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

[MumsnetGuestPosts]

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 did mental health first aid training a couple of years ago. It's a very good course (mine was 2 days) and I would recommend it to anyone who is given the chance.

It's not intended to replace NHS mental health services any more than general first aid courses are intended to replace paramedics and A&E. What it can do is give you the skills and confidence to provide initial help to someone who is experiencing a MH crisis or who comes to you in distress, while guiding them towards sources of help.

The idea that teachers must talk about MH every day is ridiculous. Teachers having the confidence to talk about MH in an everyday manner (i.e. outside the context of special lessons and assemblies) would be a much better aim.

Totally agree with Saintly. CAMHS is on its knees in this county, you could double the staff and they'd still be hugely over caseload. The threshold for referral has become ridiculously high totally negating early intervention.

Labour do this a lot. Promote everyone coming out of role, a job blur where everyone does everything to cover up the lack of the real necessary services being chronically understaffed and struggling, and it leaves unqualified people to do things they are not trained or qualified to do with highly vulnerable people, while their own core brief gets more and more dilute and neglected. Teachers teach. That's what they do. CAMHS already have this role, are trained, are brilliant at it when they have enough staff and funding to do it properly, just put the resources into the existing services.

Plenty - your two daytraining course was no doubt great, but it can't come anywhere close to enabling you to make skilled interventions into mental health. Imagine turning up at the psychologist's office to be told your appointment is with the person with two days' training! I'm pretty sure you'd be wanting to see someone else. And what about everyone else on the staff? Do they all get two days? Or do they get a couple of hours of you training them on inset?

I have a first aid qualification that was two days training. I know a tiny bit more than most people without any training. The only reasons I feel confident taking action as a first aider are a) I am very unlikely to make things worse in the vast majority of incidents I am ever likely to encounter; b) in the event of a really serious problem anything I do is at best a stalling mechanism. CPR is very unlikely to save someone's life if the ambulance doesn't get to them very quickly indeed; c) there is legal protection for first aiders (a samaritans clause) which means that should any of my actions, taken in good faith, cause harm I cannot be held legally responsible.

The same cannot be said of intervention into mental health.

Of course it can! Apart from c, which I don't know about.

This is the whole problem with mh. This shying away, fearfulness, belief that a wrong word will be catastrophic.. these are all distorted beliefs that have the capacity to do FAR MORE HARM than they have the capacity to do good.

Plenty's course basically offers some guidance in first responding, the same way as a first aid course does for cardiac arrest. It's not a mental health intervention, any more than CPR is heart surgery.

The alternative is this terror of saying the wrong thing.. how does that look to someone in distress? If someone is intensely distressed and reaches out to you, and you shy away, what does that do? It reinforces every harmful belief they have about themselves.

Would you comfort someone in distress? Most people will say yes.
Would you comfort someone with mh issues? Many people will say no.

You know that they are actually the same thing? Mental illness is mental distress, it's just distress where the causes are not immediately observable by those around the person, where the distress is predominantly internal, related to private events, as it were. What do people think it is? What harm is it that people are fearful of doing?

So, I have a cousin with schizoaffective disorder, meaning he has very severe psychotic symptoms from time to time. Should I never speak to him at a family event in case... what? When he blanks or freezes mid conversation should I... run away screaming?

The vast majority of people that this sort of first aid refers to are not going to be even nearly as severe as my cousin in presentation, they will be people suffering from anxiety and depression, OCD, PTSD and others. No one is asking ANYONE to be able to do some sort of skilled psychological risk assessment. It's about being open, being present and doing what matters - which is just being there, being kind, listening and directing to appropriate help.

Plenty said it best:
"The idea that teachers must talk about MH every day is ridiculous. Teachers having the confidence to talk about MH in an everyday manner (i.e. outside the context of special lessons and assemblies) would be a much better aim."

I think the legal protection for first aiders is to protect them from being prosecuted for assault. I can't see anything in MHFA that would necessitate that.

Website here.

Would you feel differently if it could BossWitch? Because wrt your first two points, there really isn't much difference as far as MHFA is concerned. Courses like these can be very helpful when it comes to clarity over the roles and responsibilities under existing legislation. l'd also imagine many schools already have safeguarding policies if a child was presenting as suicidal?

