A high school student visited me for psychotherapy for seven years. As a child, she was worried, but it worsened when she entered high school. Pleasant to people, it is overly stretched at the beginning of high school, striving to be everything for all people. Her attempts to be an A-Class student, a popular peer, and a participant in many extracurricular activities were costly. After her first year of high school she hit a wall. Feeling overwhelmed, she recovered some a sense of control by focusing on her food, weight and shape. Soon she developed an eating disorder. This condition was so severe that she ended up in the hospital where we first met.

She left the hospital to be under more pressure since it was the year of Junior Cert. Within the next 12 months, she relapsed and was hospitalized again. This time her mood was anxiously low and her anxiety higher than before. She is struggling to get back to school. Every time she tried, the stress and pressure became too strong and she became exhausted or overwhelmed and could not continue. She had to study at home and get most of her education in senior cycles this way. Thanks to the tremendous efforts and support of her family, she passed the certificate of leaving, passing some exams and receiving predicted grades for others. At this time last year I saw her squish across the line and finally complete her school journey. For the next few months, I heard nothing from her and thought she needed a break from therapy.

Last week she suddenly contacted me to request a Zoom session. I was scared of the worst when I saw her email, thinking she might get sick again. To my surprise, when she joined the Zoom call, I was greeted by a bright and cheerful young woman. She seemed to have grown strongly in the nine months since I had last seen her. She had an unfamiliar smile and she was looking straight at me, which was unusual for her. She wanted to tell me how good she was doing, and was recovering to make sure she could keep up the momentum.

She loves her course in college, which has a penchant for the creative arts. She also told me that she met a group of like-minded students who became great friends. Now she is in a romantic relationship and works part time. It was the first time I remember how the session came with tears and swallowing eyes. My professional peace of mind left me for a moment when I remembered the struggle this girl had gone through over the past seven years and told her how proud I was of what she had achieved.

Some may suggest that the improvements were the result of a natural maturation process, but despite the significant stages of maturity that occurred between the ages of 14 and 18, no psychological improvement was observed during our classes. However, the jump from 18 to 19 after she finished school was remarkable. Environment was the key to her recovery.

She is one of many young people who did not fit into the school system. The difference that the college environment has made in its relationship with the world and itself is monumental. She found what interested her, fascinated her and was good at it. Now she had a community of people who believed in her and finally found the place she felt.

The longer I work as a child and adolescent psychotherapist, the more I realize how narrow our education system is in Ireland. It is impossible to make a “cause-and-effect relationship” between the education system and the mental health crisis, but there is certainly a link between them. If the only goal of high school is a student’s performance on the Leaving Cert exam, it follows that there will be a lot of young people, this model will not work.

I have often told young people who are in trouble, “now it is very difficult, but in old age you will prosper”. It’s easy to say, but the challenge is to get the young man to believe your prediction and convince him to stay alive to allow such a possibility.

The archaic nature of studying the three compulsory subjects (English, Irish and mathematics) with the choice of language and science that are “highly recommended” leaves the student with a realistic version of the other two subjects. They are also expected to study seven subjects. Our education system will suit some young people, but not others who have few viable alternatives. What if we had a model like the UK where young people could choose a small number of subjects to study to get a certificate of exit?

Last week, I participated in several TV and radio programs that stressed the need to reform the exit certificate. Politicians on these panels have said it is “on the move”, but it is more like crafting on the edges rather than a concerted effort for change. Calls for Leaving Cert reform are not new, and successive governments have done nothing to address it. But what if you need to re-test the entire cycle of senior courses, not just the final certificate exam process? Are there opportunities for more fundamental change?

Parents who have a deeply unhappy or anxious teenager, possibly involved in mental health services and struggling with life, need to stay strong and not lose hope. Everything can change. We are often told that our school days are the happiest in our lives, but this is the opinion of most who have prospered in this environment.

We do little to improve the mental health of young people by killing an hour of well-being in an overly strenuous curriculum that is narrowly designed and discriminates against people with disabilities. We need to create more ways of progressing that would satisfy a number of youth strengths. In addition, we need to respect those who are not designed for regular education, and provide options for them. I am not an educator, so I am open to evidence that the current system is the best education option. But as an expert in mental health, I believe we also need to consider psychological and emotional costs.

Despite the challenges that high school can set, I hope that parents will be able to comfort the story of a brave young student with whom I have worked for years. She endured an anxiety most of us could have imagined, but she turned her life around with perseverance and changing circumstances. There are no medals or prizes for what she has achieved, but what she has managed to do exceeds anything that can be achieved on a sports field or examination hall. For this reason, I hope she can feel something outside of her for so long: pride.

  • Dr. Coleman Noctor is a pediatric psychotherapist

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