The Role of School Professionals in Identifying Early Signs of OCD in Students - On Second Thought: from Iffy to Witty Thoughts
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The Role of School Professionals in Identifying Early Signs of OCD in Students

The Role of School Professionals in Identifying Early Signs of OCD in Students

Educators and school-based mental health professionals are frequently the front line in identifying the initial onset of symptoms of a mental health disorder in youth. According to the International OCD Foundation, Obsessive-compulsive Disorder (OCD) affects 1 out of every 200 children, or about 500,000 youth in the United States. and has a profound impact on the quality of life for patients and families. The World Health Organization has deemed OCD as one of the ten most disabling medical illnesses. Delays in identification and treatment can worsen the severity of the episode and adversely impact treatment outcomes, making early identification crucial for effective intervention.

One-third of adults who struggle with Obsessive-Compulsive Disorder reported that symptoms surfaced in childhood or adolescence and worsened over time. School mental health professionals and educators possess a unique opportunity to identify warning signs and initial symptoms, as they are often the first to observe behavioral changes in students. Symptoms of OCD can present as excessive worry and anxiety, poor concentration, difficulty concentrating and making decisions, poor academic performance, and a change in behavior, including acting out. Because these symptoms mirror other childhood mental health disorders, such as ADHD, school professionals must be cognizant of the possibility of OCD.

Early identification is essential to better outcomes into adulthood. A study reported in The British Journal of Psychiatry (2018) found that OCD in youth can be a chronic condition that persists into adulthood. However, early identification and treatment may reduce the risk of chronicity. As educators are not trained extensively on mental health illnesses, symptoms of OCD may be dismissed as something else, or just a “phase.” OCD symptoms create significant emotional distress and anxiety caused by intrusive and unwanted thoughts, fears, sensations, or images. It also causes the urge to do behaviors called compulsions, also known as “rituals,” to help mitigate the anxiety; however, this relief is short-term, causing the rituals to build until they interfere with daily activities and academic performance.

Common ways that OCD can manifest in the school setting include:
• Attendance issues such as tardiness or absences from school
• Display of disruptive behavior, meltdowns, tantrums, or episodes resembling rage
• Persistent questioning or challenges in completing assigned tasks
• Frequent need for reassurance
• Engaging in repetitive actions such as rereading, rewriting, excessive erasing, or discarding paper
• Procrastination or difficulty in completing assigned work
• Regular visits to the bathroom or the school nurse
• Avoidance of specific places, individuals, situations, or objects
• Constant adjustments to the arrangement of desk contents, locker or backpack, and other items in the classroom
• Repetitive actions driven by a specific number or a “just right” feeling
• Challenges in transitioning between tasks, including entering or exiting rooms

Beyond the observable signs, it is crucial to recognize the broader impact of OCD on students. The Disorder can lead to learning difficulties, interpersonal and social challenges, and heightened levels of distress and anxiety. By understanding the multifaceted nature of OCD, educators and mental health professionals can implement targeted strategies to support affected students in both academic and social settings. Such interventions can have a significant impact. One study in the Indian Journal of Psychiatry (2019) found that early evidence-based treatment significantly modifies the trajectory caused by delays in treatment. The researchers concluded that outcomes are more optimistic for youth than for adults diagnosed with OCD. The study found that up to two-thirds of children achieved remission, and a substantial proportion of the remaining individuals showed a partial response.

As the gatekeepers of student well-being, school mental health professionals and educators play a pivotal role in identifying the early warning signs of mental health disorders, including OCD. By recognizing the symptoms of OCD in students, professionals can initiate early interventions, providing the necessary support to navigate the challenges posed by this OCD. Through collaborative efforts, the education system can contribute to the overall well-being and success of students dealing with symptoms of OCD.