Learning Together –

Understand and respect othersMaintain confidentiality

Taking equality and diversity seriously Commitment to learning

Time out

Sessions Aims• To give an overview of mental health, in the

context of risk and resilience factors within school

• To build a living brain!

• To identify practical strategies for helping to build resilience within school, and to help children to overcome mental health distress

• To introduce further sessions on supporting children and addressing mental health in school

Exercise

Talk to person sitting next to you and briefly describe a child who you know or who you believe is leading a

emotionally, mentally and healthy life.

What are the key characteristics of this child? Please display these as thoughts or behavior's on the sheet

provided.

Definition of Mental Health

Mental health is …having the capacities of:The ability to develop psychologically, emotionally,

intellectually and spirituallyThe ability to initiate, develop and sustain mutually satisfying

personal relationshipsThe ability to become aware of others and empathize with

themThe ability to use psychological distress as a developmental

process. HAS, 1995)

Another Definition of Mental Health

When looking at mental health we need to take into account emotional well-being; happiness; integrity & creativity; the capacity to cope with stress and

difficulty.Mental health, in effect refers to the capacity to live a full, productive life as well as the flexibility to deal with its ups and downs. In children and young

people it is especially about the capacity to learn, enjoy friendships, to meet

challenges, to develop talents and capabilities. (YoungMinds, 1996)

Young People’s View of Mental Health

The young people identified five main factors as contributing to mental health:

Having people to talk toPersonal achievement, andFeeling good about yourself

Pets, presents and having fun .Friends and family

were seen as making young people feel secure,supported and wanted and conversely as preventing feelings of isolation.

(Armstrong, Hill &Secker, 1998)

The Continuum

Mental Mental Mental Mental

health distress health illness

difficulty

Emotional Emotional social

Wellbeing and behavioural

difficulties

Classification of mental disorders

Emotional disordersphobias, anxiety states and

depression

Conduct disordersstealing, defiance, fire setting,

aggression, & anti social behaviour

Hyperkinetic disorders disturbance of activity and attention

Developmental disorders (general, pervasive or specific)

For example; learning disability, ASD, delay in acquiring certain skills

e.g. speech and language

Classification of mental disorders

Eating disorderspre-school eating problems,

anorexia nervosa, bulimia nervosa

Habit disorders tics, sleeping problems, soiling

Post traumatic syndromesEffects of witnessing or experiencing

traumatic event(s) e.g. disaster or abuse

Somatic disorders chronic fatigue syndrome

Psychotic disorders schizophrenia, bi-polar disorder,

psychoses including drug induced psychoses

Prevalence

One child in five (around 20%) display a mental health problem. 10% of children have diagnosable disorder

Greater in the upper age groupLevel increasing over time (for some disorders)

Differences across ethnic groupsDifferences between family typesVariations with household income

Prevalence of any mental disorder by age and sex

Prevalence of emotional disorders by age and sex

Prevalence of conduct disorders by age and sex

Prevalence of hyperkinetic disorders by age and sex

Prevalence of any mental disorder by gross weekly household income

Build a Living Brain

• This activity is great for demonstrating to children and young people how their brains function at times of stress

• It’s a powerful reminder that they can take ownership of their brain power and they can learn adaptive ways of responding to fight or flight situations

Risk Factors in the Family

• Overt parental conflict• Family breakdown• Inconsistent or unclear discipline• Hostile or rejecting relationships• Failure to adapt to a child’s changing needs• Physical, sexual or emotional abuse• Parental psychiatric illness• Parental criminality,• Alcoholism or personality disorder• Death and loss – including loss of friendship

Risk and Resilience Factors

• Risk factors can occur within the community – including the school, the family and the child, and decrease a child’s life chances

• Resilience factors can occur within the community including the school, the family and the child, and increase a child’s life chances

Risk Factors in the Child

• Specific learning difficulties• Communication difficulties• Specific development delay• Difficult temperament• Physical illness especially if chronic and or• neurological• Academic failure• Low self-esteem• Peer relationship problem

Risk Factors in the Community• Social-economic

• Disadvantage

• Housing problems

• Disaster

• Discrimination

• Other significant life events

• Neighborhood conflict

• Deviant peer group

Resilience Factors in the Child• Secure early relationships• Being female• Good intellectual ability• Easy temperament when an infant• Positive attitude, problem solving approach• Good communications skills• Planner, belief in control• Humour• Religious faith• Capacity to reflect• High self-esteem & self confidence• Positive social influence including close peer relationships

