Tag Archives: stress

“For many children we are the first point of contact”: supporting children’s mental health in schools

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A 2018 evidence review from Public Health England reported that one in 10 young people have some form of diagnosable mental health condition. This, the report suggests, equates to as many as 850,000 children and young people with a diagnosable mental health disorder in the UK. It also reported that half of all mental health problems emerge before the age of 14, and children with persistent mental health problems face unequal chances in life.

Research has also highlighted the impact of “key factors” like poverty and adverse childhood experiences (ACEs), including emotional trauma, abuse or neglect (which people living in higher areas of deprivation are more likely to experience) on an individual’s chance of developing a mental illness. However, an additional factor often cited in surveys around child mental health and wellbeing is the impact of school, including exam stress, and bullying. Mental ill health has also been found to have an impact on attainment, behaviour and a child’s ability to learn. As a result, teachers are often part of the front line of supporting adults for children who are suffering from mental ill health, with increasing pressure being placed on teachers and schools to identify and signpost children to other services.

Schools, as well as teachers,  are increasingly becoming a focus for the delivery of Child and Adolescent Mental Health Services (CAMHS) in their community. Often schools are at the centre of their local community, so it is logistically convenient to coordinate services there; it can for some be a less intimidating or stigmatising environment than attending a clinic at a GP surgery, for example. School is the primary developmental space that children encounter after their family, and children’s learning and development and their mental health are often interrelated, so it makes sense for teachers to take an interest in terms of attainment and progress in learning. In December 2017, the Department of Health and Department for Education (DfE) published the Green Paper Transforming children and young people’s mental health provision which highlighted the role of schools as key in promoting a positive message about mental health and wellbeing among school age children and young people.

Good work is already being done, but how can we do more?

Research has shown that there is already a lot of good and effective practice being done in schools around children’s mental health. Many schools already work in partnership with local health teams to provide in house CAMHS support in the form of mental health nurses and social workers who are posted on site for children to access. One of the major recommendations in a 2018 Audit Scotland report on child mental health in Scotland was to encourage more of this type of partnership working. The report stressed the importance of joint working between public services if child mental health is to be improved, and where possible to include as wide a spectrum of public services in the delivery of CAMHS support, including criminal justice and housing practitioners, as well as health and social care and education staff.

In some schools senior pupils and designated members of staff are being offered mental health first aid training, and wear lanyards to help students identify them should they ever need to talk to someone. While it is important – particularly for students who participate in mental health first aid programmes – to be made aware of the challenges the role may entail, it can be a rewarding experience for young people to participate in and can also be a vital in-road to support for some students who would otherwise feel uncomfortable talking to a member of staff.

Other programmes like those developed by the Anna Freud National Centre for Children and Families, Centre for Mental Health and the ICE PACK and Kitbag tools (which have been used widely in UK schools) look at resilience building  and promoting coping mechanisms among young people, as well as encouraging the creation of trusting relationships which focus on nurturing and normalising mental illness to encourage children and young people to feel comfortable discussing their feelings and thoughts. These programmes also integrate early intervention and prevention approaches, hoping to identify children and young people who are suffering from mental illness as early as possible and signpost them to appropriate support.

The specific role of teachers

Teachers need to remember that they are not health or social care professionals and that – as much as they would like to completely solve all of the problems of their students – they can only do what they can, and that is enough.

It is also very important for teachers to practise what they preach in as much as teacher self-care is as important as signposting children and young people who are struggling with mental health issues. A 2016 survey by the National Union of Teachers (NUT) found almost half of teachers had sought help from their doctor for stress-related condition. Teacher stress and burnout and those leaving the profession due to conditions like stress do not help to create an environment that is supportive of good mental health in the classroom. Teacher wellbeing is so important and building their own resilience is one way that teachers can start to embed good mental health in their practice. If you are doing it yourself it will be easier to help and show children how to do it if they come to you for advice!

Teachers simply being there and offering a safe space and first point of contact for many children is important. Listening and signposting can be so valuable for those pupils taking the first step and teachers should not be put off by any personal perception of a lack of expertise in mental health – a small amount of knowledge or understanding of what to do next is more than enough. In some respects, teachers should feel almost privileged that a student has chosen to come to them, someone they feel they can trust and talk to.

A poll conducted as part of a webinar held for educational practitioners found that rather than requiring more information about mental illness, what teachers actually wanted was more practical examples of how to apply support in the classroom and how to embed mental health into their teaching and the learning of their students.

A unique opportunity

Schools and teachers are on the front line of public services and have a unique opportunity through regular contact with children to help to build and promote resilience among pupils, and embedding this within the whole school can be an effective way of ensuring pupils feel the benefit without being singled out. Taking nurturing approaches to learning and teaching, and promoting the creation of trusting relationships is key to some of the already effective practice going on in schools. Sharing the learning and best practice that is already happening will be vital to ensuring that support for children suffering from mental ill health improves and adapts to changing needs in the future.

If you liked this article, you may also be interested in reading:

Writing and recovery: creative writing as a response to mental ill health

Addressing social mobility through education – is it enough?

The Changing Room Initiative: tackling the stigma of poor mental health in men through sport

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Mindfulness in schools: does it work?

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by Stacey Dingwall

Over the last couple of years, the concept of being mindful has almost become a buzzword. However, mindfulness has actually been around since the 16th century, before being developed as a modern day western Buddhist practice from the 1970s.

Transform your life?

On the 17th of March, along with almost 400 other people, I attended the Transform Your Life event at Glasgow’s Trades Hall. The event was organised by the Kadampa Meditation Centre (KMC) in Glasgow, a Buddhist temple which opened in 2013 with the aim of providing a space for people to learn how to meditate and practise Buddhism.

The talk was delivered by Gen Dao, a senior Kadampa teacher who has been ordained for over 20 years, teaching at centres in America and Australia before taking up her current post as principle teacher at KMC Liverpool. Its focus was on equipping attendants with the ability to cope with everyday stresses and anxieties, by applying some simple meditation and mindfulness techniques.

After demonstrating a basic breathing technique, Gen Dao opened her talk by commenting on how prevalent mindfulness has become, noting that it is now used as a management technique and as a means of selling women’s magazines. She spoke about the benefits of using mindfulness not only on a personal level, but also how actively improving your mind can awaken the potential to bring benefit to others. Mindfulness, she explained, was essentially just remembering to breathe, and trying to focus on experiencing only positive states of mind.

The remainder of Gen Dao’s talk concentrated on the importance of mastering the ability to ‘oppose’ negative thoughts, and making the decision to be content and happy, without the intervention of others. Also highlighted was the need to strive for ‘patient acceptance’, or the ability to give up on the feeling that things in your life should be different – instead, we should learn how to view our feelings from a more detached perspective, and not identify with painful feelings, or “bad weather” in the mind.

Speaking to Gen Dao after the talk, I raised the point that, although not a physical pursuit, mindfulness is something that you have to train in, and learning to adapt to a new way of thinking is something that could take some time. Essentially, adopting a mindful outlook could mean changing the habits of a lifetime.

Mindfulness in the classroom

This could explain why some schools are now incorporating mindfulness exercises into classes, in order to prepare young people for the future. Last July, BBC News reported on the first large-scale trial of mindfulness exercises in schools across the UK conducted by the Wellcome Trust, during which researchers will look at whether introducing mindfulness at an early age can help build psychological resilience. The exercises, which will include deep breathing and a practice called ‘thought buses’ in which participants will be taught to see their thoughts as buses that they can either get on or allow to pass by, are designed to show children how to live in the present and eventually, equip them with the ability to solve problems while under stress.

The study will involve around 6,000 children and young people; a considerably larger amount than have taken part in previous evaluations of the impact of mindfulness in schools. While the existing evidence is currently described as limited, these smaller studies have indicated that mindfulness interventions with children and young people do have some success in generating lower stress levels and a greater sense of wellbeing among participants. These findings are important, given that a recent survey of school leaders by the Association of School and College Leaders found that 55% of respondents reported a significant increase in the number of young people in their schools who are dealing with anxiety and stress.

Case study: Mindfulness in Schools Project

The Mindfulness in Schools Project (MiSP) was founded in 2007 by former teachers Richard Burnett and Chris Cullen. Having experienced the benefits of mindfulness themselves, they developed “.B”, a 9-week course that aims to make mindfulness accessible, and fun, for secondary school pupils. The course, which has also been adapted for younger children as Paws B, is now being taught in twelve countries, including the UK. Teachers and pupils who have used the programme report on its ability to restore calm to a class after break, for example, or to calm pupils down at times of particular stress, such as exams or performances. It has also been suggested that the programme can help to improve pupils’ ability to concentrate.

