Episode 2: The Need to Reach Students Earlier
Parents and educators increasingly recognize the need for a different conversation about mental health and substance misuse among high schoolers. But why are schools often hesitant to let younger students join the conversation? On this episode of Inside The Mayo Lab, the team breaks down these understandable concerns and fears. They also discuss how the Lab's schools program is trying to push past them to make change and save lives.
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David Magee, Director of Operations, The Mayo Lab: I am David McGee and this is The Mayo Lab Podcast.
All right, we're back in the studio and the team from The Mayo Lab inside The William McGee Institute for Student Wellbeing at The University of Mississippi is back together again. I have Dr. Megan Rosenthal and Alexis Lee with me.
You know, when we start talking about doing schools' work and some of this very ambitious aim we have about helping schools and communities and figure out how to solve this teen mental health and substance misuse problem I've got to be honest and tell you I run into a recurring frustration. My recurring frustration is that I'm humbled that schools regionally and throughout the country are inviting me to speak, but often here's the way that conversation goes.
"So we'll have the whole student body together and you'll meet with them, and then you'll do the parents' program that night," and I'm like. "Perfect. Hey, what grades are you going to bring into the whole student body talk?" They'll say, "Well, nine through 12," and I respond, "Really? Don't you think the middle school students need this?" They'll go, "Do you? Do you think the middle school students are ready for this. Don't you think the subject matter is a little mature," and I respond diplomatically.
What I'd like to say is if we're going to fix these students in this country and we're going to really save ourselves out of this crisis do we have any choice but not to bring the middle school students in, because the research is clear that right around... Look, you can use puberty as the demarkation point. Something that happens that changes in young people in their mind hormonally. Statistically right about that middle school period is where a lot of these anxious, depressed, I'm not sure who I am, and/or substance use begins.
So, Megan, what we're doing is really thinking about while we don't have all the answers, we're thinking about this needs to be approached from not just a middle school perspective, but actually K through 12.
Meagen Rosenthal, Ph.D., Interim Executive Director, The Mayo Lab: Yeah. No, I completely agree. I think kind of creating the balance between maybe a topic being too mature for a certain members of our K -12 audience, how do we tailor the underlying idea so that it is appropriate for our first graders, our second graders, our fifth graders. I think some of the value of what we're thinking through, we're not just doing a program about don't do drugs and drugs and drugs are bad.
McGee: Yeah. That didn't work. That did not work.
Dr. Rosenthal: It didn't work, right? We're talking about how do you build a good life, how do you make decisions that you're going to be able to be happy with at the end of the day, because I think, David, you've talked a lot about this in the past. People who are in the throes of substance misuse and addiction, they don't want that.
They're happy. They don't wake up in the morning and go, "Gosh, you know what? I need to drink a beer before I go to work today." There is something else that is going on in their lives and their body has betrayed them. There's chemical signals that aren't going to where they're supposed to go that make that good decision they have to make.
We can start to short circuit that if we get to them earlier, give them the toolbox and say you're feeling uncertain about your future, what you're going to do and how you're going to do it. The solution to that is not substances. The solution to that is conversations with their parents, going to counseling, finding new hobbies, doing all these different kinds of things that we know that work, but we're just not messaging that appropriately, in a way that's consumable to our young people.
McGee: Yeah. And middle school, it just can't be out of bounds. But as you say, catering it and tailoring it to specific ages, obviously it's a different conversation. But let me also be frank. When I do talk to schools into bringing in the middle school students they are the most engaged, and particularly young women who some of the schools are thinking is this too much or are they too sensitive?
I often look in the audience and there's many wiping tears from their faces. I will often have them come up to me later, they're just so hungry for people to talk to them honestly about the range of human emotions and to let them know they are okay and there is help that really works.
Alexis, there's not much fun about... I say this, I mean I'm sure there were fun moments, so maybe this is just my perspective, but middle school, you couldn't pay me to go back there for any amount of money.
Alexis Lee, Program Manager, The Mayo Lab: You can't. And one of my best friends is a elementary school teacher, and I just... God bless her, every single day she has so much patience for those students, you couldn't... You couldn't. It's a special person to do that. But I think like Megan is saying and we've all said, we teach math to students in the first grade. You learn these foundations that you build on for the rest of your life through.
We need to be doing that with mental health and with wellbeing conversations, because this isn't an instant fix, and that's where we are as culture of instant gratification. We think that at a split second you can change your life around. Unfortunately that's really not how this is working. You need the tools earlier to build on to use throughout your life, and to adapt when you go through puberty, to adapt when you go to high school, to adapt when you go to college, to remember oh, wait, I learned about sleep, how important sleep is. If I'm anxious maybe I should have some extra sleep.
Just things you have in the back of your head that you don't have to relearn as an adult, because it's hard. It's hard to relearn as an adult.
McGee: No, it is. The important thing for young people, regardless of their age... I mean the studies are clear, more supportive human connection is very vital to their wellbeing. What happens sometimes is the peer pressures that really emerge around the teen years, even though you can be surrounded by friends or a social club, the truth is though you can feel completely alienated from them because you're so feared of being alienated from them, and you can feel alone.
I think that's part of what we're seeing. Then you add in the social media dilemma, where I open this app and, number one, I see all my friends, oh, they're somewhere else that I'm not. I don't feel very well. Even though I'm with my family and I want to be, I'm not with them, and it kind of makes my stomach hurt. Are they moving on without me?
So how, Megan... Where are we going to dig in on this? It is seemingly so overwhelming, that people would look at three of us who are tackling this project and wonder are they thinking straight? How are they going to find their way into this?
Dr. Rosenthal: One baby step at a time. I think that's the key, right? And this team around this table, we are really cognizant of what our limitations are, so we're trying to eat that elephant, right? This is a huge problem that doesn't have one single solution and it wasn't brought about in a day. It's been building to this for many, many years at this point in time.
So we've started within our space thinking about the schools' programs, thinking about how do we give the students a toolbox, a set of tools that they can use in their space. We've talked about K through 12, middle school, high school, all of that.
We're going to start small. We're going to start with high school students. That's relatively low hanging fruit. Not really, but kind of.
McGee: It's certainly the ones that at least everybody does understand need to be approached. We'll have to start there maybe and pry our way into the middle school.
Dr. Rosenthal: Right. And I think one of the things too that I think about is that we're also working on as part of that school program is the parents of these programs. I think when you talked about the trepidation that schools had around the conversation that you were having with middle school students, that's a function of the family too, where our families are like, "Not my kid."
When I think back, kids in my grade, when did they start smoking? Fifth grade. Fifth grade. They didn't start in high school. They started sneaking cigarettes from their parents and their family members in fifth grade. Now do I as a grownup want to think about fifth graders smoking? No. But that is a reality.
So how do we provide those tools to students, but then also provide those tools to parents, to say I know you don't want this, but you're not with your kids 24/7. There are all these other factors that didn't exist when you were a kid. How do we help parents also kind of come along in parallel to be like okay, I don't want to do this. It's going to be really hard, but we're going to support them simultaneously, and how do they have these conversations with their kids or prepare their kids to have these conversations in other spaces. So it's both/and. It's not an either/or.
McGee: Yes. And you talk about fifth graders smoking. I'm reminded of a school superintendent, a public school superintendent I was with a couple of months ago who's talking about a continuous problem of third graders vaping. What he says to us is we are having to deal with third graders vaping, and all we have in our school manual is a punishment protocol. So what we're trying to do is first, give them a video to watch, and then if they continue vaping at school... Now let's be clear, they're probably vaping at home, so it goes back to the parents thing.
But when they have that first offense they will sit them down and watch a video, and then if it happens again, then they can only go to the punitive route, which is send them home... Kind of the model that's been used in this country for a very long time is send them home rather than really be able address the problem.
