Mental Health and Illness

Part One: Introduction
By: Matthew Smith, Maria Rotondo, and Hollyann Branham

Topic Explanation: Mental Illness and Health

The topic of our inquiry is mental illness and heath. According to WebMD, “The term "mental illness" is not entirely accurate, because there are many "physical" factors -- including heredity and brain chemistry -- that might be involved in the development of a mental disorder. As such, many mental disorders can be effectively treated with medication, psychotherapy (a type of counseling), or a combination of both.” Because of this complexity, the phrase is quite difficult to define; however, in our group presentation, we are defining mental illness as a type of internal struggle that may be caused by environmental factors or heredity. The texts we chose show a number of characters who deal with various mental illnesses.  In our analysis, we identify the mental disorder and highlight the treatment that a number of these characters go through.

            Through the various texts, we explore the following issues: post-traumatic stress disorder, Asperger’s, ALS, suicide, and schizophrenia. Our audience includes 6^th, 9^th, 10^th, and 12^th graders in an urban school district. For this audience we incorporated a graphic novel, a news article, audio, film, and a novel. We wanted to provide a wide range of texts that appeals and motivates every type of learner—especially reluctant readers.

Rationale

We focused on older students (6-12^th grade) for several reasons. First, mental illness is a mature topic that carries many stigmas and misconceptions. We want to address an older audience that can understand these stereotypes and think critically about their origins. Furthermore, we wanted to address an audience that can appreciate the struggles associated with the disease. Some students might have family members or friends who have a mental illness and will require extra supports. Finally, the topic might make young people feel uncomfortable and we should be sensitive to that issue.

It is important to discuss mental illness with older students because the onset of many types of mental illnesses occur in this age group. For example, schizophrenia begins to show symptoms around eighteen or nineteen years old. It is important to discuss mental illness with young people and open a dialogue about these societal issues.   

Our text-set includes the following genres: fiction, graphic novels, memoirs, multimodal, lyrics, and newspaper articles. Our group made a concerted effort to include a wide range of genres for a wide spectrum of learners. Moreover, we included multimodal texts to further engage students as well as foster a greater understanding of non-print based texts.

These assertions are supported by the following research:

 Alvermann, D. E. (2001). Reading adolescents' reading identities: Looking back to see ahead. Journal of Adolescent & Adult Literacy, 44(8), 676-690.

 Collier, L. (2012). YA literature—Where teens find themselves. National Council of Teacher of English, 6-11.

Myers, W. D. (2005). Writing for the uninspired reader. English Journal, 36-38.

Common Core State Standard	How Standard is Addressed	Assessment
CCSS.ELA-Literacy.SL.9-10.1c Propel conversations by posing and responding to questions that relate the current discussion to broader themes or larger ideas; actively incorporate others into the discussion; and clarify, verify, or challenge ideas and conclusions.	This standard is addressed through the small group and large group discussions following the students’ journal responses. The prompts provide scaffolds for students to form their own ideas and compare those ideas to others. It guides students to evaluate the film in small group and large group contexts. First, students construct ideas and think independently. Next, students construct knowledge together—sharing his/her ideas with a group and thinking critically about the ideas and thoughts of others.	-Teacher will circulate through the room while students are writing independently and working in their small groups -The teacher can facilitate discussion and check for understanding while monitoring student work
CCSS.ELA-Literacy.SL.9-10.1d Respond thoughtfully to diverse perspectives, summarize points of agreement and disagreement, and, when warranted, qualify or justify their own views and understanding and make new connections in light of the evidence and reasoning presented.	This standard is also addressed through the small group and large group discussion. Through the discussion, students decipher which ideals and opinions they agree with. The discussion offers students a dialogue about the film and schizophrenia in general. The dialogue presents varying perspectives and assumptions that the students can agree or disagree with. This is also addressed through the implementation of literature circles used with Finding Alice. Students will cite evidence to support their opinions from the texts.	-Teacher will assess this criteria through the chart produced by each group -The teacher can facilitate discussion and check for understanding while monitoring student work -Teacher can assess knowledge, synthesis, and analysis of the text through the group presentation of their chart and the verbal explanation given -Teacher can assess can assess knowledge, synthesis, and analysis of the text through the literature circle discussion
CCSS.ELA-Literacy.W.9-10.4 Produce clear and coherent writing in which the development, organization, and style are appropriate to task, purpose, and audience.	This standard is addressed through the compilation of key points on the group chart paper. For this task, students are to create a chart describing how their group defined mental illness and how the disease affected the people in the video. The purpose of the task is for students to operationalize and visualize their definition of “mental illness,” “normal,” and “abnormal.” The task offers students a chance to construct meaning together and reach a consensus on these important societal definitions. The writing can be sentences or a bulleted list. Moreover, the audience of this writing is students writing to other students. This standard is also addressed through the note-taking activity. Students produce clear and coherent writing through the note-taking genre.	-Teacher can assess convention, form, task, organization, and overall understanding through the written text on the chart -Teacher circulates through the room while students write down notes from the audio text.

Activities

Late Elementary: Depression & Suicide--- What it is and How to Deal with it

Middle/Early High School: Schizophrenia—Definitions, Social Norms, and Real People  

High School: Working with Memoirs: Analysis and Creation of Autobiographical Works Dealing With Personal Struggle

Connection to CCLS and Assessment:

Common Core State Standard	How Standard is Addressed	Assessment
CCSS.ELA-Literacy.SL.9-10.1c Propel conversations by posing and responding to questions that relate the current discussion to broader themes or larger ideas; actively incorporate others into the discussion; and clarify, verify, or challenge ideas and conclusions.	This standard is addressed through the small group and large group discussions following the students’ journal responses. The prompts provide scaffolds for students to form their own ideas and compare those ideas to others. It guides students to evaluate the film in small group and large group contexts. First, students construct ideas and think independently. Next, students construct knowledge together—sharing his/her ideas with a group and thinking critically about the ideas and thoughts of others.	-Teacher will circulate through the room while students are writing independently and working in their small groups -The teacher can facilitate discussion and check for understanding while monitoring student work
CCSS.ELA-Literacy.SL.9-10.1d Respond thoughtfully to diverse perspectives, summarize points of agreement and disagreement, and, when warranted, qualify or justify their own views and understanding and make new connections in light of the evidence and reasoning presented.	This standard is also addressed through the small group and large group discussion. Through the discussion, students decipher which ideals and opinions they agree with. The discussion offers students a dialogue about the film and schizophrenia in general. The dialogue presents varying perspectives and assumptions that the students can agree or disagree with. This is also addressed through the implementation of literature circles used with Finding Alice. Students will cite evidence to support their opinions from the texts.	-Teacher will assess this criteria through the chart produced by each group -The teacher can facilitate discussion and check for understanding while monitoring student work -Teacher can assess knowledge, synthesis, and analysis of the text through the group presentation of their chart and the verbal explanation given -Teacher can assess can assess knowledge, synthesis, and analysis of the text through the literature circle discussion
CCSS.ELA-Literacy.W.9-10.4 Produce clear and coherent writing in which the development, organization, and style are appropriate to task, purpose, and audience.	This standard is addressed through the compilation of key points on the group chart paper. For this task, students are to create a chart describing how their group defined mental illness and how the disease affected the people in the video. The purpose of the task is for students to operationalize and visualize their definition of “mental illness,” “normal,” and “abnormal.” The task offers students a chance to construct meaning together and reach a consensus on these important societal definitions. The writing can be sentences or a bulleted list. Moreover, the audience of this writing is students writing to other students. This standard is also addressed through the note-taking activity. Students produce clear and coherent writing through the note-taking genre.	-Teacher can assess convention, form, task, organization, and overall understanding through the written text on the chart -Teacher circulates through the room while students write down notes from the audio text.

High School: 12^th Grade 

Common Core Standards:

Writing Standard 10: Write routinely over extended time frames for a variety of audiences.

In the memoir writing activity, students will create original stories that deal with personal struggle. These will be shared with peers and possibly parents. Students will practice with shorter writing activities before approaching the cumulative memoir assignment.

Reading/Informational Standard Five: Analyze and evaluate the effectiveness of the structure an author uses in his/her piece.

I will incorporate structure into my lesson by having students discuss how effective Morrie Schwartz’s message comes across to the reader. If there are proper resources, I’d like to involve students in community activities to coincide with the theme of Tuesdays With Morrie.

