Steve Burnage looks at effective interventions to support children with mental health issues.
- The social and emotional welfare of children is a key focus for inspection.
- The social and emotional well-being of children is central to success at school.
- We have a responsibility to promote the positive mental health of pupils.
- Mental health is the presence of wellness or psychological health.
- Schools play an important role in working with pupils and families.
The growing number of children and young people experiencing poor mental health is one of the biggest challenges facing our teachers. An estimated three children in every classroom has a diagnosable mental health problem. This rises to one in four children when we include emotional distress. Suicide is the most common cause of death for boys aged between 5 and 19, and the second most common for girls of that age. Around one in every twelve young people deliberately self-harm, though this may rise to almost one in three for girls aged 15. Rates of depression and anxiety in teenagers have increased by 70% in the past 25 years. The number of young people calling Childline about mental health problems has risen by 36% in the last four years. The number of young people attending A&E because of a psychiatric condition more than doubled between 2010–11 and 2014–15.
In this article, we will explore what schools can do to better support good mental health in schools and those pupils with poor mental health.
What do we mean by a positive school environment?
Good mental health in schools does not mean the absence of mental health issues. A school community which supports good mental health will work together to establish a positive school environment, build a strong community and create a sense of belonging for all stakeholders. So, what might we do to establish a positive school environment, build a strong community and a sense of belonging?
The physical environment is not just the way a school looks, although a clean, tidy and well-ordered school can do a lot to support a general sense of well-being. Physical environment is also about everything we do to help all members of the school community feel safe and valued.
Strategies might include:
- collaboratively create and post school-wide expectations and consequences
- display pupil work (a full range, not just the best) throughout the school
- keep the school building clean and welcoming.
All pupils need to be able to learn effectively and make good or better progress. Pupils are more likely to be motivated when they perceive tasks to be:
- matched to their ability
- enhancing their self-efficacy
- relevant to their lives and experience
- under their control.
Of course, effective learning is not just about learning content; pupils need to be able to learn in a positive environment.
Factors contributing to a healthy context for learning include:
- positive teacher-pupil relationships
- supportive peer relationships
- positive home-school communication.
The responsive classroom approach is a method of supporting pupil and stakeholder well-being and good mental health through the application of a range of proactive, rather than reactive strategies.
- daily meetings – not just to discuss issues but also to share positive things
- planning of school-wide activities to engender a sense of community
- welcoming families and the community as partners
- organising the physical environment to avoid barriers to learning
- interactive modelling that shows pupils how to learn, how to interact with each other and what ‘good’ looks like
- collaborative problem-solving.
Schools that support positive mental health support families and engage families in every aspect of the life of the school.
They do this through:
- providing opportunities to families for learning and behavioural growth
- social support
- parenting skill development
- providing opportunities for parent involvement in school
- parent support groups
- home visits.
Coordinated services means that everything is brought together to work cohesively to support positive mental attitudes and health across a school. In order to coordinate services, educators must conduct initial and ongoing assessments of the school culture through the use of:
- surveys (a sample ‘Checklist – Mental health and well-being’ is available in the Toolkit section)
- focus groups
- opinion essays
- suggestion boxes.
Supporting pupils with mental health issues
Many pupils may exhibit risk-taking behaviours. Others may not, and so are not easily identified as having mental health issues. Stigma is a significant barrier to seeking mental health services in schools, so what can we do to better support pupils’ mental health?
Recognise warning signs
Warning signs include:
- being fidgety
- appearing flushed or tense
- appearing withdrawn
- disrupting peers or activities
- challenging authority or not complying with classroom/school rules.
Create a supportive environment
In order for the school environment to better support the mental health of its pupils, pupils need:
- an environment that is stable
- modified classroom expectations and consequences. Examples of what can be done include:
- allowing a depressed pupil, who is unable or unwilling to respond orally during class discussion, to record his or her contributions or discuss the lesson privately with the teacher
- giving pupils the opportunity to take a break. Consider discreetly asking the pupil to take a note to a teacher or take a folder to the office, or allowing them to visit a staff member with whom they have established a bond
- designating a quiet location in the classroom that provides the pupil with a place to regain their composure
- asking the pupil to draw a picture or write a story about how he or she is feeling. Follow this up to discuss the feelings associated with the story/picture.
Class-wide strategies include:
- holding an emergency class meeting to address the needs of pupils
- playing a quick game to distract or break tension (see the Further information section for a link to some good examples)
- introducing deep breathing or other relaxation techniques
- playing soft classical music
- allowing pupils to choose a brief relaxing activity such as drawing, writing or reading.
Effective teacher behaviours
The role of the teacher cannot be over-estimated in supporting an ethos of positive mental health in the classroom.
Effective strategies include:
- practising simple stress reduction techniques such as deep breathing before responding to the pupil
- speaking in a calm tone
- keeping responses brief
- wording requests positively instead of negatively
- modelling calm behaviour for the pupil
- acknowledging that the pupil has the power to make behavioural choices, and help the pupil to recognise his or her options
- offer the pupil a way to save face in the situation.
Pupils have varying levels of need for mental health support in the school setting. Most pupils’ needs will be adequately met in a positive and engaging school environment. However, a supportive school setting will not be sufficient to meet all pupils’ needs. Hopefully, within this framework of a continuum of mental health services, all pupils will successfully navigate their school experience and beyond.
- Examples of games may be found at: http://bit.ly/-icebreakers
Use the following item in the Toolkit to put the ideas in the article into practice: