Supporting Mental Health in Primary and Early Years

A Practice-Based Approach

Jonathan Glazzard, Sarah Trussler

• Publisher: SAGE Publications Ltd
• Year: 2019
• Print ISBN: 9781526459367, 9781526459350
• eBook ISBN: 9781526482730
• Edition: 1
• Topic: Education
• Subtopic: Education Counseling

Emphasising not just mental health needs, but also the importance of creating a culture of inclusion for all pupils so that all pupils develop high self-esteem, emotional intelligence, social confidence and resilience, this book provides:

• an introduction to key theories that relate to mental health;
• an overview of the current context in relation to mental health in schools;
• guidance on the identification of pupils with mental health needs;
• evidence-based research on interventions to support pupils with mental health needs;
• an assessment tool which will support teachers in identifying needs and planning subsequent interventions;
• case studies of practice from a primary school and early years setting.

 Based on action research which has been implemented in a primary school, this important text is valuable reading for students on teacher training courses, and practising primary school teachers.

Part I Mental health awareness in schools

1 Mental Health Awareness in Schools

Mental health problems affect about 1 in 10 children and young people. They include depression, anxiety and conduct disorder, and are often a direct response to what is happening in their lives.

(https://www.mentalhealth.org.uk/a-to-z/c/children-and-young-people, 2018)

We are living in an era of information, which is invaluable in understanding our world and in global communication; however, it can also put a lot of pressure on children and young people who cannot necessarily filter the volume of messages coming at them. They face challenges to their identity, to their emotional wellbeing and to their understanding of what is the ‘norm’. As the above quote suggests, children’s mental health problems can relate to what is happening to them; their life experiences, their expectations of themselves and others, their personal security and safety, and their school experience all impact. School staff and the way a school has organised its curriculum, its ethos and policies can all contribute to a child successfully negotiating these challenges and emerging with strong emotional and mental wellbeing. In 2017 Samaritans (2018) published their annual suicide figures, which stated that in 2015, 230 children (under 19) committed suicide in the UK, 10 of these were under 14. This was an increase of 51 from 2013 figures. This is an upward trend that cannot continue.

However, as well as children’s wellbeing, schools also need to take some responsibility for nurturing positive emotional and mental wellbeing in their staff, as without which it becomes an uphill struggle to provide a high-quality education to the children. ‘More than half of Britain’s teachers have a diagnosed mental health problem’, according to a new study. Three quarters of those surveyed by Leeds Beckett University believe their poor psychological and emotional conditions could have a detrimental effect on pupils’ progress – a situation campaigners have said ‘cannot go on’ (The Independent, 2018). This statistic focuses on teachers, including those who have received a diagnosis, but with the potential for staff to avoid diagnosis in case they experience stigma in the workplace, it is likely to be a much higher percentage of all education staff. Although this text is predominantly about our work with children and how we can support their social, emotional and mental wellbeing, how staff manage their own mental health is of importance to schools. Staff resilience to the inevitable stress of working in school will impact on their ability to address the pupils’ needs, which is why we have included a chapter on adult mental health (Chapter 2).

Chapter objectives

This chapter will help you to understand:

• the national context in relation to the mental health needs of staff in school
• the political context for mental health in schools
• the school context and how important a whole-school approach to mental wellbeing is
• the perspective of support for young people in a case study of a 16 year old.

Reflection point

How do we reassure teachers that they can assess a child’s social, emotional and mental health needs? There are some parallels with the development of inclusion of children with special educational needs and disabilities. Initially teachers were concerned about the increased number of children with more complex needs in schools and whether teachers were sufficiently prepared for teaching them. In my work on special educational needs and disability (SEND) (Trussler and Robinson, 2015), I warned about the potential hazard of using a medical model approach. The medical model approach encourages teachers to view children’s individual needs as symptoms which need to be ‘cured’ through teaching. In contrast, a social model perspective promotes the idea that teachers need to find a way that the children can access learning with the teacher taking responsibility for adapting the learning environment rather than trying to ‘cure’ the child. Whilst this was focusing on SEND, the same could potentially be applied to children’s emotional and mental wellbeing. Teachers are not accountable for children’s emotional and mental wellbeing as they are for SEND, and therefore some teachers are not challenged to adopt an emotionally supportive approach to learning.