Assessments:

Practice Writing: Students will critique Morrie’s struggle and message. The teacher will assess how well the students understood the message through their writing samples. These will be formative assessments in order to give feedback to students to prepare for the final project.

Final Project: Students will write a memoir detailing a personal struggle in their lives so far. Students will share these memoirs with parents at a family night.

 Tuesdays with Morrie

Albom, Mitch. Tuesdays with Morrie: an old man,a young man, and life's greatest lesson.New York: Doubleday, 1997. Print. 

            Tuesdays with Morrie explores a dying professor’s last days as he struggles with ALS.  This nonfiction text deals with a professor who is not well and therefore ties in with our unit on mental health and wellness. The professor, Morrie meets with Mitch Albom, the author, and discusses how important it is to foster relationships with the people around you.  Morrie states, “Once you learn how to die, you learn how to live” (Albom 82).  Because Morrie was dying, he saw life from a different perspective.  He wanted people to stop putting value in material objects and working their lives away. Also, he wanted people to care about each other.  As Morrie tells this to Albom, Albom writes about his life in college and his career.

Albom sees his life through different eyes as he analyzes his choices that he has made.  Working for a newspaper, Albom worked years while finding the best story, interviewing different clients, and editing article after article.  Albom visits Morrie after hearing about the disease that Morrie was afflicted with.   With every visit, Morrie seems to give Mitch life lessons.

Morrie stated, “Mitch, I embrace aging . . . Aging is not just decay, you know. It’s growth” (118).  Because Morrie had only a limited time left, he changed his entire perspective about life and death.   While many people see aging as a detriment, Morrie saw it as an opportunity to live a greater life.  Even when Morrie’s disease was at its worst, Morrie saw it as positive.  For instance, when he couldn’t wipe his behind anymore, Morrie stated that it was like being a baby once again and that he enjoyed being taken care of (116). After Morrie’s death, Albom writes, “So I hope this book keeps opening eyes about ALS, reminding people how precious our time with one another is” (199).  This was the last lesson that Morrie taught, but it did not stop there because of Albom.  It continues through the minds of readers today.

For educators, this text provides an avenue for activism in the community. Morrie cared about people and about the community.  Perhaps students could make some of his wishes come true. If I were to use this text, I would have students look at issues in the community and perhaps create an event where students could help people at soup kitchens or places like the Salvation Army. Also, students could focus on personal relationships by writing a list of goals that they have and making a plan to start one of them.  

Waltz with Bashir

Folman, Ari, and David Polonsky. Waltz with Bashir: a Lebanon war story. New York: Metropolitan Books, 2008. Print.

            Waltz with Bashir tells the story of an Israeli soldier who is suffering with post-traumatic stress disorder after the Lebanon war. This story is told in the format of a graphic novel. He cannot remember what events that he took place and decides to visit people who were in the war with him to figure out what actually happened.  His psychologist tells him, “There’s a human mechanism that blocks us from going into the dark areas we want to keep closed.  Your memory will only take you where you need to go” (17). Ari Folman spends the entire book questioning people about what happened, but when he finally finds out his role in the Sabra and Shatila massacre, he is overwhelmed.

            This book has a number of practical applications in the classroom. Due to sexual references and images of violence, this book should be taught at the 12^th grade level.   The book is engaging due to its graphic nature and uses images to enhance the meaning of words.  For instance, the comics show us what the environment looked like in Lebanon for readers who are unfamiliar with the territory.  Also, the comic book style allows readers to understand memories of war that are extremely traumatic.  For example, one of Ari Folman’s men is shot in the neck with a sniper rifle on page 37.   Because it is a comic book picture, it allows readers to separate themselves from the material, although the war was real.

            For actual classroom activities, I would focus on mental illness, issues of war, and memory.  I would pair this with the novel, The Things They Carry, as that is another memoir that students could compare and contrast with Waltz with Bashir.  Students could create journals about soldiers writing back to their families. For this to be a subjective based experience, students could create some art with a memory that they have had in their past. There is an excellent movie that I could show as well.  

