Whether a person is suffering from anxiety, depression and/or a substance disorder, he or she tends to bring to the classroom the following kinds of barriers to learning:

Printable PDF for Mental Health Challenges Instructional Strategies

Difficulty Sustaining Attention

Reasons for this problem vary, depending on their source:

  • If anxiety, the person is distracted internally by worries or fears
  • If depression, the person lacks a sufficient level of arousal to sustain attention
  • If substance withdrawal, the person is distracted by the unpleasant physiological reaction associated with having less of the substance in their body than they need to feel good

Here are some suggestions. What works depends on the person and his or her particular situation:


    1. Before testing, ask the student to write down their fears (give them approximately 10 minutes to complete).  Research has shown this method reduces anxiety and increases test scores.
    2. Occasionally give the student time to talk about what is worrying him or her. Sometimes stating the problem reduces its influence and sometimes it makes things worse; judgment is required
    3. Help the student identify the worst thing that can happen. Ask him or her to consider the chances this worst thing will occur. Aim to help the student recognize the groundlessness of unrealistic fears. (This works best with milder forms of anxiety.)
    4. Work with students to identify a way to keep their worst fear from happening. The purpose here is to identify something the student can control. Fears are usually associated with things one feels no control over.
    5. In class, give the student permission to fall short. Make it clear that practice tests and exercises don’t have to be perfect the first, second or third time attempted. Discuss each “failure,” as an opportunity to improve, and an advance toward the ultimate goal rather than a measure of success or failure.
    6. Offer lessons that are at or just above the student’s current level of achievement. Avoid challenging the anxious student too much.
    7. Help students measure incremental progress, so they have visible evidence of their accomplishments. This effort may demonstrate their fear of failure is unjustified.

  1. If anxiety is associated less with academic work and more with personal concerns, refer the person for counseling or social work support, preferably by offering a specific name and phone number and helping make the connection if necessary. (See Mental Health Resources Section for possible referral sources.)


  1. If the student reports feeling depressed or hopeless, ask if he or she is receiving any treatment, medication and/or therapy. If not, or if the treatment appears less than satisfactory, identify a good referral source starting with a counselor (who can then identify an appropriate psychiatrist if medication is indicated). Local county and school counselors and social workers are good information resources for this purpose. (See Mental Health Resources Section.)
  2. In the classroom, help the student identify realistic learning goals.
  3. Offer warmth in word, expression, gesture. Communicate that you are glad to see the person and acknowledge his or her goals. Avoid expressing confidence the person can reach their goals, because you may lose credibility in the mind of one who is sensitive to his or her academic weaknesses.
  4. Take things one step at a time, beginning at a level equal to or just above the student’s current level of competence.
  5. Provide frequent, positive progress feedback (if justified) to encourage sustained effort and counteract discouragement. If progress is not being made, help the student explore alternatives, or refer him or her to someone who can.
  6. If possible, draw out the person’s sense of humor; don’t be afraid to joke and laugh when it’s not at anyone’s expense. Focus on the student as a person.
  7. Avoid comparing the student to anyone else. This person is likely feeling he or she does not measure up to others under any circumstances. Compare the individual’s own accomplishments today to yesterday, last week, or last month.
  8. As appropriate, find out what the person enjoys or has enjoyed in the past or what they’re good at. If they answer “Nothing,” ask what others might say about them. Encourage positive answers—at least one. Try to build on the skill or characteristic they name as you adapt lessons to the person’s skills and interests. Or apply the skills/interest as a reward for progress.
  9. Ask the student, “What would make you happy?” For any feasible answer, identify this as a goal to work toward, one step at a time.Addressing suicidal thoughts. If the answer implies suicidal thinking, ask the person if they have a plan to end their life and the means to carry it out. If yes, thank the person for being honest and tell him or her you must get help immediately to protect him or her until they feel better. You do not need the student’s permission to get the help he or she needs. Consult a supervisor or resource in the school district, county, or other local emergency resource.If no, begin the referral process by expressing the belief that help is available and that you want to support the person but you are not trained to provide what they deserve. Personally introduce him or her to the referral resource if possible, or find someone who can. Ask the student to contact you after they have seen the counselor, and make an appointment to get together again.In any instance when you become aware a student is thinking of suicide, you should ask whether they have the means and a plan, and follow up as described above.

Fatigue/Lack of Initiative

This problem has several sources for people suffering from anxiety, depression, or substance abuse—including poor sleeping and eating habits, fear and hopelessness, low self esteem, and failure to functional effectively at school, work, and home.