How do you feel about being responsible for the social, emotional, personal and mental health development of young children? When are teachers expected to do this work? Do you think teachers have enough to do without having this added to the list? Is this one pressure too far?

Book Focus and Structure

This book addresses mental health in children in the primary school. Child development theory shows us that early life experiences have an impact on a child’s future. If we leave it until secondary education before we address mental health in the curriculum or in the way we communicate and work with children, the authors believe we will not be able to reverse the trend of child suicide, depression and anxiety.

The book reflects our desire for readers to be inspired to work with the children in their care in such a way that children understand their mental wellbeing and staff can help them view themselves positively, with resilience and positive self-image. This will impact positively not just on pupil mental wellbeing but also on behaviour and academic achievement. That is why schools should be involved. We know that children are far more than empty vessels waiting for knowledge to be poured into them. They are active participants in their own development, influenced by who and what they experience, but are vulnerable, in need of nurture and caring; school staff know this and are already working on children’s social, emotional and personal development. Understanding of the facets of mental wellbeing will enhance this personal, social, health and economic education (PSHCE) curriculum and the hidden curriculum – the messages children get from how we work with them, not just subject matter.

The book is structured into three parts:

• Part I: Mental health awareness in schools
• Part II: Children’s mental health support in practice
• Part III: Mental health – moving forward

Part I explores the theoretical underpinning of mental wellbeing, so readers understand the root of the issues: psychological, political and educational. Although the focus of the book is children, we start the book by looking at adults because it is only through knowing oneself and how to manage the stress, anxiety and vulnerability that is involved in educating children that adults are able to develop the strength they need to support the children. In addition to the theory of mental wellbeing and social development, Part I also introduces the Trussler–Glazzard assessment tool for teachers to begin to evaluate the children in their classes and consider their wellbeing and the approach that staff can take to support holistic development.

Part II focuses on the use of the assessment tool in Early Years, Key Stage 1 and Key Stage 2. The seven aspects of mental wellbeing are interconnected, of course, but by exploring them separately, teachers can create a repertoire of teaching strategies and ways of communicating with children that will benefit all children, not just the vulnerable.

Part II summarises the outcomes from the work in schools and encourages trainee teachers and more experienced staff to reflect on their learning. The book concludes with a rationale for how and why teachers need to move forwards with children to see positive outcomes for our young people as they enter the next stage of their lives.

Features in the text include case studies, reflection points and critical questions.

In Part I the case studies focus on adults in school (Chapter 2) and on potential perspectives on individual children (Chapter 3). In Part II the case studies focus on how teachers have applied activities in relation to the seven areas of mental wellbeing in Early Years, Key Stage 1 and Key Stage 2. Case studies are included to reflect on how teachers have used the outcomes of the activities to establish better ways of working with the children across all school activity. The sections following an outline of the case studies examine how the reader can carry out their own activity and then reflect on the process of translating the outcomes of the activity to strategies that can be applied to all teaching, communication and interaction with all children.

We were keen for this book to be interactive, so have included reflection points and critical questions. Reflection points engage the reader in considering how they can improve their own practice. There is not necessarily a ‘right answer’ from reflection, just the desire to evaluate alternative ways to view education and children’s wellbeing. Critical questions are designed for the reader to critically evaluate the theory and create a personal perspective on that, although, again, the hope is that through critical evaluation, the purpose is more to ensure a good understanding of the critical factors underpinning the practice.

Key Issue 1.1: What is mental health?

