What teenagers taught me at a psychiatric centre

By Suzanne Simpson (she/her), teacher and podcaster, North Vancouver

“What did you need from teachers as your mental health deteriorated and substance use increased?”

I asked my students this question to learn what could be improved upon for some of the most at-risk youth in our education system. During my doctoral research, I was teaching in a small classroom at an inpatient unit for psychiatric patients diagnosed with concurrent disorders. Their mental health and substance use challenges meant that these youth, statistically, were some of the most at-risk kids in the country; people with a dual diagnosis of mental health and substance use have the highest death rates for each age group across Canada, given the complexities and adverse outcomes of their trauma, substance use, and emotional challenges. (1)

I lost eight students—and counting—during my nearly six years here.

“My students at the psychiatric unit shifted my teaching philosophy by reminding me what really matters in the classroom. We remember how a teacher made us feel more than what they taught us.”

What the students said is transformative to our educational practices. Though, what struck me most is what they did not say. When I specifically asked about programs or classroom activities that helped them feel better about themselves, most responded, “What do you mean?” No one listed our social-emotional learning frameworks and worksheets, no one responded with a “don’t-do-drugs” program, and not a single participant gave me mindfulness activities.

How do we support youth mental health? The kids just want support, understanding, and care.

Bruce Perry writes that “people, not programs, change people.” (2) In a world longing for connection, if we can dive deep into the context and application of support, understanding, and care, we will connect. And when we connect, kids respond.

Support

When students say they need “support,” we often think of academics; however, the reason for the critical nature of academic support shocked me. I asked (through a youth care worker) what the best part of my classroom was. I expected youth to say it was the quiet space, Nespresso coffee, or treats I brought in from a nearby coffee shop. No one gave these answers. Instead, each of the 25 students said the best part of my classroom was success, in some form or another:

“I saw I could do math.”

“I was able to read a paragraph.”

“I completed an assignment.”

“I handed something in.”

For youth who struggle with mental health or academic challenges, sorting out a concept or assignment builds self-worth. It’s not about concept attainment; it’s about how that concept attainment makes students feel about themselves. Academic support helps foster students’ perception that they are capable; this has the potential to bring meaning and purpose that are carried for a lifetime.

Support also entails building our students’ wellness in multiple ways. For example, helping navigate conflict, getting kids together to foster connection, or ensuring that no one is left out. Feeling supported builds trust. If we want to support students, we need to pause, lean in to offer support, and be present.

Understanding

My students suggested that to be understood, they must not feel judged. If we assume or interpret a situation in the worst possible way, we are engaging in judgment, and we immediately obliterate any potential dialogue or resolution. Kids shut down.

We also must recognize the neurology of a developing brain. Research shows that the teenage brain gravitates to the negative. (3) Even though we may feel we are responding positively, the teenage brain can interpret facial expressions, tone, and vocabulary as judgment. We must be acutely aware of facial expressions, body stance, or tone of voice that can suggest judgment. And we must ask more questions such as “What’s up?” or “What?” rather than “Why?” In our podcast interview, David Woods Bartley told me this:

We’ll arrive at understanding if we use a “what” question. Because “why” is about justification. I don’t want to justify myself. But… [ask] me a “what” question, you’ve invited me to share. Well, of course I want to share. (4)

After asking the right questions, we need to under-stand students’ responses. To do this, we must listen authentically. This means not listening for the sake of listening, or to confirm my assumptions, or to plan my next response. Instead, allowing ourselves to be open to the students before us. To understand, I need to remove myself from the equation.

Care

While being supportive and understanding are things we do, caring is how we are. Nel Noddings summarizes the nature of this care:

When we genuinely care, we want to do our very best to effect worthwhile results for the recipients of our care. This means that caring is more than an attitude, much more than a warm, cuddly feeling. It is an orientation of deep concern that carries us out of ourselves and into the lives, despairs, struggles, and hopes of others. To care is to respond. (5)

Kids spot care a mile away. They sense it when we do it. I’ve had many discussions with students who talk about an educator who “cared,” simply based on initiative and effort. I believe that when we truly care about the well-being and success of students, we become more attentive. Caring requires presence; you can’t be caring if you don’t notice what needs to be cared for.

Conclusion

My students at the psychiatric unit shifted my teaching philosophy by reminding me what really matters in the classroom. We remember how a teacher made us feel more than what they taught us. When we make support, understanding, and care the very foundation of our practice, all the curricular teaching and assessment will happen in more effective and meaningful ways. With such a paradigm shift, our support, understanding, and care empower us to both create spaces the kids need and fill our own cups with such a purpose.

About the author

Dr. Suzanne Simpson is a teacher, mother, wife, speaker, and podcaster. She taught French immersion for two decades in BC classrooms as well as two years in Amman, Jordan. She worked for nearly six years at an inpatient youth psychiatric unit where she supported adapted learning and advocated for school success. Her practice and research focus on fostering connections and securely attached relationships. Suzanne facilitates workshops and produces a weekly podcast called “Encountering” about mental health, wellness, and support. Learn more at www.drsuzannesimpson.com.

1 S. Rees, A. Watkins, J. Keauffling, & A. John, “Incidence, mortality and survival in young people with co-occurring mental disorders and substance use: A retrospective linked routine data study in Wales,” Clinical Epidemiology, 14, 21–38, 2022: https://doi.org/10.2147/CLEP.S325235

2 B.D. Perry & M. Szalavitz, The boy who was raised as a dog: And other stories from a child psychiatrist’s notebook—What traumatized children can teach us about loss, love, and healing, Hachette, UK.

3 J.B. Wallace, Never enough: When achievement culture becomes toxic—and what we can do about it, Penguin, 2023.

4 S. Simpson (Host), “Healing from a suicide attempt: A survivor’s journey with David Woods Bartley,” audio podcast episode In Encountering with Dr. Suzanne Simpson, Apple Podcasts, 2025, January 27: https://podcasts.apple.com/ca/podcast/encountering-with-dr-suzanne-simpson/id1724652932?i=1000685755361

5 N. Noddings, Forward in L. G. Beck, Reclaiming educational administration as a caring profession (pp. ix-x), Teachers College Press, 1994.