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Harriet Williams2019

Supporting Young People

through Secondary School

42nd StreetInclusive, accessible mental health

services for all

Shared Mission:

To support young people aged

11- 25 years with their emotional

well-being and mental health,

promoting choice and creativity

GREEN PAPER 2017/8

GOVERNMENT VISION:

All Schools will have a Mental Health Lead by 2025: member

of staff trained and responsible for school mental health approach:

Oversee support school provide pupils with mental health

Help staff spot early signs of mental health problems

Offer advice to staff about mental health

Refer pupils to specialist services where needed

Offer training to develop skills in leading mental health work

and support staff delivering whole school approaches

Link to NHS specialist services when signposting

Educational Mental Health Practitioners: will provide support

for low mood and anxiety in schools

3

Healthy Body = Healthy Mind

What the Mental Health Champions told us

last year

Top Issues raised in the consultation

1. Young people need to be listened to and involved

2. Teachers need training

3. There needs to be better range of quality food in schools

4. Students need specific support around specific issues e.g. exams, stress, trauma, self harm, tolerance

5. The school environment needs improving , e.g. a range of spaces, sensory rooms, games

6. Parents need support too

7. There needs to be an understanding of issues inside and outside of school

8. Schools need high quality specialist counsellors/student support

Keeping Schools Mentally Healthy

“Early intervention has saved lives”

Lisa Fathers Director of teaching school, Alliance for Learning

QUOTES FROM YOUNG

PEOPLE

A weight has been lifted

Talking about things helped me become more at ease

People around me do not understand how hard my

life is. Talking about things helps me make sense of it

Talking has taken the heat out of problems that I

have not wanted to face - it has made things easier

AIMS

• Introduction of common pressures for Young People and Parents/Carers during Secondary School

• Introduction of what is going on in a Teen’s brain

• Understanding impact stress has on emotional wellbeing, mental health and Brain

• Gain knowledge & resources to identify stress and low mood in Young People

• Introduction to positive strategies to support young people deal with stress

• Increase understanding and knowledge of parenting strategies to support young people through school

8

TRAINING AGREEMENT

Confidentiality

Respect for others and difference

Listening

Participation

Responsibility for self

Time boundaries

Mobile phones

PARENTING ADOLESCENTS

It is not easy!

More Isolating

Parent/Carer Life stage challenges

Evolutionary influences of the Teenage brain

Shift from Parent/ Carer focus to Peers

Disordered Transition

Average age of leaving home increasing

11

Adolescent Brain

Development

Cortex: abstract/ concrete thought/learning

Limbic: Emotional/ Drives/Attachment/Relationships

Brain stem: Reptilian Brain: Blood pressure/ Temp, Motor regulations/ Arousal: Fight/ Fight/Freeze/ Faint

Spinal cord: nervous system, motion, sensation

BRAIN

ADOLESCENT BRAIN

Second largest development growth of the brain (from pre-adolescence-25yrs)

Risk-Taking behaviour & Pushing away evolutionary response

Problems getting to sleep as Melatonin released in a teen’s brain later

Developing Small Prefrontal Cortex Weak pre-frontal cortex is seen in many MH problems

Blame my Brain: Nicola Morgan

WINDOW OF TOLERANCEDAN SIEGEL

WINDOW OF TOLERANCE

A.C.T

Acknowledge emotion

Communication boundary

Transfer/Target an alternative

Gary Landreth Parent Child Therapy

Dr. Dan SIEGEL

‘Whole Brain Child’ building the

staircase of the mind

Connect and redirect

Use it or Loose it

Name it to tame it

Engage don’t enrage

Move it to loose it

Mindsight

What is

Emotional

Wellbeing?

20

What is

Mental

Health?

21

We all have it!

