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Always be mindful

One in ten of our children will experience significant mental health issues in their lives. So, what role should mental health play in the modern classroom - and why? We ask some experts for their perspectives

So, what role should Scottish health and wellbeing play in the modern classroom - and why? We ask the protagonists for their perspectives.

The panel:

Graeme McGregor, Campaigns Officer, Scottish Association for Mental Health

Brian Donnelly, Director of respectme, Scotland's Anti-Bullying Service

Catherine Henderson, Development Officer - The Place2Be - Scotland

Janet Westwater - St Margaret Mary's Secondary School - Janet achieved professional recognition from GTC Scotland for her work in the field of health and wellbeing.

Wendy Grindle - Learning and Teaching Scotland

What role do you feel health and wellbeing plays in the modern classroom?

GM - We're very pleased that the Curriculum for Excellence focuses prominently on health and wellbeing. In providing mental health services, we frequently see how mental health is bound up with a person's physical health, their attitudes and their ability to cope with the pressures of daily life. By making these connections clear to children and young people, teachers can ensure that their students are better equipped to stay mentally and physically healthy in later life.

That said, we're not convinced that teachers are getting enough support or training to equip them to teach about health and wellbeing, and particularly about mental health. This creates a risk that children and young people will be denied the information they need about mental health, and it puts additional stress and pressure on teachers, who are expected to teach about something they may have little knowledge of or training in.

BD - Children are resilient, often more than we give them credit for, but we need to make sure that their mental and emotional health and wellbeing is at the heart of everything we do. All our activity should be underpinned by this. That means giving them the skills to recognise when they're maybe not as happy as they could be, or recognising when something's not quite right with others in their peer groups.

Relationships are very important, from an early age and schools and families need to strive to create environments where children can develop the skills to negotiate and navigate these. The impact of friendships not working, or them being used against children can be huge. Environments that foster respect and consideration rather than 'everyone needs to be friends'.

CH - Teachers have a crucial role to play in developing the minds of children. They serve to develop children's academic potential as well as to enhance their social competence and emotional well being and mental health. In order to do this adequately, they need a wide range of practical, emotional and social support.

The majority of children are able to attend school and co-operate with and respond well to the learning process. There is usually a significant proportion, however, who have difficulties in concentrating and behaving appropriately, largely because of emotional and family problems. All too often, these children bring these problems into the classroom. Teachers need to be aware of the pressures that they are living with, to know better what they are in the midst of emotionally in the classroom and to know what is reasonable for them to be able to do and not to do in their roles as teachers.

Teaching staff tell us that supporting the emotional needs of children in their classroom has become more complex. At The Place2Be we see a wide range of children struggling with troubles, from worries over friendships, to family breakdown, to families with drug and alcohol issues. Unfortunately many of the families and children we see are challenged by social and economic deprivation, living chaotic lives and experiencing daily traumas that prevent them from looking at life with a sense of hope. Our mission is to improve the mental health and emotional wellbeing of whole families, of whole school communities, and ultimately of the adults of tomorrow.

JW - Health and wellbeing has a big part to play in the modern classroom. It is now everyone's job to make sure that there is a health and wellbeing input into every classroom. It is now running along literacy and numeracy in importance. Scotland is ground breaking when it comes to this input and especially with child obesity in Scotland every school has an important part to play in educating pupils in the importance of healthy living.

WG - Evidence tells us that learners learn better when their physical, social and emotional needs are recognised and addressed. Health and wellbeing in Curriculum for Excellence is the perfect vehicle to deliver this covering Mental, emotional, social and physical wellbeing; Planning for choices and changes; Physical education, physical activity and sport; Food and health, Substance misuse and Relationships, sexual health and parenthood. If we focus on developing our children and young people's health and wellbeing they will achieve far more in everything they do. The health and wellbeing of staff is obviously very important too.

Why is instilling a sense of mental health and wellbeing in students important?

