Children’s Mental Health and Emotional Well-being in Primary Schools

Colin Howard, Maddie Burton, Denisse Levermore

• Publisher: Learning Matters
• Year: 2019
• ISBN:
  9781526468246
• Edition: 2
• Topic: Education
• Subtopic: Elementary Education

Many teachers feel overwhelmed and lack confidence when it comes to dealing with mental health and emotional well-being of children these issues in their classrooms. This text supports schools and teachers to develop strategies to enhance the importance of mental health and emotional well-being, to work on preventative strategies and to support children when they need more intervention. The new edition of this important text is now updated to include coverage on the impact of early life experiences on children?s mental health as well as more on the influence of technology and social media. This second edition also comes with a new ?critical thinking? feature that encourages students to reflect on these issues. It outlines lots of effective strategies for working with children who are struggling to manage the school day and offers advice for engaging meaningfully with parents. The final chapter ?Who?s looking after who?? reminds the reader that schools should seek to support their staff, as well as their pupils.

1 Mental health and emotional well-being

Chapter objectives

By the end of this chapter you should be aware of:

• what we mean by whole school approach in relation to emotional health and well-being;
• how schools can help;
• common psychological and mental health problems affecting children and young people;
• origins and prevalence;
• impact of early-life and adverse childhood experiences (ACEs) on children and young people’s mental health;
• being curious about any change in children and young people’s behaviour;
• changes in behaviour may be context-specific or about a potential emerging mental health problem;
• the importance of getting a balance and not always pathologising and medicalising children and young people’s behaviour;
• some presenting behaviours can be considered ‘normal’ when the context is understood, so the ‘context’ beyond the child may require attention;
• being mindful of children who live in difficult circumstances, including looked-after children, refugees and asylum-seeking children;
• treatments, interventions and therapeutic approaches;
• changing and rephrasing the language we use.

Teachers’ Standards

This chapter supports the development of the following Teachers’ Standards:

• TS8: Fulfil wider professional responsibilities
  • Take responsibility for improving teaching through appropriate professional development, responding to advice and feedback from colleagues.
  • Communicate effectively with parents with regard to pupils’ achievements and well-being.

Introduction

This chapter will consider aspects of child and adolescent mental health with a brief overview of some of the most common presenting problems, together with consideration of the role schools and teaching and educational staff can play. Although eating disorders and self-harm tend to occur from age 11 and on through adolescence, a short description has been included in the chapter. Other important considerations in relation to child and adolescent mental health, such as self-esteem, risk and resilience theories and their application, are explored in Chapter 4.

The No Health Without Mental Health strategy (Department of Health, 2011 a) stated that over half of lifetime mental health problems begin to emerge by age 14, and three-quarters by the mid-20s. Where it arises mental ill health really is a concern, at what should be an optimum time of life, requiring appropriate supportive responses and interventions. These children and young people are in our schools, often when mental health problems are emerging. Good mental health is the foundation of healthy development. But having mental health problems early in life can have adverse and long-lasting effects (Murphy and Fonagy, 2012; Young Minds, 2018). Teaching staff and other school staff are the professionals spending the most time with children and young people – more than any other professional group – and are well placed to notice any behaviour changes which may indicate a problem (Weare, 2015). School is a major part of children and young people’s lives; they spend over a third of their time in school, meeting and making friends there, and teaching staff play a large part in their development (Royal College of Psychiatrists, 2016, p11). A parent advocate aptly stated:

My daughter trusts her teacher more than anybody … As they get older that trust becomes even more precious … They are going to talk to their teachers. School is a unique opportunity but … there is [also] an awful lot of pressure on teachers.

(Menzies et al., 2018, p22)

We have a ‘window of opportunity’ because of the progressing and continuing developmental aspects, unique to children and young people, for offering early help and support so that lifelong outcomes can be improved.

The Pursuit of Happiness report (CentreForum Commission, 2014, p36) and the House of Commons Health Committee (2014) recommend that teaching and educational staff should receive training in child development, mental health and psychological resilience so that vulnerable children and children at risk can be identified. The CentreForum Commission recognised that teachers are not mental health professionals but they should have skills of recognition and know how to access help and when to refer to Child and Adolescent Mental Health Services (CAMHS). Other recommendations in the report include a requirement for the National Curriculum to include teaching on children and young people’s mental health and improving their resilience.

