Mental Health in Your School

1. Mental Health in Your School • School is important to children • Place where they find out about themselves and their world • Place where they meet and learn from each other and from people older than they are: older children adults and teachers

2. Mental Health • Process of education affects mental health • Acknowledgment, encouragement and achievement- help to develop confidence and capacity to adapt and meet new challenges which are key hallmarks of mental health

3. Mental Health • Factors include family and school • School can foster well-being of children • School can be of immediate and practical help to them when problems arise • Education and mental health of children are much of the same process to respect and meet the diversity of needs of children

4. Basic Facts • Problems can arise: school refusal, difficulty with concentration and learning, disruptive behaviors, eating and sleeping problems • Some are transitory, mild and moderate • Others serious causing distress, confusion, lack of control, unmanageable

5. Mental Health Problems • 10-20% children may need help at some time • Up to 2% serious mental health problems • Rare in young children and uncommon in teenagers • Emotional and conduct disorders 10% in children and 20% in adolescents

6. Mental Health Problems • Eating disorders in about 1% of 15-19 year old girls • About 2 in 100 children under the age of 12 are depressed • 4-5 in 100 show significant distress • 5 in 100 teenagers seriously depressed and at least 10 in 100 show significant distress

7. Mental Health Problems • In a secondary school in a reasonably settled area about 50 in 1000 will be depressed in any one year • Primary school of 400 in an inner city area- 8 seriously depressed • 16 significantly depressed • Others will have disruptive behavior and learning difficulties; bullying

8. Mental Health Problems • Mental health is important because: • Untreated problems create distress for the children and caregivers • Unresolved problems may continue or increase in adulthood • Increase demands on social services, education and justice

9. Mental Health and Schools • Awareness of the importance of children’s mental health and the role of the school in promoting it and help when problems arise

10. What is Mental Health? • Way we feel, think, perceive and make sense of the world • Strength and vitality • Emotional well-being, happiness, integrity and creativity • Capacity to cope with stress and difficulty, live a full, productive life, deal with ups and downs

11. What is Mental Health? • In young children: • Capacity to learn • Enjoy friendships • Meet challenges • Develop talents and capabilities

12. Mental Health and the Teacher • Plays crucial role in providing a wide range of opportunities and possibilities to help children learn about themselves and the world • Education and mental health closely intertwined

13. Providing Healthy Culture • Values and principles • General culture of school • Everyone in the school treated with respect • Effective schools have common characteristics

14. Effective Schools • Emphasis on raising children’s self-esteem • Provide positive feedback • Maintain clear and fair discipline • Importance of achievement and high expectations for all students • Work collaboratively with community and parental involvement

15. Effective Schools • Emotional well-being of children enhanced • Children are valued and supported • Individual needs are understood and met • Difficulties noticed and listened to • Parents/Guardians informed and consulted • Violence and abuse not tolerated in the school

16. Mental Health Problems • Complex • Combination of genetic, developmental, family and social factors • Abuse, neglect, parental violence or discord • Experiences outside the family • School bullying, racism

17. Mental Health Problems • Some children cover up problems in school and display disturbed behavior at home • Emotional and behavioral problems at school • Learning difficulties • Special learning needs

18. A Child’s Journey • What are the pressures that a child has to contend with in going to school and growing up?

19. Pressures • The way a child copes with these situations and is helped to deal with them by friends, family and teachers can have a major bearing on her/his mental health.

20. The Journey • Home to primary school • Nursery school can help with transition • Primary school-learn about relationships and develop new ways of thinking • Need reliable and consistent structure • Need time to adjust and clear expectations

21. Secondary School • Major changes • Significant step in growing up • Larger environment • More complex organization • Some panic and refuse to go to school • Watch for signs of stress during transition • Plan for transition

22. Secondary School • Demands of curriculum • Pressures of group living • Adolescent issues • Questioning authority • Challenging assumptions • Testing limits

23. Secondary School • Later years involve career questions • Fear of failure • Offer information and advice • Positive role modeling • Well-established systems needed to monitor children who give concern

24. Signs to Look For • Difficult to define one clear “normal” developmental pathway through childhood and adolescence • Respect different cultures and values • Look for persistent problems or that interfere significantly with development and learning • Early identification and intervention

25. Signs to Look For • Many communicate through behavior and attitude and they way they relate to each other

26. Sudden changes in behavior, mood or appearance • Standard of work dropped dramatically • Subdued or over-excited • Failure to hand in homework • School refusal • Dressing in noticeably different style

27. General behavior • Hyperactive, attention-seeking, anxious, restless • Aggressive, defiant, disruptive • Unusually quiet, passive, withdrawn • Odd or regressive behavior • Terse or unhappy, hostile • Obsessive • Extremely conscientious, perfectionist