It relates to how we think, feel, behave and interact with others

‘Child mental health is the strength and

capacity of children’s minds to grow and

develop with confidence and enjoyment. It

consists of the capacity to learn from

experience and to overcome difficulty and

adversity. It is about physical and emotional

wellbeing, the ability to live a full and creative

life and the flexibility to give and take in

friendships and relationships. Children who are

mentally healthy are not saints or models of

perfection, but ordinary children making the

most of their abilities and opportunities’YOUNG MINDS

23

Positive Mental Health

Mental Health disorders

Changing Behavioursshowing distress

Mental Health problems

MENTAL HEALTH CONTINUUM

MENTAL HEALTH

Mental health problems are one of main

causes of the burden of disease worldwide

In UK MH is the largest burden of disease

(28% of total burden)

1: 4 people will experience MH problems in a

given year

Mental health services overstretched/

inconsistent/ waiting lists /higher thresholds

Public spending focus on crisis driven

services not preventative workMental Health Foundations (Fundamental Facts)

24

YOUNG PEOPLE UNDER PRESSURE

PRESSUREIdentity/

Image

Body

Image

Pressure

Bullying

https://youtu.be/y7gkVF4w2ww

Body Confidence DOVE Campaign

TOLERANCE

Banter or Bully

BANTER is having fun with friends

When someone is getting hurt or upset by

ongoing banter it starts becoming bullying

behaviour

Bullying behaviour is also when someone’s

physical trait or characteristic is picked on and

used as the butt of ongoing jokes

As well as Sexualised language which intimidates

or is inappropriate

Other friends may feel pressure to laugh and not

stop this

www.themix.orgwww.bullying.co.ukwww.childline.org.uk

How might all these pressures impact on a YP if they

don’t receive the right support? 31

32

BEHAVIOURAL CONCERNSHYPER-AROUSAL:

Anxious, clingy, fearful, tearful, panicky

Difficulties in Sleeping: Too much or too Little

Hyperactive, lack of concentration, focus and fidgety

Irritable, frustrated, argumentative

Disruptive, Aggressive behaviour: to others, objects or self

Inability to comprehend rules, boundaries, oppositional

Unable to be independent, needing constant reassurance

Risk taking behaviour

Self Harm, Eating issues, Drug and Alcohol, Crime

HYPO-AROUSAL:

Sad, hopelessness, low mood, depression

Withdrawn, Non-communicative, school non attendance

Difficulties in forming relationships with peers/ adults/isolated

Worthless, shame, lack of self esteem, loss of interest 33

MEANING BEHIND BEHAVIOUR

Young People ‘show’ us how they feel in their behaviour

CYP’s Emotional Literacy can be affected by lots of things:

Experiences in life, Our coping strategies, Relationships,

Loss, Special Needs etc

When a Young Person is in stress their BEHAVIOUR

SYSTEM becomes switched ‘on’ or ‘activated’

When they feel safe and in control it turns ‘off ’

34

HYPO-AROUSAL

HYPER-AROUSAL

REGULATION

CHALLENGES IDENTIFYING

CMH PROBLEMS Knowing what to look for

Presentation commonly hidden/not obvious

They may not want to talk to us?

May look like behavioural issue and Young Person

can feel blamed/ responsible

Multiple causes

May feel challenges at school/home are hard to face

Mental Health Stigma

How do we open up conversations?

37

A Royal Team Talk-Tackling Mental Health 2019

://youtu.be/Yn_shQZz5tw

A Royal Team Talk-Tackling Mental Health 2019

https://youtu.be/Yn_shQZz5tw

You’re their Emotional Coach

You’re a Coach

Modelling Emotional Literacy

Show we have feelings and can get it wrong

Repair/ Active Listening/ Empathy

Time to listen and hear their solutions

Don’t trivialise their feelings or reactions

Open Questions

Don’t bring it back to YOU

www.emotioncoachinguk.com39

https://youtu.be/7KJa32r07xk

https://youtu.be/7KJa32r07xk

THE MOST COMMON CYP

MENTAL HEALTH PROBLEMS

LOW MOOD/DEPRESSION (HYPO-

AROUSAL)

STRESS/ ANXIETY (HYPER-

AROUSAL)

STRESS

Stress is defined as a process that exists over

time

Stress response is necessary for survival

Stress & anxiety are normal features of life

and responsive to external and internal

threats

Perceived threats to safety trigger a set of

chemical and neurobiological events known

as the STRESS RESPONSE in the brain

Stress affects all aspects of ones functioning (Collins & Collins 2005)

