A new report says students in high-pressure environments should be considered at risk, similarly to peers living in poverty or foster care. Experts explain how parents can alleviate the pressure.

By Sarah Lindenfeld Hall
Updated October 28, 2019

Ashley Morris still remembers the student who was more than capable of doing a math problem in class. But when it was time to come up with the answer on the board, the girl started sobbing.

"It's not because she got stuck. It was everything else, and that was the tipping point," says Morris, a former high school teacher, including at high-achieving schools, and longtime math tutor in North Carolina. The high school student was simply overworked and overtired.

In her work and discussions with other teachers, Morris says scenarios like these regularly play out in high-achieving schools where the focus is often placed on high test scores and prestigious college acceptances. And despite typically coming from affluent, well-educated families, studies show that children and teens in these high-pressure environments have a greater risk for serious mental health and substance abuse problems.

In fact, according to a National Academies of Sciences, Engineering and Medicine report on boosting health equity for children, students in high-achieving schools should be considered at risk, just like their peers who are living in poverty or foster care or have a parent in prison.

"It starts from grade one and two with competition for the advanced reading track, the travel soccer team, the top-notch record," says Suniya Luthar, Ph.D., professor emerita at Teachers College, Columbia University, who has studied students in high-achieving schools for decades and worked on the National Academies report. "By the time they are in high school, it's nonsensical. They're going on four and five hours of sleep and have absolutely no downtime. This is a very messed up system."

A New Reality for Students

Categorizing students in high-achieving schools, who appear to have every opportunity, with children who are struggling because they have few advantages may seem counterintuitive, as the National Academies report notes. But Nadine Burke Harris, M.D., a pediatrician and California's first surgeon general, says the science is straightforward. "It's not about demographics," says Dr. Burke Harris, who also worked on the National Academies report. "It's about basic biology: The higher your doses of stress, the worse your outcomes are."

And the National Academies report isn't the first to raise alarms about the stress and resulting negative consequences for students who are surrounded by the intense pressure to excel. It cites other studies, including a 2018 Robert Wood Johnson Foundation report, that called out the same impacts for kids in competitive environments. Elsewhere, studies show higher levels of substance misuse for upper middle class students while time-consuming homework assignments in these communities cause academic stress and physical health problems.

It's not all bad news. Many students attending high-achieving schools do well, says Dr. Luthar. But similarly to other at-risk situations, these students face a higher probability of experiencing stress-related problems without proper support. "What the data says is the likelihood of having serious depression, anxiety, substance abuse, and rule-breaking behaviors is at least two to three times as high, overall, when compared to national norms," says Dr. Luthar.

At the same time, the pressure to compete and achieve has only grown in the last 20 years. As the middle class shrinks, parents believe their children need to attend the most prestigious college to have the best shot at future success—or even to just enjoy the same lifestyle their parents provided for them, says Dr. Luthar. Meanwhile admission to the nation's top colleges is getting more difficult. One study found that the admission rates dropped from about 36 percent in 2006 to about 23 percent in 2018—and from 16 percent to 6 percent for the top 10 schools in the nation.

Help Students Take a Breath

For some kids in the most rigorous school settings, the stress may seem unrelenting, but when they have a loving relationship with a parent or caregiver to fall back on, they can overcome it, says Dr. Burke Harris, an expert on childhood trauma. Here are ways parents can help their kids achieve in a healthy way.

Set the tone early

The pressure to achieve doesn't begin in high school. Even preschoolers are competing for coveted school placements. Parents need to be aware of the messages they're sending early on.

"Even with a raised eyebrow or change of tone of voice, one can certainly convey high levels of expectations," says Dr. Luthar. "It's very early we need to start being conscious of this."

Look for schools that also focus on well-being

Academic success should be encouraged, but it shouldn't come at a cost to students. "We want that, and we should have that," says Dr. Luthar, who works with schools on well-being indexes as co-founder of Authentic Connections. "But attend to the other question too: What are you doing to minimize pressures?"

When selecting schools, look for administrators and teachers who value both their students' academic success and their mental health and have the programs and initiatives to back it up.

Pay attention

Life gets busy, but it's vital for parents to be available for their kids as much as they can, says Dr. Burke Harris, a mother of four boys. "Take the time to connect and really listen and be present," she says. This will help foster a safe, stable, and nurturing relationship needed to ease pressure.

Teach healthy habits

Stuff happens in life. Parents need to model and encourage habits that will bring kids back into balance when they're stressed out, including regular exercise, a healthy diet, plenty of sleep, and loving relationships.

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