive symptoms. Clinical depression can result from chemical imbalances in the brain. A family history of depression or mental illness can also result in an individual being more susceptible to experiencing depression. Depression is common and treatable.

What are common symptoms?

Some common symptoms include sadness; lack of pleasure in things that previously brought you pleasure; disrupted sleep, eating and concentration; and fatigue. Those around the depressed person may notice him or her acting differently, seeming exhausted often, not being able to perform the usual routine or having to work extremely hard to accomplish things that used to be easy (e.g., working eight hours in a day). You may attempt to "cheer them up" with things that usually bring them pleasure, such as a weekend away, but the loved one is still sad and unchanged by your attempts. An individual may also appear irritable and easily frustrated.

Who suffers from depression?

Anyone and everyone can suffer from depression. Almost everyone has had periods of feeling depressed, or at least exhibited signs of depression. Clinical depression has a strong genetic link, and statistics show people are more likely to exhibit depressive symptoms if someone genetically related has as well. Individuals who have experienced trauma may also be more susceptible to depression, especially if it is or was prolonged trauma.

Source: La Selva

WHERE CAN I SEEK HELP LOCALLY?

(Note: This is not an exhaustive list)

Youth

ASPIRE, El Camino Hospital, 2500 Grant Road, Mountain View, CA 94040; 650-940-7000

All ages

La Selva, 206 S. California Ave., Palo Alto, CA 94306; 650-617-1759

Asian Americans for Community Involvement (AACI), 2400 Moorpark Ave., Suite 300, San Jose, CA 95128 ; 408-975-2730

Stanford Hospital, Outpatient Psychiatry Clinic, 401 Quarry Road, Stanford, CA 94304; 650-498-9111

The Palo Alto Weekly has created a Storify page to capture the numerous voices, opinions and our news coverage on teen well-being. This page will continue to be updated. To view it, go to Storify.com.

Comments

10 people like this
Posted by Perhaps leaving pausd 2
a resident of Another Palo Alto neighborhood
on May 15, 2015 at 8:03 am

Sammy,
Thank you for your courage in speaking out. I wish I could give you the benefit of hearing years of conversations by my spouse and colleagues who have developed an aversion to hiring students with perfect academic records (in a highly STEM-oriented industry). Love what you do, and do what you love. The grades will not seem as important, to you, and to anyone who works with you.

All the best to you.


1 person likes this
Posted by Maryanne
a resident of Evergreen Park
on May 15, 2015 at 8:37 am

Thank you for your continuing coverage of this important topic. At Family & Children Services of Silicon Valley, we also offer individual and family counseling for children, teens, and adults at our office in Palo Alto, as we have since 1949.

Culturally competent services (including free social activities) also are available for LGBTQ youth and families.

Students may be eligible for free services (with Palo Alto school referral), and we also accept most insurance and have a sliding fee scale. Info: 650-326-6576, www.fcservices.org

More info about our award-winning LGBTQ youth services is available at www.youthspace.org.


1 person likes this
Posted by Gotta Wonder
a resident of Another Palo Alto neighborhood
on May 15, 2015 at 8:46 am

The high rate of incidence of mental health issues is shocking - 57% at some point in their lives! I have to wonder if there isn't possibly some environmental factor at work here.


1 person likes this
Posted by Harold A. Maio
a resident of Adobe-Meadow
on May 15, 2015 at 9:44 am

----Breaking the silence: How youth, adults overcame cultural stigmas against depression and got help

You mean, of course:

----Breaking the silence: How youth, adults overcame cultural prejudices against depression and got help

Why not say it?


1 person likes this
Posted by Perhaps leaving pausd 2
a resident of Another Palo Alto neighborhood
on May 15, 2015 at 9:58 am

@Gotta Wonder,
One thing I have always wondered about is something I have witnessed in a few people I know -- and I'm absolutely NOT suggesting this is why everyone experiences depression, just that it seems to affect some people (I'm not even one of them) -- they become absolutely manic depressive if they eat even small amounts of wheat over a few days (eat 2 days in a row even small amts, wait 2 days, presto manic episode). Our schools don't really offer much for eaters with allergies much less dietary restrictions, and anyway, most people wouldn't even know. How could they, no medical consensus. I know someone who only realized it after decades of absolute misery (Italian, won't touch wheat now). There's a book by a doctor, Wheat Belly, that maybe takes that idea to an extreme, but on the other hand, if I hadn't witnessed it, I wouldn't believe it myself. Most people I know who realized it only decided to try after a long string of trying other things and failing.

A lot of people are GF eaters now -- I wonder sometimes if any of our illustrious residents would be willing to underwrite a harmless but possibly useful experiment: Underwrite the cost differential so we could offer a semester of all gluten-free (good) meals for school lunch, and see if there is any difference in behavior and mental health. Maybe not, but it wouldn't hurt, and it might help, if cost wasn't an issue.

It just seems like it's a straightforward environmental factor that could be addressed. I don't know how difficult it is to eat GF at Stanford, my recollection that it was near impossible in college but times have changed.


3 people like this
Posted by Colleen Crangle
a resident of Crescent Park
on May 15, 2015 at 11:11 am

Thank you for a great article. NAMI, the National Alliance on Mental Illness, is the largest grassroots mental health organization in the country. There are local chapters in Palo Alto, Stanford, and almost every community in the Bay Area.

I know the writer said the list at the end of the article was not exhaustive but the resources of NAMI are unparalleled. You can find your local NAMI here
Web Link


1 person likes this
Posted by Red
a resident of Downtown North
on May 15, 2015 at 1:47 pm

Red is a registered user.

Thank you "ASPIRE, ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT (AACI) and LA SELVA" and others helping us to understand and to cope with our mental/emotional distress. A big "Thank You" to Superintendent Dr.Max McGEE for aggressively arranging qualified professionals and agencies to assertively assist our youth and children with their social emotional issues and providing timely and effective leadership to stop bullying on our campuses.


1 person likes this
Posted by Marc Vincenti
a resident of Gunn High School
on May 15, 2015 at 2:16 pm

Dear Palo Alto Onliners,

Many, many thanks to the Weekly for its continuing journalism, covering this topic.

With the news, today, that several students at MIT have killed themselves in the past year, and with the deaths in Palo Alto and at Stanford, this topic is of utmost concern. For far too long now, our community has had to live with this scourge.

Sadly, though I think inadvertently, our District superintendent has deepened the stigma around mental illness--by insistently suggesting that the deaths of our four teenagers this school year have to do with nothing EXCEPT mental illness.

This insistence, perhaps to deflect all blame or responsibility from the institutions that are at the center of our teenagers' lives, makes it seem as if these departed kids must have inhabited a complete vacuum, as no other human beings do, in which they simply are not affected by anything around them--neither by warm days or cold, kindness nor indifference, pressure nor ease, crowds or solitude, praise or blame.

Even a person who is "mentally ill" feels the difference between a slap and a caress.

Our high schools do not create teenage despair, nor can they cure it; but they can go much to make it more bearable, more survivable.

To sign on to a campaign to achieve this, visit: www.savethe2008.com

Sincerely,
Marc Vincenti
Co-Founder, with Gunn soph Martha Cabot
Save the 2,008 -- reviving the heart of school
savethe2008@gmail.com


7 people like this
Posted by Traumatized in Therapy
a resident of Another Palo Alto neighborhood
on May 15, 2015 at 4:35 pm


I was traumatized in psychotherapy, and I am much, much worse for receiving that treatment. I believe that kind of outcome is pretty rare, but I don't automatically trust that the profession is adequately tracking and communicating risks. It can be a very intrusive experience, and it does carry risk. Yes, some of our children will benefit from psychotherapy in their lives.... and a few will be damaged by it. We should not uncritically wish it on them in large numbers, as we do vegetables and adequate sleep. Maybe similarly to Marc, I'm worried about entrusting this problem solely to the experts.


Like this comment
Posted by is right
a resident of Meadow Park
on May 15, 2015 at 5:09 pm

mr. vincenti is sright. even under duress,you know when you are being abused and condescended to.


4 people like this
Posted by Karen
a resident of College Terrace
on May 15, 2015 at 6:58 pm

[Post removed.]


9 people like this
Posted by CriminalizingMentalIllness
a resident of Old Palo Alto
on May 15, 2015 at 8:51 pm

@Marc mistakes reality: "Our high schools do not create teenage despair,... "

Well, that's not true at all. Although I agree with you that the Super is trying to dodge responsibility for the institution, even though many people with experience in the school know that he is simply wrong. And you almost point this out, but then, for some reason, you mistakenly make a U-turn and end up agreeing with him that the schools are not a cause.

But the schools are a cause of despair, anxiety and depression for many students.


My experience has been that the school marginalizes many kids with stress, ADHD, mental illness, anxiety and depression. These are precursors to suicide.

Some of these issues are criminalized in the classrooms, for example organization requirements are heavily penalized in PAUSD, and that creates unreal stress and disengagement for ADHD kids. Students with anxiety are even more marginalized, as teachers expect kids to advocate for themselves when something goes wrong - anxiety prevents this, and many teachers write-off the kids as uninterested, lazy, whatever. They really don't treat kids with mental illness very well at all.

