Guest post: 'The odd assembly isn't enough - teachers must talk about mental health every day'

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Mental health support for under-18s is in the spotlight. A shocking lack of beds for young people and cuts to child and adolescent services have led the Labour Party to describe the current situation as a "scandal of neglect"; it is pledging to prioritise child mental health, including training teachers to spot the warning signs.

Had this been the case when I was a child, my bipolar disorder may have been recognised. I developed my first symptoms of bipolar at 11, my first depression at 12 and first suicidal thoughts at 13 - yet I wasn't diagnosed until adulthood. That sounds shocking, but it's not uncommon. The Office for National Statistics found that approximately one in ten young people will have some form of mental health disorder - around three pupils in every class - while a study published in the Archives of General Psychiatry found 50% of adults with a mental illness experienced initial symptoms by the age of 14.

This is why we must get mental health on the agenda in secondary schools.

Talking to my teenage son reveals the worrying lack of education around mental health. Ask him what he's been taught and he's pretty scathing. He says that it rarely gets a mention, and when it does, there's too much emphasis on problems like exam stress. Having received treatment for anxiety and depression in Year 12, he's pretty clued up on the subject and gets frustrated, knowing that adolescence is when people can start to develop much more complex conditions. "They mentioned Stephen Fry, but they didn't even say what bipolar was. There must've been kids sitting in that hall who needed to hear about the more serious stuff," he told me, and he's right.

Eating disorders are especially prevalent in the upper years of secondary school; a recent study in the British Medical Journal found that ages 15-19 is the most common time to develop anorexia or bulimia. Self-harm, often a coping strategy that points to other underlying problems, is also common. Selfharm UK suggest that around 13% of those aged 11-16 will deliberately harm themselves at some point.

Less common problems can also show up in adolescence, anxiety conditions such as obsessive compulsive disorder (OCD) or panic attacks. In every school there will be a few, probably undiagnosed, cases of bipolar disorder or psychosis. And sadly, around 600 15-24 year-olds take their own lives every year – enough to fill a small secondary school.

Teachers must get to grips with the fact that some of their pupils will already have diagnosable problems such as clinical anxiety and depression. Discussing mental health issues may mean staff have to venture out their comfort zones, and nobody can blame them for being reluctant or anxious when asked to talk about it - as a society we're only just becoming comfortable talking about depression, never mind suicide or self-harm. It's tempting to wheel out celebrities. But starting a conversation about Stephen Fry without explaining what bipolar is, or bringing up YouTuber Zoella but not discussing how to help with a panic attack, means a wasted opportunity.

Learning about mental health is learning for life. As young people move into adulthood it's exciting to start work or university, leave home or have a first serious relationship - but major life changes can also be stressful, and can lead to anxiety or depression. This phase of life is also the most likely time for bipolar or psychosis to appear. We need to equip our children with knowledge about these conditions early, so that they're able to spot potential problems and seek help before they escalate.

The best way to support kids is to support teachers, by improving their knowledge of conditions and treatments and giving them confidence to talk about mental health. As a Mental Health First Aid instructor, I work with teachers to achieve this, giving participants with no prior knowledge the skills to support others in mental distress.

Supporting young people's mental health cannot be done via the odd PHSE lesson or a one-off assembly on World Mental Health day. It's about creating an environment in which staff have the confidence to talk about mental health every day. Stigmatising words like "psycho" or "schizo" need to be challenged, as do phrases like, "she's so bipolar" or "OCD, much?" It's about a cultural change, not just offering support or spotting symptoms, and the best place to begin a society-wide shift in attitudes is in schools.

I disagree , bipolar is not something that should be diagnosed in children,adulthood is the appropriate time.

Mostly people need compassion, recognition as a human being, kindness...

Yes, I agree. However the OP is suggesting that we give them lessons on bipolar disorder, which is different.

The best place to begin a society wide shift in attitudes is in schools

No it bloody buggering isn't. It's in the NHS. The underfunded, overstretched NHS where the model of community mental health care is simply not working. One of my best friends has been in an acute crisis for the past three years and apart from meds (which are keeping him alive) and the community crisis team (excellent but they are there to also keep people alive and then pass them on to regular services) his care has been non-existent.

Don't get me wrong, I'm grateful for the meds and the crisis support, but for him to get better he needs tailored, intensive help which he's not getting.

