2. I have a range of different experiences
in the field of mental health, both
through my work as a learning
disability support worker in adult
services, and through my voluntary
work with charities. I am currently in my
final year of a primary teaching degree
at the University of the West of England
(UWE) and feel very strongly about
how mental health is viewed. I want
to encourage an open dialogue about
it because I think our mental health is
as important as our physical health. I
wrote this booklet because I feel there
is a serious lack of information and
training on the subject for teachers.
I wanted to create an easy to follow
resource which is clear and gives good
information and advice to teachers
- because I know how precious time
can be working in a school. I couldn’t
have done it without the support of
UWE, Laura Brain at Off the Record
(Bristol), and Matt Daniel from Young
Minds. I hope you find this a useful and
This booklet is about
the mental health
and wellbeing of
children, specifically
in the school context.
Its main aim is to
offer suggestions on
how best to support
children vulnerable
to developing mental
health issues and
stimulate discussion
on the subject of
mental health among
professionals in
schools
WHO IS THIS
BOOKLET FOR?
1.
3. role to take on but something which
is likely to be part of your professional
practice already.
What is mental
health?
Mental health is difficult to define
and is generally associated with
negativity. It is often confused with the
term ‘mental illness’, but in fact mental
health is primarily about the ‘health
of the mind’ (Wilson in Prever, 2006).
Rather than focusing on the presence
of illness, it is generally agreed that to
view mental health in a more positive
light and be supportive to those in
distress, we must start look at our
mental health in the same way we
have come to think about our physical
health –as something that changes
and needs care and attention.
interesting read, and that you’ll share
and reflect upon it with others.
Katrina Slater – author (21)
“Katrina has been an outstanding
volunteer who has shown a
great amount of passion and
determination to see this project
through. We are all extremely proud
of her work and impressed with
what she’s achieved.”
Laura Brain - Young People’s
Participation & Rights Worker at Off the
Record (Bristol)
This booklet is for pre-service or in-
service professionals who work with
children and young people in schools.
Schools have an important role in
supporting pupils’ mental health as they
see the children five days a week and
are well placed to recognise changes
in mood or behaviour. Supporting
children’s mental health is not another
2.
4. REFLECTIVE POINTS:
• What is your understanding of
mental health?
• Where does this understanding
come from?
• How far do you think we have
come in ending mental health
discrimination?
• What experiences have you had
with mental health? Do you think
this affects your view of it?
What about children and
young people’s mental
health?
For schools, a central concern is the
impact poor mental health (including
that of parents and carers) can have on
a child’s educational attainment. A child
cannot learn or progress if they do not
feel safe or happy in their environment,
and their psychological and physical
needs must be met before they are
able to study to their full potential.
Good mental health can be
recognised by our ability to:
• Manage our emotions well
(expressing both the negative and
positive).
• Be resilient to life’s challenges,
(bouncing back from adversity).
• Build strong and supportive
relationships.
If someone is not coping with life well
it can seem like a constant battle,
and their negative thoughts, feelings,
and behaviours can get in the way of
them leading the life they want. For
some, the inability to cope and an
unwillingness to access help (because
of stigma) can soon spiral into a more
serious condition.
Mental health
can be explained
in terms of an
interaction
between:
5. interest in school life
• Struggling to deal with failure and
criticism
• A difficulty managing own
emotions (e.g. tearful)
• A difficultly accepting issues and
moving on
• A withdrawal from social activities
and friendships
• Low self-esteem and self-image/
respect
• An increased or decreased
appetite
• Tiredness in class
• Mood swings
• Attention-seeking behaviour
It can be difficult to know whether
the behaviours being expressed
are an innate part of an individual’s
personality or part of a mental
health problem. A child may
appear hyperactive on occasion,
and withdrawn and shy at other
times. They may have difficulty
concentrating in class but have
As education professionals, our role is
to support children and young people
to become self- aware and promote
their well-being. We also need to
recognise poor mental health in
students, and know what to do in these
instances. As well as this, we need to be
aware of those children who may be at
risk of developing poor mental health.