 Extremely Loud & Incredibly Close

Extremely loud & incredibly close. Dir. Eric Roth. Perf. .. Distributed by Warner Home Video, 2012. Film

            In this film, Oskar, a nine year old, loses his father in the first scene to the horrific events of 9/11.  At home, his father left messages on the answering machine before the attack; however, Oskar hid the tape and never showed the messages to anyone.   The movie tells the story of his quest to remember his father.  Oskar tries to find the lock that fits a key that his father left behind.  He scours New York City day and night searching for the key. His mother does not approve of his adventures, but he finds ways to sneak out of the house.  He meets a plethora of people and learns about himself in the process.   

            This film relates to our topic of inquiry because Oskar has Asperger’s and has strange interactions with people from all around the world.  Some people are kind when he asks them if they have anything that the key might unlock. Some shut him out and we see the slamming of the door.  Oskar eventually finds the lock to the key, but it does not seem to solve his problems.

            In the classroom, this film would work well because it deals with trauma and adventure.  Adventures are often engaging and that could hold student’s attention.  Also, students might be able to relate to Oskar if they know someone with the condition. Dealing with loss can be difficult to overcome, and this movie can help someone remember a person that he/she might have lost. 

Late Middle School, Early High School (9^th & 10^th)

True Life: I’m a Schizophrenic

True life: I’m a schizophrenic United States: MTV Films. Retrieved from http://www.mtv.com/videos/true-life-i-have-schizophrenia/1586145/playlist.jhtml

           

In True Life: I’m a Schizophrenic, MTV documents the experience of three young people living with schizophrenia. Josh has struggled with schizophrenia for the past few years. He refuses treatment because he likes to hear the voices—it is better than feeling lonely. Ben on the other hand takes medication daily to fend off the voices in his head. He has been doing well for the past two and a half years but fears the voices will return due to the stress of his grandfather’s fatal cancer. Alternatively, Amber was recently diagnosed with schizophrenia. After getting her symptoms under control, Amber attempts to return to college. Each young person offers his/her own unique experiences to the struggles of living with a mental disorder.

            This text could be implemented as a journal prompt for students. Before viewing the episode, students will respond to the following prompts: What is a mental illness? How do you define normal and abnormal? After viewing the students will respond to these prompts: How did schizophrenia affect Josh, Ben, and Amber’s life? How does the social stigma associated with mental illness affect the people who are mentally ill? After students are given about ten to fifteen minutes to write, students will break into smaller groups and discuss their reactions to the documentary. Students will create a chart describing how their group defined mental illness and how the disease affected the people in the video.

Overall, this text includes most learners. It incorporates perspectives from various ethnicities, social classes, and genders. Moreover, the text appeals to young people because it portrays young people who suffer from the disease.

This text connects to our overall theme of mental health/illness in many ways. First, it discusses a severe mental illness through the stories of three young people living with the disease. It offers an honest depiction of the disease through the perspective of the people that know it best.

       

“Patient Voices: Schizophrenia”

Parker-Pope, T. (2012, September 15). Patient Voices: The Voices of Schizophrenia. Retrieved from http://well.blogs.nytimes.com/2010/09/15/the-voices-of-schizophrenia/

http://www.nytimes.com/interactive/2010/09/16/health/healthguide/te_schizophrenia.html

      

In “Patient Voices: Schizophrenia,” The New York Times interviews people who suffer from schizophrenia. Seven men and women share their experience with the disease. Although the all share the same disease, their individual experiences are all unique.  

            In regards to practical applications, this text could be implemented with a note-taking lesson. After direct instruction with note-taking strategies, students would listen to the audio and take notes using one of the new strategies. This text does not offer any visuals; therefore it allows students to practice this skill with a completely auditory text. Students will be prompted with the following questions after they complete the note-taking activity: What are some effects of schizophrenia that the participants discuss? Are there any benefits to the disease? How does the stigma of mental illness affect the people living with the disease?

            This text connects to our theme because of its discussion of a mental illness. Moreover, it offers varying perspectives to view the experiences of a schizophrenic. It is important to highlight that even though each person suffers from the same disorder they do not experience the same symptoms and struggles. It is also important to underscore that not every person suffering from schizophrenia feels the same way about the disease. Students need to be exposed to all perspectives.

Finding Alice

Carlson, M. (2009). Finding Alice. WaterBrook Press.

