“Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have.” — Margaret Mead
That quote has stayed with me for a long time, and it feels especially true when I think about the work being done in schools around mental health. The people doing that work are teachers, counselors, administrators, and parents who care deeply. And caring, it turns out, changes things.
This week I want to share something that’s been on my mind, along with a few resources worth knowing about.
According to the CDC, 18% of high school students reported seriously thinking about attempting suicide in the past year.
Let that number sit for a moment.
Nearly 1 in 5 high schoolers. Not struggling quietly with stress or occasional sadness, seriously thinking about ending their lives.
This is not a fringe issue. It’s not something happening in someone else’s school or someone else’s family. It is happening in every school, in every zip code, across every income level. And most of the time, the adults around these students have no idea.
That’s not a failure of caring. It’s a failure of awareness and access, which is exactly why conversations like this one matter.
When teenagers are struggling with thoughts of suicide, hopelessness, or self-harm, the most important thing is connection to consistent, professional support. Teen and adolescent counseling provides a confidential space where young people can say what they cannot say at home or at school, and that outlet can genuinely save lives.
For years, schools have operated under an unspoken assumption: emotional wellness is the family’s job; academic achievement is ours.
That’s changing, slowly, but meaningfully.
The Distinguished School of Mental Health & Wellness (DSMHW) is a national non-profit headquartered right here in St. Louis that is doing some of the most intentional school-based mental health work in the country. Their model is a 12-month intensive training program that works with schools on:
Schools that complete the program are nationally certified and recognized as a “Distinguished School.” More information is available at dsmhw.org.
This kind of systemic investment matters because individual therapy alone cannot reach every student who needs support. Schools that embed mental health awareness into their culture create the conditions where students are more likely to ask for help, and more likely to get it early.
Here’s something I see regularly in my work: parents who are shocked when they find out their child has been struggling for months, sometimes longer.
It’s not that these parents weren’t paying attention. It’s that anxiety and depression in young people often don’t look the way adults expect them to.
Anxiety in students might look like:
Depression in students might look like:
When these signs are present and persistent, they deserve more than a wait-and-see approach. Anxiety counseling and depression counseling offer evidence-based approaches including Cognitive Behavioral Therapy (CBT) and mindfulness-based strategies that work especially well with young people when started early.
One thing DSMHW’s training program gets right is the explicit inclusion of trauma in their curriculum. Trauma-informed education isn’t a buzzword, it’s a fundamental shift in how teachers and administrators interpret student behavior.
A child who is consistently disruptive is often a child who is dysregulated. A student who refuses to turn in work is often a student who is overwhelmed. A teenager who lashes out at teachers is often a teenager who has learned that adults aren’t safe.
None of this excuses the behavior. But understanding its source changes the response, from punishment to curiosity, from discipline to support.
For students carrying significant trauma, classroom-level support has limits. Trauma and PTSD counseling with a trained clinician particularly approaches like EMDR, which is specifically designed to process traumatic memory, can reach what even the most caring teacher cannot.
This point doesn’t get enough attention: teachers cannot give what they don’t have.
The burnout rate in education is staggering. Teachers absorb enormous amounts of stress, grief, secondary trauma, and emotional labor, and most school systems provide little structured support for it.
DSMHW’s inclusion of teacher self-care in their training model is one of the things that sets it apart. You cannot build a mentally healthy school environment on top of a burned-out staff. It simply doesn’t hold.
The same principle applies at home. Parents who are running on empty, who are managing their own unprocessed anxiety or depression or grief, have less capacity to support their children through difficult moments. That’s not judgment, it’s just the reality of how emotional resources work.
Individual counseling for parents isn’t a luxury. For many of the families we work with, a parent getting the right support turns out to be one of the most impactful things that happens for their child.
The Tiny Buddha article “45 Simple Self-Care Practices For A Healthy Mind, Body & Soul” is worth bookmarking, not because self-care is a trend, but because sustainable mental health requires daily maintenance, not occasional rescue operations.
What I tell clients is this: self-care isn’t the bath you take when you’ve finally hit a wall. It’s the small, consistent things you do so you don’t hit the wall as often.
For students, this might look like a 10-minute wind-down before bed instead of scrolling. For parents, it might look like a 20-minute walk without a phone. For teachers, it might look like a firm boundary around email after a certain hour.
None of these are dramatic. But they compound. And that compounding, over weeks and months, is what builds the kind of emotional resilience that makes hard things survivable.
