helping children with mental health difficulties

4COMPONENT Helping children with mental health difficultiesCOMPONENT

I would like to acknowledge the traditional

custodians of this land and pay my respects to

Elders past, present and future, for they hold the

memories, the traditions, the culture and hopes

of Aboriginal and Torres Strait Islander Australians.

Acknowledgement of Country

To understand Component 4 is not about teachers diagnosing students or becoming psychologists.

To develop a shared understanding about mental health difficulties in primary school children.

To provide a structured framework for gathering information about students who might be experiencing mental health difficulties.

To understand the benefits of getting help early. To clarify the role of school staff in getting

students the help they need. To increase knowledge of common mental

health presentations and additional strategies to help these students in the classroom.

To increase understanding of how the four components of KidsMatter Primary help students with mental health difficulties.

Professional learning goals 4COMPONENT

A national whole-school approach to mental

health and wellbeing that aims to contribute to:

What is KidsMatter Primary?

Encourage ALL staff to have a voice in contributing to planning for each component

KidsMatter Primary professional learning

Increase awareness and

understanding of eachof the four components

The KidsMatter Primary framework

The best interests of children are paramount.

Respectful relationships are foundational.

Diversity is respected and valued.

Parents and carers are recognised as the most important people in children’s lives.

Parents and teachers support children best by working together.

Students need to be active participants.

Schools, health and community agencies work together with families.

The guiding principles

The four components of KidsMatter Primary

KidsMatter model for mental health promotion, prevention and early intervention (PPEI) in schools

Whole-school community, staff, students, parents and carers, health and community agencies

All students (and their parents and carers)

Students experiencingmental healthdifficulties (20-30% of students) and the 3-12% of students with mental health disorders, and their parents and carers

Adapted from World Health Organization (1994)

Works with the whole community and provides

support and information to staff, parents and carers

Through the curriculum,creates opportunities to practise skills and

engages parents and carers

Supports children in school and develops clear

processes and referral pathways (by working

with parents and carers and health and

community agencies)

Session 1: Recognising children who areexperiencing mental health difficulties

Session 2: Getting help: Why and how?

Session 3: Four component support plan

An outline of what’s to come

4COMPONENT Session 1

Recognising children who areexperiencing mental health difficulties

(Adapted from Everybody’s Business, 2001)

Mental health difficulties are…

A very broad range of social, emotional or behavioural difficulties that may cause concern or distress.

Relatively common. Sometimes transient, but also encompass

mental health disorders that are more severe and/or persistent.

Distinct from children’s normal reactions to stressful situations (though they may still require support).

A continuum for mental health

Risk and protective factors for children’s mental health

Risk factors – increase the chances of children developing mental health difficulties (for example, childhood adversities).

Protective factors – are associated with good outcomes for children and can protect them in circumstances where they are exposed to risk.

(adapted from Commonwealth Dept of Health and Aged Care, 2000 and Spence, 1996)

Risk and protective factors for children’s mental health

What causes mental health difficulties?

Activity

Thinking about your students

Who are the children that you are concerned about?

How many of these children are in a typical class?

What are your concerns about these children?

Estimates suggest mental health difficulties affect 1 in 7 Australian primary school children.

Prevalence of mental health difficulties

National Child Mental Health Survey (Sawyer et al., 2000)

How might this be reflected in a classroom?

ActivityThinking about your students

List the most common things you observe in children who may be experiencing mental health difficulties, for example, they: are disruptive in class are often sad have difficulty making friends get bullied worry a lot have trouble sitting still.

Mental health difficulties can be observed as externalising or internalising.

Externalising behaviours are more frequently noticed than internalising behaviours.

Externalising and internalising

Typical behaviours might include: constant arguing with adults attention deficits / hyperactivity frequent temper tantrums hostility toward authority figures deliberately annoying others quickness to react to others (a ‘short fuse’) refusal to carry out requests or conform to rules.

Externalising behaviours

Typical behaviours might include: being withdrawn isolation from peers excessive worrying being excessively fussy or perfectionistic being fearful or anxious often being upset (‘sensitive’) being shy or cautious with other people.

Internalising behaviours

What to look for?

Teachers are very good at identifying students who are experiencing mental difficulties (Dix et al., 2008).

Collecting educational observations is part of what school staff already do.

Collecting observations also helps:– address all aspects of mental health difficulties

– provide evidence for your instincts

– organise your thoughts

– communication with other professionals.

Why collect observations?

Behaviour – what is the child doing?

Emotions – what might the child be feeling?

Thoughts – what might the child be thinking?

Learning issues – what area of learning is the child having difficulty with?

Social issues – what area of social functioning is the child having difficulty with?

Using BETLS

ActivityBETLS: Part 1

What do you notice about this child that concerns you?

Try to separate your observationsinto the different categories.

Activity What do we know about Sam?

Activity What do we know about Maya?

ActivityBETLS: Part 2

There are a number of other people that have observed Maya and Sam… What do you notice about the BETLS

chart now? Is there any additional information

that might be helpful to gather?

Should I be concerned?– The more symptoms/behaviours persist over time (> 2 weeks)

– The more they are noticeable across different situations and contexts.

– The more they interfere with functioning (for example, schoolwork, relationships) and cause distress to the person and others.

The greater the concern…– Act on the side of caution.

– If concerned, speak to someone at your school.

– You do not have to act alone.

At your school, what is the process for raising concerns about a child? Who do you talk to?

What now?

Mental health difficulties are on a continuum.