Pubes, I didn't take the "every day" comment to mean anything

Posted too soon and will have to finish that sentence later.

The other thing is, if you work in schools and come across a child in crisis, no amount of funding of CAMHS or NHS or whatever will change what you do in THAT moment.

I work in a secondary school and we have had a number of students who have CAMHS intervention and some who have designated EBD profiles etc. While it's undoubtedly true that CAMHS would be better placed to support these students, when it all kicks off at 2pm on some random Tuesday, there isn't always a crisis team to hand and even if the service was all singing, all-dancing and could be summoned up for a child that was previously not known to their service with parental consent within 20-30 minutes to attend at school, there's 20-30 minutes there that someone is in intense, acute distress where it's helpful to know what to do and to avoid causing further harm to the person by acting as though they are crazy and shying away from them because of your own discomfort (which most of us WILL feel, it's conditioned in our culture).

Do you think the first time this ever happened, at which point we didn't even know one particular student was experiencing issues, that we automatically knew what to do and how to do it, there and then? How many school staff could or would? MHFA is there for THOSE times, which are by nature, unpredictable.

You can be trained in the basics in 8 hours to 2 days. You're not acting as a clinician, you just have some basic, basic understanding for this particular type of circumstance, which so far has happened to me three times in my work. It's similar to learning how to handle a disclosure. We hope never to need that knowledge, but it is so important.

I know there are too many initiatives. I know teachers are asked to be all things to all people. Yet if you had to ask me what would I personally value more in my work with young people, knowing how to support their literacy in Science subjects or learning manual handling or moderating AFL documents or knowing how to respond in a mental health crisis, I know that mental health responding would be really high up on my agenda.

Beautifully put duplodon.

And I don't feel the need now to finish my sentence as you basically covered it.

Duplodon, I would love to have some training in how to respond appropriately to a child in a mental health crisis, or with mental health issues. That's not what teachers are objecting to in this thread.

We are objecting to being apparently charged with responsibility for children's mental health. That we should be teaching the kids about various mental health disorders and performing amateur diagnoses of things like bipolar disorder. That we should become the front line.

Of course I already do things like look out for signs of self-harm, eating disorders and depression and flag up students to pastoral support if I think there are issues. This term I have already filled out a couple of mental health questionnaires for students that I teach. I am happy to support them with any information I can provide, and will act on any advice I am given. I don't want to be put in a position where instead of flagging up a student for intervention that I'm supposed to dive in there myself.

What noble said!

I don't think anyone is asking or expecting teachers to be performing amateur diagnoses of things like bipolar disorder or diving in there with a full intervention.

Noble, I think there will be many teachers who, like you, "look out for signs of self-harm, eating disorders and depression and flag up students to pastoral support if I think there are issues." But equally there will be many who feel out of their comfort zone, unsure what to do, if what they have done is effective or not, etc, so it is great it is recognised on this thread that some training around this might be helpful.

As far as helping to educate our children is concerned, forgive my ignorance on the depth of the curriculum (it's been a while since I was there!) but this is making me wonder if aspects of Mental Health could be incorporated into the Biology Curriculum? As far as I am aware, children study the nervous system, immune system, effects of viruses etc; could this also be an opportunity to visit and cover basics around how the brain and mind works? Effects of too much/too little seratonin etc, the names of some common MH conditions, debunk some myths about mental health issues? Just as this might cover conditions such as diabetes or Parkinson's disease? Or does this happen already?

I don't think teachers should have to take full responsibility for our children's mental and emotional health, but they can play a part in raising awareness and educating about issues. And, like many aspects of learning, it should be a partnership between school and home, supported by experts in the field. That's what I mean by working in conjunction.

But I would have to agree, that without central support, or it being viewed as an alternative to good mental health care or absolution of parental responsibility; poor execution in the exisiting dire state of CAMHS, will do nothing but add further stress to our teachers.

I totally agree with the sentiment that there needs to be a lot more focus on the mental wellbeing of children and young people, and that part of that should be through education. However, I also agree with the many other teachers on here that this can not be addressed just through schools.