GM - Children and young people have stresses and pressures to deal with, such as bullying, sexual identity, exams and deadlines. The benefits to teaching mental health and wellbeing to children and young people are numerous.

One in ten young people will have a mental health problem severe enough to require professional help and the chances of developing a mental health problem increase as young people enter adolescence. Young people are also at a high risk of self-harming - 14% say they have self-harmed at some point. Without proper training and education, teachers and other students will not be able to recognise such problems or provide the support that pupils need.

We also need education to tackle the ongoing stigma and discrimination associated with mental health problems. Such negative attitudes and beliefs are prevalent among young people - 40% of children would not want anyone to know if they had a mental health problem - so it is vital that schools become a place where young people can feel comfortable talking about mental health problems.

There are also broader benefits to promoting good mental health in schools. Numerous studies show that early intervention and prevention of mental health problems in children and young people, through education and support, can avert more severe problems developing in adulthood. Not only does this have economic benefits, as the cost of treatment is avoided, but it prevents the damage that mental health problems can inflict on a person's life.

CH - With over half of all future adult mental health problems starting in childhood before the age of 15, instilling a sense of mental health and wellbeing in students has never been more important. Through working in over 170 schools, providing a universal service for all 58,000 children in these schools, group sessions, support to teachers and intensive 1:1 therapeutic support to children with more high tariff needs - our aim is to give children the chance to explore their problems and challenges through talking, creative work and play. When children are happier and less preoccupied with problems, they are able to learn, and their educational chances are improved, with knock-on benefits throughout their adult life.

JW - In this high powered stressful world that we all live in. It's important that our pupils understand how to deal with the stress that jobs and live can throw at us. The mental and emotional wellbeing outcomes in the curriculum for excellence are in place to help every child in Scotland develop a stronger mind and for them to become more confident in their own decision making by knowing their own minds.

WG - The experiences and outcomes in mental and emotional wellbeing are about equipping children and young people with the skills they need for life, learning and work. These interpersonal and intrapersonal skills include, resilience, decision-making and the ability to form positive relationships. Everyone with each learning community shares the responsibility for creating a positive ethos and climate of respect and trust which will allow young people to flourish. This could be in the way they interact with each other both in and out of the classroom. Good relationships are key in sustaining positive mental, emotional and social wellbeing.

Do you have practical examples where work you have been involved in (esp. with students) in this area has made a lasting difference?

GM - The respectme anti-bullying programme, managed by SAMH and LGBT Youth Scotland, is one of the key ways that we support adults who work with children and young people in schools. You can read more about respectme elsewhere in this issue of Teaching Scotland.

In addition, we have carried out work with children and young people through the "see me" campaign, which works to combat the stigma associated with mental health problems. "see me" worked with Positive Mental Attitudes on their curriculum pack for use in schools in Scotland, which has been shown to significantly improve the attitudes of young people towards mental health problems.

BD - In 2008 respectme embarked on an anti-bullying project with students from St Margaret Mary's Secondary School in Glasgow, which looked at the difference between fear and respect. The resulting drama, Andy's Story, tells the story of a young boy who is being bullied at school and the choices he makes. The young people involved reflected that the workshops and discussions they held to inform the story had a real impact; it made them think about their own behaviour and how it might make others feel. The story was so thought-provoking that we filmed the drama and sent a DVD to every secondary school in Scotland. It's also an online resource that is being used by other Scottish schools as the basis for discussion about bullying behaviour and how it can impact on children and young people. The young people involved also went on to receive a National Diana Anti-Bullying Award. The young people involved reflect on this experience very positively and tell us how their thinking and behaviour has changed.