Resilience Factors: in the Community

• Wider supportive network• Good housing• High standards of living• High morale school with positive policies for

behaviour, attitudes and anti-bullying• Schools with strong academic and non-

academic opportunities• Range of positive sport/ leisure activities

Resilience Factors: in the Family

• At least one close and affectionate parent-child relationship

• Clear, firm and consistent discipline

• Support for education

• Supportive long term relationship/absence of severe discord

The Resilience Rucksack

• This resilience rucksack contains symbols of ordinary magic which represent schools as therapeutic communities

Map

• The longest journey starts with a single step

• Help and model planning a day – it develops a cerebral response as it helps to work out where the dangers are and how to manage them

• It gives a sense of purpose

Trainers

• Exercise reduces cortisol

• It provides a channel for energy and an avenue for success

• It can teach perseverance

• It can be great for building alliances with hard to reach kids

Professor Dumbledore – the teacher

• Recent research shows that good teaching and good learning is one of the powerful tools in promoting mental health

• Do what you do well and the pupil benefits

Rope

• We need to link with others

• The need to belong is a fundamental human need

• Exclusion produces a sensation in the brain similar to that of physical pain

An anchor

• We need a secure base from which to explore the world

• Vulnerable children need to know where they turn to in times of crisis

• Where can kids feel safe in school?

A chill out CD

• We need to learn to relax

• It needs to be programmed into our brains as well as our hectic lives

• For those with heightened sense of danger they need explicit exercises to teach self regulation and self calming

• You can’t change children’s lives but you can help them to cope with the life they have

Snakes and ladders- going down……..

• In groups identify some of the factors within your school which may contribute to a downward spiral. These could relate to your own wellbeing as well as that of the pupils – it could relate to institutional practice

Snakes and Ladders – going up……..

• In groups, identify some of the factors within your school and within your dealings with young people which promote resilience

What helps - Anxiety

Prevention - A number of causes of general anxiety in childhood can be prevented by sensible handling

For illogical fears that are not quite phobias, simple explanations and reassurance will help many children gradually get over them

Detailed interview with child and familyLook to other agencies for interventions eg Educational Psychologists or

Education Socal Workers if anxiety is about school, social workers if about home life

What helps - Anxiety

Talking to or helping children and parents to understand how the problem has developed

Specific fears are usually treated by helping children confront their fear in a way and at a pace that they can manage eg carefully planning a gradual return to

school if the anxiety is school basedTeaching relaxation

Help children talk through their anxieties using drawing or play

What helps - Depression

About 10% of children and young people with depression recover spontaneously within 3 months

Be able to determine, recognise and assess those with depressionEnsure timely information is available on the nature, cause and treatment in all

local languages (NICE, 2005)

Ask sympathetically how they are and listen to the responseEncourage them to remain active

Praise all efforts(Royal College of Psychiatrists, 1999; YoungMinds)

What helps - Hyperactivity

Learn about hyperactivity and what it meansGive structure and encourage regular routine

Give clear instructions, sufficient time to complete tasksProvide a variety of physical activity

Reward any achievements(HASCAS, 2004)

What helps – conduct disorder

All approaches are grounded in respect for the childEmpathy, attention and involvement, play, problem-solving, listening, talking.

Praise any achievements and reward themEncouragement

Clear limits and consistent rules with consistent follow-throughIgnore negative behavior, distract from negative behavior (positive verbal

redirection) and use re-engagement strategiesRemind of expected behavior and warn of consequences

Use consequences

What else helps children’s and young people’s mental health?

Adults being self-awareFeeling helpless/angry/rejected

Learn from your experiencesRespect their view even if an alternative adult view is presented

UnderstandingThem

Their peer groupTheir developmental stage/age

Their life circumstances

What else helps children’s and young people’s mental health?

ListeningActively

Open questionsWarmth and empathy

Take account of cultural issuesNever promise to keep a secret

Child protection proceduresEmotional language

What else helps children’s and young people’s mental health?

BoundariesKnowing what they can and can’t do

Be consistent Expect challenge

Skill DevelopmentEnabling children and young people to improve their mastery of stressful

situations