Stress in children at ‘the best’ schools can triple risks of anxiety, depression, substance abuse and delinquency.

Children in America’s “good schools” – those with high test scores and graduates heading to selective colleges – may look like they have it all. But appearances mask an epidemic of children’s mental health problems. In fact, major policy reports now list students at high-achieving schools as an at-risk group, alongside children in poverty, those experiencing trauma, and those in foster care or with incarcerated parents.

Rates of clinically significant anxiety and depression can be as high as six times the national norm in many high-achieving schools (HASs), where children’s mental health is severely affected by ongoing, ubiquitous, and unrelenting pressure to achieve. Students are scrambling to stay on top of a group of high performers; amid a squeeze of the middle classes in the US, young people tend to fear that, unless they are among the very top performers, they will somehow be left behind.

Pressure on these children’s mental health comes from multiple sources in their lives, including teachers, coaches, parents and peers. Elite universities – fervently sought by many of these children – play an important role, as they pick fewer and fewer from many applicants with exemplary resumes. By 2018, the admissions rate for the top 50 ranked US higher education institutions had dropped to 22.6 per cent, down from 35.9 per cent in 2006. The drop was most pronounced in the top 10 schools, where the admissions rate fell in that 12year period by almost two thirds, from 16 percent to 6.4 percent.

Children’s mental health problems in every high-achieving school

Our group, Authentic Connections, has found high rates of serious disturbance – anxiety, depression, substance abuse or delinquency – in every HAS we have studied, including day schools and boarding schools, and public and private schools. These rates can be two to three times the national averages, and in some cases, six times as high and even greater. Other developmental researchers have shown that in large national data sets, serious problems in children’s mental health tend to be the highest in schools at the lowest and highest levels of community affluence, with those in the middle income range faring the best.

It’s not surprising to find high levels of stress amid poverty, given challenges related to physical and emotional survival and its consequent ill effects on mental health. But it’s unsettling to find that a notion of “survival of the fittest” is leading to similar symptoms in high-achieving settings, where anxiety about being (or remaining) among the small group of the “very best among the best” can lead, essentially, to a state of hypervigilance.

Children’s mental health problems observed as early as 7

Most of the HAS samples we have studied are from high schools, or grades 9-12 in the US, but we have documented high distress levels among younger children as well, starting around 6th and 7th grade (ages 1213). Anecdotally, many of our school collaborators routinely report seeing high levels of stress among HAS children when they are as young as 7 or 8.

“Major policy reports now list students at high-achieving schools as an at-risk group, alongside children in poverty, those experiencing trauma, and those in foster care or with incarcerated parents.”

I first stumbled upon the risks to children’s mental health in high-achieving cohorts in 1999. In this early study involving relatively affluent, suburban students, we were surprised to see higher rates of problems among them as compared not only to national norms, but also to their counterparts in poverty.

In our early interpretations of these findings, we speculated that suburban youth might have experienced some degree of isolation from parents (who often had demanding jobs), and also, perhaps, lack of after-school supervision (as communities generally seemed to be safe). It has taken me over 20 years of research, and dozens of conversations with adults and students across the country, to see clearly that this is a systemic issue. There are serious stressors coming from all levels of influence in HAS students’ lives – not just from families but also peers, schools, and universities.

Stressors on children’s mental health

Consider just the stressors coming from peers. Adolescence is a time when children are supposed to form close relationships with their peers. But how does one get truly close to, and trusting of, peers with whom one is in direct competition for being the star or “standout”?

Teachers in HASs are expected to maintain high test scores, and naturally, these expectations filter down to their students, resulting in gruelling workloads and hours of homework. Coaches want to win prestigious sports competitions, again resulting in long hours of practice among student athletes plus, of course, high pressure during their games.

And as I’ve said, the admissions criteria of selective colleges are a major root cause. There is little hope of getting into a well-reputed college unless a child has stellar accolades across multiple academic and extracurricular domains (and often, even these aren’t enough, given the growing number of accomplished applicants).

The problem is not confined to the United States. When I present our findings on these schools to international audiences, they acknowledge that a constant battle to succeed in high-achieving environments is taking a toll on their children’s mental health as well.

children's mental health

Photo: Tom Woods. Creative Commons.