How can we be alert to
signs of poor mental health
in children?
There are no definitive criteria or
checklist you can ‘tick-off’. Every child is
an individual, and their circumstances
and presentation will be unique to their
experience. Some common signs that
children and young people may need
extra support include:
• A lack of concentration during tasks
• A lack of motivation and/or loss of
4.
6. Diagnosing a mental health
problem in children and
young people.
Diagnosing a mental health problem
is not the same thing as diagnosing a
physical health problem. There are no
objective scientific tests to determine
the existence of mental illness, only
symptoms (behaviours, patterns) that
professionals try to cluster together in
order to make a judgment about what
is going on – the diagnosis.
A child or young person may present
with signs of a mental health disorder,
yet formal diagnosis may never
happen. This could be because the
signs were not recognised, were not
present for long enough, or did not
disrupt everyday life significantly.
Moreover, children’s brains are still
developing well into late adolescence,
making psychiatrists and other mental
health professionals reluctant to
diagnose.
built many good relationships with
classmates. If a behaviour presents
no difficulty for the child or others,
then is any action required? It’s also
important to consider the young
person’s wider environment at home
as well as school, because an event
like a family bereavement or divorce
will undoubtedly impact upon a
child’s wellbeing in the short and
sometimes long run.
The most important thing we can do
as teachers is notice; to pay attention
to our students’ behaviours and
moods over a period of time and be
aware of any changes in these.
REFLECTIVE POINTS:
• In your view, what kinds of
behaviour would be a sign that a
child needs support?
• Would these always be
behaviours that disrupt others?
“If a behaviour pre
difficulty for the ch
then is any action
5.
7. Working in a school, it may be difficult
to judge behaviour as ‘normal’ or
‘abnormal’. Most children will have
an occasional outburst of challenging
behaviour, but only a few will have
a mental health problem. Labels are
powerful tools, and we should be
mindful of the impact they can have on
a child’s education and life chances.
With the immense pressure schools
are under to do well in league tables,
mental health problems (including
behavioural and conduct disorders)
may be overzealously used to justify
poor results in some way, and children
may all too quickly be moved or taken
out of the classroom.
esents no
hild or others,
required?”
6.
8. for noncompliance. Think about the
intention and experience behind the
behaviour. If you think it is because a
child wants attention, then ask yourself
why they might want that attention?
REFLECTIVE POINTS
A conduct disorder is an identified
mental disorder which can be
described as a general rejection
of rules and expectations, with
involvement in anti-social and
disruptive behaviour. To what extent
can or should this be regarded as a
mental health issue, or simply a child
learning how to behave? Who should
decide this?
Reflecting on behaviour problems you
may have dealt with in school, what
could have been at the root of these?
Could the child in question have been
covering emotional struggles?
How might your school’s behaviour
policy affect a child with mental health
issues? How might a strict and ‘one size
fits all’ policy cause problems?
The behaviour of children with
an underlying mental health
problem may be disruptive or non-
disruptive. It is not the case that
only ‘bad’ behaviour is evidence of
some problem, although disruptive
behaviour is undoubtedly more
difficult to manage when it is
affecting the learning of the rest of
the class. Research by Loades and
Mastroyannopoulou (2010) found
that behavioural disorders were
more easily recognised by teachers
and received more support than
emotional disorders like depression
and anxiety. While they concluded
that this is due to the disruptive
nature of such behaviours in class, as
teachers we should also notice the
quiet and withdrawn student, who
may be quietly struggling.
It is important to build up a good
knowledge of and relationships
with the children in your class. If
a good relationship is not there,
behaviours can easily be mistaken
BEHAVIOUR AND
MENTAL HEALTH
7.
