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Common student mental health concerns

In Ontario, an estimated one in five children and youth has a mental health challenge. Early identification and prevention services can make a critical difference for a student who is having difficulty with their thoughts, behaviour, or emotions. As children and youth spend most of their day in school, educators have an important role in helping to identify students in need of more support and reinforcing helpful skills and strategies in the classroom.

Educators’ role in supporting student mental health

The work you do every day to create mentally healthy learning environments promotes positive mental health and well-being and enhances students’ availability for learning. In every class and school, some students will need additional support for their mental health and well-being. Your knowledge of common mental health concerns can help you feel more confident in providing support through everyday actions with your class or with individual students and will help you know when additional support is needed. The ONE CALL Desk Reference can be a helpful tool in this process.

Go deeper: Take our health literacy course for educators to build your knowledge.

Did you know? The Ontario College of Teachers has a Professional Advisory on Supporting Students’ Mental Health.  

Struggles with attention, mood, and anxiety are common mental health concerns in youth. These concerns may be long-term and diagnosed conditions. Or, they may be acute reactions to a tragic event or other life situation.   

Every student is unique, and what works for one individual may not work for another. Mental health needs can also change over time, requiring more or less support. Knowing each student and routinely communicating with families, caregivers, and service providers (as appropriate, with consent) can enhance student wellness when more support is needed in the classroom. You are part of a team that supports students and are not alone in this work.   

Anxiety in the classroom

Anxiety in the classroom 

Most of us feel anxious from time to time. And while it can be uncomfortable, anxiety is often a helpful emotion. Appropriate levels of anxiety can help us with focus and performance. You can help students learn to recognize and manage anxiety and can connect them with more support if levels of anxiety are heightened, long-lasting, and problematic for them. 

Here are some everyday strategies to try:

  • Have predictable classroom routines and tell students about changes in advance
  • Normalize the experience of anxiety, and work to reduce potential sources of stress at school
  • Recognize that students may experience or express anxiety differently, depending on their cultural background and personal circumstances
  • Teach/reinforce time management and study skills so that students feel more prepared and confident for tests and assignments
  • Help students to break down large tasks into manageable pieces
  • Take time to practise stress reduction techniques in the classroom and model effective strategies – see our resource section for classroom resources to help.
  • Reinforce identity affirming social-emotional skills, like problem-solving, decision-making, and conflict resolution
  • Encourage healthy risk-taking, and reinforce students for solid effort, maintaining a growth mindset
  • When students are struggling with a new skill, remind them to be gentle with themselves and to take the time they need to learn and practice
  • Set up ways for all students to comfortably participate in class (e.g., talking in small groups for students who may be shy or new language learners).

There are many specific subtypes of anxiety disorders, but in general, the following are some common signs of concerning anxiety:

  • attendance concerns
  • difficulty speaking in groups or in class
  • exaggerated need to be perfect
  • excessive worry
  • fears
  • performance on tests doesn’t match ability
  • recurring physical symptoms without medical explanation (stomach aches)
  • refusal and avoidance of tasks
  • separation issues (younger students)
  • social issues, like extreme shyness around peers

If you notice a student showing concerns in this area that are causing distress or getting in the way of their learning, monitor and note your observations and try targeted classroom strategies.

