“Young people prefer to talk to a trusted teacher about an issue, rather than a health professional,” says Paula Lavis of the UK’s Children and Young People’s Mental Health Coalition, so if a problem does arise, teachers need to be prepared. IB World investigates how educators can spot the signs
“ I noticed one of my students was acting…well…odd. He had always been a good student, very engaged, and suddenly he was tired, sullen, and distracted. When I asked him why he just said he hadn’t slept for three weeks. He had no idea why,” writes teacher Laura Preble on her blog.
“I contacted his counselor, just to give her a heads up. Two days later, I got an email from her telling me that he had been admitted to a psychiatric hospital because there was a fear he might hurt himself.
“My heart stopped when I read this. The fact that I just happened to notice and mentioned it, and that the counselor just happened to follow up led to this intervention, which might have saved a life.”
Preble’s experience highlights the need for teachers to be able to spot signs of distress. One-fifth of the world’s young people have mental health problems, according to the World Health Organisation (WHO), meaning many more teachers around the world probably have a similar story to share.
Schools are ideally placed to reach out to children to promote wellbeing and mental health. It’s thought that untreated issues can spiral into psychiatric problems later in life unless more is done to provide appropriate and effective mental health support at an early stage. Schools are a key partner in providing this support but, without knowledge and adequate training, teachers are fighting an uphill battle in helping to ensure children are kept safe.
Paula Lavis, Coordinator and Policy Lead at the Children and Young People’s Mental Health Coalition, which is hosted by the Mental Health Foundation, UK, tells IB World’s editor Sophie-Marie Odum how educators can identify a mental health problem and how they can support students:
Sophie-Marie Odum: According to WHO, depending on age, the most common types of mental health problems reported in the classroom include development difficulties and disorders – including ADHD – and emotional disorders – such as anxiety and depression. What are the typical signs of these problems, and how can educators spot them?
PL: Firstly, this refers to diagnosable mental disorders. It is likely that there will be other children and young people who have milder problems, which haven’t become serious enough to meet the threshold for a mental disorder, but will still be causing them distress.
Look out for any changes in a child’s behaviour, or mood. Such as becoming angry and getting into fights, or other trouble; sad and tearful; continuously late for lessons; loss of concentration; or excessive loss of, or gain in, weight. Also, be vigilant of signs of self-harming such as cutting or injuring the body, and any symptoms of drugs or alcohol abuse. When you think something is wrong, sensitively look into it.
There are times during the term that are more stressful – the obvious being exam time. For some students, it may be holiday times – this is particularly an issue if there are problems at home, or if a young person has an eating disorder.
Any transition within or between schools, such as moving from primary to secondary school, can also induce stress. However, for individual children, there may be problems at home or in the community that put them at greater risk. For instance, if a child has experienced a bereavement, parents separating or divorcing, violence or abuse within the household or within the community. These are opportunities to look out for and help any student who may be very stressed or could potentially have a mental health problem.
In terms of specific signs for the most common types of mental health problems, these are summarized as:
There are three main symptoms but they may not all be present, or to the same degree.
- Problems with attention – individuals may find it difficult to think or concentrate
- Hyperactivity – students may be full of energy, which they find difficult to control
- Impulsivity – Children may do things without thinking. In a classroom environment, young people with ADHD are often labeled difficult or badly behaved.
It is important to note that some children, especially very young children, may display these behaviours but not actually have ADHD. These symptoms have to be present both at home and at school.
The main symptom is feeling really fearful or frightened most of the time, which is often related to a specific fear or worry. For example ‘school phobia’, or a student might feel anxious about being away from their family, or frightened about speaking in public, for example. But there can also be no apparent reason.
These feelings can lead to panic attacks, feeling sick, pains in the chest and so on. It is important to point out that we can all feel anxious at times, but if it is ongoing, it can be quite serious and distressing for the child.
This is a term that is used to mean ‘low mood’, or feeling ‘a bit down’, but can also be much more serious. Depression is often linked to suicide or suicidal thoughts. (Refer to the box-out for a detailed list of symptoms.)
It’s important to note the difference between ‘mental health’ and ‘mental health problems’. WHO defines mental health as “a state of wellbeing in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
SMO: At what ages do particular mental health conditions arise?