Now I'm not picking on the school or the superintendent. They are not equipped to do it, whereas that's where we must come in, because there's two problems here. Problem number one, that video is ancient. They also don't have any research to know if it actually works. Then problem number two is then they resort to punitive means and the student is sent home for a 10-day expulsion, and hello, I'm pretty sure that third grader will be vaping for 10 days.
So we do in fact have to get upstream, but I think you're right. We also have to deal with the lay of the land. We need the low hanging fruit and the easy way in, and the fact of the matter is high schools are probably the easiest door to first walk through. But the truth is we're going to have to continue finding ways to alter that message and get your research and the research of the teams behind that to be able to continue to move it upstream.
Alexis, you have talked before... I've heard you talk, and you've spoken on this podcast about some things that you faced as a college student. You went through a hard time, losing a friend, you're maybe not in the right place, and you just kind of have that moment where life hits you hard.
When you're say on the volleyball team in high school, how were you and your peers... Were these issues cropping up or were you able... Were team members and friends even able to be aware of this?
Lee: Yeah. I remember there was a moment in high school when we had some of our teammates get suspended from school because they were caught drinking at a party. It was going on around me, the drinking and the drugs and the suicide ideations. I had a friend in high school, he was an incredible swimmer, and he was depressed and no one knew about it, and he died by suicide when we were seniors.
But when that happened I remember coming around us and giving us a safe space, said if you need to talk about it or if you feel sad or something is going on let's talk about it. But it was a reactive measure, not a preventative measure. We weren't having the conversations before. It was okay, this has happened. Let's talk about it now, what are you feeling, instead of maybe giving us the tools, talking about it, and just being open about it.
But I had no idea that he was struggling. I don't think a lot of our friends in the group did. It was hidden, because you were nervous or you were ashamed, you just didn't think... Like he should have had it all in the sense of, you know, he was so incredible at all he did. He was committed. He had Olympic trials. Again, it looked like he had it all and-
McGee: Looks like you have it all.
Lee: And you don't. So it was around in high school, and I think for whatever reason I was fortunate enough to be a little bit aware of it and not be sucked into it, and for what reason that is, when I figure it out I will let us know, because that will probably be a golden key to us.
McGee: Yeah. Yeah. But certainly when you got in college you did have a little bit of encounter where life hit you?
Lee: Oh, yeah. Uh-huh.
McGee: And you have to realize I've got to fight my way out of this or-
Lee: You do. I said this in the podcast earlier, that the turning point for me when I look back was the conversation I had with parents and how they responded to me telling them my career was over. I can say today that if that conversation had not been we love you, we're so proud of you, it's okay, I don't know how I would have responded.
I think I would have gone down a really bad path, because knowing that they believed in me, it didn't turn the switch overnight, but I was able to stay on my feet long enough to be like they're proud of me. They love me. This is going to be okay.
I mean, yes, I did still go out and drink, and, yes, there were days when it was hard to get out of bed, but at the end of the day, when I came round to it, it was so encouraging to know that I have people back home, I have my friends behind me. I had a best friend that year that also decided not to play volleyball and transferred.
People making smart decisions around me, that kind of helped. A rising tide lifts all boats in a way of who are you surrounding yourself with, what messaging are you hearing. I remember I just had to back away from some friendships, and I know Hudson did it too. There were certain friends I could only go to lunch with. There were certain friends I could only hang out with at certain times of the day.
Separating yourself and identifying who are your, quote-unquote, drug dealers in the way of where do I need to put myself so I'm not vulnerable and where do I need to put myself, what measures do I need to put in place to make sure that I'm not going to fall to temptation.
McGee: Yeah. My son, Hudson, recognizing who the friends you choose and the people who you spend time with makes all of the difference. I too in my senior year of high school... I wrote about it in my memoirs, Dear William, but I had a friend who died by suicide, and he was a very close friend of mine. I think it remains one of the heaviest... I'm 57 years old today, and that is still almost hard to talk about because it lingers so heavy with me.