CH - Steven* lives with his mother and is in the final year of primary school. He has been attending The Place2Be as part of a long-term intervention following a drive-by shooting three years ago, which left him with a gunshot wound in the back of his head. Following the shooting, Steven received counselling for post traumatic stress disorder at his local hospital, but wasn't able to engage with the service successfully before being discharged. Since then Steven has struggled to concentrate. He has often fought with other children and is underachieving. More recently, Steven has become socially isolated and subdued. He is fearful of one pupil in particular and reluctant to go into the playground. As a result, school staff members have voiced concerns about how he will cope with the move up to secondary school. Weekly counselling with The Place2Be is providing Steven with a safe space in which to explore his feelings about past and current experiences. After just six sessions, Steven's counsellor and teacher have both observed a significant change in his wellbeing. He is already more sociable and better able to voice his worries, and he is becoming increasingly secure and confident.

* All names have been changed

JW - As part of my project leadership for Glasgow City Council and GTCS professional recognition for Health Promotion, I ran 2 health and wellbeing days focused on health and wellbeing outcomes. Pupils took part in active alternatives to what they may not have tried before. The main objective of the days was to engage pupils in health activities, with the view that they would start to look differently at activity and themselves.

I key example is after introducing S3 boys to a British Military Fitness session, 1 pupils has started to attend gym sessions on a regular basis, and I was able to gain 'Big Lottery Funding' for extra sessions as this type of fitness was so popular, this is now being run, once every two weeks after school by British Military Fitness and has been extremely popular with boys and girls.

Likewise girls got a taster in the health days on the hugely popular Zumba craze that is sweeping the nation. This proved a great hit with girls so I have since been able to work with the Active Schools Co-ordinator to provide an after school class once a week for girls.

WG - Please see LTS website for examples of emerging practice - Health and wellbeing curricular area and also Supporting Learners - Supporting wellbeing.

Money is tight. Isn't it time to focus on more practical issues?

GM - Promoting and supporting mental health in the classroom is a practical issue. By using mental health education to tackle, for example, stress and bullying, we can create a happier, more productive environment for students - this isn't just good for the students, it's better for teachers as well.

Particularly with spending on everyone's mind in the current economic climate, it's important to note that investing in the mental health of children and young people is beneficial for society. Research shows that early intervention in the mental health of children, through education and support, improves a child's chance of avoiding social and economic deprivation in later life. Through education and support, we can reduce a young person's chances of poor educational achievement, long-term unemployment, financial difficulties, criminal conviction and drug and alcohol problems.

When you look at it this way, we can't afford not to invest in the mental health of children and young people.

BD - Taking a practical approach to this is crucial and there are a number of free resources that can be used to facilitate discussion with children and young people. The respectme website has a range of publications and online resources that can be used to initiate a ten minute discussion or develop a full drama performance. It doesn't have to be time consuming or costly, but it's important to give children and young people the opportunity to reflect on and discuss how they're feeling.

This is something we need to do, children regularly reflect that bullying is one of their major concerns and in responding with creative ways where we are engaging and including children and young people, we can address an issue that can significantly impact on health and wellbeing.

CH - It makes no economic sense not to focus on health and wellbeing. Through economic impact modelling we know that for every £1 spent on our service we save £6. These savings are across a range of services including reduced use of health and social work, special educational support, criminal justice costs, welfare benefits and of course the cost of impact on families and carers.

Headteachers of the schools we work in consistently tell us that our support prevents children from being excluded. The cost of a child being excluded long term from school is estimated at £20,000 to the education system, £68,000 to society as a whole given the long term implications resulting from exclusion. We need to invest in early intervention and take it into everyday settings where children and families are. In schools, in children's centres, into our local communities. It's important for us all to champion the mental health needs of children and families, and in ways that give a clear return on investment.

Our evaluations consistently show that children who start the year with profound anxieties and who are helped by The Place2Be end the school year with their state of mind significantly clearer and therefore more able to access their learning and achieve their potential.

JW - Money is tight but now is the time to become creative. It is time we look to our staff to see what they can bring from outside their own subjects to the Curriculum For Excellence. I am a drama teacher with a passion for exercising, the gym and running. So it was logical for me to think outside the box. For example I took a girls running club in May/June with a build up to the women's race for life 5k in Glasgow. What an achievement for all the girls taking part not only physically but mentally to have gained an achievement such as completing a 5k. For many they had not run before.

