Helping schools to support young people with mental health needs.

1. Helping schools to support young people with mental health needs. 24th October 2014Oakwood House – John Wiggin Room

2. Focus on: • Context • Main areas of need • Risk and Protective Factors • What to do • What works • The opportunity

3. Mental health and behaviour in schools- Departmental advice for school staff. Department for Education - June 2014

4. Context • One in ten children and young people aged 5 -16 have a clinically diagnosed mental health disorder • A further 15% (i.e 1 in 7) have less severe problems that put them at increasing risk of developing mental health problems in the future

5. 10% of children and young people with a diagnosed mental health disorder • 5.8% of all children have a conduct disorder. (This is twice as common among boys as girls) • 3.7% have emotional disorders • 1.5% have hyperkinetic disorders. • 1.3% have disorders such as ASD, tic disorders, eating disorders, mutism • 2.0% of all children are diagnosed with more than one of the main categories of mental disorder.

6. Main Areas of Need • Conduct disorder (defiance, aggression, anti –social behaviour, stealing and fire setting) • Anxiety ( worries about things that are happening at home or school or due to a traumatic event) • Depression (where feeling low or sad dominates or interferes with a persons life) • Hyperkinetic disorders – such as ADHD involving inattention, hyperactivity and impulsivity. Core symptoms present before 7 years and evident in two or more settings

7. Main Areas of Need • Attachment disorders:The affectionate bond children have with special people in their lives. An important protective factor for mental health and the absence of this as a risk factor for the development of behaviour problems. • Eating disorders: Anorexia nervosa and bulimia nervosa • Substance misuse : Can result in physical or emotional harm • Deliberate Self Harm : e.g. hitting, cutting, burning, inflicting punishment on oneself

8. Video Interaction Guidance and Attachment • Strong evidence supports video feedback based interventions. • http://www.edukent.co.uk/our_services/service/educational_psychology/

9. Understanding the risk and protective factors for child and adolescent mental health ( examples) – In the Child Risk Factors Protective Factors Secure attachment experience Good communication skills, sociability Humour Being a planner and having a belief in control Problem solving skills and a positive attitude Capacity to reflect • Communication Difficulties • Difficult temperament • Academic failure • Low Self esteem

10. Understanding the risk and protective factors for child and adolescent mental health ( examples) – In the Family Risk Factors Protective Factors At least one good parent-child relationship ( or one supportive adult) Affection Clear consistent discipline Support for education Supportive long term relationship or the absence of severe discord. • Overt parental conflict • Inconsistent or unclear discipline • Hostile or rejecting relationships • Failure to adapt to a child’s changing needs • Death and loss- including loss of friendship

11. Understanding the risk and protective factors for child and adolescent mental health ( examples) – In the School Risk Factors Protective Factors Clear policies on behaviour and bullying Positive classroom management A sense of belonging Positive peer influences. • Bullying • Discrimination • Poor pupil to teacher relationships • Lack of positive friendships • Peer pressure

12. The balance between risk and projective factors is most likely to be disrupted by difficult events in pupil’s lives: • Loss or separation ( e.g. death, parental separation, divorce, hospitalisation, loss of friendships , family conflict of breakdown) • Life changes ( e.g. birth of a sibling , moving house or changing schools) • Traumatic events ( e.g. abuse, domestic violence, bullying etc)

13. Resilience • “Resilience seems to involve several related elements. Firstly, a sense of self esteem and confidence; secondly a belief in one’s own self-efficacy and ability to deal with change and adaptation; thirdly , a repertoire of social problem solving approaches”- Rutter M (1985)

14. Resilience • Big Lottery define’s resilience as: “ The opportunity for and capacity of young people – in the context of adversity- to negotiate for an navigate their own way to resources that sustain their mental health” • Young people in Kent define resilience as: “The ability to be mentally strong enough to bounce back from the problems of life”.

15. What to do….. • Cultures • Policies • Practices

16. Culture • A committed Senior Management Team- values all pupils, promotes a sense of belonging, enables talking about problems in a non-stigmatising way. • An ethos of high expectations and consistently applied support- clear policies on behaviour and bullying, clear responsibilities of all in the school, a range of acceptable and unacceptable behaviour for children. Understood by all and consistently applied. • An effective strategic role for the qualified teacher who has the role of SENCO-ensuring that all adults understand their responsibilities to children with SEND. This includes those with persistant health difficulties and therefore require SEN provision. Liaising with external SEND professionals.

17. Policies • Clear Systems and processes – schools working closely with other professionals to have a range of support services that can be put into place to meet identified need. • Should be set out clearly in the schools published SEND policy. • Having ongoing CPD for school staff that empowers and enables them all to be responsible in promoting good mental health

18. Practice Using a graduated approach to inform a clear cycle of support through a plan do and review cycle to achieve good outcomes. • Assessment- Analysis to understand pupils needs. • Plan – To set out how the pupil will be supported • Do – Action to provide the support • Review- To assess the effectiveness of the provision/ intervention and lead to changes where necessary.

19. An Educational Psychology Contribution- What works. • Video feedback based interventions with mothers of pre school children with attachment problems ( e.g. Video Interaction Guidance- ViG) • Video Enhanced Reflective Practice • Cognitive Behavioural Approaches • Solution Focused Approaches • Solihull Approach • Mindfulness • Crisis Support

20. Solihull Approach in Kent The aim of this stream of work is to ensure that the wider children and young peoples’ workforce: • Have an increased knowledge of children and young people’s mental health to be able to identify those who need help. • Increase their capacity to give advice and support to those with minor problems with relating to psychological health and emotional well being. • Understanding the role that parenting plays in the psychological development of children. • Refer appropriately when necessary. The approach is a highly practical way of working with families within a robust theoretical structure.

21. Mindfulness Bases Approaches for Working with Children and Young People • A particular way of paying attention to everyday experiences. • Forms the basis of an evidence based intervention (MBCT) recommended in NICE guidelines for depression • Can form part of universal preventative interventions or be used to support targeted groups of vulnerable youngsters • Can support positive well being, including improved attention, concentration and resilience.

22. HeadStart Project • KCC has been awarded £500K to trial a range of activities the support resilience and emotional well being amongst 10 -14 years

23. Six new locality bases An Opportunity to: Provide support for pupils with mental health needs through having: • The right information • Identifying, providing and co-ordinating the right support • Delivering in the right place at the right time