MENTAL HEALTH AWARENESS WORKSHOP

1. MENTAL HEALTH AWARENESS WORKSHOP

2. VIDEO CLIP

4. WORKSHOP OBJECTIVES To provide a understanding of common child and youth mental health difficulties. To improve the capacity of teachers to identify and respond early to indicators of mental health difficulties in children and youth To provide opportunities to share information and enhance working relationships

5. NOT OBJECTIVES To turn participants into mental health professionals To cover every mental health and/or learning concern To include comprehensive discussions of mental health concerns It is not to be interpreted as specific advice on a specific situation

6. WHO USUALLY NOTICES A PROBLEM? Parents/Caregivers Teachers Often the first to notice a mental health difficulty In a classroom of 30 students, about 5 to 6 will be facing a mental health problem Early intervention is the most effective way to prevent future problems.

7. POSSIBLE SIGNS OF MENTAL HEALTH PROBLEMS Behaviours Fight (aggression), Flight (avoidance or withdrawal) Problems functioning at home, school, work Hyperactivity / Passivity Inattention/distractibility Emotions/Feelings Sadness, depression, anxiety Irritability, anger Thoughts Low self-esteem, thoughts of life isn’t worth living

8. CHILDREN/YOUTH ARE LIKE ICEBERGS Behaviours Thoughts Feelings Image by Uwe Kils

9. ANXIETY DISORDERS

10. ANXIETY • Healthy • Just enough anxiety is helpful because it keeps us cautious and safe • Unhealthy • When it interferes with the child’s function, and/or causes distress

11. SIGNS/SYMPTOMS OF ANXIETY Behaviours Avoidance of feared situations, e.g. school Feelings Worry, anxiety Physical symptoms Thoughts “The world is a scary place”, and/or “I am not competent”

12. TYPES OF ANXIETY DISORDERS Generalized Anxiety Disorder Panic Disorder Obsessive Compulsive Disorder (OCD) Social Anxiety Disorder Post Traumatic Stress Disorder (PTSD)

13. WHAT ANXIETY CAN LOOK LIKE Refusal or reluctance to attend school Excessive worrying Fear of new situations Physical complaints not attributable to health problem Social isolation/withdrawal from peers

14. WHAT CAN ANXIETY LOOK LIKE WHAT ANXIETY CAN LOOK LIKE • Tiredness, fatigue, difficulty getting through • the day, frequent bouts of tears • Anger, opposition, defiance, aggression • Obsessions (consuming thoughts and • worries) • Compulsions (behaviour rituals)

15. WHAT CAN ANXIETY LOOK LIKE WHAT ANXIETY CAN LOOK LIKE • Experimentation with drugs and alcohol • Suicidal thoughts • Anxiety may co-exist with other disorders

16. POST TRAUMATIC STRESS DISORDER (INCLUDING POST TRAUMAT In vulnerable individuals, exposure to trauma can result in lasting symptoms Trauma = event that involves actual or threatened death or injury Violence/aggression such as bullying; domestic abuse at home; abuse/neglect

17. POST TRAUMATIC STRESS DISORDER (INCLUDING POST Symptoms Re-experiencing the event over and over again (e.g. flashbacks) Hyper-vigilance Avoidance/numbing Loss of function

18. MOOD DISORDERS

19. MOOD PROBLEMS: A CONTINUUM Normal moods Mood problems Mood disorders

20. MOOD DISORDERS • Healthy • Sadness can be an appropriate response to life stressors • Sadness signals to us that there is something wrong • Unhealthy • When sadness and depression start interfering with life

21. SIGNS/SYMPTOMS OF MOOD DISORDER Behaviours Social withdrawal, avoidance Feelings Sadness, depression, irritability, anger Physical symptoms Thoughts “I am not loved” / “Nobody cares” “I am powerless” / “I am not competent”

22. TYPES OF MOOD DISORDERS Major Depression Dysthymic Disorder Adjustment Disorder Bipolar Disorder

23. GENERAL INTERVENTIONS

24. PROFESSIONAL MENTAL HEALTH HELP Start by speaking with families about concern Encourage families to see a physician or paediatrician Can help rule out medical conditions Can help with referrals to other services

25. WHERE MIGHT YOU FIND HELP? Friends, Family, Colleagues Schools / Education Sector Addictions Sector Child/Youth/Family Private Practitioners (e.g. Psychologists, Counsellors) Hospital, Mental Health Agencies Justice / Policing Sector Child Welfare Sector Self-Help, Mutual Aid, Peer Supports