Go deeper: What to do if you’re concerned about a student

What you’re observing Targeted strategies
Difficulty separating from caregivers
  • provide consistent and predictable arrival routines
  • reinforce brave behaviour
  • refrain from commenting on fears
  • arrange for a buddy to greet the student and help with the transition
  • maintain regular communication with the parent/guardian
  • work with the parent/guardian to identify positive ways to reinforce non-anxious behaviour (e.g., allow the student to take home a particular book or toy when they are brave at school)
An exaggerated need to be perfect
  • model that mistakes are a part of learning and can be seen as opportunities
  • encourage the use of brainstorming and rough drafts
  • use rubrics to outline realistic performance expectations
  • acknowledge the student for finishing tasks on time without continual revising
  • use self-talk that reinforces self-compassion (“Oops, I made a mistake. Oh well, I’ll get it better next time)
  • acknowledge that imperfection can feel disappointing or uncomfortable without trying to “fix it.”
Worries about tests and exams
  • provide instruction about effective test-taking strategies (e.g., writing down things you memorized before looking at the questions, doing easy questions first)
  • encourage the use of breathing exercises to keep calm
  • avoid ‘pop’ quizzes; some students need advance notice
  • provide a separate environment for test-taking
  • allow additional time, if needed
Anxiety about completing tasks in time
  • provide advance notice of tests, assignments and time-limited tasks
  • use checklists and visual reminders of tasks and upcoming events
  • help students chunk tasks into manageable units using a calendar or schedule
  • provide feedback and encouragement for each section of the task completed
  • allow additional time, if needed
Fear of social situations at school, including public speaking
  • work to develop a culture of acceptance and kindness throughout the classroom
  • reassure students that everyone feels nervous about speaking in front of a class
  • gradually work up to class presentations by having students practice in pairs/small groups
  • do not allow the student to avoid social interactions – they must be exposed to these situations and experience overcoming the fear
  • if a student is worried about responding to questions in class, consider having the student answer yes/no questions first (instead of open-ended), rehearse questions and answers before class, or develop a cue that tells you that the student is ready to respond

Attention in the classroom

Many students will occasionally have difficulty paying attention, managing their impulses or completing tasks. Class-wide strategies and supports can help all students to maintain focus and optimize learning. 

For most students, general strategies and support will be enough to help them to maintain attention. We can help students learn skills for focusing their attention, staying on task, waiting their turn, etc. We can maintain learning environments that help students engage and self-regulate, so they’re more available for learning.

Here are some everyday strategies to try in your mentally healthy learning environment:

  • Maintain a safe and positive environment with clear expectations
  • Have predictable classroom routines and tell students about changes in advance
  • Use visual reminders and prompts
  • Teach/reinforce/model organizational skills, helping students to have needed materials ready for learning (e.g., spare pens/pencils available for loan)

  • Teach/reinforce/model time management skills, helping students to chunk assignments and use class time well (e.g., using a calendar/agenda)
  • Teach/reinforce study skills, helping students to prepare for tests in advance and to be methodical during test-taking (e.g., strategies for checking work)
  • Offer a range of engaging ways for students to access information and to demonstrate their strengths
  • Create a culture of caring within your classroom, through which students know they can ask for help when needed.
  • Design environments that minimize crowding and distractions

  • Consider creating spaces that may assist with concentration when students are trying to focus
  • When students struggle with attention and hyperactivity/impulsivity occasionally, remind yourself that they are learning executive functioning skills and that this takes time.

As an educator, you are well-positioned to observe early signs of attention concerns. For some students, signs of difficulty with attention are obvious and noticeable from a young age. For others, concerns can be hard to notice but can be just as impactful, particularly when they are not identified until later grades.

Signs you may observe for elementary students Signs you may observe for secondary students
  • difficulty paying attention and following instructions
  • fidgety, excessive activity
  • acts without thinking
  • may blurt out answers
  • has trouble taking turns
  • difficulty with / avoids written work
  • easily distracted, daydreams
  • processes information slowly
  • forgetful
  • acts younger than age
  • may have difficulty with friendships
  • difficulty organizing self and activities
  • trouble starting/completing work
  • difficulty with setting goals
  • trouble maintaining attention to tasks and ignoring irrelevant information
  • restless, distracted, may appear to daydream
  • difficulty with multistep problem-solving and managing deadlines
  • challenges performing under pressure
  • difficulty making decisions quickly
  • difficulty retaining information
  • may have more frequent negative moods (anger, anxiety, stress, sadness)
  • may have difficulty with friendships

If you notice a student showing concerns in this area that are causing distress or getting in the way of their learning, keep an eye on them, note your observations and try targeted classroom strategies.

