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Bacs presentation
1.
2. Learning Together –
Understand and respect others
Maintain confidentiality
Taking equality and diversity seriously
Commitment to learning
Time out
3. 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
4. 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.
5. Definition of Mental Health
Mental health is …having the capacities of:
The ability to develop psychologically, emotionally,
intellectually and spiritually
The ability to initiate, develop and sustain mutually satisfying
personal relationships
The ability to become aware of others and empathize with
them
The ability to use psychological distress as a developmental
process. HAS, 1995)
6. 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)
7. Young People’s View of Mental Health
The young people identified five main factors as contributing to mental health:
Having people to talk to
Personal achievement, and
Feeling 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)
8. The Continuum
Mental Mental Mental Mental
health distress health illness
difficulty
Emotional Emotional social
Wellbeing and behavioural
difficulties
9. Classification of mental disorders
Emotional disorders
phobias, anxiety states and
depression
Conduct disorders
stealing, 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
10. Classification of mental disorders
Eating disorders
pre-school eating problems,
anorexia nervosa, bulimia nervosa
Habit disorders tics, sleeping problems, soiling
Post traumatic syndromes
Effects 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
11. Prevalence
One child in five (around 20%) display a mental health problem.
10% of children have diagnosable disorder
Greater in the upper age group
Level increasing over time (for some disorders)
Differences across ethnic groups
Differences between family types
Variations with household income
17. 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
18.
19. 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
20. 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
21. 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
22. Risk Factors in the Community
• Social-economic
• Disadvantage
• Housing problems
• Disaster
• Discrimination
• Other significant life events
• Neighborhood conflict
• Deviant peer group
23. 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
24. 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
25. 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
26. The Resilience Rucksack
• This resilience rucksack contains symbols of
ordinary magic which represent schools as
therapeutic communities
27. 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
28. 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
29. 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
30. 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
31. 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?
32. 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
33. • You can’t change children’s lives but you can
help them to cope with the life they have
34. 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
35. 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
36. 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 family
Look to other agencies for interventions eg Educational Psychologists or
Education Socal Workers if anxiety is about school, social workers if about home
life
37. 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 based
Teaching relaxation
Help children talk through their anxieties using drawing or play
38. 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 depression
Ensure 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 response
Encourage them to remain active
Praise all efforts
(Royal College of Psychiatrists, 1999; YoungMinds)
39. What helps - Hyperactivity
Learn about hyperactivity and what it means
Give structure and encourage regular routine
Give clear instructions, sufficient time to complete tasks
Provide a variety of physical activity
Reward any achievements
(HASCAS, 2004)
40. What helps – conduct disorder
All approaches are grounded in respect for the child
Empathy, attention and involvement, play, problem-solving, listening, talking.
Praise any achievements and reward them
Encouragement
Clear limits and consistent rules with consistent follow-through
Ignore negative behavior, distract from negative behavior (positive verbal
redirection) and use re-engagement strategies
Remind of expected behavior and warn of consequences
Use consequences
41. What else helps children’s and young people’s mental
health?
Adults being self-aware
Feeling helpless/angry/rejected
Learn from your experiences
Respect their view even if an alternative adult view is presented
Understanding
Them
Their peer group
Their developmental stage/age
Their life circumstances
42. What else helps children’s and young people’s mental
health?
Listening
Actively
Open questions
Warmth and empathy
Take account of cultural issues
Never promise to keep a secret
Child protection procedures
Emotional language
43. What else helps children’s and young people’s mental
health?