Behaviour can be observed as internalising or externalising.

It’s useful to gather information from different people, over time and across situations (BETLS).

It is important to discuss your concerns with the appropriate person – who is this in your school?

Summary

4COMPONENT Session 2

Getting help: Why and how?

Mental health difficulties are on a continuum.

Behaviour can be observed as internalising or externalising.

It’s useful to gather information from different people, over time and across situations (BETLS).

It is important to discuss your concerns with the appropriate person – who is this in your school?

Key messages from last session

For many students, mental health difficulties are transitory and resolve over time, but they still benefit from support.

For others, mental health difficulties can be distressing and may interfere with everyday activities and enjoyment of life over a longer period of time.

Without help, many mental health difficulties can become progressively worse and further disrupt the child’s academic and social development.

Mental health difficulties in childhood

Potential pathways and outcomes from childhood

Minimises the negative impact of mental health problems.

Reduces the chance of developing more serious mental health problems.

Is easier to treat mental health problems at an early age.

Getting help is important because it…

Improves children’s mental health and helps them to:– enjoy life

– handle challenges

– be better learners

– relate to others in a positive way.

Better mental health enables children to more successfully manage the transition to adolescence and adulthood, including having better prospects for employment.

Getting help…

Picking up the signs and doing something about it

Schools and staff are well placed to help because they: know and understand their students through

regular contact across a variety of situations are exposed to many children, so can identify

signs that are concerning and not part of normal development

can facilitate access, together with community agencies, to effective interventions.

The goal is to prevent problems worsening

and improve the child’s mental health.

How do you decide what to do?

See next slide for details.

Methods of support

Referrals: A starting point

Discussion

At your school, when a staff member has a concern about a child…

Professionals and services in the community who can help:

* Increased access to private psychologists through Medicare.

Referrals: Who can help?

General practitioner Paediatrician/ child

psychiatrist Psychiatrist Child and adolescent

mental health services Non-government

community agencies

Counsellor Psychologist Social worker Occupational therapist Mental health nurse Community health centres

Discuss your observations of the child (BETLS) with the mental health professional.

Make continual efforts to destigmatise mental health problems through positive attitudes.

Encourage a help-seeking school environment. Support parents and carers:

– Remember Components 1 and 3.

– Continue developing collaborative working relationships.

– Facilitate access to mental health information.

Supporting external referrals

School-based strategies: Why do we need them?

External referrals are not always necessary, accepted or available.

Even when external services are involved, the best outcomes are achieved when children are also supported at school.

Support provided at school can have a significant positive influence on children’s mental health.

Particular strategies often work best with particular types of difficulties.

ActivitySigns and strategies

Read the common signs of five different types of mental health difficulties.

Brainstorm strategies that may suit each type.

Compare your list with KidsMatter Primary suggestions.

Component 4 information sheets, including topics:– Children’s mental health difficulties and how to get help

– Children with depression

– Children with anxiety problems

– Children with Attention Deficit Hyperactivity Disorder (ADHD)

– Children with serious behavioural problems

– Children with Autism Spectrum Disorders

Enewsletters www.kidsmatter.edu.au

KidsMatter Primary supporting resources

Getting help early:

minimises the negative impact of mental health difficulties

is about recognising signs of a problem and doing something about it

involves decision-making by all staff regarding referrals, school-based strategies and mental health promotion.

Summary

Where to next?

Reflection

To help a child experiencing mental health difficulties…

What is one thing I can do immediately?

What is one thing our school can do to support these children better?

Improvements to student mental health:– Increased positive mental health.

– Reduced mental health difficulties.

– Students experiencing mental health difficulties showed significant improvements in their mental health.

14% more teachers strongly agreed that KidsMatter Primary led to improvements in students’ schoolwork.

Evaluation outcomes

Teachers believed the school had improved its capacity to support students experiencing mental health difficulties.

Teachers felt more capable of recognising students experiencing mental health difficulties.

Component 4: Evaluation outcomes

4COMPONENT Session 3

Four component support plan

Getting help early:

minimises the negative impact of mental health difficulties

is about recognising signs of a problem and doing something about it

involves decision-making by all staff regarding referrals, school-based strategies and mental health promotion.

Key messages from last session

Steps to effectively helping students

Four component support

Holistic support for children experiencing mental health difficulties

Component 1: Positive school community

Belonging and connectedness Inclusion Collaborative involvement

How does Component 1 support children experiencing mental health difficulties?

Component 2: Social and emotional learning for students

Five core social and emotional competencies. Taught formally, regularly and in a coordinated

way throughout the school. SEL skills are practised and generalised.

How does Component 2 support children experiencing mental health difficulties?

Component 3: Working with parents and carers

Promotes effective relationships between parents and carers and school staff.

Provides parenting support and information. Creates opportunities for families to

develop support networks with each other and the community.

How does Component 3 support children experiencing mental health difficulties?

Component 4: Helping children with mental health difficulties

Recognise and act on early signs of mental health difficulties.

Develop policies and practices within the school, and identify clear roles and responsibilities.

Connect students and families with help before difficulties worsen.

Implement appropriate school-based strategies to support children with mental health difficulties.

ActivityFour component support plan

Think about a child who may be experiencing mental health difficulties.

Complete the support planner.

For Component 4:– What’s coming up?

– What more do we need to find out?

– Ideas for Component 4 planning.

For KidsMatter Primary:– Cycle of continuous improvement.

– Keep up-to-date at www.kidsmatter.edu.au

Where to from here?