First, it is important to emphasise that everyone has mental health. People’s mental health falls along a spectrum which ranges from positive to negative and it can fluctuate depending on a range of factors. According to the World Health Organization (WHO, 2014):

Mental health is defined as a state of well-being 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 … Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

This definition adopts a holistic perspective on wellbeing in that it includes physical and social wellbeing as well as mental wellbeing. These aspects of wellbeing do not exist in isolation; they are interrelated. Our social and physical wellbeing can influence our mental state and our mental state can also influence our physical and social wellbeing. To remain mentally healthy, it is important to pay attention to all these aspects of wellbeing. Mental health is broader than the absence of mental disorders. It is an integral part of a person’s health. Having a mental health need is not the same thing as having mental health.

Mental health is influenced by a range of socioeconomic, biological and environmental factors. These factors can act as a risk or they can be protective. The important point here is that the wider social, cultural, environmental and political contexts in which people live their lives can influence a person’s mental health. The use of terms such as ‘illness’ or ‘disease’ are problematic because they suggest that the problem has resulted from an impairment within a person’s biology. In the case of mental illness, this is the brain. However, developments in neuroscience have demonstrated that the brain is more malleable than was once thought. Scientists have demonstrated that environmental factors can affect the structure and functioning of the brain in both positive and negative ways and therefore our mental health can, in some cases, be directly attributed to these.

Critical question 1.1

In what ways might a child’s family experiences influence their mental health? How might social and cultural perspectives influence people’s views on mental health?

Key Issue 1.2: The political context

The Conservative government in England prioritised mental health and emphasised the critical role that schools and teachers can play in supporting children and young people’s mental health. In 2015 mental health needs were, for the first time, identified as a special educational need in the 0–25 special educational needs and disabilities Code of Practice (DfE, 2015). Whilst this was a positive development, mental health needs form part of the category of social, emotional and mental health difficulties which to some extent underestimates the breadth of needs that mental health represents.

In 2017 the government in England published its proposals to transform mental health provision for children and young people in a Green Paper, Transforming Children and Young People’s Mental Health Provision (DoH/DfE, 2017). It stated that ‘Children with a persistent mental health problem face unequal chances in life. This is one of the burning injustices of our time’ (p. 6). One of the key recommendations was that all schools should appoint a member of staff to the role of Designated Senior Lead for Mental Health to lead and manage mental health provision across the school.

A second proposal in the Green Paper was for mental health support teams to be deployed within schools to support individuals and groups of children with mental health needs through targeted interventions (DoH/DfE, 2017). Currently in England, children and young people with the greatest mental health needs are supported by the Child and Adolescent Mental Health Services (CAMHS), which is operated by local authorities. However, waiting lists to access specialist support through these services are long and young people often receive support too late. In addition, there are strict criteria for referral which result in many young people not receiving the help they need. Basing mental health support teams in schools will result in young people receiving more rapid support. However, the implementation of this proposal will require significant financial investment.

Critical to both roles is the need for training and continuing professional development (CPD) for staff. However, mental health is also everyone’s responsibility in school and therefore it is essential that all staff receive appropriate high-quality training to enable them to identify needs and to provide appropriate support.

Critical question 1.2

Is it a teacher’s responsibility to identify and support pupils with mental health needs...

Table of contents

• Cover
• Half Title
• Acknowledgements
• Title Page
• Copyright Page
• Contents
• About the Authors
• Introduction
• Part I Mental health awareness in schools
• 1 Mental Health Awareness in Schools
• 2 Mental Health Awareness in Schools: Adults
• 3 Mental Health Awareness in Schools: Children
• Part II Children’s mental health support in practice
• 4 The Assessment Tool
• 5 Self-Esteem
• 6 Emotional Intelligence
• 7 Resilience
• 8 Family and Wellbeing
• 9 Social Confidence
• 10 Mood and Behaviour
• Part III Mental health – moving forward
• 11 Approaches to Mental Health and Wellbeing
• 12 Conclusion
• References
• Index