Go deeper: What to do if you’re concerned about a student

What you’re observing Strategies to try
Challenges with attention
  • Maintain a predictable classroom environment.
  • Limit noise and distractions when students are completing tasks requiring sustained attention.
  • Teach in manageable chunks.
  • Reinforce on-task behaviour.
  • Provide a quiet workspace.
  • Provide preferential seating.
  • Keep tasks short & achievable.
  • Provide visual schedules and visible timelines.
Challenges with impulsivity
  • Remind students about mindfulness, listening, and pausing before speaking.
  • Teach and model a planned approach to tasks and conversations.
  • Provide reminders to check work.
  • Support the development of pausing skills.
  • Reinforce on-task behaviour.
  • Intervene at the point of performance – give reminders as required.
Challenges with overactivity
  • Provide movement breaks (for all).
  • Schedule short brain breaks in the day to maximize learning.
  • Stand to work if necessary.
  • Prompt for “stop and think” before acting.
  • Offer opportunities for movement at points throughout the day (e.g., office errands).
Challenges with processing speed
  • Provide copies of notes.
  • Repeat complicated instructions or concepts.
  • Extend time limits.
  • Provide cues that a question/request is coming, and allow for a longer response time.
  • Shorten assignments.
Challenges with working memory
  • Post critical information and reminders visually for all students to reference.
  • Teach in manageable chunks.
  • Offer step-by-step instructions, particularly for complex tasks.
  • Provide prompts as needed.
  • Provide memory aids (e.g., mnemonics).
Challenges with executive functioning
  • Prepare students for transitions.
  • Set achievable timelines for tests and assignments.
  • Chunk work expectations with intermediary deadlines.
  • Provide checklists and graphic organizers to support sequencing and organization.
  • Provide extra support for organizing desk, notes, materials, etc.
  • Use daily home-school communication to support work completion.

Mood in the classroom

Everyone experiences periods of sadness or irritability from time to time. For most students occasional difficulties with mood are short-lived. Sometimes though, concerns with mood are associated with a diagnosable mental illness that requires assessment and support from a mental health professional. 

Most students will do well with general support for their mental health. Here are some everyday strategies to try in your mentally healthy learning environment:

  • Greet each student warmly every day.
  • Show them that you are glad they are part of your class and pleased that they are at school today.
  • Consider including time at the beginning of class for checking in and connecting with students as they settle into the academic work.
  • Show an interest in student stories, opinions, and concerns. They may be “trying on” new ideas, and you can help to influence this in positive ways through careful listening and support.
  • Develop understanding and vocabulary around mental health within the classroom to reduce stigma for students who may be struggling.
  • Convey by your words and actions that each day offers the chance for a fresh start.
  • Notice when students are late or absent frequently, and wonder why, especially if this is a behaviour change. Offer a warm welcome to those struggling to get to school.
  • Reduce stigma by normalizing emotional ‘ups and downs’ and by being a good model for coping with life stress.
  • Encourage participation and active engagement in classroom life.

Many signs of a mood challenges are also typical components of adolescent development and don’t necessarily indicate a mental health disorder. Knowing a student’s typical behaviour and recognizing changes is a good place to start.

Signs you might observe Things a student may describe
  • less interest and involvement in previously enjoyed activities
  • sadness, tearful
  • irritability, quick to anger
  • difficulty concentrating on tasks/activities, forgetfulness, inattention
  • hypersensitivity (e.g. cries easily, appears to overreact to small issues)
  • lethargy, fatigue
  • decreased academic performance and follow-through on tasks
  • impulsive and risky behaviour
  • periods of elevated mood, racing thoughts, feeling unrealistically powerful
  • aches and pains
  • changes in appetite
  • changes in sleep patterns
  • feelings of low self-worth
  • sense of boredom
  • substance use
  • suicidal thoughts and behaviours

Important: Take all disclosures of suicidal thoughts or behaviours seriously. Follow your school protocols for response and support. Never leave a student who has expressed suicidal thoughts alone without support.

If you notice a student showing concerns in this area that are causing distress or getting in the way of their learning, keep an eye on them, note your observations and try targeted classroom strategies.