Critics of the impact of mindfulness in the classroom argue that these results cannot be relied on, due to the experiments taking place outside of the boundaries of a randomised controlled trial. They also point to the possibility that participants’ ability to concentrate may only have improved due to their being informed that this is what the exercises are designed to do. Richard Burnett has openly recognised the limits of mindfulness himself, emphasising that it cannot replace the fact that some people require medication and clinical care to deal with their condition, and is more effective in smaller groups supervised by medically trained professionals. Trainers delivering the programme are also open about the fact that mindfulness is not something that will work for every child. What it can do, however, is provide a reminder to breathe when things get too much – something that can surely only be a positive for everyone.

If you enjoyed this post you may be interested in our previous commentary on mental health issues:

Ecotherapy in practice: nature based mental health care

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Ecotherapy, also known as nature-based or green care is an alternative therapy for people suffering from mental health issues. It can be delivered as an individual treatment or in combination with traditional medicinal and talking-based treatments. Charities and research has suggested that it can reduce depression, anger, anxiety and stress as well as improving self-esteem and increasing emotional resilience.

Spessartbach

The mental health charity MIND emphasises the positive health benefits, commenting that ecotherapy:

  • is accessible
  • can take place in both urban and rural settings in parks, gardens, farms and woodlands
  • works through people either working in nature or experiencing nature

It can be structured or more informal, with some areas providing therapist led classes while elements of ecotherapy, such as taking walks or gardening, can also be done without specialist supervision, on your own or with family members and friends.

AAT and AAI (Animal Assisted Interventions and Animal Assisted Therapy)

This form of therapy uses guided contact with animals such as horses or dogs. It is becoming increasingly popular in university settings, with dog cafes or dog rooms during student mental health weeks or during exam times to help alleviate student exam stress. Pet therapy has also been shown to be effective with children and young people who suffer from anxiety or who have experienced trauma, and for elderly people suffering from dementia.

Therapy could be one to one or in a group and could also be delivered to people who are in residential care setting. AAT can also be used to assist mobility and coordination or simply to spend relaxed time with animals where patients can feed or pet them. This interaction can promote bonding between the individual and animal which has been found to reduce stress and anxiety.

Nature Arts and Craft Therapy

Nature based art therapy takes inspiration from nature to create and provide materials to create art work. This type of therapy can also include social and therapeutic horticulture (STH). This can be a particularly effective form of nature based intervention as it can be adapted to suit a wide range of mobility and abilities and could potentially lead to work experience or the sale of goods created, which in itself can build self-confidence and transferable skills.

Adventure Therapy

This therapy focusses on using physical activities to encourage psychological support, It includes activities such as rafting, rock climbing and caving. Often done in a group, this type of therapy aims to build trust and raise confidence. While it can be strenuous, less able individuals can take part in green exercise therapy, which largely includes walks and rambling, or wilderness therapy (which includes physical group and team activities such as making shelters and hiking).

Effectiveness of ecotherapy

In February 2016, Natural England published A review of nature-based interventions for mental health care, which considered the benefits and outcomes of approaches to green care or ecotherapy for mental ill health.

One of the main challenges the report highlights is to increase the availability of green therapies in order to make the practice more normalised within treatment. The authors also speak about the importance of standardising the use of terms such as ‘ecotherapy’, ‘green care’ and ‘nurture based interventions’ to allow people to fully understand what different interventions entail. The report makes nine recommendations, including:

  • expanding the evidence base around green therapy
  • increasing the scale of commissioning of green care initiatives
  • increasing collaboration between the green care sector and health and social care practitioners

Ecotherapy is still not widely accepted as a mainstream approach to mental health treatment. However, it is increasingly being offered as a combination therapy alongside traditional drug-or talking-based interventions. Advocates of ecotherapy hope that this will lead to wider acceptance of the approach and the positive effect it can have on people who suffer from mental ill health.

Advocates emphasise the holistic and person-centred benefits of ecotherapy, which has been shown to improve physical health as well as mental wellbeing. As the video below demonstrates, it increases social skills and in many instances can help people build new or develop existing skills which can help them enter, or re-enter employment. Potentially this may also reduce the burden on care and community mental health services.

Our popular Ask-a-Researcher enquiry service is one aspect of the Idox Information Service, which we provide to members in organisations across the UK to keep them informed on the latest research and evidence on public and social policy issues. To find out more on how to become a member, get in touch.