Probably two years before that I had a family member attempt suicide, and the truth of the matter is when my friend died when we were seniors in high school what happened is all of the friends and all of the parents said, "I just can't believe that. I had no idea. How did this happen?"
What I remember thinking is I thought about doing that every single day when I was 14 years old, and I understood, but I still couldn't even speak it. I often look back, because when I felt that I still thought I was the only one that thought that, and I look back and I wonder how many of my other friends actually thought the same very thing?
So I think that helps give us the empathy to what students face today, because we generationally as parents, as peers, as aunts and uncles, as friends, we want them to be fine. We want them to be okay. And we, the three of us, I think are such glass half full people that we especially want them to be fine. But I think, Megan, part of the fact we have to face is to help them be fine we have to help them have an honest conversation that we are willing to listen to.
Dr. Rosenthal: Right. And I think the last part of what you said is the key here, having an honest conversation that we are prepared to listen to, to think through and just sit there silence and say, "How are you," and then stop talking, and then just let them go. That awkward silence, you got to get comfortable with that awkward silence, because somebody will fill it.
Then as they start talking about their feelings and what's going on and maybe thinking about suicide or thinking about something that we don't want for them in that way... I talk to this with my graduate students all the time who do interview work, you got to hold our face still. Hold your face still. Don't tell them with your expressions or your words that this is bad, that they're wrong, because they're not, because those feelings are real.
McGee: They're real.
Dr. Rosenthal: They're real. I watched this video of a man who attempted suicide of the Golden Gate Bridge. He fortunately survived and had kind of gotten help since that time, but he narrates this video of the day that he was going to the bridge, or he decided that he was going to take the leap. He talks that entire day, he's like if one person reaches out and sees I'm struggling and sees something is wrong I'm not going to do it.
So he went the whole day, and he talks about walking downtown, getting on the bus to go over to the bridge, and he's sitting visibly crying and just in an awful, awful place, and if just one person knew, one person knew I wouldn't do it. And, fortunately, there was a police officer who saw him on the bridge that day and said, "Hey, bud, let's have this conversation," and he just sat there and held space for him. He saved the man's life.
But if you think about that as it relates to our young people, one person says, "How are you doing," not with the expectation that, "I'm good. I'm good." "No, really, how are you doing today," and then just stop talking. That's so hard, but it's so important. It's so important.
McGee: I love that so much. I think that's at the essence of the work we're going to do. I was walking yesterday into a restaurant for lunch and a gentleman saw me who has heard a little bit about how we're endeavoring to get into schools and finding some partner schools and begin to work on finding solutions for this, and he just knew a little bit.
But he said, "Hey, I'm sure you saw about this young man. It made the national news. His father is speaking out, who died by suicide, a high school student in Starkville, Miss.." I said, "Oh, I did. So tragic." He said, "I think about the work that you all are trying to do with The Mayo Lab and The William McGee Institute, and what I think is what if you had had some of this programming in place?"
Might somebody have been able to be the proverbial police officer to that student through the platform, the educational format that we can put together, the content that we aim to deliver. We call it our joy content, our content that we create that helps students find and keep the joy they want and deserve. What if that student had had that in place? Might it have made a difference?
I said, "I can tell you you're thinking right on the right line, because actually statistically it shows that we would have had an excellent chance." That's why we're warriors on this, and that's why we're so determined to just build a grassroots movement and bring parents and educators... It's not about all thinking alike. There's no political application to this except the politics of caring for young people and families in this country.
If you fit that model, then we're the place for you, because that's all we are about, and the whole concept of being able to bring them closer to that person of help is exactly why we are doing this.
Lee: I think what Megan has said about being able to hold space for people... I think asking intentionally, "How are you," and being ready to actually hear an honest answer... I think the how are you phrase is then kind of turning the what's up, just casual. I want people and I challenge people to be ready to ask that question and actually hold space for people, because it's incredible the outcomes you can get when you actually say, "How are you," and you don't let your people off the hook with an, "I'm fine," or just then moving on and they turn the conversation on you. Make them answer, but do it lovingly.
