INSET - Monday 5th September 2016 Sue Plechowicz Mental Health – Identifying and Supporting Learners with Difficulties

Outcomes: By the end of the session you should: Have an understanding of what mental health disorders are Know how to help children to develop mental health well being Know how to identify when child may have mental health difficulties Know how to support children with mental health difficulties in school

What is Mental Health? Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. health.gov The strength and capacity of our minds to grow and develop, to be able to overcome difficulties and challenges and to make the most of our abilities and opportunities. Yong Minds, 2006

Mental Health in Childhood

28% of pre-school children face problems that have an impact on their psychological development One in ten 5to16yr-olds has a mental disorder At least 3% of children suffer from anxiety disorders but relatively few are referred for treatment. Meltzer et al (2000) Nearly 80,000 children and young people suffer from severe depression. Over 8,000 children aged under ten years old suffer from severe depression. Office for National Statistics, 2004 Facts and Figures

Children and Young Person’s Mental Health Taskforce - set up in 2014 to look at how to improve the way children’s mental health services are organised, commissioned and provided and how to make it easier for young people to access help and support, including in schools, through voluntary organisations and online. "I want to change the way we think about mental health care so that any child, whether they have a mental illness or simply need support through a difficult time, can get the right help at the right time," says Care Minister, Norman Lamb. March 2015

Teaching about Mental Health (Helping in the long term) The aim is to Increase awareness and understanding in order to: Give children a language to talk about their own and others’ mental health Reduce stigma, negative viewpoints and prejudice Reduce fear of the unknown Ensure they understand that recovery from mental illness is possible and likely Know how and where to get help when needed

What is Mental Illness? A psychiatric disorder can be classified as a change in behaviour, emotions or thought processes (the three main aspects of mental functioning), which is so prolonged and/or severe that it interferes with everyday life and is a handicap for the child or those who care for the child. (Pearce, 2003)

Mental Illness on a Continuum Resilient Vulnerable

Risk Factors  Gender – boys are more likely to be diagnosed with a mental health disorder than girls.  Socio-economic background – children from poorer families are 2.5 times more likely to suffer from mental health difficulties; community factors;  Intelligence – low IQ and Learning Difficulties place children at greater risk of low self-esteem, academic failure and therefore potentially mental health disorders.  Parenting – conflict, family breakdown, inconsistent discipline, poor relationships (e.g. attachment) and abuse are all factors affecting mental wellbeing.  Trauma – significant life events such as bereavement, homelessness, abuse and removal from family can lead to mental illness if not supported long-term.

Resilience - ‘Bouncebackability ’ “resilience is created when risk is reduced through protective mechanisms … (and) are helped to have a positive appraisal of their “self”…and believe in their ability to cope” (Young Minds Resilience Handout)  Gender – pre-pubescent girls are more resilient than pre-pubescent boys.  Secure Attachment, feeling secure and loved  Family – Being raised in family where parenting style is warm, nurturing with consistent discipline  Communication Skills – the ability to talk about emotions and express fears and worries  School – Being ‘connected’ in a positive way with peers, teachers and schools and being involved in activities  Planning, Problem-solving, Achievement – experiencing success, belief in control, good self esteem.

Teaching about Bouncebackability… How to bounce back when life delivers you a set back Ensure children and young people know that not all stress is bad eg a bit of adrenaline is good to enable high performance in sports /exams Teach Coping Strategies for times when things are not going well Help individuals to recognise their strengths Teach how to externalise the problem eg ‘Mr Meany’; ‘Boss the anxiety away’; ‘The Black Dog’ Problem Solve with them - Actively listen then ask what they would ideally like to happen; help them to think about all possible approaches Encourage rehearsal for how they would manage a stressful situation Teach relaxation techniques and deep pressure activities

Mental Health Disorders Anxiety disorders ◦ Generalised Anxiety Disorder GAD ◦ Phobias ◦ Separation Anxiety ◦ Social Anxiety Disorder ◦ Panic Disorder ◦ Obsessive Compulsive Disorder OCD ◦ Selective Mutism ◦ Eating Disorders Depression. Psychosis brought on by: Schizophrenia. Bi-poplar (Manic Depressive) Self-harm Post traumatic stress disorder.