FIGHT FLIGHT FREEZE FAINT

Stress Response

STRESS RESPONSE

When stress continues over time, escalates or

increases it can lead to debilitating outcomes

When a YP experiences multiple stresses their

body and mind can become overwhelmed

If continued these responses/behaviours can

become a regular mode of functioning…. Even

when the danger is NO longer there

Pat Crittenden: calls these behaviours a child’s

clever strategies of survival within challenges

Stress: When under

threat changes in body

& brain affect physical/

psychological being

Under threat:

Limbic System engages

Frontal lobes disengage

Safety returning:

Limbic chemical

reaction stops and the

frontal lobes re-engage

Bessel Van de Kolk 2005

PHYSIOLOGY INFORMATION

THOUGHTS

BEHAVIOUR

PHYSIOLOGY

EMOTIONS

Swatting or Stamping out the

NATS & ANTS

ANTS

NATS

NEGATIVE AUTOMATIC THOUGHTSIdentifying Patterns

ALL OR NOTHING THINKING

OVER GENERALISATION

NEGATIVE FILTER

JUMPING TO CONCLUSIONS

◦ Mind Reading

◦ Fortune Telling

◦ Predicting the worst

CATASTROPHISING

EMOTIONAL REASONING

SHOULD/ MUST’S AND OUGHTs

LABELLING AND MISLABELLING

PERSONALISING /BLAMING YOURSELF

PSYCHOEDUCATION

STRESS/ ANXIETY Anxiety is a normal

It is a reaction to any situation that is perceived by the individual to be threatening

Anxiety is a natural human response to danger following the hard wired human responses of:

FIGHT FLIGHT FREEZE FAINT

Anxiety is experienced physically, cognitively and with behavioural changes as a result of physiological changes that we experience in response to stress

Symptoms can be frightening, particularly if someone does not know that they are symptoms of anxiety

We can learn ways to fight stress and anxiety and good idea to practice even when you are feeling well as hard when you feel your stress is escalating

49

Support for Stress/Anxiety

50

How can we Help? BE there…..at any time!

Active Listening and don’t tell everyone

Let them talk and off-load and give space if needed

Support them in de-escalation skills,

Psycho-education

Support to regulate their feelings/ Distraction

‘Be a Thermostat not a thermometer’

Show them exceptions to the Rule

Empathise (imagine how it feels for them)

Don’t do it for them- help them find their Solutions

BE Consistent, Predictable and Nurturing 51

Low Mood

Hypo-arousal

Low-mood affects our Mind, Emotions, Body, Thoughts

Sadness and Unhappiness are normal emotions

Depression can only be diagnosed by a medical profession ie: GP, Psychiatrist

Depression is diagnosed when key symptoms persist over time significantly impacting on a person’s day to day functioning

Depression describes a continuum of moods

MILD MODERATE SEVERE

Struggle to focus or decline in academia

Withdrawal from family and friends

Lost interest in activities/ events or past enjoyment

Sleep problems

Appetite or weight changes

Feelings of guilt or feeling misunderstood

Clinging to a parent

Unexplained crying

Shyness, fears, unexplained physical somatised complaints,

anxiety

Self Esteem Issues

(DSM-V American Psychiatric Association 2013)

LOW MOOD/ DEPRESSION IN YP

Support for Depression

54

Support

Role

Active

Listening

KEY ADULT’S SUPPORT

STRATEGIES (Louise Bomber)

Providing commentaries (Nonverbal and verbal)

Create opportunities for the Young Person to try and

practice new things out

Communicate Empathy, Hope, Aspirations

Affirmations

Advocacy

Responding

Inclusion

Check-Ins

Transparency and Apologies for changes

Communication with young person and other

professionals and Carers/ Parents

PSYCHO-EDUCATION

BARNARDOS (Tony Newman)

Effective strategies for CYP

Strong social support networks.

The presence of a least one unconditionally supportive parent or parent substitute

A committed mentor or other person from outside the family

Positive school experiences

A sense of mastery and a belief and one’s own efforts can make a difference

Participation in a range of extra-curricular activities

The capacity to re-frame adversities so that the beneficial as well as the damaging effects are recognised

The ability – or opportunity – to ‘make a difference’ by helping others or through part-time work

Not to be excessively sheltered from challenging situations that provide opportunities to develop coping skills

THREE R’S REACHING THE LEARNING BRAINDr Bruce Perry, a pioneering neuroscientist in the field of trauma, has shown us that to help a vulnerable child to learn, think and reflect, we need to intervene in a simple sequence.

