Editorial: Education Systemic Realities and Adolescents’ Pathos

How many of us have really reflected and empathized with the struggles of adolescents’ during their schooling years and correspondingly with their related crusade? Increasing rates of suicides amongst the youth are a major concern, but the moot point is whether this is an outcome of a situational context or culmination of the slowly accumulating stress since school time! Children tend to walk with a slouch due to being weighed down by their bags. Additionally, tuitions tend to be a norm; but barely affordable for a child from a lower-middle economic background. An adolescent with Attention Deficit Hyperactivity Disorder (ADHD) or Specific Learning Disability (SLD) maybe regularly attending a coaching center for improving one’s grades, but it would be akin to simply killing time (i.e. “flogging a dead horse”). Leaving aside the usual “run-of-the-mill” school routine of a 12^th class teen; first term- second term- preboards and boards, the final step-preparation is extremely exhaustive.

In this background, the NEET- 2024 shattered hopes of many! The news of a systematic leakage of the NEET paper came as a tremendous shock to aspirants. Furthermore, the time lag in waiting for the decision regarding upholding NEET again, along with the pressure to continue studying till the second date for the test was finalized brought on immense emotional stress for the students. The sudden rush of adolescents’ along with their parents visiting the clinic reflected their underlying turmoil. The desire for a miracle pill in order to obtain a calming effect, an increase in concentration and improved academic performance started a vicious cycle of doctor shopping.

Apart from the process of competitive exams, the recent change in the educational patterns has added to the uphill battle of acquiring a professional seat. As if a single preboard exam was not enough; now two preboards have been introduced, thereby leading to reduced availability of time to finish the syllabi. Due to the combination of their skill set, expertise and experience, a teacher can, in all probability, definitely manage this change but the students tend to feel more pressurized in how to manage all the subjects well ahead of exams. Increasing the number of exams may inadvertently reduce academic performance due to extreme stress and external pressures may necessarily not help in building the internal motivation to study. This has also resulted in decreased writing practice, be it at home or at school.

In a recent ongoing work by the principal author (unpublished data) involving a survey of approximately 7000 students of classes 9^th-12^th from schools in Delhi and Chandigarh showed that new issues have arisen since COVID and school re-opening thereafter. Adolescents’ reported a decline in writing skills and increased exam stress due to a combination of poor concentration and lack of practice in writing long answers. A decline in clarity of concepts due to online classes was oft reported by students in today’s times as well. Teachers’ too felt that habits once broken during COVID have yet to be properly regained by some students. These COVID related (and/or emergent) concerns were reported by all stakeholders (students’, parents and teachers). Students have fallen into the habit of typing rather than writing innovatively as ‘Google’ tends to give instant answers thus saving time which is conveniently used in netsurfing. Device dependency triggered by COVID and online classes was found to be associated with less study time, reduced creative writing, mental health issues and family conflicts. Parents and teachers alike have consistently highlighted continuation of academic disengagement, while impact of financial crunch due to job loss is another source of distress in a certain proportion of students.

The United Nations adopted 17 Sustainable Development Goals (SDGs) in 2015, which were initially developed in 2012 at Rio. Quality education is one of the 17 goals that aims to provide lifelong learning opportunities by promoting inclusive and equitable quality education for all. By 2030, the goal is to upgrade child, disability and gender sensitive education to equip them with knowledge and skills required to promote sustainable development and lifestyles. In India, SDG was launched in 2016 to stimulate development actions in areas of critical importance, including education which is also related to reducing poverty.

An analysis of our education patterns and systems tends to show that it is completely enmeshed in the complex interplay of psychological (resilience and coping) and social (society rules, family dynamics and economic factors) factors. New concerns have additionally emerged since COVID, especially related to academics, that are apparently modifiable; but have they really been pondered over, especially with the government priority focused on achieving the SDG goals!

In this context, the educational system paints an even more bleak picture for the students with neurodevelopmental disorders and other mental health conditions. Academic issues (along with high expectations and academic overload) faced by adolescents with certain not so uncommon pre-existing mental health issues (borderline intelligence, Specific Learning Disorder or ADHD) are well known both world wide^1,2 and especially in the Indian context^3,4; yet the steps taken for them in India have not been satisfactory enough to resolve their related problems. In fact, worst outcome is probably being faced by adolescents with borderline and dull average intelligence. The schools and teachers often advice parents’ of such adolescents to obtain a disability certificate though there is no provision for the same. Even identification and disability certification for SLD only partially resolves the stressful situation as they are still not able to avail remedial training due to unavailability of special educator or the costs involved.

What is the way forward? Can overcoming shortage of mental health professionals be the crux of solution for all such issues? Or addressing lack of coping skills (arising due to psychological issues and faulty parenting) through intervention can be the panacea for adolescents’ problems?

In this context, a recent mapping exercise, with regards to mental health services for children and adolescents has been conducted by Indian Association for Child and Adolescent Mental Health (IACAM) in partnership with UNICEF (unpublished data). A grim picture has emerged! Many of the national level policies and programs are generic in nature ignoring the mental health of children and adolescents. The mental health budget of 2024-2025 is only 0.003% of the total budget. Human resources are unequally distributed with rural areas devoid of trained psychiatrists, clinical psychologists and special educators. Field studies which were conducted (including focus group discussion and in-depth interviews in two districts of Maharashtra) showed poor understanding of “mental health”. It may be pertinent to mention here that such poor understanding was seen among teachers and principals of schools in Delhi as well (independent of the field study and based on principal author’s experience at various schools).

Overall, if we analyze the situation longitudinally, then there has been a definite growth in the area of mental health promotion and prevention through advocacy and related government and various inter-sectoral initiatives. However due to poor coordination and monitoring, the effect of these initiatives is akin to a drop in the ocean. This is further compounded by poor documentation and lack of common platform to act as a repository for involved stakeholders (mental health professionals, teachers and funding organizations). Therefore, efforts made are laden with problems of duplicity devoid of any strong evidence for efficacy or sustainability. Though schools remain a viable option for implementing programs yet they are unable to yield the desired results of promoting positive mental health and prevention of psychological problems. Can we hope that any attempt to change one of the major sources of stress (i.e. the educational system) would be a one time solution?

Till we as child and adolescent ‘Carers’ initiate actions, we will let the struggles of the adolescent continue!

The adolescents’ pathos will continue…….unheard, unresolved, unabated!