‘Young people with Anxiety problems have ‘anxiety thermostats’ that are over- sensitive and ‘out of sync’ with the reality of the threat presented or remain on all the time’ – Carol Fitzpatrick, Helping Young People Manage Anxiety In anxiety, the main feelings are of insecurity or fear. As well as unpleasant feelings, anxiety can affect children in many other ways such as: Hyperventilating, rapid heart rate, dizziness, trembling, nausea, stomach aches, head ache, bed wetting, difficulty with sleeping, nightmares, tics and … Anxiety – What are the signs?

difficulty with concentration, difficulty with making decisions, becoming confused, going blank, distractibility, obsessively hard working, perceive work is not good enough, trying to fade into the background (too quiet), difficulty making and keeping friends, bullied physical or verbal aggression They frequently feel like they are ‘Going Mad’

Childhood Depression Depression occurs when sad feelings do not go away, and when they overwhelm a person and stop them from doing the things they normally do. Children and young people may show it in a different way to adults. The defining characteristic of depression, and what sets it apart from anxiety (and grief) is lowered self-esteem. Signs of depression may include: o Finding it hard to concentrate, losing interest in schoolwork and play o Refusing to go to school, o Constantly complaining of feeling bored or lonely, even when they have friends o Irritability and moodiness beyond the normal range o Tearfulness o Defiance or violent outbursts o Lack of confidence; low self esteem; blaming themselves if things go wrong o Disruptive behaviour at school, bullying, stealing or doing other things that lead to them being punished. o Becoming very withdrawn o Self-injury o Sleeping very little or too much o Younger children may appear to take backwards steps in their development, for example with toilet training or eating.

What can you, as a teacher, do to help a child with anxiety or depression?  Be positive – smile when you see the child, show that you are pleased to see them, make every day a fresh start.  Listen – take time to find out how the day is going, what happened at the weekend, why playtime went wrong etc. If “now” is not the time, tell them when will be!  Talk to them – share your thoughts and experiences, be honest and open when possible, share your fears and anxieties, talk as a whole class about emotions.  Notice but don’t question – ‘I noticed that you seemed a bit stressed this morning. Is there any way I can help?’

 Give ‘Worry Time’ ;  Have Worry Boxes and/or ‘Worry Eaters’ in classrooms  Help them to become more socially confident by praising everyday activities; choose them to take messages to others  Ask them to buddy another anxious child  Provide alternatives at unstructured times (eg board games; quiet areas)  Plan and encourage exercise & healthy eating (It is said that it can be as effective as medication) NB– these children should be at “On Alert” if not on the Record of Need and therefore should be monitored carefully with an appropriate system. Note any conversations that happen with regard to the child – SEN Code of Practice 2014

What else can be done to help in school?  Teach emotional literacy – explain the meaning of words like sad, depressed, upset, anxious (and happy, calm, safe etc) so that children can talk about their feelings appropriately.  Work with parents ; Pastoral Support Workers  Peer and adult mentors ; Trusted Adult whole school scheme  Time out and Quiet spaces; Nurture Group  Social Skills groups e.g. Talkabout, Socially Speaking, Circle of Friends  Book of Blobs; Draw and Talk; 1:1 therapy intervention  Encourage all children to identify, affirm, use and celebrate their strengths  Teach about Mental Health and Well Being

Teach children how to take care of their own mental health eg… 1.Connect. 2.Be active. 3.Take notice. 4.Keep learning. 5.Give. ( Five Ways to Wellbeing

Mental_Health_EasyRead.pdf website for bereaved children including social network resources for emotional literacy, social skills and anger management The Mental Health Handbook for Primary Schools – Belinda Heaven (Speechmark) Helping Young People Manage Anxiety – Carol Fitzpatrick ‘Worry Eaters’ – google for best prices! Book of Blobs ; Draw and Talk Websites, Publications, Books and Resources