Go deeper: What to do if you’re concerned about a student

For a student at risk for a mood concern, the following strategies may help to prevent things from escalating or may minimize the impact. The same strategies may also support recovery from a diagnosed mood disorder. Working with the student, their family, and involved mental health professionals is important to ensure that the strategies used best meet the student’s needs.

  • Pay particular attention to tier 1 everyday strategies for students at greater risk (they may benefit from a higher “dose” of these caring practices!).
  • Check to see that there is a support person (you, another teacher, a school administrator) available to quietly welcome the student to school and/or to check-in with the student during the school day.
  • Acknowledge the effort required to attend class each day, as appropriate.
  • Provide support to help with school performance, like offering advance organizers, checking student understanding of concepts and tasks, and giving ample notice for tests, assignments, other deadlines.
  • Limit timed tasks and other stressful academic demands.
  • Chunk assignments and provide support and encouragement for attempting school work.
  • Correct errors or suggest improvements in the context of offering praise and support.
  • Set realistic expectations and priorities collaboratively, including the student whenever possible, providing accommodations for learning (e.g., extra time for tests and assignments).
  • Develop a classroom coping plan with the student (this may include developing signals to indicate when they need extra support, or to remind them of a coping strategy).
  • Look for natural opportunities to teach/reinforce problem-solving, relaxation techniques, and other coping skills.
  • Develop a home–school communication system to share information about the student’s academic, social, and emotional progress.
  • Be aware that some situations may be particularly difficult for the student. Understand that refusals to participate may be associated with their mood challenges.
  • If students fall behind academically, reassure them that they can catch up. Show them the steps they need to take and be flexible and realistic about your expectations.
  • Model an optimistic outlook, and help the student to ‘find a silver lining” when challenges occur.
  • If a student is returning to school following hospitalization or a prolonged absence, work collaboratively with the student, their family and their support team to develop a plan of specific strategies for reintegration considering issues of stigma, workload, missed content and reassurance.
  • Be aware and familiar with your board’s procedures for dealing with students who are expressing suicidal thoughts.

How to tell if more support is needed

As an educator, it’s beyond your role to assess or diagnose a mental health disorder. However, your work to notice and document concerns is crucial. You can work collaboratively as part of a team to provide caring support at school. Consult your school board’s protocol for accessing mental health support if what you’re noticing is: 

  • consistent and persists over long periods (e.g., for two-weeks or more) 
  • seems exaggerated and doesn’t seem to match the situation or stage of development  
  • causing distress or impacting daily functioning and school performance 

What to do:  

Follow your school board’s protocol for accessing mental health support. This may include:  

  • consulting with your principal, vice-principal or member of your school’s mental health leadership team  
  • discussing your observations with the student and/or their parent/caregiver  
  • a referral for professional mental health support from school board personnel (e.g., school social worker or school psychologist)  
  • a referral for professional mental health support within the community 

You remain part of the student’s circle of support as they move to, through and from professional mental health services. There are specific strategies you can use to support students who are receiving mental health treatment.  

It’s essential that you take care of yourself too—for your well-being, and so you’re better able to support the students you serve. Pay attention to your thoughts and feelings and try basic self-care strategies. Learn to recognize when you need additional support. Help is available for you through your employee assistance program.

Resources to help you support students


Georgiades, K., Duncan, L., Wang, L., Comeau, J., Boyle, M. H., & 2014 Ontario Child Health Study Team. (2019). Six-Month Prevalence of Mental Disorders and Service Contacts among Children and Youth in Ontario: Evidence from the 2014 Ontario Child Health Study. The Canadian Journal of Psychiatry, 64(4), 246–255.

Ontario College of Teachers (2018). Professional Advisory: Supporting Students’ Mental Health.

World Health Organization (2021). Adolescent mental health.

Government of Ontario (2013). Supporting minds: An educators guide to promoting students’ mental health and well-being. Draft version.

School Mental Health Ontario (2022). Supporting minds strategies at a glance: Ideas to support and bolster students with mental health problems in the classroom.