Many of the Teachers overwhelmingly moralize organizational failings as "lacks responsibility" or "lazy" or "stupid". These kinds of harsh judgements speak to the core issue which these kids are struggling with, and become extremely demotivating to kids for which the mental illness makes such capability out of their control. The kids are being judged, and they know it. Essentially the teachers penalize the grades for organizational issues, and the kids internalize this as judging the kid badly (which is probably accurate to describe the teacher feelings towards these kids). This sets up a negative feedback where the kid disengages, and the teacher makes no effort to reach out, engage, etc. and rather feels the kids just don't care. Couldn't be further from the truth - these kids want to succeed; they really need to be recognized for being good at something; many are extremely bright and desperately need school to be exactly the kind of place which it is not.

504 plans and accommodations are a joke. Universally, the teachers refuse to implement accomodations. They will NOT accept late work, refuse to support ADHD students with reminders, refuse to offer make-up, or substitute classwork for homework. There are many good techniques to reduce the organizational overload on students. Never done. The teachers flat-out refuse to support this kind of help, because they have moralized organization as a failure on the students part. They just don't accept mental illness as a real issue.

This kind of systemic failure, this failure by teachers to understand how to work with kids ADHD, anxiety and depression all collude to create a very toxic environment for these kids in the classroom.

Parents who try to raise issues, gain support, or just end the cruelty and harsh judgments are often treated as Helicopter parents, ignored, and retaliation on the students occur for having involved parents and administration.

From here it is practically a direct line from the dysfunctional classrooms to the tracks. Parents can help, support, get therapy, hospitalize, etc. but the entirety of Middle and High School is spent working against a system that is demotivating, demoralizing, and dehumanizing students.

If you are lucky you survive. Very rarely do they thrive. It is not a happy place. And the administration, principals and board members don't really do anything to help.

Which is sad, really, because the majority of the time, they just need to NOT do some very harmful things. It would honestly take very little effort to make classrooms accommodating to children with mental illness.

So there is little or no cost to making school better; we just don't.


1 person likes this
Posted by In my own experience ...
a resident of Midtown
on May 15, 2015 at 11:24 pm

@criminalizingmentalillness - I am so sad to hear that you have experienced and observed some very callous insensitive responses from some quarters of PAUSD.

I can only speak from our family's experience with my child's playground bullying incidents, and a variety of physical and mental health issues. I have found amazing organizational support from the teachers, principal and counselors. There seemed to be a clear process in place and they handled each request for help with professionalism. I came away with a sense that they knew the policies clearly and they did not have to do anything special for my child. I felt heard and there was a lot of room to accommodate my child's many absences and make-up work without making us feel like we're asking for the impossible.

I hope you get to have the same experience some day soon to counter these earlier negative episodes. There are some amazing people in this school district and while PAUSD is not perfect, we have been lucky to find some great people in our time of need.


5 people like this
Posted by The L Word
a resident of Another Palo Alto neighborhood
on May 16, 2015 at 8:29 am

As a college student, I sought help for severe depression and was unfortunate enough to find a charlatan referred to me by STANFORD! Turns out that these psychiatrist that STANFORD U and STANFORD Hospital refer you to PAY Stanford for this service.

My first psychiatrist turned out to be a Persian Lesbian who, after several sessions, would not stop coming on to me. She also put words in my mouth and tried to convince me that I had all these repressed memories--which she was actually trying to put I to my mind!!

I tried several times to escape her, but she would scream and cry and obviously take it personally. SHE was the real sicko in this. I finally, literally walked out on her. She tried to bill me for missed appointments that did not exist. I began seeing another psychiatrist referred to me by word of mouth--no STANFORD connection at all ( the Persian Lesbian shrink was a STANFORD grad!)

The new psychiatrist told me that he had hear a lot of complaints about my previous one, and that she had had her license suspended for six months at one point. To make matters worse, she absolutely refused to send my records to the new psychiatrist, so I had to start over from scratch with the new guy.

To make a long story short, it took a year of therapy to recover from what the first psychiatrist had done to me over a mere four months!


3 people like this
Posted by Perhaps leaving...
a resident of Another Palo Alto neighborhood
on May 16, 2015 at 11:10 am

@experience & @criminalizing,

Our elementary experience resembled yours, experience, but later experience so resembled criminalizing's":

"My experience has been that the school marginalizes many kids with stress, ADHD, mental illness, anxiety and depression. These are precursors to suicide.

