Inclusion

The national crisis of child mental health

The last ten years have seen a 92 per cent increase of eating disorders among young people and a 62 per cent rise in self-harming. The figures are shocking, but what are the reasons behind this explosion in children with serious mental health problems?

At least one in ten children in the UK have a diagnosable mental illness, and the numbers are only rising. But what are the reasons behind this explosion in children with serious mental health problems?

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      string(5738) "the ongoing lockdown and Covid-19 situation has had a negative impact on their child’s mental health, with many highlighting increased levels of anxiety in their children.Schools will therefore need to be prepared for a higher percentage of students returning to school with SEMH as their primary need, including those with heightened levels of anxiety. What we have been able to identify during the National Lockdown will enable us to apply and develop the practices that we use in our schools.The lockdown and virtual learning experience – some positivesAs seen in the  article (Removing Barriers- Learning from Lockdown), for some children with emotional difficulties, the context of working from home has lowered social anxieties and helped them form stronger family bonds. This may have impacted positively on the child’s ability to focus and process information. Within the home learning environment, students have had more control over how to access materials to support a learning activity, and, for some, this has encouraged independence and allowed some degree of flexibility over timeframes to complete tasks at a time which is more suitable for the learner. This can have a positive improvement on students’ organisational skills.In supportive family environments, time has enabled some students to build upon quality bonds and given opportunities to work through previous family difficulties or traumas. Caregivers may have been able to spend time to better understand their children’s needs. This may benefit the child with a higher level of support during learning in specific subjects which they may not have qualified for within the school context. For some students, therefore, levels of anxiety have become reduced, and the recent lockdown experience has been a positive and nurturing one where they have been able to feel safe within their own home context.The challenge for these students, however, will be the transition back into school, away from their safe place at home, and we must therefore be aware and monitor closely any increased levels of anxiety as those students return to schoolHigher level sof prescribed medicinesThe Children’s Commissioner for England, Anne Longfield, reported a significant increase in prescribed medications to children due to a to a sharp rise of sleeping problems, eating disorders and self-harm since the Covid-19 crisis began.ii Fears related to the virus, social isolation, loss of routine and structure and bereavement or other traumatic events is having a profound impact on mental health of young people.iiiThe sudden experience of school closures and National Lockdowns due to Covid-19 has increased the risk of serious mental health disorders including obsessive-compulsive symptoms.iv This has an effect on how a student is able to access their learning. These symptoms may develop into ritual behaviours which then elevates the challenges students will face when returning back to school.Sleep disordersCaregivers have expressed an impact in regard to routines and children’s sleeping patterns. This can have decremental effects on one’s mental health and emotional state as sleep deprivation compromises the decision-making processes and creativity. Sleep deprivation will affect how much a student engages with online learning and their ability to complete tasks at an appropriate standard. Prescribed sleep medication for under 18s has risen by 30% compared to the last two years.v Freedom of information figures have shown 186,000 of children were prescribed sleep medication between March and June 2020.vi The results reflect the rise in emotional difficulties. It is also important to highlight that there is no data reported of non-pharmacological approaches that may have of been adopted to support this need. These could be positive or negative strategies that one has established. Substances or alcohol usage may be used/increased due to the side effects of a disruptions of the natural productions of norepinephrine and acts as a central nervous system depressant or more positive approaches like mindfulness activities to aid sleeping patterns.Eating disordersEating disorders have a high co-morbidity with other mental health illnesses- 80% of people with eating disorders also had an anxiety disorders at one point in their lives.vii The relationship betweenanxiety and eating disorders is well established. Being able to control an aspect of one’s life, even food, exercise or weight can relieve symptoms related to anxiety for a short period of time. These ‘controlling’ behaviours become a coping mechanism for the cause of anxiety responses.Orri, a specialist service for eating disorders, reported that an increase of enquiries in July 2020 were 92% higher than February 2020. This indicates that many more children are experience heightened levels of anxiety and a growth of controlling behaviours to feel safe during these uncertain times. It may also suggest that the reduced exercise opportunities, closed sports teams, PE sessions or limited opportunities to exercise outdoors has directed a ‘compromise’ to control food intake. Caregivers being more present may also of help identified unhealthy eating or exercise habits.So it is clear that some of our students are living and experiencing adverse experiences due to Covid-19. The Prince’s Trust (have reported that a quarter of young people felt unable to cope with life and almost a third have experienced panic attacks. These figures indicate that one in three children are struggling to think clearly. It is clear to"
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Uncategorised