Schools dicking around with the odd buzz word here and there wouldn't have 'caught' him, or 'saved' him when he was at school, and it won't save him now.

Honestly, mh has been done a huge disservice by the idea that a foot out of place and someone's mind will cave in. Mostly people need compassion, recognition as a human being, kindness

If someone cannot give this naturally, it is just not in them. It can't be taught!

This brings to my mind, the utter fucking idiot pe teacher, who forced my dd to run 800 metres, after the ligaments in her knee failed.

He either could not tell the difference between crocodile tears and tears borne put of extreme pain - or he did not care.

My dd had never been in any trouble at school. Top set pupil, didn't lie, didn't evade lessons, yet he subjected her to enduring incredible pain and potential lifelong damage.

Fortunately, a teacher with 'compassion and kindness' rescued her but not before she'd hobbled and cried over halfway through, with a knee cap put of place!

This is a bloody pe teacher! Who should have a reasonable understanding of sports related injuries, because it is related to his subject.

Can you imagine the damage someone like that could do

...to a sensitive mind?

My dd had never been in any trouble at school. Top set pupil, didn't lie, didn't evade lessons, yet he subjected her to enduring incredible pain and potential lifelong damage. ...meaning he really had no reason to disbelieve her.

Really, it's up to parents. Even if a teacher suspected something wasn't quite right a school surely can't do anything without parental consent.

I remember many years ago a doctor suggesting to my mother I see a psychologist as I was obviously unhappy and nobody knew what to do. My mother dragged me out saying that I wasn't mad. With hindsight I was depressed but my mother saw it as a failure on her part/my part, who knows.

There is a stigma attached to any mental health issues. Maybe teachers can help by talking about mental health in schools to help reduce the stigma attached but at the end of the day what happens about a child's mental health depends on the parents and the NHS.

As a teacher of PSHE (amongst other things, obviously) I can talk about mental wellbeing, resilience, self-esteem, knowing that it is ok to get help and where to get help from.

What I do not want to be doing is devising a list of mental illnesses and covering them week by week just to out the fear of God into the kids.

As a pastoral care teacher my day to day is working alongside children, their parents and the various hcp who support children. It is my job to keep subject teaching staff informed of how best to support pupils, I can provide time outs and strategies to assist and I can feed in to the therapist's work by having an overview of that child.

I can't see that more can be asked of me than that

My son has had anxiety issues which resulted in anxiety in school and negative behaviour in school. With the help of CAHMS and others and once the teacher had clear, appropriate strategies for dealing with issues then his issues literally disappeared. Teachers should have mental health training. CAHMS lady said that 1:4 children have mental health issues at some point. That is a lot of children. I think there would be a lot less conflict in the classroom if teachers were more skilled / trained in specific issues.

cherriesandapples - is there no limit to the number of specific issues we are supposed to be skilled/trained in? Do people not realise that the most uptodate skills/training in many issues is often virtually worthless anyway?

I don't think a one size fits all approach is needed. But targeted training on specific issues would surely help? A whole school approAch to mental well being is surely a positive thing? In different areas different things may be required.

I can maybe see that working in a primary school more cherries.

There is nothing wrong with having a general ethos of support and trying to educate about certain words and negative uses. That would normally happen in PSHE anyway. Actually, I can't see many schools not talking openly about stress, anxiety, good mental wellbeing and such like.

Cherries, no it wouldn't. you are being totally unrealistic.

And I meant to say that I hope your DS is well

Perhaps the best solution would be for each secondary school to have a student counsellor / welfare person on hand, as this obviously can't be the responsibility of teachers. That would require funding of course...

Thanks, he is well. I think evidence is growing about whole school occupational therapy interventions targeting co ordination handwriting problems etc.. And brief alcohol interventions in the work place so I can see specific interventions in schools working, with the support if specialist staff.

here we go again with "specialist staff", there are really no such thing, just staff who have done one version of the latest training in whatever, which will contradict the other version, and contradict the last version, and contradict the next version. I've been the ASD "specialist staff member" in two separate schools with diametrically opposing views on the education and management of children with ASD, and i have never met two dyslexia specialists who agree on anything.

The public have this myth that there are somehow special magic wands that can perform miracles, and if only staff have the right skills, training or specialism, they will be able to wave them. the magic wands do not exist.

evidence? don't get me started on what passes for "evidence" in an educational setting.......