I am not 'reluctant' to talk to my students about mental health - I am completely unqualified! I have had one 20 min training session in my 7 years in education! Even if it were more, I will never be a mental health professional. I can be trained to spot warning signs and give initial support, but mental health is a complex issue and needs to be addressed by professionals.

We do need more training, but there also need to be much wider support systems in place, better referral systems, much more investment in NHS mental health services for young people and support and advice for parents and carers - they see and know children far better than anyone else.

I feel some of these comments have been a little harsh and critical and I do applaud your efforts. I just think we need to (and hope we can do) much more than just tackle things through school.

(I also think it's sadly ironic that we want to get away from one off, tokenistic efforts, but this says it's been published as part of Children's Mental Health Week - as if this isn't an ongoing issue?)

I agree totally with you Charlotte except I believe there should be AT LEAST one teacher trained in every school including Primary School. In my case my son was in year 6 when anxiety began....please if anyone else agrees then sign and share my petition to the government to fund schools for approx 300 pounds to train one member of staff in mental health first aid.

www.change.org/p/nicky-morgan-mp-make-mental-health-first-aid-training-mandatory-for-at-least-one-teacher-in-every-primary-and-secondary-school-in-england

Your post is absolutely spot on. That is why we need at least one teacher in every school trained. As a simple helper on hand for kids in crisis (or maybe not in crisis just needing understanding and a bit of support).

Signed Perfect.

Thanks WhistlingPot

whistling you asked about what already happens and I feel that most of what you talk about happens within the scottish PSHE curriculum. We talk repeatedly about good mental wellbeing and how to maintain it as well as how to know if it seems less good.

While I really do understand the ire of fellow teachers being asked to do yet one more thing (it feels like we are responsible for the world at times) there are schools who currently do much of what the post talks about. Of course every lesson doesn't need to 'cover it'. It should be part of your methodology in the class and ethos as a school

Just out of curiosity does anyone follow the OP on Twitter? I find it very interesting. She is very directive in what she thinks is right, and yet refused to take feedback from anyone else; openly 'names and shames' people she disagrees in and, in my opinion, engages in direct and indirect cyber bullying. I would not engage her to support on training people to support mental wellbeing. Which is a shame, actually, as some of her points would be really valid if she handled herself more appropriately.

I don't follow her but have trawled back a few hours. She seems to be firmly of the view that some parents don't want to, or are unable to, support their DC adequately in this area. I agree with her and I can't see where she's been nasty to anyone. Cyberbullying is quite a strong accusation.

I agree totally with you Charlotte except I believe there should be AT LEAST one teacher trained in every school including Primary School. In my case my son was in year 6 when anxiety began....please if anyone else agrees then sign and share my petition to the government to fund schools for approx 300 pounds to train one member of staff in mental health first aid.

This is another case of people wanting a magic wand, when no such wand exist.

At least one teacher trained in every school?

There is no such training, that would qualify a teacher for this, there is no possible time for anyone to do it in, record it in, set it up in a school, ( and the set up would be massive, financially and in terms of time, the paperwork generated alone would be impossible to manage, on top of everything else) there is no benefit, there is just scope for more policies, more paperwork, more demands on staff, more responsibilities, more for ofsted to check the paperwork on, and more blame, without benefiting a single child in any way what so ever.

A few hours?
I've been following her for nearly 2 years. I feel I am justified in my statement, however hard that sounds. I wish there were more people suffering with mental health issues speaking up and trying to act; I find her way aggressive any very directive.

Mental health can be affected by everyday life. People with mental health problems can present very differently in different situations and occupation can affect both positively and negatively a persons well being. Children are at school 5 days a week, 38 (ish) weeks of the year.

I think mental health could be brought in to lots of subjects. The history of how the state has "cared" for people with mental health problems, at home locked away, in asylums, the move to community care, the current lack of beds in hospital and how children in this country are still being sent to police stations when they are I'll, the affect that skunk has on the brain and increase in psychosis amongst skunk users probably a good one ( I remember debating cannabis use at school, what an interesting topic.)

At primary level simple techniques for managing anger or conflict. The OP has bi polar, I think people that have experienced the world of mental illness should have a voice because from my perspective ( have a family member with bi polar) as someone who has visited institutions since I was 6 years old, nothing will get better unless everyone looks on mental health in the same way as physical disability.