The topic of child and adolescent mental health is now frequently featured in the media and is the subject of political debate. Future in Mind: Promoting, Protecting and Improving Our Children and Young People’s Mental Health and Well-being (Department of Health, 2015) set out the findings and recommendations of the Children and Young People’s Mental Health and Wellbeing Taskforce. It firmly sets a whole-child and whole-family approach, promoting good mental health at the earliest ages and moving away from only thinking about mental health from a clinical position. It acknowledges the role schools are already playing in supporting pupil mental health and that this needs to be further developed by earlier identification of issues and early support.

In 2017 the government set out its commitment: Transforming Children and Young People’s Mental Health Provision: A Green Paper (Department of Health, Department for Education, 2017). This was followed in 2018 by: Government Response to the Consultation on Transforming Children and Young People’s Mental Health Provision: A Green Paper and Next Steps (Department of Health and Social Care, DfE, 2018). It firmly shifts the lens on to schools in terms of early recognition of potential mental health problems with a commitment to designated senior leads for mental health in schools, mental health support teams and a 4-week waiting time for access to specialist CAMHS. £1.4 billion has been set aside to support the School Designated Lead and Mental Health Team, although only reaching one in four schools by 2022–2023. This is a timely reminder that CAMHS represents under 1 per cent of the total NHS budget and that the Green Paper commitment only provides for one in three children and young people able to access specialist support, thus leaving two out of three reliant on others or with no support (RSA, 2018).

Teaching children and young people how to improve their resilience should be a whole school approach with the promotion of emotional health and well-being embedded into the culture and core business of school settings. Promoting and supporting the emotional well-being of the whole school community is noted as very important given that educational staff have high rates of work-related stress. (CentreForum Commission, 2014, pp32–33; Weare, 2015). The MindEd e-portal was introduced in 2014 as an online electronic resource for professionals interested in child and adolescent mental health and provides clear guidance on children and young people’s mental health, well-being and development. Mental Health and Behaviour in Schools (Department for Education, 2018) proposes that a whole school approach should pervade all aspects of school life, including the culture, ethos and environment, teaching and partnerships with families and the wider community.

In 2017 the Prime Minister Theresa May announced a commitment to improve mental health and well-being, including mental health first-aid training for all secondary school staff with an additional emphasis on improving mental health in the workplace for staff (British Association of Counselling and Psychiatry, 2017). Again in 2019 Theresa May unveiled a plan for all new teachers to be trained in identifying early signs of mental illness but questions remain over resourcing such a plan (Ward, 2019).

Prevalence

Public Health England (2015) identified that in an average class of 30 15-year-old pupils:

• three may have a mental disorder;
• ten are likely to have witnessed their parents separate;
• one may have experienced the death of a parent;
• seven are likely to have been bullied;
• six may be self-harming.

These figures in 2015 were based on the previous prevalence study (Department of Health, 2004), so the most recent 2017 statistics are likely to indicate an increase in those areas. In November 2018 the Mental Health of Children and Young People in England, 2017 report was published (NHS Digital, 2018), announcing that one in eight (12.8 per cent) children and young people aged between five and 19, surveyed in England in 2017, had a mental disorder. This is an increase from one in ten (10 per cent) in the previous published research in 2004. Emotional disorders for 5–15-year-olds showed the most significant increase over time whereas all other types of disorder have remained stable.

Under-fives were not included in the previous 2004 study (Department of Health, 2004). For the first time 2–19-year-olds were included in the 2017 study (NHS Digital, 2018). Findings showed that one in 18 2–4-year-olds were identified with at least one disorder, with boys more likely than girls to have a disorder. Research has suggested that 50–60 per cent of children showing high levels of disruptive behaviour at ages 3–4 years will continue to have these problems at school age (Murphy and Fonagy, 2012). For primary-age children the figure rises to one in ten. At a House of Commons round-table event a parent advocate stated: My ...

Table of contents

• Cover
• Half Title
• Acknowledgements
• Title Page
• Copyright Page
• Contents
• About the authors
• Acknowledgements
• 1 Mental health and emotional well-being
• 2 Promoting a whole school approach
• 3 Children and young people’s behaviour What is being communicated and how should we respond?
• 4 Self-esteem and resilience
• 5 Bullying
• 6 Social media, cyberbullying and body image
• 7 The influence of family mental health
• 8 The need for inclusion
• 9 Who’s looking after whom?
• Index