Special Needs

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(389) "... 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 ..."
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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

2 Nov 2010

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      string(2757) "Freund, M., Hodder, R., & Wiggers, J. (2015). Systematic review of universal resilience interventions targeting child and adolescent mental health in the school setting: Review protocol. Systematic Reviews, 4(186).Stallard, P. (2013). School-based interventions for depression and anxiety in children and adolescents. Evidence Based Mental Health, 16(3): 60-61.Langley, A. K., Nadeem, E., Kataoka, S., Stein, B. D., & Jaycox, L.H. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School Mental Health, 2(3): 105-113.Ford, T., Parker, C., Salim, J., Goodman, R., Logan, S., & Henley, W. (2018). The relationship between exclusion from school and mental health: A secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007. Psychological Medicine, 48(4): 629-641.Lewinsohn, P. M., Hops, H., Roberts, R. E., Seeley, J. R., & Andrews, J. A. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 102(1): 133-44.Noguera, P. A. (2003). Schools, prisons, and social implications of punishment: Rethinking disciplinary practices. Theory Into Practice, 42(4): 341-350.Department for Children, Schools & Families. (2008). Back on track: A strategy for modernising alternative provision for young people. London: Department for Children, Schools and Families.Sutherland, A., & Eisner, M. (2014). The treatment effect of school exclusion on unemployment. SSRN Electronic Journal. https://www.researchgate.net/publication/272302570_The_Treatment_Effect_of_School_Exclusion_on_UnemploymentChristle, C. A., Jolivette, K., & Nelson, C. M. (2005). Breaking the school to prison pipeline: Identifying school risk and protective factors for youth delinquency. Exceptionality, 13(2): pp. 69-88.Howarth, C. (2006). School exclusion: when pupils do not feel part of the school community. Journal of School Leadership. http://eprints.lse.ac.uk/15346/Okonofua, J. A., Paunesku, D., & Walton, G. M. (2016). Brief intervention to encourage empathic discipline cuts suspension rates in half among adolescents. Proceedings of the National Academy of Sciences, 113(19): 5221-5226.Okonofua, J. A., Paunesku, D., & Walton, G. M. (2016). Brief intervention to encourage empathic discipline cuts suspension rates in half among adolescents. Proceedings of the National Academy of Sciences, 113(19): 5221-5226."
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Emotional and Behavioural Difficulties

Embracing Empathy

6 Feb 2019

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      string(5969) "In 2017, 98 per cent 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 (2017)Government Green Paper, Transforming Children and Young People’s Mental Health Provision,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 per cent 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. 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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"
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Special Needs

Averting Disaster

6 Feb 2019

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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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Leadership

Catching Them Before They Fall

13 Sep 2018