Boundaries
Knowing what they can and can’t do
Be consistent
Expect challenge
Skill Development
Enabling children and young people to improve their mastery of stressful
situations
Editor's Notes
Resources for this activity a pack with an A4 continuum and five case study vignettes for each group ( there are 30 copies of this in the mental health cupboard) Participants read the case studies and then decide where on the continuum each of the young people should be placed. I have amended the case studies. Teaching point – mental health distress is a normal response to upsetting life events – we all benefit from support and encouragement to learn how to manage difficult events Our ability to manage difficult events is an interaction of our resilience( which is a learned aspect of our personalities), the support we have available and the extent to which we have other complicating factors in our lives. When we experience mental heath distress to the extent that it impairs our functioning over a prolonged period of time, and affects our ability to manage the day to day challenges of life then we have a mental health difficulty – if mental health difficulties go unaddressed then they could develop into a mental health illness. Teaching points : Mental Health is not a fixed personality trait – although there may be aspects of genetic heritage Our mental health is an interaction of life events, our personality, and the support we receive to help us to deal with slings and arrows of outrageous misfortune Some children will be much more vulnerable because of their life events – others because of within child factors – sometimes it may be school that has an adverse impact on a child’ mental health Some children will overcome difficult life events and will move from mental health difficult to mental health again – others – if more negative events occur or if they don’t get help, acknowledgement and support, will remain locked into mental health difficulty – for some people this permanently afected lives – not able to apply themselves purposefully, not able to form relationships , dependent upon maladaptive coping strategies which control their lives. Others may develop a mental illness – anxiety becomes agoraphobia – difficulty with relationships and self regulation becomes psychopathology- disordered attachments may become borderline personality disorder
Ask participants to build a living brain using the cards Expalin that CYP whose lives are uncertain – who deal with a high degree of change or who have insecure attachments or who are vulnerable for specific reasons are much more likely to
You can read these at leisure I don’t intend to read these outloud – they are self explanatory and you know them. It’s why nursery school teachers often know which are the kids who will turn out to have difficulties by their teenage years. However, conversely we don’t want to label kids – we can pick out and build on their resilience possibilities
Actually as we go through it I think some of you will find that it’s helpful to think about your own resilience and the things you can do to manage your own mental health and to build your resilience Ask volunteers to come out to the front and pull something out of the resilience rucksack. Ask other volunteers to explain why the item might help to build resilience
Building in strcuture and predictability helps children to feel secure. Lots of our kids needs to be taught this as they don’t have anyway of learning in chaotic homelives. We can help them to think about short and long term goals – we can help them to do some strategic planning. Breaking down big challenges into small ones is a way of doing this e.g if you want a kid to stop abusing everyone – set a target of greeting 2 members of staff politely each day! Teach kids how to use their plans it’s not an innate skills – and do it at the begniing of a lesson so it has value and time – not in a rush at the end Model planning and thinking aloud – model how to negotiate challenges – whether it’s dealing with a learning challenge or a social challenge
Children need to learn and need to succeed. Providing mastery learning experiences where the child experiences success is one of the cornerstones of building self efficacy. Self efficacy relates to our beliefs about our ability to manage the challenges and opportunities that life throws at us – it also gives us the chance to achieve some positive outcomes in a difficult world. You may not know how to protect your mum from being battered by your stepdad but being able to start and finish an activity – and to achieve recognition for it builds a sense of competence We know that children are unlikely to tell us if something is wrong with direct questions – but if we show we notice and care then some important information might come out. For example – saying to a child that you have noticed she hasn’t handed her homework in for two weeks might lead her to explain she is too busy looking after younger siblings because mum has been sectioned – Asking about being very withdrawn from groups of kids she used to work well with might indicate that she has withdrawn from all social contact. Saying you have noticed a boy looks tired might mean you find out he hasn’t been sleeping because he is worried about his Dad in Afghanistan –or in prison. You are giving postive attention – showing care and concern. This gives you a chance to focus on the school work which can be a welcome relief but also to acknowledge if they have too much to bear – you can suggest that you refer on to the skilled helping team
Talk about attachment – healing relationships with adults who know them and show they care about them are powerful. At times of change this is especially important – Some children don’t have the emotional resources to form an attachment – they have never had a safe figure so the first task for them is to learn to trust e.g. AN who was slowly building a relationship with one of your wonderful TAs Make it safe – judge how far to go At a Place to Be, the charity run by Camilla Bhatti……….. they use ‘corridor counselling’ because the CYP are too fragile and suspsicious to be able to bear the intensity of a one to one relationship Transitional objects which an adult gives a child can be a tangible reminder that you are ‘holding them in mind.’
Have a word of warning here that we should be respecting each other – that is the fundamental prerequisite of an emotionally healthy environment – Try to get people thinking in terms of their own actions this is personal policy not school policy – it could include things like knowing everyone’s name – not writing homework up at the last minute so the kids who struggle have no cahnce of getting it down – it could be about not gibing a label to a child and never looking beyond – saying things to kids that confirm a bad reputation – only noticing the negative – talking but not listening
It would be great if you are able to recognise your own good practice and that of your colleagues – recognising it and making it explicit helps to build on it and embed it. It helps weave it into the core fabric of the school. Try again to get people thinking about what they do themselves to make a difference Sharing a joke – helping children to achieve – giving them a chance to learn something new – knowing their name – making sure you say something positive about each kid at least oce a week – notice small things – a new hat – concentrating for one sec – a good answer-
