Learning Plans & Activities
Reading Middle Grade Literature with a Focus on Mental Health Issues

As a part of small-group book talks, students read and discuss middle grade fiction that features characters dealing with mental health issues. Teacher-provided discussion prompts encourage students to view multiple elements of the story through the lens of mental health.


English Language Arts




Classroom teacher

School counselor


Students will reflect on one element of a story and how it impacts and is impacted by other story elements.

Students will directly connect text to personal reactions and questions.

Students will engage in a thoughtful and respectful discussion about mental health disorders as they relate to a piece of fiction.


Middle grade titles containing characters with mental health issues

Walk in Our Shoes for Grownups website from the California Mental Health Services Authority (https://walkinourshoes.org/for-grownups)

National Institute for Mental Health website (https://www.nimh.nih.gov)


Two to four weeks


AASL National School Library Standards

III.A.2. Developing new understandings through engagement in a learning group.

III.D.1. Actively contributing to group discussions.

V.A.2. Reflecting and questioning assumptions and possible misconceptions.

Common Core State Standards

CCSS.ELA-Literacy.RL.5.1. Quote accurately from a text when explaining what the text says explicitly and when drawing inferences from the text.

Instructional Procedure

Collaborate with a classroom teacher to implement this unit. Together, select one or more titles that will resonate with your students and feature a character dealing with a mental health disorder. For some recommended titles, see the article "Looking at Mental Health in Our Middle Grade Fiction Offerings." Expanded and updated lists of titles can be found through online searches for "middle grade mental health fiction literature." Acquire multiple titles of the selected book(s) to be used in small book talk groups through purchase, inter-district library loans, or public library loans. The classroom teacher can group students in a way that will be successful for a small-group book discussion. Groups of three to five students in each group may be preferable.

Before students begin reading the book, begin with a discussion that activates students' prior knowledge or provides foundational knowledge about the issues of mental health in the book(s). Ask students to draw upon their understanding of story conflict and resolution as well as character relationships and growth to make predictions about what they will discover while reading the book as a group. For resources on introducing mental health topics to elementary students, see the site maintained by the California Mental Health Services Authority at https://walkinourshoes.org/for-grownups.

Encourage students to set their own pace for their reading over a set number of weeks. The librarian and classroom teacher may want to select points where it would be beneficial for discussions to take place. These moments in the book are likely to be varied for different titles based on how and when the mental health issue is shown in the story and the pacing of the story in general. Students can build these days into their calendars when determining the pacing for their group.

For each small-group discussion day, the librarian and teacher can provide a set of focus questions to direct discussions. These can help assure that as students are discussing elements of mental health and that student comments are thoughtful and respectful. Below are suggested questions that can be modified for a specific story. Depending on how the mental health disorder is revealed throughout the story, questions may be chosen from one category to focus on one element of mental health or from multiple categories to vary or build a single student discussion.


  • What mental health disorder is portrayed in the book? What do you know about it or want to know about it?
  • What character has the mental health disorder? What evidence do you see in the book? Is the character a main or secondary character?


  • How is the mental health disorder shown in the story through the character's actions, thoughts, or feelings?
  • How is the mental health disorder described in the story?
  • Based on what you know, is the portrayal of the mental health disorder accurate? What is portrayed that is new to you? What is not portrayed that you feel should be?

Character and Story:

  • How does the mental health disorder impact the story?
  • How is the character with the mental health disorder impacted by it in the story?
  • How is the character with the mental health disorder treated by other characters?
  • How does the mental health disorder impact other characters?
  • How are relationships between characters impacted by the mental health disorder?


  • What role does medical treatment for the mental health disorder play in the story?
  • How do understandings of the mental health disorder evolve? How do characters in the story become more informed about the mental health disorder? What moments in the story brought about that change?
  • How do characters in the story grow or change in how they accept the character with the mental health disorder? What moments in the story brought about that change?


Provide access to the audiobook for students who are striving readers and cannot access the written text or could benefit in other ways from listening to the story while reading text or instead of reading text.

Invite parents to take part in the book groups inviting them to read with or alongside their child or by sending questions home to prompt discussion after the small-group discussions in the classroom.

Following group discussions, provide additional reading directly from or adapted from the National Institute for Mental Health website to address students' questions or misunderstandings.

As part of your library collection development, these questions can assist in assessing how your fiction collection represents characters with mental health disorders. Titles that contain characters with mental health disorders to be added to a middle grade collection should give authentic portrayals of that disorder and show either positive understanding, acceptance, and relationships or growth towards understanding, acceptance, and relationships.


Students complete an exit slip following each group discussion. The exit slip prompt should focus on the aspect of mental health from the discussion and customized for the mental health disorder explored in the MG fiction book. Exit slips prompts may include:

  • When considering the mental health disorder portrayed in the story, I used to think ___ and now I think___.
  • In the story, who is impacted by the mental health disorder?
  • Share three ideas discussed by your group, two parts of the story that were talked about, and one question you still have about part of the story.
  • Consider the character with the mental health disorder in the story. Now choose another character who has changed how they feel about the first character. He/she used to think _____ and now they think ______.

Additional Resources

Richmond, Kia Jane. Mental Illness in Young Adult Literature: Exploring Real Struggles through Fictional Characters. Libraries Unlimited, 2019.

Tom Bober

MLA Citation Bober, Tom. "Reading Middle Grade Literature with a Focus on Mental Health Issues." School Library Connection, February 2010, schoollibraryconnection.com/Home/Display/2189116?childId=2189119&topicCenterId=1955265&tab=1.

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Entry ID: 2189119

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