McGee: Megan, you talked about awkward moments. I think that you have your finger... Look, I'm a lay person in this but over the past year I have been blessed to engage with tens of thousands of students literally in schools. I engage with them by speaking to student bodies, and I see their eyes, and I see what they respond to, and they come up and talk to me afterwards, and then their parents engage with me, so I've learned a lot. I have learned so much.
Number one, I've learned how much I care about each and every single one of them. But, number two, you just spoke a fundamental truth there. A lot of the research has to go to specifics that's been done so far. It'll tackle teen addiction. It'll tackle teen nicotine use. It will tackle social media, and it all lives in various pockets.
But if I had to articulate what I hear from teens, it's that they in their generation have been stolen from being able to learn how to live in the awkward moments. My teen nieces and nephews, others I engage with, I just see this constantly they, they are uncomfortable if it lingers even for a minute and it doesn't feel right, so they're more apt to change how they feel.
Dopamine from feedback through an app on their smartphone, Dopamine from a substance. Dopamine from a bad relationship that gives you affirmation. Learning to live in that awkward moment. If we could figure out the recipe just for that, if we could figure out simply the recipe for that, we might save the world.
Dr. Rosenthal: I love that idea, and I think we're on the way. The joy content that you talked about earlier, and this importance of distinguishing joy from happiness, so happiness and joy are not the same thing. Happiness is really this ephemeral moment, right? So I'm happy because I drink my cup of coffee in the morning. That's awesome and I love coffee. It's fabulous. But eventually the coffee cup empties and so that happiness fades, right?
Joy, on the other hand, is more of a... And I don't have the right words for this yet, but we're working on it, more of like a state of existence in the world. So you can have joy and sadness simultaneously. You can have joy and discomfort simultaneously. Those things are not mutually exclusive. So as we work through the development of this joy content it's really thinking about how do we equip our students and empower our students to have both those things simultaneously.
I think a lot of... And my parents certainly did this for us, we don't want children to be uncomfortable. We don't want them to suffer. I remember I used to play ringette, which as a young-
McGee: Help me understand what that is.
Dr. Rosenthal: So I'm Canadian-
McGee: Miss Canada.
Dr. Rosenthal: Yeah. At the time that I was growing up there wasn't hockey for girls, so this was like the version of hockey for girls. The difference between hockey and ringette basically is our sticks don't have blades on them and play with big rubber rings. So with that background in place, the first time I got a penalty in ringette, which people think is funny, because if you know me, I don't strike you [inaudible 00:26:14] at all.
I got to the penalty box and promptly burst into tears, like I got busted. I'm a bad person. And my mom and dad, I could see them up in the stands. My dad was a coach, he was across the ice, but my mom was up in the stands, and she was like... Because she was so uncomfortable, the fact that I got punished for doing something I shouldn't have done.
We don't want that for our kids. We don't want to sit there while our kids are in the penalty box because they did something bad. But really it was kind of need to, because we've done our best to set up our lives and our children's lives so that they don't have to face discomfort, but the reality is that that's life.
McGee: Well, yes.
Dr. Rosenthal: So how can we, with our joy content, really bring a balance to that measure? You can have happiness and you can have really great things and your life should be good, but it's also going to be some bad stuff sometimes. So how do we couple those things together so they can simultaneously exist but give you the tools that you need to walk through that uncomfortableness, walk through the bad feelings in a way that doesn't lead you down the wrong path?
McGee: In the way that you don't end up with a penalty in ringette?
Dr. Rosenthal: Right. Exactly. And I will say I went on to get many, many more penalties in ringette, so I didn't learn my lesson.
McGee: While you were getting penalties in ringette, I was growing up as a professor's child in Oxford, Mississippi and sneaking out on a motorbike at 3:00 in the morning to go run in the neighborhood with friends, and didn't get any penalties because nobody was even awake to find out.
