Helping children with mental health difficulties COMPONENT

Acknowledgement of Country I would like to acknowledge the traditional custodians of this land and pay my respects to Elders past, present and future, for they hold the memories, the traditions, the culture and hopes of Aboriginal and Torres Strait Islander Australians.

Professional learning goals 4 Professional learning goals COMPONENT To understand Component 4 is not about teachers diagnosing students or becoming psychologists. To develop a shared understanding about mental health difficulties in primary school children. To provide a structured framework for gathering information about students who might be experiencing mental health difficulties. To understand the benefits of getting help early. To clarify the role of school staff in getting students the help they need. To increase knowledge of common mental health presentations and additional strategies to help these students in the classroom. To increase understanding of how the four components of KidsMatter Primary help students with mental health difficulties.

What is KidsMatter Primary? A national whole-school approach to mental health and wellbeing that aims to contribute to:

KidsMatter Primary professional learning Increase awareness and understanding of each of the four components Encourage ALL staff to have a voice in contributing to planning for each component

The KidsMatter Primary framework

The guiding principles The best interests of children are paramount. Respectful relationships are foundational. Diversity is respected and valued. Parents and carers are recognised as the most important people in children’s lives. Parents and teachers support children best by working together. Students need to be active participants. Schools, health and community agencies work together with families.

The four components of KidsMatter Primary

KidsMatter model for mental health promotion, prevention and early intervention (PPEI) in schools Whole-school community, staff, students, parents and carers, health and community agencies All students (and their parents and carers) Students experiencing mental health difficulties (20-30% of students) and the 3-12% of students with mental health disorders, and their parents and carers Works with the whole community and provides support and information to staff, parents and carers Through the curriculum, creates opportunities to practise skills and engages parents and carers Supports children in school and develops clear processes and referral pathways (by working with parents and carers and health and community agencies) Adapted from World Health Organization (1994)

An outline of what’s to come Session 1: Recognising children who are experiencing mental health difficulties Session 2: Getting help: Why and how? Session 3: Four component support plan

Session 1 Recognising children who are experiencing mental health difficulties

Mental health difficulties are… A very broad range of social, emotional or behavioural difficulties that may cause concern or distress. Relatively common. Sometimes transient, but also encompass mental health disorders that are more severe and/or persistent. Distinct from children’s normal reactions to stressful situations (though they may still require support). (Adapted from Everybody’s Business, 2001)

A continuum for mental health

Risk and protective factors for children’s mental health Risk factors – increase the chances of children developing mental health difficulties (for example, childhood adversities). Protective factors – are associated with good outcomes for children and can protect them in circumstances where they are exposed to risk.

Risk and protective factors for children’s mental health (adapted from Commonwealth Dept of Health and Aged Care, 2000 and Spence, 1996)

What causes mental health difficulties?

Thinking about your students Activity Thinking about your students Who are the children that you are concerned about? How many of these children are in a typical class? What are your concerns about these children?

Prevalence of mental health difficulties Estimates suggest mental health difficulties affect 1 in 7 Australian primary school children. National Child Mental Health Survey (Sawyer et al., 2000)

How might this be reflected in a classroom?

Thinking about your students Activity Thinking about your students List the most common things you observe in children who may be experiencing mental health difficulties, for example, they: are disruptive in class are often sad have difficulty making friends get bullied worry a lot have trouble sitting still.

Externalising and internalising Mental health difficulties can be observed as externalising or internalising. Externalising behaviours are more frequently noticed than internalising behaviours.

Externalising behaviours Typical behaviours might include: constant arguing with adults attention deficits / hyperactivity frequent temper tantrums hostility toward authority figures deliberately annoying others quickness to react to others (a ‘short fuse’) refusal to carry out requests or conform to rules.

Internalising behaviours Typical behaviours might include: being withdrawn isolation from peers excessive worrying being excessively fussy or perfectionistic being fearful or anxious often being upset (‘sensitive’) being shy or cautious with other people.

What to look for?

Why collect observations? Teachers are very good at identifying students who are experiencing mental difficulties (Dix et al., 2008). Collecting educational observations is part of what school staff already do. Collecting observations also helps: – address all aspects of mental health difficulties – provide evidence for your instincts – organise your thoughts – communication with other professionals.

Using BETLS Behaviour – what is the child doing? Emotions – what might the child be feeling? Thoughts – what might the child be thinking? Learning issues – what area of learning is the child having difficulty with? Social issues – what area of social functioning is the child having difficulty with?

Activity BETLS: Part 1 What do you notice about this child that concerns you? Try to separate your observations into the different categories.

What do we know about Sam? Activity What do we know about Sam?

What do we know about Maya? Activity What do we know about Maya?

Activity BETLS: Part 2 There are a number of other people that have observed Maya and Sam… What do you notice about the BETLS chart now? Is there any additional information that might be helpful to gather?

What now? Should I be concerned? The greater the concern… – The more symptoms/behaviours persist over time (> 2 weeks) – The more they are noticeable across different situations and contexts. – The more they interfere with functioning (for example, schoolwork, relationships) and cause distress to the person and others. The greater the concern… – Act on the side of caution. – If concerned, speak to someone at your school. – You do not have to act alone. At your school, what is the process for raising concerns about a child? Who do you talk to?