If you’re curious about the science underneath all of this, why mindfulness works, why trauma changes the brain, why talk therapy produces measurable neurological change, the TED Talk “What We’ll Learn About The Brain In The Next Century” by Sam Rodriques is a fascinating starting point.
Understanding that mental health is a brain health issue, not a character or willpower issue, changes how we talk to children about what they’re experiencing. It removes the shame. And removing shame is often the first step toward actually getting help.
The Cosmopolitan piece “19 Celebrity Quotes On Mental Health” might seem like light reading, but there’s something genuinely important happening when public figures speak openly about panic attacks, depression, and therapy.
For teenagers especially, seeing someone they admire acknowledge a mental health struggle, and survive it, and thrive, quietly gives them permission to acknowledge their own. Stigma doesn’t survive visibility. And every young person who stops feeling alone in their struggle is one step closer to being willing to ask for help.
Reading about school-based mental health programs and national statistics is valuable. But I also want to bring this back to something concrete.
If you are a parent in St. Louis wondering whether your child is struggling with more than typical stress, the most useful thing I can tell you is: trust your gut, and don’t wait too long.
Early intervention consistently produces better outcomes than crisis-level response. A few sessions of child counseling when you first notice something feels off is far less disruptive than a full-blown crisis months later.
If your teenager has become withdrawn, irritable, or seems to have lost interest in things they used to care about, these are worth taking seriously. Teen and adolescent counseling provides a confidential, non-judgmental space where they can talk to someone who isn’t their parent or their teacher, and that distinction matters more than most adults realize.
If your family is navigating something together, a major transition, a loss, communication that has completely broken down, family counseling brings everyone into the same room with a neutral, trained third party who can help untangle what’s gotten stuck.
And if you are the one struggling, not just your child, individual counseling is available for adults too. Your mental health matters. Not just because you’re a parent or a caregiver, but because you matter.
The team at Pearlman & Associates offers in-person appointments at our Creve Coeur office and secure online sessions for clients anywhere in Missouri. We work with children, teens, adults, couples, and families, and we can typically get someone in within a few days. Explore everything we offer on our mental health services page.
Dr. Lena Pearlman is a Licensed Clinical Social Worker and Clinical Director at Pearlman & Associates, specializing in medical and forensic mental health support. She is passionate about removing barriers to mental health care and advocates for integrated, school-based wellness programs as a critical part of supporting young people’s long-term wellbeing.
Call: 314-942-1147
Email: doctor@STLmentalhealth.com
Location: 655 Craig Road, Suite 300, St. Louis, MO 63141
www.stlmentalhealth.com
In-person and telehealth appointments available Monday through Saturday.
What is the Distinguished School of Mental Health & Wellness (DSMHW)?
DSMHW is a national non-profit headquartered in St. Louis that partners with schools to implement a 12-month intensive mental health and wellness training program. Topics include anxiety, depression, trauma, perfectionism, teacher self-care, and mindfulness. Schools that complete the program are nationally certified as a “Distinguished School.” More information is available at dsmhw.org.
What percentage of high school students struggle with suicidal thoughts?
According to the CDC, 18% of high school students reported seriously thinking about attempting suicide in the past year. Early access to professional mental health support, including teen counseling is one of the most important protective factors for at-risk young people.
How do I know if my child needs counseling versus just going through a phase?
A helpful guideline: if the behavior or emotional shift has lasted more than two weeks, is affecting school performance or friendships, or involves statements about hopelessness or not wanting to be here, that warrants professional evaluation. You don’t need to wait for a crisis. Child counseling can provide clarity even if the concern turns out to be mild.
What does anxiety look like in teenagers?
Teenage anxiety often doesn’t look like nervousness. It can present as irritability, avoidance, physical complaints (headaches, stomach aches), perfectionism, or rage. If a teen seems to be struggling in any of these ways consistently, anxiety counseling with a licensed clinician can help identify what’s happening and build practical coping skills.
Does Pearlman & Associates offer online therapy?
Yes. We offer secure, HIPAA-compliant virtual therapy sessions for clients throughout Missouri. Telehealth appointments are available Monday through Saturday and provide the same quality of care as in-person sessions at our Creve Coeur office.
What mental health services are available at Pearlman & Associates in St. Louis?
We provide individual therapy, couples counseling, family therapy, child counseling, teen counseling, anxiety counseling, depression therapy, grief counseling, and trauma and PTSD therapy, both in-person in Creve Coeur and via telehealth across Missouri.