Some of these issues are criminalized in the classrooms, for example organization requirements are heavily penalized in PAUSD, and that creates unreal stress and disengagement for ADHD kids. Students with anxiety are even more marginalized, as teachers expect kids to advocate for themselves when something goes wrong - anxiety prevents this, and many teachers write-off the kids as uninterested, lazy, whatever. They really don't treat kids with mental illness very well at all.

Many of the Teachers overwhelmingly moralize organizational failings as "lacks responsibility" or "lazy" or "stupid". These kinds of harsh judgements speak to the core issue which these kids are struggling with, and become extremely demotivating to kids for which the mental illness makes such capability out of their control. The kids are being judged, and they know it. Essentially the teachers penalize the grades for organizational issues, and the kids internalize this as judging the kid badly (which is probably accurate to describe the teacher feelings towards these kids). This sets up a negative feedback where the kid disengages, and the teacher makes no effort to reach out, engage, etc. and rather feels the kids just don't care. Couldn't be further from the truth - these kids want to succeed; they really need to be recognized for being good at something; many are extremely bright and desperately need school to be exactly the kind of place which it is not.

504 plans and accommodations are a joke."

Same here.


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Posted by CriminalizingMentalIllness
a resident of Old Palo Alto
on May 16, 2015 at 11:49 am

I agree with the poster above, and probably over generalized. To be more specific:

- Our elementary school was very supportive, and the teachers were great.

- Our middle school experience (Jordan) was literally terrifying. As in, "they terrified my kid" at school. This generates anxiety and disengagement. Problem teachers were probably 3/year, and often worked together to make pressured demands from kids. Requests to stop the excessive pressure, yelling, beratings, and homework disorganization/overload were ignored, and supported by the principal.

- Paly for High School was hit-or-miss. There was very little supports, but far more teachers were engaging rather than terrifying. We maybe had 1-2 teachers/year that really did not get it.

So, I would say the low point was Jordan, but anything beyond Elementary was problematic. Once the anxiety around school sets in during Middle School, it stays with the kid through High School. So while they were somewhat better, the problems had grown worse.

Good luck - it is hit or miss.

And it shouldn't be. If the school really wants to address mental illness and supports, they need to start working from the most impacted kids first, and address how their staff treats mental illness. Today it is a program of abusiveness, ignorance, intolerance, and administrative stone-walling.

It would take very little effort to just not be a bunch of a$$****s to these kids.

I think as long as the school treats mental illness as a liability, and a burden to be shunned, they will continue to fall short to address the worst behaviors among their staff.


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Posted by ADHD in PAUSD
a resident of Another Palo Alto neighborhood
on May 17, 2015 at 3:25 pm

I have an ADHD student with a 504. She has been in PAUSD schools her entire academic career. It's not our experience that she was ever abused. Most of her teachers have been kind and supportive and they also implement her accommodations. A few have been disorganized or short tempered. One was actually abusive to students, not just mine. It was reported and dealt with. My student's experience is not very different from my own school experience. Teacher quality varies over the course of most students' academic careers anywhere. That's life. I've taught my kids that adapting to different classroom leaders is good experience. They'll have good and bad colleagues and bosses all their lives. They need to learn to deal with all kinds of people. However, the district fell short on identifying learning problems and providing diagnostic support early in elementary school. An elementary school teacher told me that she thought there might be a problem.

It didn't take long to figure out that the district was not going to advocate for my child. That is my job. I needed to figure it out and take the reins if my daughter was going to get the help she needed. We paid for outside diagnostic work and got it early. That helped a lot. Medication helped. We worked hard with her on developing skills that support executive function so that by the time she graduated elementary school she was ready to independently track and manage her middle school workload.

It wasn't easy, but raising kids isn't easy. I realized I needed to prepare my daughter to independently meet the challenges that she would encounter outside of school as an adult. It has been a long road, but she is graduating this year with good grades, high confidence, and excited to start college next fall.

Good things happen when parents are proactive about engaging help, teaching them skills to compensate for their weaknesses (true of all kids, not just kids with learning disabilities) working with our children as partners, helping them pursue their passions, and loving them all the way.

It is not too early in elementary school to start teaching your ADHD child how to use a calendar, checklists, how to break down complex long-term projects into manageable parts with a schedule. ADHD kids can LEARN these skills, but parents have to start early. Get help. Be a disciplined partner as your child learns skills to compensate. He CAN do it. YOU can help. If your child is having trouble in elementary school, get him checked out early. It is money well spent.

I say this to encourage parents to take the reins. Be your child's champion.


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