Summary Mental health difficulties are on a continuum. Behaviour can be observed as internalising or externalising. It’s useful to gather information from different people, over time and across situations (BETLS). It is important to discuss your concerns with the appropriate person – who is this in your school?

Session 2 Getting help: Why and how?

Key messages from last session Mental health difficulties are on a continuum. Behaviour can be observed as internalising or externalising. It’s useful to gather information from different people, over time and across situations (BETLS). It is important to discuss your concerns with the appropriate person – who is this in your school?

Mental health difficulties in childhood For many students, mental health difficulties are transitory and resolve over time, but they still benefit from support. For others, mental health difficulties can be distressing and may interfere with everyday activities and enjoyment of life over a longer period of time. Without help, many mental health difficulties can become progressively worse and further disrupt the child’s academic and social development.

Potential pathways and outcomes from childhood

Getting help is important because it… Minimises the negative impact of mental health problems. Reduces the chance of developing more serious mental health problems. Is easier to treat mental health problems at an early age.

Getting help… Improves children’s mental health and helps them to: – enjoy life – handle challenges – be better learners – relate to others in a positive way. Better mental health enables children to more successfully manage the transition to adolescence and adulthood, including having better prospects for employment.

Picking up the signs and doing something about it Schools and staff are well placed to help because they: know and understand their students through regular contact across a variety of situations are exposed to many children, so can identify signs that are concerning and not part of normal development can facilitate access, together with community agencies, to effective interventions. The goal is to prevent problems worsening and improve the child’s mental health.

How do you decide what to do? See next slide for details.

Methods of support

Referrals: A starting point Discussion Referrals: A starting point At your school, when a staff member has a concern about a child…

Referrals: Who can help? Professionals and services in the community who can help: * Increased access to private psychologists through Medicare. General practitioner Paediatrician/ child psychiatrist Psychiatrist Child and adolescent mental health services Non-government community agencies Counsellor Psychologist Social worker Occupational therapist Mental health nurse Community health centres

Supporting external referrals Discuss your observations of the child (BETLS) with the mental health professional. Make continual efforts to destigmatise mental health problems through positive attitudes. Encourage a help-seeking school environment. Support parents and carers: – Remember Components 1 and 3. – Continue developing collaborative working relationships. – Facilitate access to mental health information.

School-based strategies: Why do we need them? External referrals are not always necessary, accepted or available. Even when external services are involved, the best outcomes are achieved when children are also supported at school. Support provided at school can have a significant positive influence on children’s mental health. Particular strategies often work best with particular types of difficulties.

Signs and strategies Activity Read the common signs of five different types of mental health difficulties. Brainstorm strategies that may suit each type. Compare your list with KidsMatter Primary suggestions.

KidsMatter Primary supporting resources Component 4 information sheets, including topics: – Children’s mental health difficulties and how to get help – Children with depression – Children with anxiety problems – Children with Attention Deficit Hyperactivity Disorder (ADHD) – Children with serious behavioural problems – Children with Autism Spectrum Disorders Enewsletters www.kidsmatter.edu.au

Summary Getting help early: minimises the negative impact of mental health difficulties is about recognising signs of a problem and doing something about it involves decision-making by all staff regarding referrals, school-based strategies and mental health promotion.

Reflection Where to next? To help a child experiencing mental health difficulties… What is one thing I can do immediately? What is one thing our school can do to support these children better?

Evaluation outcomes Improvements to student mental health: – Increased positive mental health. – Reduced mental health difficulties. – Students experiencing mental health difficulties showed significant improvements in their mental health. 14% more teachers strongly agreed that KidsMatter Primary led to improvements in students’ schoolwork.

Component 4: Evaluation outcomes Teachers believed the school had improved its capacity to support students experiencing mental health difficulties. Teachers felt more capable of recognising students experiencing mental health difficulties.

Session 3 Four component support plan

Key messages from last session Getting help early: minimises the negative impact of mental health difficulties is about recognising signs of a problem and doing something about it involves decision-making by all staff regarding referrals, school-based strategies and mental health promotion.

Four component support Steps to effectively helping students Holistic support for children experiencing mental health difficulties

Component 1: Positive school community Belonging and connectedness Inclusion Collaborative involvement How does Component 1 support children experiencing mental health difficulties?

Component 2: Social and emotional learning for students Five core social and emotional competencies. Taught formally, regularly and in a coordinated way throughout the school. SEL skills are practised and generalised. How does Component 2 support children experiencing mental health difficulties?

Component 3: Working with parents and carers Promotes effective relationships between parents and carers and school staff. Provides parenting support and information. Creates opportunities for families to develop support networks with each other and the community. How does Component 3 support children experiencing mental health difficulties?

Component 4: Helping children with mental health difficulties Recognise and act on early signs of mental health difficulties. Develop policies and practices within the school, and identify clear roles and responsibilities. Connect students and families with help before difficulties worsen. Implement appropriate school-based strategies to support children with mental health difficulties.

Four component support plan Activity Four component support plan Think about a child who may be experiencing mental health difficulties. Complete the support planner.

Where to from here? For Component 4: For KidsMatter Primary: – What’s coming up? – What more do we need to find out? – Ideas for Component 4 planning. For KidsMatter Primary: – Cycle of continuous improvement. – Keep up-to-date at www.kidsmatter.edu.au