Anxious Children And How They Can Be Helped

9 May 2021

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      string(5802) "factors that reduce the probability. What weas a society should strive for is that all young people aresecurely attached to a warm and sensitive parent who isresponsive to their needs. Inevitably some children will notreceive such a good start in life for all sorts of reasons. Evensecurely attached children who seem to be on a positivedevelopmental trajectory can be affected by significant lifeevents. A follow-up to the National Child and AdolescentMental Health study found that children who face threeor more stressful life events are three times more likelyto develop emotional and behavioural disorders (Parry-Langdon, 2009). So as well as ensuring that all families aregiven the help and support needed to form these importantrelationships, there is also a need to offer help whenproblems start to arise to ensure that what might start asa problem doesn’t turn into a more serious and enduringmental disorder.Early intervention is important, but we must notforget about the many young people who have a mentaldisorder. As we have seen, many young people have toface long waits for an appointment with specialist child andadolescent mental health services (CAMHS). According tothe 2008-2009 CAMHS Mapping data, 1,636 young peoplehad to wait over 26 weeks to be seen by CAMHS. This is along time to wait when you are likely to be very distressedand frightened. YoungMinds’ Very Important Kids group(VIK)2 has said that having someone to talk to early onabout their problems is important. This person needs tobe someone who they can engage with and trust. If youngpeople don’t feel that they can talk to the person trying tohelp them, or feel that they can trust them, then they won’ttalk to them about their problems. Building trust takes timeand effort, and unfortunately VIK often report that theymight see three or four different practitioners, and are oftenonly offered a short-term intervention. So they are not giventhe time to build up a relationship, and this can actuallymake them feel worse, or actually put them off seeking help.The problem of stigmaImproving child and adolescent mental health services(CAMHS) is not easy, and services in different areas will notnecessarily be exactly alike as they need to be responsive tolocal need. However, at the same time all young people shouldexpect to receive the same level of service and should expectto feel better as a result of using services. To help ensure thishappens young people need to be involved in decisions aboutwhat services should look like and how they should operate.Young people need to feel that services are safe places wherethey can go and receive the help and support they need, ratherthan being fobbed off or made to feel that they are beingpunished for being ill. They need to be able to talk to someonewhen they first experience problems, rather than wait untilthey experience a crisis and are admitted to hospital.Unfortunately, many young people are also put offwww.teachingtimes.com n Vol 2.1Health Every Child Journal61accessing services because of the stigma associated with mentalhealth problems. Younger people generally have been shownto have very negative attitudes to people with mental healthproblems (DH, 2010). This is connected to a lack of knowledgeand understanding of what mental health actually is. A study ofyoung people’s knowledge and attitudes to mental health foundthat a very high number of derogatory and technically incorrectlabels are used to describe mental health (Rose et al. 2007). Sothere is a need for education, and there is some evidence thatlessons in mental health have reduced stigma (Naylor et al.2009). There are a number of initiatives in schools, such as thesocial and emotional aspects of learning (SEAL), which aimsto develop empathy and emotional literacy in young people.Young Minds has a Schools Outreach Service3 which promotesmental health awareness in schools and other relevant placessuch as youth clubs. The work of the Schools Outreach Workerhelps the young people and the staff who work with them togain a greater understanding of their own mental health andhelps them think about what they can do to help themselves.Interestingly, the outreach worker finds that she cannot use theterm ‘mental health’ with young people as they associate it withmental health problems and the lesson goes nowhere. However,they do engage with the idea of emotional wellbeing. Thisdemonstrates the power of stigma. Generally speaking, mentalhealth and emotional wellbeing mean largely the same thing,but young people’s perception of these terms is very different.Stigma is not one thing, but consists of a lack ofknowledge, prejudice and discrimination (Thornicroft,2006). These are big topics to understand and tackle, but amulti-dimensional framework has been developed by FionaWarner-Gale (National CAMHS Support Service, 2010), and isbeing piloted in the form of six anti-stigma projects. Her worksuggests that stigma operates at a number of different levels,such as at the individual, the family, healthcare provision, aswell as at the media and social policy level. This means thatstigma needs to be tackled at all of these levels. A toolkit basedon Fiona Warner-Gale’s work has just been published and itbrings together guidance, resources and information about thepilots (National CAMHS Support Service, 2010). This toolkit canbe downloaded from www.chimat.org.ukThe consequences of stigma are fundamental to mentalhealth, and to seeking help and support. Young people ushow stigma makes them feel worse about themselves andputs them off seeking"
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Special Needs

Minding young minds

20 Dec 2010

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      string(394) "... 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 ..."
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      string(356) "Schools across the UK are dealing with a mental health epidemic, with both primary and secondary school leaders reporting a rise in stress, anxiety and panic attacks in their pupils as well as depression, self-harm and eating disorders. Dr Margot Sunderland believes that schools can spot and avert mental health issues."
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      string(5968) "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"
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Behaviour Management

