In 2017, 98% of teachers and school leaders came into contact with pupils they believed were experiencing mental health problems, according to a National Association of Schoolmasters Union of Women Teachers Teacher’s survey. And with children spending 190 days at school per year, teachers are in a prime position to provide much-needed support to pupils with mild to moderate mental health problems. This is reinforced in the recent Government Green Paper (2017), Transforming Children and Young People’s Mental Health Provision,2 which states, “There is evidence that appropriately-trained and supported staff such as teachers, school nurses, counsellors, and teaching assistants can achieve results comparable to those achieved by trained therapists in delivering a number of interventions addressing mild to moderate mental health problems such as anxiety, conduct disorder, substance use disorders and post-traumatic stress disorder”. Research also shows that, on average, it takes 10 years for a child to get help for a mental health condition (Centre for Mental Health, Missed Opportunities Report, 2016) – and even then, only half who seek help get better, so teachers play a crucial role in spotting, addressing and mitigating mental health issues early on.
But before schools can appropriately tackle poor mental health, it is essential that they take a step back and understand the causes behind ill mental health and the transition from emotional pain, which is experienced by us all, to mental health problems. Emotional pain for children and teenagers may be caused, for example, by their parents separating, an illness or a death in the family, multiple house moves or bullying at school. The impact this can have needs to be understood and normalised by schools. Before discussing mental health conditions, schools should first focus on providing children with a space to talk about painful life experiences and offer appropriate support. The wealth of scientific research on ‘social buffering’ (having someone at the time of the painful life experience, to listen, empathise and understand) shows that this can prevent students’ emotional pain transitioning into a mental health issue.
Adverse Childhood Experiences
Countless research suggests that painful childhood experiences that occur without ‘social buffering’ at the time of occurence have a significant impact on children’s behaviour, attendance and learning outcomes. The Adverse Childhood Experience and Toxic Stress: A Public Health Crisis study found that children with three or more adverse childhood experiences (ACEs), such as those mentioned above, were three times more likely to experience academic failure, five times more likely to have attendance problems and six times more likely to have behavioural problems. For those with four or more ACEs, more than 50 per cent were likely to have learning problems and were 32 times more likely to have behaviour problems. For teachers, knowing that early identification of the warning signs that a student’s painful life experience or emotional pain could, if not addressed, become a mental health problem, is critical. Some key signs to keep an eye out for include: marked changes in concentration, losing ability to focus on learning, staring out the window, tiredness and low self-esteem. More concerning signs and symptoms to watch for could include isolation and withdrawal from peers, parents also reporting marked deterioration in several areas of functioning, and indications of serious self-harm or suicidal ideation. In these cases, the pupil should be referred to Child and Adolescent Mental Health Services.
Our results-driven culture and focus on academic outcomes is also adding to widespread mental health problems in schools. Exams are frequently cited as one of the worst stressors facing pupils. In a recent National Education Union survey of teachers (April 2018), 82% said tests and exams had the biggest negative impact on mental health, with exams causing children acute stress, and many pupils breaking down in class due to the pressure or turning to self-harm or suicidal thoughts. Counselling service Childline receives a surge of calls from young people during the SATs and GCSE season, and reported receiving 3,135 calls from young people about tests and exams in 2016/17, an increase of 11% over the previous two years, according to statistics from the National Society for the Prevention of Cruelty to Children. Problems sleeping and eating, school avoidance, panic attacks, self-harm and suicide are increasingly being reported among young people during exam time.
Student wellbeing is just as important as academic outcomes, and needs to be treated as such. In fact studies show that paying attention to student wellbeing improves academic outcomes. Until government education authorities, such as the Department for Education, Ofsted and the Regional Schools Commissioners, balance the scales between wellbeing and academic achievement, there will continue to be a mental health problem in schools. The UK should look to other countries that are less testing-focused and follow their lead. Finland, for example, epitomises progressive education policy, with a later introduction to formal schooling (age seven) and no tests in primary schools (pupils are only tested at 18) and was ranked fourth in the world for reading in the last Programme for International Student Assessment (PISA), in 2016. The United Kingdom is way down the list, ranking 22nd. There needs to be national recognition of the importance of monitoring the wellbeing of schools. Governing bodies, trust boards and directors need to make pupil wellbeing, along with staff wellbeing, a key performance indicator for schools across the UK. While test results continue to trump wellbeing, the education system will continue to add to mental health problems in students and staff, not heal them.
One approach schools can take to avert mental health issues is to provide pupils with ‘emotionally available’ adults. In effect this means that school staff should focus on building rapport with their students and strengthening their listening and empathy skills to help children regulate their emotions and reduce their levels of emotional stress. Research in the report by YoungMinds and Cello, Talking Self Harm (2012) indicates that two out of three teachers are worried that if they have a conversation with a teenager about self-harm they might make it worse. If they listen empathetically, this is absolutely not the case. It is important for schools to focus on building teachers’ confidence in this area and providing them with opportunities to gain skills around the type of language to use and how to approach a mental health conversation with a student. If a teacher notices that a child is expressing symptoms of poor mental health, for example, they should take the student aside and ask open-ended questions using empathetic language, for example: “I’m so sorry that you are going through a tough time at the moment, would you help me understand what is happening for you in your life at the moment?’” or “Would I be right in thinking that things at home are hard for you right now?”, “Is there anything we can do to help you with what’s going on for you in your life?” and validating the child’s feelings with statements such as, “Of course you’re feeling upset because your mother is sick”, “It’s understandable that you’re feeling worried”. It is about building on the natural empathy that many teachers are likely to already possess.