I'm saddened to read the reaction this OP has got, I really am.

I totally get that teachers are completely over-stretched and under-resourced, I really do. I come from a teaching family and have many friends and relatives who are teachers.

But I don't think that qualifies the teaching profession to turn their backs on the importance of their part in helping to break down stigma and taboo of mental illness, particularly in childhood, and working in conjunction with appropriate services towards better ways of achieving this. In exactly the same way as mental health awareness in the workplace, and across society, has increased over the years.

But yes, there does definitely need to be central support so that in doing so, it does not become the straw that brakes the camel's back, particularly for individuals on the educational front-line. That would be counter-productive.

Well done OP, I completely support where you are coming from with this.

But it ISN'T our job! You can't just pluck more and more and more and more responsibilities out the air and pile them onto teachers. Teachers are walking out by the thousand as it is. And you reckon we are turning our backs on the importance of taking our part in breaking down the stigma of MH, it isn't our part to take!

you might as well ask why bus drivers aren't playing their part, or leisure centre managers, or pest control agents - because it isn't their job, not is it ours. It is nothing to do with us.

There are many sectors of society who see improving awareness of MH issues as part of their role, including bus drivers and railway staff, for example, in the same way as 1st Aid for physical issues, disability awareness etc has increased over the years.

I think the OP is being misunderstood. I feel she is asking teachers to model change that is needed in society in challenging a culture which stigmatises and perpetuates mental distress; not asking for detailed mental health issues to be added to the curriculum, or for teachers to be trained to diagnose mental illness. I don't think it has to be that onerous, but I can understand that is might feel that way, given the existing pressures.

And I'll repeat my earlier point that there does definitely need to be central support so that in doing so, it does not become the straw that brakes the camel's back, particularly for individuals on the educational front-line. That would be counter-productive.

The OP states she is already working with the teaching profession, it would be interesting to know more about this, and what they have, between them, found.

I quite agree hijk. I find it extraordinary that in a school setting, where teachers are not considered qualified to give a student a paracetamol or a plaster, we are considered qualified to wax lyrical about mental health problems. I wouldn't dream of trying to explain how to reset a child's broken arm, why on earth would I try to explain how to recognise or alleviate depression?

I do think that teachers should show compassion and sensitivity to students with mental illnesses, of course I do, but it sounds like Labour would like us to do a bit more than that. When would we fit in "talking about it every day"? or "working in conjunction with other services"? What does that even mean?

When a student presents themselves as suffering with anxiety for example, I will acknowledge that they are unwell, refer them to the pastoral team or school nurse as appropriate, and I will check that they are receiving professional and parental support. I will take advice from parents or medical professionals on how to help them manage their anxiety in relation to my class. I will be accommodating and kind. I don't really see how I am qualified to do any more than that, nor do I see how a short training course would qualify me to do more. And a training course wouldn't free up any more time for me to do any more to help anyway.

The article is absolute rubbish. The parents role has been completely overlooked and undermined. Equipping parents with extra skills and education would be far more beneficial to children, surely?

I far prefer the Green Party's intention to abolish extensive testing of children and introducing optional flexischooling. Those actions in themselves, would reduce stress upon pupils and teachers and see an overall improvement in the mental health of children, IMO.

Schools have become a ghastly machine which does not have the time or inclination to care for children as individuals. Having read the posts by teachers here, it is clear it is not they who are at fault.

The issue as I see it is that CAMHS is on its knees. My son needs an urgent referral to CAMHS. His teachers have recognised that & are doing what they can to speed that process up. As is his paediatricisb, as an I. We are getting nowhere - 18 week wait for urgent referrals here. And in the meantime he's dangerous.

Don't blame the teachers - there are no mental health services to refer to.

I genuinely care about my students. As a high school teacher I taught on average 150 children a day. But do you know who knows them better? Who knows when its just puberty, relationship strife , a hangover or genuine medical mental health issues ? The people they live with. When I had a concern I spoke to these people. Sometimes they did nothing. Sometimes we tried and because of poor child mental health provision no help was available. But am I responsible and qualified and equipped with access to services to help every child with emergent mhn? No. Am I happy to listen ? Yes. Am I happy to raise awareness? Yes. Am I happy to help a parent/carer to find a local service provider? Yes if there is one. But there are limits to what teachers can and should do. The parent needs to take the lead on this one.Really.