9. REFLECTIVE POINTS:
How might you teach about mental
health to children? What would you
include, what would you not include?
How can you support the
child of a parent with
mental health issues?
The child of a parent with mental
health issues may experience
emotional neglect, and this can
in turn affect their emotional
development. Parental bonds may
be disrupted, be unreliable, or in
some rare cases be non-existent,
impacting on a child immensely.
The child or young person may be
taking on extra responsibilities at
home, such as looking after siblings
and other aspects of family life. This
might lead to additional stress in their
lives, as well as complicated feelings
It is well known that children have vital
basic needs that must be met if they
are to feel physically and emotionally
safe, happy, comfortable, and ready
to learn. Poor mental health is likely to
have a negative impact on motivation,
confidence and ultimately academic
achievement. A child with mental
health problems may have unrealistic
expectations of themselves, experience
difficulty accepting failure, and may
‘punish’ themselves for not doing
well. The problems they experience
might also affect their ability to
make friends and view school as a
positive, lively, social environment. The
early identification of mental health
problems are then crucial to a child’s
academic potential and attainment.
A significant way to reduce the impact
on academic achievement and learning
is to actively teach children about their
mental health, encouraging them to
understand their thoughts, feelings
and actions, and become emotionally
literate.
How does mental health effect
educational attainment? How
can we make sure that a child
with mental health issues
does not ‘get left behind’
academically?
10. they are automatically a bad parent.
Everything depends on how well the
parent is currently managing their
mental health and if they are receiving
adequate support.
How can your setting take a
whole school approach to
mental health?
The first and most important thing
is being open about mental health.
Promoting the idea that mental health
is closely linked to - and as important
as - physical health is essential to
creating a school culture that promotes,
notices, and supports mental wellbeing.
A positive whole-school approach
to supporting mental health also
recognises the importance of access
to the curriculum in encouraging
each student’s personal and social
development. The school will also
value the teaching of mental health to
children, and have strong relationships
of shame, anger and anxiety. Young
carers sometimes try to hide what life
is like at home as they realise it is not
the same as their friends.
The best way to help is to know
how (in your role) you can focus
on the child’s well-being and listen
actively to what they tell you. No
one is expected to know everything.
Instead, draw upon the specialist
knowledge of other professionals.
Work in partnership with specialist
organisations, develop good
relationships with parents whenever
possible, and learn what is available
in your area so you can signpost to
services.
Understandably, it is never your role
to tell a parent how they should be at
home, but sometimes safeguarding
concerns are more important than
being seen as interfering. Of course, it
is just as important not to jump to the
conclusion that because you know a
parent has a mental health problem,
9.
BE OPEN ABOUT
MENTAL HEALTH
11. How can I support a
child with mental health
problems or those at risk
of developing problems?
RESPONSIBILITY
Some might see their role as
more limited to teaching subject
knowledge, and may worry
about assuming further pastoral
responsibility. The Department of
Health outlines responsibilities of staff
working with children and young
people relating to mental health in
the National Service Framework for
Children, Young People and Maternity
Services (2004). They describe the
need for school staff to play an active
part in promoting mental health and
intervening early, as well as working
effectively with CAMHS and other
multi-agency teams. Both teaching
and non-teaching staff are in a good
position to recognise mental health
and good communication with families.
Mental health will be addressed in
school policies (with a particularly clear
policy on self-harm) and procedures
will be clearly stated so that teaching
and non-teaching staff know their
responsibilities and what to do. In any
policy, the rights of the child should be
actively promoted, and principles of
confidentiality should be clearly stated
so that staff know what can be shared
and with whom. These policies need
to be communicated or accessible to
pupils.
REFLECTIVE POINTS:
• What examples of good practice
relating to supporting children’s
mental health have you seen in
schools?
• Why do you think people may not feel
comfortable talking about mental
health in a school environment?
• How might you encourage others in
school to be open about their mental
health?
10.
