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By Sarah DiGiulio

Elementary, middle and high school students across the state of New York have a new topic on their educational agendas as they head back to class this fall: mental health.

On July 1, a new law took effect in New York, which adds a paragraph to the state's Education Law mandating mental health as part of health education in schools. New York is the first state in the U.S. to require mental health to be taught as part of health education.

Mental health experts say it’s a big deal.

The stigma associated with mental illness and treatment for mental illness still exists, and is still a significant barrier standing in the way of more people seeking treatment for problems they face, Meredith Coles, PhD, professor of psychology at Binghamton University of the State University of New York, told NBC News BETTER. “It’s time to recognize that mental illnesses are real and treatable.”

Estimates from the National Institutes of Mental Health show that among U.S. adults 19.1 percent have had an anxiety disorder within the past year; 31.1 percent will experience an anxiety disorder at some point in their lives; and 6.7 percent are estimated to have had at least one major depressive episode.

The numbers among children are similarly if not more jarring. Data published in the Journal of the American Academy of Child and Adolescent Psychiatry from a nationally representative sample of 10,123 adolescents ages 13 to 18 found that 22.2 percent had a serious mental illness.

The intention is to give students the knowledge they need to recognize in themselves and others when they need help.

Other data estimate 50 percent of mental illness begins by age 14, and 75 percent begins by age 24.

And people aren’t getting help: The 2016 National Survey on Drug Use and Health showed that more than 11 million Americans do not receive needed mental health services.

“We need to change attitudes around mental health,” says Coles, whose work focuses on anxiety disorders in both children and adults. “Starting to educate children in schools makes sense.”

Decreasing stigma, changing attitudes and giving students practical knowledge they can use when it comes to mental health problems they or others face is why New York passed this legislation, New York’s State Education Commissioner, MaryEllen Elia, tells NBC News BETTER.

“When young people learn about mental health and that it is an important aspect of overall health and well-being, the likelihood increases they will be able to effectively recognize signs and symptoms in themselves and others and will know where to turn for help — and it will decrease the stigma that attaches to help-seeking,” she says in an email. “It is critical that we teach young people about mental health.”

It’s NOT about teaching psych 101. Students will learn skills they can use.

The law gives the latitude to individual districts, schools and classrooms to decide, as long as they meet some broad parameters, how to design curricula and lesson plans that cover mental health (as is the case for all subjects — including alcohol, drug and tobacco abuse and the prevention and detection of certain cancers, the only two other topics included in the education law that are required to be taught as part of health education in the state of New York).

But New York schools aren’t exactly being left on their own to figure out how to add mental health education to their teaching agendas.

After the changes to the law were passed in 2016, the New York State Education Department, along with the New York State Office of Mental Health and the Mental Health Association of New York State, Inc. (MHANYS), established the New York State Mental Health Education Advisory Council in August 2017 to provide guidance to schools on how to add mental health to the curricula.

The group published guidelines that include nine core elements they recommend be part of mental health education in all schools. Some of those core elements in the Advisory Council’s guidelines include (among others):

  • The concept that mental health is part of wellness, and we all have a personal responsibility to practice the self-care we need to maintain our mental health
  • How to identify early signs of mental health problems, as well as mental health crises
  • Negative stigma and attitudes toward mental illness can contribute to discrimination against people with such conditions and cause people to avoid getting help
  • Appropriate resources to turn to for help and support if you or someone you know is facing a mental health problem

The group has also created an online resource center — including teacher trainings, lesson plans and other tools to help schools comply with the new law — which are all available for free for all New York State schools.

The intention is to give students the knowledge they need to recognize in themselves and others when they need help, and also make sure they know where to go to get help, explains John Richter, Director of Public Policy for MHANYS and author of the white paper that outlines the guidelines.

The new requirement isn’t about teaching kids an introductory psychology course, he says. “It’s meant to be a public health approach to mental health education.”

The approach is based on principles similar to those used in mental health training programs for adults such as “Mental Health First Aid,” which are designed to increase mental health literacy by increasing knowledge in how to prevent mental health problems, recognize early signs of mental health problems, and get help (as well as where to get it). Evidence suggest this approach works, according to a systematic review and meta-analysis published in May in the journal PLoS One.

But, what does it look like when you teach it to first-graders in New York City or 10th-graders in Albany?

Elementary school students might learn about how to describe their feelings and some skills to manage their feelings, Richter says: What does it mean to be sad? What does anger look like? What does it mean to be happy? If you are angry, what are some ways you can talk about that? What can you do to feel less angry?

Older students might learn how to distinguish more specifically between times in your life when sadness is part of a healthy range of moods and emotions in everyday life (such as when you lose a family member or friend) versus when it’s a symptom or problem to be concerned about (if you’re withdrawing from your friends or losing interest in hobbies and activities you typically enjoy).

The goal is to change the way educators, students and, ultimately, everyone talks about mental health, Richter says. “We want people to get the message that your mental health is just as important as your physical health.”

Teaching mental health young has the possibility to change a lot in New York — and elsewhere.

Other mental health experts agree this approach has the capacity to do a lot of good.

“It’s really important for kids at all ages to have some understanding of what a mental health concern is so that it can be normalized,” Louis Kraus, MD, chief of child and adolescent psychology at Rush University Medical Center in Chicago, tells NBC.

Kids (and everyone, for that matter) should be able to recognize signs and symptoms of mental health problems, just like they know when someone else has asthma, allergies or another medical concern, Kraus says.

“Mental and physical health are not necessarily separate concepts and the two depend on each other for total health,” says Linda Chokroverty, MD, an attending physician and assistant clinical professor of pediatrics and psychiatry at Montefiore Health System and Albert Einstein College of Medicine in New York City.

“Knowing what traits and behaviors make young people more resilient in facing mental health challenges is important,” she tells NBC News BETTER. And teaching kids accurate and age-appropriate lessons about mental health in schools (under the guidance of knowledgeable adults) is usually a better option than allowing kids to learn about it from TV shows, movies, social media and elsewhere that may or may not provide kids with the tools they need, she says.

While New York is the first state to mandate mental health education in elementary school through high school curricula, it is certainly not the only state paying attention to the issue. Virginia passed legislation that also becomes effective this school year requiring schools to teach mental health lessons to ninth- and 10th-grade students.

Richter says other states have been in touch with MHANYS about how to implement similar legislation.

Kraus adds that many schools across the country do already teach some mental health education even though it’s not mandated to be part of the curriculum — but certainly not all schools. And similar efforts to require it should be made elsewhere, he says. “It could have a huge positive impact.”

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