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Putting Mental Health on the Timetable
Dr Joanne Robinson, DClinPsychol, CPsychol.Chartered Clinical Psychologist
37% of the public would turn to a teacher for help and advice if they suspected a child had mental health issues.
“More than 1 in 5 with fewer than 5 GCSEs A* to C struggle to concentrate on school work due to family problems” Prince’s Trust, 2013
“90% of teenagers in the UK, aged 13-18 years, felt under pressure to achieve” Scout Association, 2007
“47% of Heads said their increasing workloads were affecting their ability to identify pupils’ with mental health difficulties” Sunday Express, 28.12.14
“Schools are struggling to cope with increasing numbers of pupils with mental health problems – teachers often having difficulty identifying pupils with problems like anxiety and depression” NASUWT Teacher’s Union
“More than half of schools in England are unable to provide proper mental health support for troubled pupils”
"Children and young people are growing up in a toxic climate. They exist in a 24/7 online world where they never switch off, where cyberbullying, consumerism and pornography, sexting and the pressure to have the perfect body bombard them daily, where any exam grade below a C means failure and employment prospects are bleak.” Lucie Russell, YoungMinds
An extraordinary Place Trust to care for children/young
people
Reliance to make children happy
Enrich and Cultivate
Fit and Healthy
Prepare for adult life
High academic ability
Social & Emotional Wellbeing for Children and Young People Pathway, NICE 2015 (Pg. 2)
The Challenge
• Schools are the nations primary mental health provider for children
• Teachers are often asked to go beyond the scope of their training while working in overcrowded and understaffed schools and classrooms
• Schools must access training and support(Health & Wellbeing, Relationships, Living in the wider world)
“Schools Must Have a Vision”
Peter Wilson, 2004 Young Minds
Whole School ApproachEmotional Health is Everyone’s Business
- Increase wellbeing & resilience - Awareness of Mental Health in curriculum - Promoting Staff Health and Wellbeing
Dialogue
- Pastoral support- How to seek
counselling/psychological support
- How to make parents aware of the services
- Views of children & young people
Definition of Mental Health
• “… a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”
WHO, 2012
Mental health and well-being
Individual attributes and
behaviours
Social and economic
circumstances
Environmental factors
Schematic overview of risks to mental health over the life course
Cited in WHO, 2012
Current Trends• 1 in 10 have a diagnosable mental health disorder• 12.8% 11-15yrs, boys; 9.65% 11-15yrs girls• Between 8% and 34% have been cyber bullied • 1 in 12 deliberately Self Harm; 68% in last 10 years admitted to hospital• 18% increase in counselling sessions re. suicide• 72% children in care have behavioural and emotional problems• Number of 15-16 year olds with depression has doubled between 1980s and 2000• 28% pre-school children face difficulties – impact on their psychological
development• 35% Young People with mental health difficulties actually get help
Social Trends (Peter Wilson, 2003)
• Divorce, lone parents and reconstructed families• A growing number of children living below the poverty line• An increasingly socially mobile population• A growing number of young people without qualifications or prospects of
work• A greater emphasis on testing and exam success at schools• An increase in commercialisation of children’s activies• A greater exposure to the influence of media and wider range of
information via the internet• An increase in the availability of illegal drugs
Developmental Stage: Adolescence
• Hormonal & Physical Changes• Greater Negative affect• Higher risk of drug/alcohol
abuse• Social/Peer Acceptance• Learning who you are, your
identity vs being the person your friends and family want you to be
Influences & Systems
First ScenarioBirth
To School
Infant/Child Mother
Depressed: spent time in hospital
Anxious, demands attention
unresponsive
more demanding
Rejecting, can not cope, more withdrawnEither more clingy or
more independent“I don’t care anyway . No one cares for me”
Second ScenarioHistory
Child Goes to school to learn
History
Teacher Goes to school to teach
Feels depressed Wants to provide help
Seeks attention and wants approval
Cannot meet demands, feels guilty, frustrated
more demanding Feels useless, punitive
Feels rejected
Withdraws, refuses to go to school
Challenging, aggressive
Keeps trying Withdraws, gives up
Factors concerning to school-aged children• Fear of Failure• Bullying• Body Image• Online• Sexual Pressures• Employment Prospects
What to look out for…
• Sudden changes (mood, behaviour)• Decline in academic ability• Missing deadlines, not handing in work• Withdrawn• Poor school attendance• Sudden change in appearance
What to look out for…
Behaviour• Hyperactive• Disruptive, aggressive• Regression• Hostile (tense/unhappy)• Obsessive• Extremely conscientious
School related• Difficulty in focusing and
concentrating• Loss of motivation• Overily focussed on work• Attendance
What to look for…
Relationships• Difficulty getting on with others• Isolated, not settling in to a
particular peer group• Few/no friends• Bullying & aggressive behaviour• Easily led/influenced by others• Eager to please
Other• Looking unhappy, tired, unwell• Daydreaming• “not bothered”• Eating: less, more, throwing food
away – losing or gaining weight• Promiscuity• Drug, alcohol misuse• Self destructive behaviour
• Distorted perception of self in young people“I know I’m ugly now”
• Guilt“It’s my fault my mum died. I should have made her stay at home that day”
• Fear may override sadness.“I’m so sad my mum died in the fire. But I’m too scared to cry”
• Nightmares of dying or being hurt“Last night I dreamt I was in a car crash. I was so frightened”
What to look for…
What to look for…
• Overriding feeling of terror“I can’t concentrate on homework. I worry a plane will crash into my house. I’m afraid I will die”
• Anger“If I ever found the guy that murdered my brother, I’d kill him!!!”
In Joanne Morris-Smith & Michel Silvestre: EMDR for the Next Generation. Healing Children & Families. 2014.
The Diagnosis Tree
“Every day begins with an act of courage and hope: Getting out of bed” Mason Cooley
It’s a balancing act…
Educational AgendaAcademic Achievement
Issues Important to Young People
“First do no harm” (PSHE Association Guidance, 2015)• ©Therapeutic Aims (Robinson, 2014)
The Teacher’s Role?
• Observation• Listen• Self Organisation• Help to design and implement each young person’s own understanding• Understand the experiences, lines of enquiry and personal strategies
used by the young person• Provide a safe and supportive climate to articulate views & put ideas to
the test (“man the scientist”, G. Kelly, 1955)• Adopt a reflective and enquiring stance
The Teacher’s Role - Reflexivity?
• “Teacher identity, resilience and belief in themselves to do the job were vital to being a successful and effective practitioner” Day et al, 2007• “The journey taken by teachers…involves not only effective
professional practice, but also emotional effectiveness” Kington et al, 2013• “Tensions emerge through careers: decisions re. classroom
management, enhancing learning outcomes, how to respond to individual pupil needs” Kington et al, 2013
Be mindful…• The goggles through which others view their world might not easily
be altered
A Personal Perspective
•“If learning is to be an enriching experience, the meanings that emerge must be personally significant in some part of the person’s life. The viability of these meanings depends on how richly the individual incorporates them in to personal experiences”
Thomas & Harri-Augstein, 1985 pxxiv
How Wolves Changed Rivershttps://youtu.be/ysa5OBhXz-Q