First: We must help the child to

regulate and calm their

fight/flight/freeze responses

Second: We must relate and connect with the child through an attuned and sensitive relationship

Third: We cansupport the child to reflect, learn, remember, articulate and become self-assured

SECURE BASE MODEL(Schofield and Beek 2009, 2014)

Promotes security and resilience.

Availability- helping the CYP to trust

Sensitivity- helping the CYP to manage

feelings and behavior

Acceptance- building the CYP’s self esteem

Co-operation- helping the CYP to feel

effective

Family membership- helping the CYP to

belong

5 WAYS TO

EMOTIONAL WELLBEING

5 WAYS TO WELL-BEINGBuilding on Resilience and Strengths

Connect ……….. Supporting young people to make

connections in school and community and seek support

Keep learning ….. Try something new, teaching varied

ways, build on a pride of learning new things to build young person’s confidence

Be Active …..Supporting activity homes/ schools

Notice ……… curiosity in the world around us, notice

the extraordinary the beautiful

Give ……Encourage the joy from giving: do something

nice for a friend, stranger, school.

63

www.neweconomics.org.uk

What can we Model & do?

RESPECT FOR ALL

TOLERANCE AND NON- JUDGMENTAL CULTURE

CELEBRATE DIFFERENCE & ACCEPT UNIQUENESS

UNDERSTAND THE MEANING BEHIND BEHAVIOURS

NOTICE AND HELP OUT WHEN YOU SPOT OTHERS BEING DISRESPECTED

THINK ABOUT WHAT YOU WOULD FEEL IF THIS WAS HAPPENING TO YOU

ADDRESS DISRESPECT WHEN WE SEE IT

SUPPORT FOR YOUR YP

If they need help……..

Talk to someone they trust (teacher/parents/carer/ coach etc)

Report any disrespectful behaviour to school

Don’t retaliate

Talk to a friend

Keep involved in things which make you feel good

Ask School for EMHP Support

Don’t join in with friends when you hear unkind banter

Support TOLERANCE and RESPECT in School

Set up a Campaign, Support, or Discussion Group

Get Involved in helping others affected

Become a MENTAL HEALTH CHAMPION

All Websites and Support is available in Pastoral

REMEMBER WE ALL HAVE TIMES WHEN WE ARE AFFECTED BY STRESS AND LOW MOOD AND SEEKING EARLY HELP…

HELPS!

NETWORK OF SUPPORT WEB

Handy Tips Be open to discuss concerns

Acknowledge their feelings with Empathy

Seek support/ advice/ resources when you need it

Quiet /private space to talk with YP

Be clear about the time you have available

Listen calmly & actively and ask open questions

Respect and take seriously what YP tells you

Be clear about what you can and can’t do

Recognise your own limitations and seek help where needed

Look up support they can use on web

Ask school for support where appropriate

Get support for yourself!

How can you be a support if you are depleted

67

MINDFULNESS

DAN SIEGEL

CALMING TOOLS

BREATHING & RELAXATION

TECHNIQUES

Square Breathing

Controlled Breathing

Visualisation

Muscle Relaxation

Belly Breathing

Body Scanning

Mindfulness eating, walking, brushing teeth..

Drawing circles, drawing with water/ colour

Mindfulness Colouring

Relaxation Tips

https://youtu.be/cyEdZ23Cp1ERel

ATTENTION: Strengthens "mental muscle" for bringing focus back where we want it, when we want itEMOTIONAL REGULATION: Observing emotions helps us recognize their transience, see when they occur and how to respond ADAPTABILITY: Becoming aware of our patterns enables us to gradually change habitual behaviors wiselyCOMPASSION: Awareness of our own thoughts, emotions, and senses develops understanding of other’s experiencesCALMING: Breathing and mindfulness practices relax the body & mind, giving access to peace independent of external circumstancesRESILIENCE: Seeing things objectively reduces the amount of narrative we add to the world's natural ups and downs, giving us greater balance www.mindfulschools.org

BENEFITS TO MINDFULNESS PRACTICE

THANK YOU

https://youtu.be/hMyDFYSkZSU

BRAIN BUILDERS ( NSPCC)

Twitter @42ndStreetmcr

@TheHorsfall

www.42ndstreet.org.uk

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