Multiple approaches to improving children’s mental health

How do we tackle this epidemic? The first step is for schools to know how they’re doing on critical aspects of children’s mental health. This implies a rigorous assessment, using research-based instruments and sophisticated analyses of data, to pinpoint the most important issues to be addressed within that particular community. I’ve found repeatedly that when parents, faculty and administrators see findings on their own children (rather than data on HAS kids in general), the adults begin to mobilise for change. It tends to be a wake-up call as they understand that of, say, 10children sitting around their kitchen table on a given evening, four could be struggling with serious depression or substance abuse.

Next, we need collaborations between parents and educators to take meaningful steps toward reducing the high stress levels. One place to start is by looking at practices that exacerbate competition among kids, as well as feelings of embarrassment when they don’t “measure up”.

Do the students receive marked assignments and tests in the order of grades, for example, so that everyone knows who has the top scores and who has the lowest? Do coaches replay – for the whole team – videos of a mistake that one team member made during a particular game? After college acceptance, do students come to school wearing the logo of the schools to which they are headed – and thus publicly embarrass those who are accepted by less prestigious institutions?

Parents have a key role in supporting their children’s mental health

Parents and teachers can help in other ways. Research has shown that children feel the effects of harsh words much more keenly than those of praise or affection. So minimising negative interactions is vital, especially because these highly pressured children are already fragile.

A balanced perspective on achievement also matters greatly. We’ve found that adolescents have better mental health (and better test scores) when they believe that both their parents value character traits such as being helpful and respectful as much as, or more than, achievements such as attending a good college, excelling academically or having a successful career.

Getting a handle on substance use in adolescents is important. HAS students consume alcohol and drugs, and suffer from addiction at higher rates than their peers. Our studies have shown that if parents are perceived as lax on this front, teenagers may use more often, and that this is linked to greater risk of addiction in early adulthood.

HAS youth and universities 

The elevated problems of HAS children’s mental health, which begin to appear as early as elementary school, become clearly manifest in alarming ways when they get to college. In US universities, campus mental health services routinely report that they are overwhelmed by students’ serious mental health issues.

“Colleagues internationally acknowledge that a constant battle to succeed in high-achieving environments is taking a toll on their children’s mental health as well.” 

But universities have thus far remained largely uninvolved in the conversation about distress among highachieving students—even though much of this is tied to acceptance policies, particularly at selective institutions. One suggestion to consider, raised by my colleague Barry Schwartz many years ago, was that, after students’ résumés reach a stipulated point of excellence, college admissions might essentially use a lottery process.  The underlying logic is that, in reality, there is always some randomness in final selections culled from thousands of stellar applicants; knowledge of this could help stop students from feverishly pursuing that one extra percentage point in a course, or taking on yet another demanding sport, believing that this would be the tipping point in gaining acceptance.

Whether or not universities consider such changes (or others) to their admissions policies, leaders in higher education must begin to address what has truly become an epidemic of distress in today’s high achieving schools. It would be invaluable for these leaders to join collaborative conversations involving HAS educators, developmental scientists, parents and practitioners, and ultimately, policy makers at the local and national levels.  In the absence of such collaboration, we will only see further escalation of the already frightening rates of children’s mental health problems, such as serious depression, anxiety, and self-harm, that affect a large swath of today’s young – at least 20-25 percent of children who are attending the “good schools” in the United States.

Header photo: Megan Skelly. Creative Commons. 

Policy Implications

Provide support for research and associated interventions for this newly identified, at-risk group: Students at High Achieving Schools.

Practice Implications

Practitioners must ensure that intervention targets and strategies are supported by research evidence, and should strive to mobilize change at the levels of communities (not of individuals), bringing together adult stakeholders and students themselves to shift cultures of unhealthy hyper-competitiveness.

References

 Luthar SS & Kumar NL (2018), Youth in High-Achieving Schools: Challenges to mental health and directions for evidence-based interventions. In Leschied AW, Saklofske DH & Flett GL, Handbook of School-Based Mental Health Promotion: An Evidence-Informed Framework (New York: Springer)

 Luthar SS, Kumar NL & Zillmer N (2019), High Achieving Schools connote significant risks for adolescents: Problems documented, processes implicated, and directions for interventions, American Psychologist