Here are some suggestions. What works depends on the person and his or her particular situation:

    1. Encourage the student to focus on one subject at a time. Start, if you haven’t already, with the strongest area based on student’s interest and/or initial test scores.
    2. Work with the student to plan other responsibilities and social-recreational interests to allow them to get a good night’s sleep before they come to class.
    3. If the student continues to sleep poorly no matter what he or she does, ask him or her to see a physician for help.
    4. Find what inspires the person (don’t give up easily). Ask what would make them happy, how they want to see themselves five years from now, what one accomplishment is most important to achieve, how they want their children to see them, etc.  Relate the student’s response to one or more learning goals.
    5. Develop a realistic plan for achieving the student’s goals. Lay it out in smaller increments so the student can see results at each step. Start at his or her current achievement level or just beyond.
    6. Discuss the best time to study for homework. If possible, schedule instructional time accordingly. Try to capitalize on the time of day when energy is highest. Encourage him or her to set the same time each day. Urge the person to ask for help with child supervision if necessary, or arrange a trade.
    7. Find another student to pair up with the low-energy person. Most people will keep commitments to a peer before they keep them to themselves. Thus, if the student feels the other person is counting on them to do their part, she or he may be more willing to step up to a learning challenge.

  1. Look for ways to reward the student and increase hopefulness. Fatigue can represent loss of hope, or it can result from the exhaustion that follows unnecessary worrying and maladaptive coping, or it can arise from insults to the body’s chemistry produced by substance abuse. Interest and energy follow success and make it less likely that a student will look for artificial means of arousal or withdrawal because they are discouraged.


Impaired mental health is highly distressful, whether the condition is characterized by extreme anxiety, depression, substance withdrawal, or a developmental problem (e.g., difficulty learning, difficulty fitting in). Many of the students enrolled in an ABE program have a low opinion of themselves, and may carry unpleasant memories from their youth of failure, embarrassment, or ridicule at school. Many experience feelings of heightened sensitivity and vulnerability in a learning environment.

When one or more significant mental health problems affect a student in this context, it can be difficult to control emotions. Emotions may be disturbed before the person walks in the door. The person who appears irritable is clearly unhappy. The one who bursts out in anger is not only frustrated, but beginning to feel out of control.

Here are some suggestions. What works depends on the person and his or her particular situation:

  1. Offer the person a time out, meaning set the lesson aside for a few minutes to let the person talk about what is bothering him or her. It may be necessary to take the person to another room, office, or hallway.
  2. Ask gently if this is a good time to be studying or taking a test. Talk about maybe finding a better time. If there is no better time, discuss how the person wants to proceed—for example, do part of the assignment, do a different assignment, work on the computer instead of with a group.
  3. If you know the person and have a good relationship, suggest he or she find a comfortable position and take deep breaths. Learn how to breathe deeply from the abdomen, so you can coach the student to do so.

Deep Breathing

Tell the person …….. “put your hands on your stomach just above the waist and below the ribs, and breathe in, so you can feel your abdomen rising. Focus on taking in air and sending it deep inside, so you can raise your hands—slowly and steadily. Breathe in and out through your nose.”  Continue for at least 5 minutes.

  1. If the student has upset others too, ask all of them to relax and participate in a deep breathing exercise along with you.
  2. It is often necessary to refocus the anxious or angry student on the task at hand, or on a new task if the current one is too frustrating. Give the person a choice about what they are going to do next. It’s one way to reduce the intensity of their emotions. He or she will usually feel grateful for your flexibility (though it may not be evident).
  3. An out-of-control student who cannot calm down or accept redirection will have to leave. It may be important to have someone leave with him or her if they appear ready to hurt someone or something. It is appropriate to tell them they are welcome to come back when they are ready to try again.
  4. Sometimes it is useful to describe for the student what you observe about their behavior, whether they are irritable or angry. In non-judgmental language, point out what you see and ask whether you are interpreting appropriately. If you feel uncomfortable yourself (e.g., angry, hurt, scared), tell the person how this behavior is making you feel. Tell the person you would like to figure out a way to handle things so neither one of you feels so uncomfortable.
  5. Keep in mind that anger often arises from another feeling—hurt, guilt and shame, or fear.  If you ask the angry or very irritable student, “What are you afraid of?” he or she will usually turn from attacking or criticizing to talking about themselves.What the person might be afraid of is hard to predict. It may include one or more of the following or something else:
  • Fear of failing and feeling ashamed
  • Fear of letting someone down
  • Fear of punishment, often based on prior experiences
  • Fear of economic suffering and loss of opportunity for improvement
  • Fear of losing someone’s love, respect, or loyalty
  • Fear of feeling afraid
  • Fear of losing control
  • Fear of hopelessness and despair
  • Fear of harming oneself or someone else

If you see the person is struggling with emotions he or she can’t or won’t describe, ask whether there is someone they can talk to about the things that bother them. If yes, ask whether they will find that person (“soon” or “today”) and talk to them. If not, make a referral for counseling if the person will accept it. Let the person know you take their feelings seriously and hope they will, too.