WG - Developing Health and wellbeing is a practical way to support the nation's future health and prosperity; by teaching our children and young people to be physically active, mentally well and make positive choices about food, relationships and substances.

If money is tight, schools working with partners to plan programmes for learners is an excellent model and these partners can often support school staff to develop sustainable models of delivery. Delivering effective programmes for Health and wellbeing involves schools and partners reflecting on pedagogy and being creative about approaches to learning and teaching.

What resources, support or advice would you point teachers towards if they are embarking on this?

GM - SAMH is involved in a number of mental health campaigns that do excellent work with schools. These include the "see me" campaign against stigma and discrimination and respectme, the anti-bullying programme, both of which are funded by the Scottish Government. You can find more information about these campaigns and the resources they provide through their websites.

BD - respectme offers free training, resources, advice and guidance to individuals and organisations across Scotland to give adults the confidence and skills to deal with bullying behaviour. To find out more, visit www.respectme.org.uk

CH - Teachers often feel overwhelmed by the complex health and wellbeing needs of the children in their classrooms, in recognising this, The Place2Be has developed a range of training programmes which are tailored to the specific needs of school staff working with primary age children. Based on experiential techniques of learning, The Place2Be training equips school staff with skills, expertise, awareness and theory which greatly improves their ability to relate to children and manage difficulties in a school setting. The Place2Be training consists of both specialist one-day workshops concentrating on particular issues and ongoing accredited (Open College Network) training for any professionals working with children. All trainers are qualified and experienced therapists or counsellors and the programmes are based upon years of experience of delivering training and supporting our own staff and volunteers to work to the very high standards set by both The Place2Be and schools themselves.

JW - For any teachers embarking on the new health and wellbeing outcomes in the curriculum. I would recommend using the health and wellbeing committee/working group and asking them to collate an audit of health and wellbeing across each curriculum area.

I would defiantly recommend a health day focus, even for 1 day every so many months, to continue to refresh the ideal and keep it to the front of everyone's focus.
Use the pupils council to help the school decide what activities and events can be held.

WG -

•The LTS website and Glow
•NHS Health Scotland
•The superb work already out there in our early years centres and schools
•Professional dialogue across schools and clusters is essential for understanding progression
•Working with partners such as health boards, the police, voluntary and charitable organisations

Anything else you'd like to add?

GM - SAMH has just launched a range of new training and consultancy services. These are great for teachers and include training on mental health awareness, as well as more specific courses such as suicide prevention. You can find full details of the training available on our website.

BD - A key message that underpins our work is that, 'You don't have to like me, agree with me or even play with me… but you do have to respect me'. Respecting someone can just mean leaving them alone, we do not always need to 'connect' with everyone, if you do not like someone or disagree with them, then leave them alone, do not shout things at them, spread rumours or post messages on line.

CH - There is a need for teachers to have the opportunity to stand back from the demands of the classroom and to learn from each other how best to respond to some of the challenging situations that face them. This can be arranged in different ways. In The Place 2Be schools, our School Project Managers (qualified counsellors) who are based in schools offer what we call The Plac2Think for teachers to think over some of their experiences with children with whom they are having difficulty. The Place2Be is also piloting a similar service to teachers from other schools who do not have The Place2Be in them. We believe that a service such as this is in the interests of teachers being better resourced to enable children to learn and to manage misbehaviour when it occurs.

The Place2Be believes it is important that Teacher Training needs to include more input on child development and child emotional and mental health problems.

WG - There are many different approaches and materials that can be used in the development of children's mental and emotional wellbeing. There is not one resource or strategy that fits all. Leadership at all levels is essential to ensure that all practitioners have a shared vision of health and wellbeing and understanding of their own roles and responsibilities. Learners, parents/carers and other partners should also be included in careful planning and professional dialogue as this is key in the delivery of effective health and wellbeing.

ISSUE 38

January 2011