Catching Them Before They Fall

12 Sep 2018

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      string(357) "... their own identity and getting an education.It has also been shown that mental health problems in childhood can result in pooroutcomes in adult life. Mental illness during childhood and adolescence results in UK costsof £11,030 to £59,130 annually per child.9 By comparison, early intervention services areoften ..."
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      string(361) "Mental health services for children have never been a priority, particularly in schools. Now, despite a growth in interest in wellbeing, they are languishing further behind as the cuts bite in. Paula Lavis, from the Children and Young People’s Mental Health Coalition, looks at the problems, the evidence and best practice."
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      string(5867) "time and it will be anotheryear or so before we have any good data.We know that there are considerable pressures onbudgets and this is particularly the case for local authorities.YoungMinds issued a Freedom of Information (FoI) requestthat asked local authorities about their CAMHS budget. Theyfound that two thirds of respondents had reduced theirCAMHS budget since 2010, and some had made significantcuts to their budget. This is important, as local authoritiesare likely to fund or contribute to early intervention services. More recently, it has beenannounced that there will be further cuts to mental health services of 20 per cent. Childand adolescent mental health services have been historically underfunded, and theselarge cuts can only have a detrimental impact on provision.nnnhttp://www.cypmhc.org.uk/resources/overlooked_and_forgotten_full_report/http://www.cypmhc.org.uk/resources/overlooked_and_forgotten_full_report/https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2012-our-children-deserve-better-prevention-payshttps://www.gov.uk/government/publications/chief-medical-officers-annual-report-2012-our-children-deserve-better-prevention-paysVol 4.3 n www.teachingtimes.comSafeguarding/Mental health and wellbeingEvery Child Journal76Anecdotally there seems to have been an increase in the number of young peoplebeing referred to CAMHS.6 There has been a 68 per cent increase in the number of youngpeople being admitted to hospital due to self-harming.7 As a result of these pressures, itseems that many services are amending their referral criteria. This is likely to result in onlythe most ill children or those who are self-harming or at a high risk for suicide being seen.There is a crisis surrounding inpatient provision for young people. There have beenrecent cases across the country where young people have been admitted to inpatientunits miles from their homes because of a lack of local beds. Data from the Health andSocial Care Information Centre has found that so far this year, there has been an increasein the number of young people under 18 being admitted to adult psychiatric units. Thisis despite the Mental Health Act 2007 stating that young people should not generally beplaced on adult wards.It is not only statutory services that are feeling the strain. Voluntary sector services, whichare well liked and well used by young people, are also under pressure. These services are alsofacing funding cuts and are finding it hard to cope with the volume of demand.8The human and financial costsExperiencing mental health problems in childhood or adolescence has a major impact onthe lives of children and young people and their families. ‘Normal’ life may be put on holdfor a while, as depending on the condition and the severity, recovery can be slow. This canhave a huge impact on a young person, as this is a time when friends and the peer groupare so important and when they are forming their own identity and getting an education.It has also been shown that mental health problems in childhood can result in pooroutcomes in adult life. Mental illness during childhood and adolescence results in UK costsof £11,030 to £59,130 annually per child.9 By comparison, early intervention services areoften low cost and can make such a difference to children and young people’s lives.Over the last ten years, there has been a resurgence of interest in wellbeing and thehappiness and wellbeing movement has brought an increased focus on the importancethat mental health has in our lives. This interest has had a huge impact on everythingfrom social and emotional learning to wider issues such as what we want from theeconomy and the sort of measures we should be putting in place to identify what reallycounts as progress. Years ago, GDP was a sacrosanct measure of progress. Now it isbeing questioned. Questions of social inequality have been given added impetus withthe understanding that the gap between rich and poor creates unhappiness and that isdetrimental to us all, including the rich.Schools and other services have to deal with these questions albeit at a micro level.What are the problems that hinder children? How does their unhappiness impact on theirprogress? How do you promote positive mental health, and how do you tackle problemswhen they arise? Schools are in the front line of these issues and the way that they dealwith them will have a massive impact on children’s life chances.Paula Lavis is Coalition Coordinator Policy and Campaigns at Children and YoungPeople’s Mental Health Coalition.References1. Parry-Langdon, N. (eds) (2008) Three years on: survey of the development and emotional wellbeing of children and young people, London: Office for National Statistics.http://tinyurl.com/qzlwlxm2. Green, H., McGinnity, A., Meltzer, H., et al. (2005). Mental health of children and young people in Great Britain 2004, London: Palgrave. See3. Morrison & Vorhaus (2012) The impact of pupil behaviour and wellbeing on educational outcomes, London: Department for Education.4. Richards, M. et al. (2009) Childhood mental health and life chances in post-war Britain, London: Sainsbury Centre for Mental Health.5. Sabates, R. & Dex, S. (2013), ‘The impact of multiple risk factors on young children’s cognitive and behavioural development’, Children and Society, Online Early6. YoungMinds (2013) CAMHS cuts survey. YoungMinds Magazine, 118, pp. 24-27.7. YoungMinds (2011) 100,000 children and young people could be hospitalised due to self-harm by 2020 warns YoungMinds. London: YoungMinds.8. Youth"
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Special Needs

Striking a balance

21 May 2014

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