There has never been a more difficult time to be young. Despite all the material advantages that so many of today’s young people enjoy compared with the lot of previous generations, we know that the agencies that work with them – schools included – report increasing concern over problems associated with the wellbeing of young people.
I am often asked to explain why mental health issues with young people are on such a rapid increase. It is an extremely difficult question to answer. Expectations of the young are increasing and with it increased competition and anxiety. Further, the ubiquitous nature of social media makes it very difficult for any child ever to ‘switch off’. The world can never be left behind – and it can intrude into even their most private moments. When I was at school, the difficulties I may have had during the school day were gone by the time I was home. There is no such division now. The problems will follow the child home via text and then be with them during the evening via any one of a number of platforms on their computer. It will probably even keep them awake at night. This ‘digitally-native’ behaviour is affecting children at an increasingly younger age. Indeed, so many of these pressures are already established before adolescence even begins. When one adds into the mix the problems of relationships, drugs, alcohol and self esteem that will accompany the young person on their journey through adolescence, then it is not a surprise that at times their mental health may not be in the best shape.
And neither are children unaffected by stresses that come with the fast-changing economic situation.
At a recent talk to a group of Y11 children, I heard the speaker announce that 60% of his teenage audience would be working in a career that was not in existence yet and that their examination grades would not help them to get jobs. They would either have to cope with the fast-changing technological demands, or they would be dependent on their personalities – their ability to impress. If they wanted to do to well, it was important that they learned how to be liked, how to sell themselves and how to be ‘great in all they did.’ Not only do our children have to cope with the uncertainties of the here and now, they are also forced to look to the future, where the prospect of further doubt – both social and financial – awaits them.
All of us who work in schools are well aware of the rise in issues associated with poor mental health, but faced with choices of cost, limited staff resources and academic priorities, it seems easier to hope the problem will go away rather than take on the often difficult task of trying to intervene.
And often the problem will go away; or more precisely, it will disappear from view - for a while – only to reappear with sometimes devastating consequences at some point in the future. According to Health Society Research, some three quarters of all adults who access mental health services can have their difficulties traced back to their youth, something confirmed by the NHS in their review. The message from countless studies of this sort is clear: we ignore concerns over mental health at our peril and at our cost.
In an area awash with statistics, there are some from which we would prefer to look away. The most poignant of these is to do with suicide: despite all the advances in psychiatric intervention and care, every day 16 people decide to end their life. It is a figure that comes on the back of a worrying report carried out by YouGov that states that a third of school students polled had, by the age of 16, considered suicide. A similar proportion had also self-harmed because, according to Mindfull, the charity that commissioned the poll, ‘of stress at school, because they are worried about their future and because they feel they are not good enough.’
These are sobering statistics.
It would seem that schools themselves are not as aware of the deficiencies in the care they offer to their pupils as they might like to think. A quick look at any school’s description of its pastoral care provision and words like ‘comprehensive,’ ‘dedicated’ and ‘excellent’ suggest a care programme which will look to support not just the intellectual and physical development of the pupil, but also the emotional and mental health. The reality, though, is somewhat different. Beneath the glossy claims of the school brochures, the reality is often an institution where the priorities are written by the school rather than the child and where signs of poor emotional health are often missed through poor (or no) training of staff. The contrast with training in physical first aid is stark. Every three years since I started teaching I have received training in physical first aid. It is a requirement of my contract at my current school – and a good thing, too. Even if I have never had to apply anything other than a plaster, I am more confident and capable for the training.
How questionable it is that no such training is required for mental health, a point stressed by Poppy Jaman, CEO of Mental Health First Aid (England) at a recent Talking Schools Conference at Bradfield: ‘When a child presents with symptoms of physical illness or disease we don’t ignore them – we act quickly and appropriately. Why should it be any different for mental ill health? In the same way that every school and college will have one or more physical first aider, there should be trained Mental Health First Aiders, too.’ It is a cry echoed by Education Secretary, Nicky Morgan, who suggests that early identification and intervention in mental health issues ‘isn’t just essential for a child’s education; it’s essential for that child’s whole life’.