28. Pattern of work • Difficulty settling down to work, concentrating • Losing enthusiasm and motivation • Overly absorbed in study

29. Pattern of attendance • Reluctance to leave school or class • Arriving very early or late every morning • Missing school or lessons, truancy

30. Relationships • Few or no friends • Being bullied or bullying others

31. Younger children • Extremely clinging or demanding; tears • Fights and temper tantrums • Damaging other children’s work • Insisting on initiating sexual play • Very bossy and over-organizing others

32. Older children • Unhappy, solitary, tired, unwell • Careless or indifferent about work • Problems with eating • Promiscuity, delinquency or alcohol and drug misuse • Violent behavior • Breaking the law • Self-destructive behavior

33. Abuse • Some of these problems can be the result of physical or sexual abuse • Guidance from teacher federation, school and board policy, inform social services • Signs do NOT automatically mean mental health problem, but may be indicative of one.

34. Key questions to ask • How extreme is the behavior or attitude? • How prolonged or persistent? • Sudden changes in behavior? • How ‘driven’ or out of control? (does not imply to wait until child is out of control to get help) • Contrast between home and school? • Effects on others?

35. Key questions to ask • Accurate and dated record of observations and concerns • Is child receiving help or been offered help? • Medications? • ADHD? • Ritalin? • Behavioral plan

36. The teacher can help • Teach/facilitate learning to broaden knowledge and level of competence • Build on student strengths • Explain what to do and help with self-assessment • Reassure about making mistakes-it is a part of learning • Use interesting and stimulating materials

37. The teacher can help • Positive and secure environment • Teachers’ attitude to emotional problems • Firm and clear discipline, encouragement • Space and opportunity to talk • Receptive and sensitive • Careful and clear about boundaries • When to refer?

38. The teacher can help • Confidentiality • Parental involvement • Contraception and pregnancy under age 16 • Disclosure of possible abuse

39. Teachers need support • Not expected to work as therapist or social worker • Liaison with others • Educational psychologists • Parental consent

40. Children’s Mental Health • Well-being-emotionally, socially, educationally • Business of everyone- teaches are central in children’s lives • Promoted in healthy cultures in effective schools • Notice signs and refer

41. Age group 4-8 • Sanjay is a 7-year-old who is quiet, withdrawn and doesn’t talk much. He has little to do with the other children. He always sits in the same place in the book corner and is distressed if he can’t. He is good at math and spends ages doing jigsaw puzzles.

42. Age group 4-8 • The atmosphere in the class of 5 and 6 year olds is generally quite noisy. Occasionally the noise reaches a quite uncomfortable level and two or three of the younger children show signs of distress. One becomes very giggly, another tearful and the third sucks her thumb all the time.

43. Age group 8-11 • Anjum., a 10-year-old girl makes you, her new teacher, somehow feel uncomfortable. She whines a lot, refuses to cooperate and sometimes scribbles all over the work she has just completed. She has never had a male teacher before and always seems to want your attention.

44. Age group 8-11 • Eleven-year-old Dean has suddenly grown into a big, tall young man. He has always been reasonably cooperative but has become surly and aggressive. He arrives late for lessons with no apology or explanation, and has started to bully smaller children. He is mixing with older boys outside school.

45. Age group 11-16 • Anne, aged a3, has always been a keen, interested pupil who contributed in class and produced a reasonably high quality of work. Lately, however, she has become rather sullen and withdrawn and her work is handed inn late and contains no original thought and hardly any effort. In one essay she wrote of wanting to kill herself.

46. Age group 11-16 • Judi is a 16-year-old. She is very bright, always on the alert, and at times quite assertive and pushy. She can be provocative with the teachers, especially men, but for the most part this is manageable and she is well-liked. The standard of her academic work is high. In the last two months, she has become slightly more irritable. She looks unhappy and you have noticed that her arms are always covered.

47. Age group 11-16 • Dwaine is nearly 12. He arrived at this school with good reports from his previous school. However, he is dull and lethargic, sits alone in the playground and has recently be absent a number of times.. His dad, apparently, has left home recently.

48. Questions • How do you understand the predicaments of these children? • Do you think they have a mental health problem? • What are the main factors that need to be considered??

49. Questions • What further information would you like to have to be more clear about what to do next? • Should you ignore the situation, or leave it for the time being to see how things develop?

50. Questions • If you think you should do something, what would your next step be? • Ask child if s/he wants to talk to someone • Talk to parents to see if a problem exists at home • Talk to colleague • Refer to Child and Family Services, other • Objectives for IEP, behavioral plan