In this novel, Melody Carlson describes the struggles of Alice Laxton. Alice seems like a very normal, bright, and inquisitive young woman. However, after a particularly stressful senior year of college, her genetic disorder of schizophrenia begins to develop at a rapid pace. The novel documents her experiences and offers a powerful portrayal of what it means to live with schizophrenia.  

            This text could be incorporated as a book for literature circles. During that week of instruction, students could select from three different texts about mental illness. After reading his/her book, each student would be assigned a role within the literature circle, i.e. illustrator, discussion leader, connector, and summarizer. Students will discuss the text through his/her role and teacher prompts. Generally this text reaches all learners but it could alienate male readers because of the female protagonist.

            This text connects to our theme through its portrayal of a mental illness. Furthermore, it describes a young girls experience through a narrative format. This different genre offers yet another genre and lens to view this complicated disease.

Elementary: Grade 6

Jen's Story

Jen’s Story | Bring Change 2 Mind. (2013). Retrieved from http://www.bringchange2mind.org/stories/entry/jens-story

Bring Change 2 Mind is a website that is working to end the stigma and discrimination of mental illness. One way in which they do this is through sharing real life stories of people diagnosed with mental illness. Jen’s story is the story of a 21 year old girl who talks about her first experiences with depression starting just a few weeks after her 10^th birthday. She started spiraling into a deep, dark depression that consisted on crying days on end and not wanting to get out of bed. She even reminisces on not wanting to live within her own mind but that it is almost impossible to hold yourself underwater. Her story continues into seeking help and getting the help she needs.

This article is relevant to students because they will be able to relate to the age of Jen and her story, even if they don’t experience depression on a daily basis. Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds making it a “culturally relevant” mental health issue. As many as 1 in every 33 children may have depression and in their teens that number can become as high as 1 in 8 making it even more important to educate students, teachers and parents on the importance of looking out for depression signs in our youth. This story would be an excellent exemplar to use in comparison to Runyon’s The Burn Journals to compare and contrast the texts in different forms or genres in terms of their approaches to similar themes and topics which in this case would be depression and suicide attempts.

Runaway Train by Soul Asylum

Pirner, David. (1993). Runaway train [Soul Asylum]. Grave Dancers Union. Columbia. (1992).

“Runaway Train” is a song by the American rock band Soul Asylum. It was released in June

1993 and eventually went on to win a Grammy Award for Best Rock Song in 1994. The songs

lyrics discuss feeling “like a firefly without a light” and “It seems like no one can help me now,

I’m in too deep, there’s no way out” which could be read as signs of depression or suicide

This song is relevant to all students because it is accessible to all students through viewing, reading or listening while discussing an issue that many have felt at least once in their lives, alone. For classroom implications, students could analyze how a particular sentence or stanza fits into the overall structure of a text and contributes to the development, theme, setting or plot of depression and suicide.

 The Burn Journals

Runyon, B. (2005). The burn journals. New York: Vintage Books.

The Burn Journals is the true story of author, Brent Runyon, when he was 14 years old in eighth grade. After a bad day at school, he came home, played a little basketball with his brother, and then went inside and soaked his bathrobe in gasoline, and set himself on fire. The book is centered on Runyon’s devastating suicide attempt and his recovery over the following year where we follow him into the Burn Unit in children’s hospital and through painful burn care and skin grafting procedures. Within his year of recovery, we also get to see into his life as he goes to a rehabilitation hospital for intensive, physical, occupational and psychological therapy to back home to prepare for the even more frightening issue of entering high school. He shares his thoughts and hopes and fears with the reader as his fourteen year old self which puts the reader into his shoes to provide clarity on what it means to want to kill yourself and how it feels to struggle back toward normality.

Suicide is a serious public health problem that affects all ages but for youth between the ages of 10 and 24, suicide is the third leading cause of death and it results in approximately 4,600 lives lost each year. Sixth grade students are typically between the ages of 11 and 12 which means that suicide awareness is relevant to their lives and that they should be aware of so that they understand risk factors and where to go for help. Some implications for classroom use with this text would be as an exemplar of narrative writing, a writing exemplar to base a writing center or workshop focused on daily writing or students could use the text to make informational, posters, articles, websites, videos or other multimodal texts to make students aware of suicide and mental health.