26. UNIVERSAL INTERVENTIONS FOR MOOD/ANXIETY Lifestyle strategies Exercise Healthy nutrition Getting enough sleep

27. UNIVERSAL INTERVENTIONS FOR MOOD/ANXIETY Reduce risk factors / stressors Identify stresses at school, work or home Reduce stresses or problem-solve to help deal with them

28. UNIVERSAL INTERVENTIONS FOR MOOD/ANXIETY Improve resiliency factors / strengths Improve connections to supportive, nurturing adults Ensure parents know how to listen and support the child Ensure that the child can turn to parents for support

29. COMMON TYPES OF COUNSELING/PSYCHOTHERAPY Cognitive behavioural therapy (CBT) Interpersonal and attachment-based psychotherapies Solution-focused psychotherapy Collaborative problem solving (CPS)

30. WHEN SHOULD MEDICATIONS BE USED? When non-medication options (e.g. counseling/therapy) have already been tried, but have not been successful Common medications include Anxiety / depression  SSRIs ADHD  ADHD medication Psychosis/Schizophrenia  Antipsychotic medication

31. SCHOOL INTERVENTIONS

32. SUPPORTING STUDENTS WITH ANXIETY/DEPRESSION Inform the school when a child has mental health needs so if faced with behaviours, the school can be supportive Foster a relationship between the student and the school Ensure that key educators make a point of building a connection with the child

33. SUPPORTING STUDENTS WITH ANXIETY/DEPRESSION Regularly communicate with the child about: 1) how things are going 2) any stresses and possible solutions 3) positives Develop a system so the child can let teachers know when s/he is overwhelmed, in order to have a break in a resource room or library

34. SUPPORTING STUDENTS WITH ANXIETY/DEPRESSION Provide positive feedback on positive behaviours as well as academics For negative behaviours, help the student to see mistakes are a necessary part of the learning process Reduce expectations if possible

35. BEHAVIOUR DISORDERS

36. BEHAVIOURDISORDERS • Healthy • Most children/youth misbehave at some point • May indicate confidence, persistence and other positive traits • Unhealthy • Behaviour disorders can severely impair function at home, school and elsewhere

37. TYPES OF BEHAVIOUR DISORDERS Oppositional Defiant Disorder (ODD) Conduct Disorder (CD)

38. OPPOSITIONAL DEFIANT DISORDER Oppositional Defiant Disorder (ODD) Seen in younger children Child is oppositional towards rules and authority Child has frequent temper tantrums

39. CONDUCT DISORDER Conduct Disorder (CD) Seen in older children Child violates rights of others through: Physical aggression Stealing Bullying Deceit

40. IMPACT ON SUCCESS Likely to fare poorly at school May also have learning problems Behaviours can alienate other children and result in isolation May miss class time, teacher instruction, and school work May affect their ability to commit to school/life

41. APPROACH TO BEHAVIOUR PROBLEMS Many approaches to behaviour problems Collaborative problem-solving (CPS) Children do well if they can; they want to please their parents, and want to do well at school If they cannot do well, then there is some other issue, stress or problem that is getting in the way

42. BASIC STRATEGIES TO HELP CHILDREN WITH BEHAVIOUR PROBLEMS Provide consistency, structure, and clear consequences Use positive behavioural expectations (describe desirable behaviour) Praise child (in subtle ways) when they respond positively

43. ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

44. RECOGNIZING ADHD Inattention Problems paying attention, e.g. parents/teachers need to repeat themselves Hyperactivity Needs to move or fidget

45. RECOGNIZING ADHD Impulsivity May blurt out things Say inappropriate things without thinking Difficulty waiting for their turn Low frustration tolerance

46. RECOGNIZING ADHD High need for stimulation and excitement Difficulty playing quietly Gets bored easily; likes stimulating/exciting activities

47. STRATEGIES FOR ADHD Distractibility Reduce distractions Move child closer to the front of the class and away from windows Talk with the child when there are less distractions

48. STRATEGIES FOR ADHD: HYPERACTIVITY Hyperactivity Give appropriate ways for the child to move in the classroom E.g. mobile seats like ball seats, wedge cushions, disc-o-sit, etc.

49. STRATEGIES FOR ADHD: HYPERACTIVITY Ideally have physical activity prior to difficult academic or mental tasks Allow use of ‘fidgets’ in the classroom, with appropriately agreed upon rules

50. STRATEGIES FOR ADHD: ATTENTION Break large tasks into smaller ones E.g. Asking child to clean their room would become: Task 1: Place dirty clothes in laundry basket Task 2: Place toys in toy box Task 3: Make bed Task 4: Vacuum floor Etc….