PL: There is no clear cut answer to this. Mental disorders generally first arise in the teenage years, but we know that younger children also have mental disorders. ADHD is often first diagnosed in younger children, but it can also be detected in teenagers.
What we do know is that what happens in early childhood, especially the first two years of life, has a significant impact on a child’s developing brain and mental health. This is particularly important for pre-school and primary school settings to understand.
SMO: What should educators do if they suspect a problem?
PL: Try and talk to the young person in a sensitive and supportive way. If educators don’t have a good relationship with the child, speak to a colleague who does. Young people often prefer to talk to a trusted teacher about an issue, rather than a health professional.
There is a lot of stigma around mental health, and it can be difficult for young people to talk about it. Be sensitive, but if you think there are problems, persevere. If possible, get some advice from mental health professionals – some schools may have a counselor, or links to mental health services. Depending on what is available in the school, suggest the young person speaks to the counsellor, or school nurse.
Speak to the student’s parents, or carers, and suggest they see their doctor, who can refer them to a specialist. Some schools have a referral pathway between the school and specialist mental health services.
SMO: How can educators best support students with a mental health disorder?
PL: A culture within the school that encourages open and honest conversations about mental health is imperative. Students and teachers should feel that they can talk about their problems without fear of judgement. This will also go a long way to remove the stigma surrounding mental health. For any of this to happen, you need good leadership, which fully understands the importance of promoting mental health within the school, and a champion who will take the work forward.
This approach includes strategies to manage stress before it evolves into something more serious, such as mindfulness and yoga lessons. Sport and exercise is also helpful.
Peer support – older students learning about mental health and supporting younger students – is beneficial, as is managing bullying within school, which can contribute to mental health problems.
Teachers should talk to the parents if they suspect an issue. But they also need to be careful about how they do this if they suspect the problem is related to home – if abuse is suspected, for example.
SMO: What can educators do if they suspect (or know for sure) that parents are the problem for the student?
PL: Many schools will have a safeguarding policy, although this differs around the world. If abuse is suspected, local authorities should be made aware.
For more information about child protection in international schools, please visit: http://www.cois.org or http://www.icmec.org/
SMO: What are the other challenges schools should be aware of?
PL: Accessing specialist children and young people’s mental health services can be difficult in many parts of the world. It can be very frustrating for schools, which probably have no training in mental health, and may have little experience of it, meaning they are left to manage a very distressed child.
As some mental health problems may manifest as behavioural problems, or as a ‘difficult child’, teachers require ongoing training in mental health to help manage these difficulties within the classroom. Training will also help teachers identify potential mental health problems.
It isn’t possible to avoid stress or anxiety. Some stress can be a good thing as it can motivate us. For example, think about how adrenaline can help during exams. What isn’t helpful is when an individual is so overcome by stress and anxiety that it takes over their lives. They require help to manage this.
It’s also important to discuss teachers’ mental health. Schools need to find ways to support their staff’s mental health as well as students’. Teachers can model good behaviour and encourage students to follow their example – for instance, how they respond to stressful situations – and manage their own mental health. Teachers need support from management to enable them to do that.
Having someone to talk to is important. Local helplines are invaluable as are face-to-face conversations. Discussions with a counselor or other mental health professional are kept confidential – it’s worth letting students know this as it might encourage them to reach out for help.
– MindEd – free online training on children and young people’s mental health – https://www.minded.org.uk/ Please do share other sources of support you may have discovered.
– MindEd – free online training on children and young people’s mental health – https://www.minded.org.uk/
Please do share other sources of support you may have discovered.
- Moody and irritable – easily upset, ‘ratty’ or tearful
- Withdrawn – avoiding friends, family and regular activities
- Feeling guilty or bad, being self-critical and self-blaming – hating yourself
- Unhappy, miserable and lonely a lot of the time
- Feeling hopeless and wanting to die
- Difficulty concentrating
- Not looking after your personal appearance
- Changes in sleep pattern: sleeping too little or too much
- Not interested in eating, eating little or too much
- Aches and pains, such as headaches or stomach aches
Source: Royal College of Psychiatrists leaflet for parents and young people
This article is part of IB World magazine’s “A deeper look at mental health'” series. To read the others please click below: