The National Institute of Mental Health estimates that 20 percent of school-age children and adolescents have a serious debilitating mental illness. That equates to approximately 48,000 children in Collin County and 39,000 children in Denton County last year, according to the U.S. Census Bureau.

State Rep. Garnet Coleman, D-Houston, was part of that statistic; he was hospitalized for depression when he was about 16 years old.

The politician has been diagnosed with bipolar disorder—a mental illness that carried on into his adult years. But Coleman said early intervention helped him learn how to handle his illness.

“I didn’t understand things in high school the way I do now, which is why I know it’s difficult for a teenager who’s having a hard time anyway to grasp what’s going on,” he said.

Though NIMH estimates 20 percent of the youth population has a mental illness, it estimates that only about 5 percent of the adult population has a mental illness. LifePath System Program Administrator Carrie Crutcher said she thinks this may be because children are provided the local services they need to manage mental illnesses as adults, which is why early prevention programs are needed.

“If you didn’t catch it early, now you’re going to have 20-25 percent of your adults—your workforce out there—who can’t work,” she said.

Organizations such as LifePath Systems—a nonprofit organization that will soon be Collin County’s authority on mental health—look to address childhood mental health issues on the local level.

LifePath Systems will take over as the mental health authority by 2017, handling state funding and creating policies for mental health services. It will replace Collin County’s former mental health provider NorthSTAR, a state Medicaid behavioral health program currently being phased out.

On the state level, many legislators have pushed for laws requiring training for school districts on recognizing signs of mental health issues, Coleman said. Following the 2011 Texas legislative session, the state required school district employees to undergo mental health intervention training as described in HB 1386, which was written by Coleman.

The 2015 Texas legislative session saw the passage of more bills, including SB 674 and HB 2186, which require new educators to undergo suicide prevention training.

“The earlier you can intervene the more successful you’re going to be and the less impact you’re going to have,” LifePath Systems CEO Randy Routon said.

School district training

Frisco ISD trains its employees to recognize signs of mental health issues in students both to comply with state law and to fulfill part of the district’s mission to develop a comprehensive plan for student health and wellness, Student Assistance Coordinator James Caldwell said.

The training program is not designed to make every FISD employee a psychologist or psychiatrist, Caldwell said.

“The teacher’s main job is to get that student in touch with a counselor and to try to get them help,” he said.

Based on the NIMH statistics, potentially four students out of a class of 20 could have a mental illness, said Crutcher, who also used to be a teacher. Without training, teachers may not know if their students need help.

“I [could] have four kids who I have to spend extra time with,” Crutcher said. “Do I even know what to look for? As a teacher, that’s really kind of scary that that many in one classroom has a special need.”

Anxiety and depression are the two biggest mental health issues with which students struggle, Caldwell said. Oftentimes, this could be the result of pressure for a student to do well in school, he said.

As part of the training, employees are taught to spot potential signs of mental health issues, including lack of hygiene, anger or poor grades.

“If a student is not doing well emotionally and not doing well physically then almost always their academic success is going to suffer,” Caldwell said.

Students are also encouraged to self-report any mental health concerns seen in themselves or in a classmate beginning at the elementary school level, Caldwell said. Students concerned about classmates can report any concerns through the district’s anonymous reporting system, which will alert a counselor to students who may need guidance, he said.

School counselors may be able to help students work through issues without seeking outside help, Caldwell said. But if a student needs help outside of school, FISD has a list of external resources students and their families can contact.

“We can’t guarantee success at any of these places, but these are places that we’ve heard have had good success in the past,” Caldwell said.

Mental illness symptoms, stigma

Recognizing symptoms of mental illness in children can be challenging because the signs can be mistaken for other behavioral issues, Routon said.

“Kids don’t do sadness as well as adults,” he said. “They’re much more likely to strike out or talk about wanting to hurt somebody badly. They really express it more as an outward thing rather than an inward thing.”

The symptoms can also change as a child gets older. Elementary school-age children, for example, may wet the bed if they are anxious, Crutcher said, but teenagers in high school may turn to substance abuse.

“I think the first sign is if you notice a change,” she said, noting that a change in friends, sleep patterns or appetite can indicate a mental health issue.

Caldwell said FISD tries to talk to parents about recognizing these symptoms at home, but many parents are afraid that talking about it could intensify the issues.

“For example, if you talk about suicide then [people think] that someone is going to kill themselves,” he said. “There’s no research anywhere that shows that, but people will think that.”

That stigma and the notion that a person seeking help for a mental illness is weak is prevalent in both parents and students, Caldwell said. A lot of that stigma starts to form in middle school because students are in a transition period before high school.

Crutcher said talking about mental illness more, especially when it affects children, will help people understand it and learn how to address it.

“I think the biggest thing for parents and teachers to know is to talk about it, ask about it, learn about it, read about it,” she said.

The state laws regarding mental health training in schools are, in part, designed to help overcome the mental illness stigma, Coleman said. The stigma can prevent children from seeking help, which could have adverse effects on them as an adult, he said.

“If a cancer is not treated it gets worse; it’s the same for mental illness,” Coleman said. “If a person doesn’t know how to manage their illness at an early age and doesn’t have support, then the future is very, very bleak.”

Emergency/Crisis Hotlines

Adapt Mobile Crisis

Denton County MHMR Center Mobile Crisis Hotline

Suicide and Crisis Center of North Texas
214-828-1000 (suicide and crisis hotline)
214-824-7020 (suicide survivor group)

General Mental Health Services

1. Child and Family Guidance Center
4031 W. Plano Parkway, Ste. 211, Plano

2. Galaxy Counseling Center
2600 K Ave., Ste. 206, Plano

3. Health Services of North Texas
2540 K Ave., Ste. 500, Plano

4. LifePath Systems (McKinney)
1416 N. Church St., McKinney

5. LifePath Systems (Plano)
7308 Alma Drive, Plano

6. SMU Center for Family Counseling
5228 Tennyson Parkway, Bldg. 3, Ste. 102, Plano

4501 Medical Center Drive, Ste. 300, McKinney

8. Strengthening Families of North Texas
3415 Custer Road, Ste. 140, Plano

9. Texas Health Behavioral Center North Texas Frisco
5858 Main St., Ste. 200, Frisco

10. The Wysong Campus at Medical Center of McKinney
4500 Medical Center Drive, McKinney

This list is not comprehensive.

View a map of local health care providers