Many teachers acquire excellent skills in counselling children and supporting their emotional health as their experience in the classroom develops, but even the best can miss the signs and symptoms of poor mental health, often because potential problems are disguised by compliant behaviour. It is a story told too often by those who have come through the school system. Laura Myles was one such pupil. She was a highly-motivated, highly-successful pupil at both primary and secondary school. Her success disguised a deep unhappiness that expressed itself in alienation, self harm and, eventually, two suicide attempts. Laura also spoke at the Talking Schools Conference, sharing a school report which was written about her at one of her low points. It spoke of her academic success, her positive contribution in the classroom and that she had so much to look forward to. The fact that her teachers were unable to spot the crisis she was enduring was less a criticism of them and more an indication of the need for training and expertise in the area of mental health in the school environment.
What can schools do?
Laura’s story – similar to so many stories of young people who have recovered from poor mental health in younger years – should make us all look again at the organisation of the pastoral care we offer in schools. The claims and promises made in the school prospectus need to be supported by a whole-school approach in dayto-day practice. Part of this determination to provide the best support must have to do with training. Nicky Morgan is hopeful to have someone trained in mental health every school, but that should be a mere base target: what is really needed is training for all those who are likely to be working closely with children. In the same way as many of our schools make physical first aid mandatory, so to should they with mental health first aid.
Training should be the first step and Mental Health First Aid (England) offer a range of courses, some lasting a few hours to others covering a full two-day programme which will help any school develop these useful skills in their staff (more information can be found at the MHFA website: mhfaengland.org). The courses all provide an introduction to the signs and symptoms to look out for in children’s behaviour which might indicate underlying mental health issues.
Teachers will be understandably concerned that they are busy enough already and asking them to take on more responsibility may well put their own wellbeing in jeopardy let alone compromise the learning of their pupils. However, it is important to stress that mental health first aid is not designed to turn teachers in to psychiatrists or psychotherapists – in the same way physical first aid is not designed to turn them into surgeons - but to give them some basic skills which will enable the intervention process to begin earlier if necessary. A teacher may spot early warning signs which may well then be taken forward by other agencies.
The Welsh authorities are to be applauded in their plans to assign a mental health counsellor to every primary and secondary school in that country. Let us hope that, in the run up to the May General Election, we will hear similar plans being put into motion for the rest of the UK. It is important that those of us who work with young people make the case as forcefully as possible. At a time where mental health resource is being cut in the NHS (even the new targets from the deputy prime minister offer a modest 18 week wait time). Eighteen weeks - fours months - is just not good enough for a patient who is depressed or anxious: for a patient who is suicidal, it might well be the difference between life and death.
Things do get better
Attitudes to mental health are changing, but many people are still liable to see mental health problems as difficulties which stay with a person for life. It is not a view we would expect anyone to hold of a person who has suffered a physical injury. A physical injury or illness is something from which a person recovers and so should it be with mental health. People may be ill with a mental health condition, but they can absolutely get better and the earlier the intervention, the more likely that longer-term difficulties might be avoided. The plaster in the first aid kit provides a useful symbol here. Let us imagine a pupil comes running into the classroom with a grazed knee which is bleeding from a playground fall. The teacher spots the injury and takes the child to the first aid point where the wound can be cleaned and a plaster supplied. The child returns to normal routine and within a few weeks the wound is forgotten. Imagine now that the cut was not spotted; that no cleaning or plaster was applied – neither now nor in the weeks to come (perhaps even eighteen weeks to come). The problem may well develop into something far more serious. Mental health first aid is about spotting that early cut and preventing the later difficulties which often prove so damaging to families and communities.
This article featured in the CWMT Newsletter, issue 31, March 2015
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