12. issues in children, but you need to
know when to pass information or
concerns on so other professionals
and services can be brought in. If
there is a mental health issue there is
no simple ‘fix’ and the student is likely
to need support in all other areas of
their life.
Avoid jumping to conclusions and
taking on problems where it is
not your responsibility to do so.
Remember to signpost young people.
Treat each case individually, with
sensitivity and a non-judgemental
attitude.
Avoid stereotyped views or rigid
ideas about mental health issues.
Mental health problems are actually
relatively common (as many as 1 in 10
young people are affected by them
according to the national charity,
YoungMinds).
RESILIENCE
Help children to build their resilience
to the challenges they face. Some
children are better able to cope with
adversity in their lives, but all children
can learn and nurture their resilience.
RELATIONSHIPS
A teacher or learning assistant
could be one of the most important
11.
13. people in a child’s life – someone
they respect, trust and look to for
support (particularly if they do not
experience these at home). Having
a good relationship with pupils is key
to understanding changes in their
behaviour and encouraging them to
talk to you if they are struggling.
MODEL
Modelling positive mental health
is very important. This does not
mean being a happy, wonderful
or perfect person. It means being
aware of your thoughts, feelings and
behaviour, and understanding how
these are connected. Demonstrate
you are proactive in looking after
yourself, managing your stress, and
show resilience in difficult situations.
Encourage your students to do the
same, and talk to them about mental
health.
Get children to ‘Check- in’ and
‘Check- out’ by asking them how they
are feeling at the start and end of the
day. ‘Buddy up’ children you know are
experiencing difficulties and would
benefit from having someone to be
there for them and cheer them up
from time to time.
REFLECTIVE POINTS:
What would you consider to be your
main role and responsibilities as a
teacher in supporting children with
their mental health?
12.
14. 13.
RESOURCES:
‘Alone With My Thoughts’ is a report
by Mindfull that sets out the results
of a nationwide survey of young
people’s mental health:
http://www.mindfull.org/static/mf/
pdfs/alone_with_my_thoughts.pdf
For some practical ideas on how to
build resilience in children and young
people look at:
http://www.boingboing.org.uk/
For up to date information on children
and young people’s mental health
and wellbeing try:
http://www.youngminds.org.uk/
http://www.otrbristol.org.uk/
http://www.barnardos.org.uk/
Websites on mental health in general:
http://www.mind.org.uk/
Mind Health Charity
http://www.time-to-change.org.uk/
Department of Health led campaign
to reduce stigma of mental health.
Backed by a lot of public figures and
a lot of ways to get involved with
active volunteering to break down
stigma.
The ‘Mental Health Handbook for
Schools’, by Mary Atkinson and Garry
Hornby (2002) is full of great ideas.
So too is Mark Prever’s (2006) book,
‘Mental Health in Schools: A Guide to
Pastoral and Curriculum Provision.
Research Journal Article: Teacher’s
Recognition of Children’s Mental
15. 14.
Health Problems Maria E. Loades &
Kiki Mastroyannopoulou. Child and
Adolescent Mental Health Volume 15,
No. 3, 2010, pp. 150–156
Department of Health (DoH) policy
Making Mental Health Services more
effective and accessible:
https://www.gov.uk/government/
policies/making-mental-health-
services-more-effective-and-
accessible--2#actions
Department of Health (DoH)
(2004) National Service framework
for children, young people and
maternity services Policy- teacher’s
responsibility with children’s mental
health outlined – Standard 9.
Department for Education and
Skills (DfES). (2003) Every Child
Matters: Summary [online]. London:
Department for Education and Skills.
Available from:
https://www.education.gov.
uk/publications/standard/
publicationDetail/Page1/DfES%20
0672%202003
Copies of this booklet available upon
request if you would like some for
your workplace or organisation.
Practical workshops based on this
booklet are also available. For all
enquiries please email:
katrinaslater91@hotmail.co.uk