The fact is that you can't have joy without the counterbalance, and I think that as we talk about there is that desire by parents, and I'm sorry to say, because I did it too. I just wanted my children to be happy. I wanted them to have so much, and I see it every day. Parents will tell me, "My child is suffering from addiction, or they're suffering from anxiety, and what do you think we should do?" What they want is like an immediate fix.
When I say, "It's a process," they're like, "Whoa, what do you mean?" Then suddenly they're almost unwilling to allow their child to be labeled that, because they're afraid of the process, afraid it will label them. But the fact is that you can't have joy without this pain and discomfort of life sometimes. That's the foundation of resiliency, and resiliency is really the backbone of joy, because when you can learn to process feelings, when you can learn how to get through those moments, you can absolutely be guaranteed that you will get the gift of joy down the road. You will. It is just a fact of human being.
So that's part of our big challenge in this work, is we have to really zero in on helping young people be okay in that quiet moment that might feel a little awkward, that might be a little uncomfortable. But once they learn to manage and process that they have a chance.
Alexis, you're now training to be a yoga teacher. You have retired from volleyball and you've moved into becoming a yoga teacher. That is a little bit of the essence of being in the moment, because I have done some yoga in a pretty hard studio and it was a difficult class, and I was told it's about learning to sit through that discomfort, right?
Lee: Uh-huh. There's this idea of sitting in the fire. When you want to come out of the pose, that's when the pose really starts. It's this idea of fight or flight kind of thing. You can sit in it and feel the discomfort and feel the uncomfortable awkwardness because you're going to come out on the other stronger, with different tools.
On the muscular side, our body holds onto trauma and responses and things like that, so it's also a great place of sitting to be able to release things. What comes up in a pose? What comes up when it's quiet and silent? Don't run from that. Sit through that and fight through out.
Also this idea of leave people in their greatness, and let yourself be left in your own greatness. You don't have to be corrected. You don't have to be adjusted in any way. You are in your own greatness however you all.
I also think... I listened to a podcast the other day and they were talking about when you finally admit you don't know yourself is when you really start to know yourself, and I just think all of those kind of ideas, and being in yoga and sitting in the sweat and the heat and the fire figuratively and literally, you start to know yourself on a different level and what you're capable of, and you start to tell yourself and think through it, I can do this. Let's think through it. Let's talk through it.
You reach out then when there's thoughts that come up or there's experiences that come to light, that you need to talk about. I've left yoga sometimes and called friends, or called my parents, or called my counselor and been like, "Okay, I have something." But it's being okay and letting things come up, because if you don't let things come up you can never solve them.
McGee: If we could just get that snippet right there and you take that to every teenager across America, then I think we have our beginning of how we're going to help teens solve this problem.
Thanks for joining us on this episode of The Mayo Lab. I'm David McGee, and for Alexis Lee and Dr. Megan Rosenthal come back and see us, and tell others about it.
Lee: The Mayo Lab Podcast is produced by Dr. Natasha Jeeter, Dr. Megan Rosenthal. David McGee, Alexis Lee and Slade Lewis. This podcast was recorded at Broadcast Studio in Oxford, Mississippi. The show was mixed and mastered by Clay Jones. Our original music was composed by Slade Lewis. The Mayo Lab Podcast is brought to you by The William McGee Institute for Student Wellbeing.
For more information on The Mayo Lab head over to themayolab.com and follow us on social media @themayolab. If you enjoyed listening to The Mayo Lab Podcast with David McGee we need your help. Tell others about it, and we'd love for you to subscribe, rate and give us a review on iTunes, Spotify, or wherever you are listening to this podcast.
This podcast represents the opinions of David McGee and guests of the show. This podcast is not intended to be a substitute for the medical advice of a licensed counselor or a physician. The listener should consult with their mental health professional in any matters relating to his or her health or the health of a child.
Mentioned in This Episode:
Book: Things Have Changed by David Magee
Website: William Magee Institute