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Why resilience matters for social workers

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By Heather Cameron

A recent storyline in the BBC’s Silent Witness programme graphically illustrated the emotional pressures that social workers operate under. Troublingly, this was not a case of dramatic license. Stress is damaging the ability of a significant number of social workers to do their job. This is often compounded by a lack of workplace support, particularly with regard to difficult cases such as child abuse.

In a recent Community Care survey of more than 2,000 frontline staff and managers, more than 80% of social workers felt stress is affecting their ability to do their job.

A third were trying to cope with stress by using alcohol, while 17% are using prescription drugs such as anti-depressants. Despite almost all respondents (97%) stating they were moderately or very stressed, only 16% said they had received any training or guidance on how to deal with work-related stress, and less than a third had been offered access to workplace counselling.

Social workers need high levels of confidence and resilience when dealing with safeguarding issues. And these are worrying findings, given the serious emotional impact more challenging cases can have.

Lack of support

New research for the NSPCC in six local authorities, highlights that social workers are finding it difficult to deal with the emotional impact of child sex abuse cases.

Adequate support and supervision is key to moderating the negative impacts of stress and burnout. The Assessed and Supported Year in Employment (ASYE) – introduced in September 2012 – provides a support framework for newly qualified social workers. However, the research found supervision for experienced social workers continues to still be lacking, with many having to find their own informal support networks.

With reports on child abuse a regular occurrence in the media, the public pressure on social workers and other professionals involved in such cases is unlikely to subside. It’s even been suggested that politicians and the press have a common agenda in presenting ‘bad stories’ about social work to the public.

So what can be done?

With nearly 1 in 10 social workers considering leaving their jobs, its clear that addressing stress is a priority. But they are working in an environment where local authority budgets are being cut and the numbers of children subject to child protection plans increased by 12% between March 2013 and March 2014.

Back in 2009 the Laming Report emphasised the need for social workers to “develop the emotional resilience to manage the challenges they will face when dealing with potentially difficult families”. Research at the University of Bedfordshire has explored what resilience means in practice, and how individual resilience can be improved. It suggests that resilience can be learned, and is supported by reflective practice and self-awareness.

Active listening by line managers or supervisors can be an effective tool for identifying and dealing with the onset of stress within their team. And qualitative research in Scotland suggested that with the right support, social workers can retain the sense that their work is worthwhile and satisfying.

Let’s hope that Community Care’s next annual survey of social workers will show an improvement in work-related stress.

 

Further reading

Some resources may only be available to Idox Information Service members.

‘Heads must roll’? Emotional politics, the press and the death of Baby P, IN British Journal of Social Work, Vol 44 No 6 Sep 2014, pp1637-1653

Social Work Watch: inside an average day in social work – how social work staff support and protect people, against all the odds (2014). Unison

‘Bouncing back?’ personal representations of resilience of student and experienced social workers, IN Practice: Social Work in Action, Vol 25 No 5 Dec 2013

Inquiry into the state of social work report (2013). British Association of Social Workers

Managing mental ill health in the workplace

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Laptop and coffee mug photoBy Donna Gardiner

As one in six employees will suffer from mental ill health at some point during their working lives, ensuring the wellbeing of employees is increasingly becoming a management priority (EU-OSHA, 2014). Indeed, the financial cost to British business of mental ill health has been estimated at £26 billion per year – which is equivalent to £1035 for every employee.

A public sector problem?

Mental ill health is particularly prevalent among public sector workers. According to the latest Chartered Institute of Personnel and Development (CIPD) absence management report, 60% of public sector organisations reported an increase in mental health conditions such as anxiety and depression among employees over the previous 12 months. This is compared to 38% of private sector organisations and 37% of non-profit organisations. Public sector organisations were also more likely to report that stress-related absence had increased among the workforce as a whole (55% compared to 38% of private organisations and 39% of non-profit organisations).

Considerable organisational change and restructuring was one of the most commonly reported causes of work-related stress, followed by workload. Both of these could be viewed as knock-on effects of budget cuts caused by the economic recession, the current drive towards public sector transformation and the increasing need to ‘do more with less’.

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How should we address loneliness and social isolation among older people?

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For elderly men sitting on a bench

Image courtesy of http://goo.gl/A8ykMA using a Creative Commons licence.

By Steven McGinty

“Loneliness and the feeling of being unwanted, is the most terrible poverty“– Mother Teresa

Yet, for many older people, loneliness and social isolation are the normal state of affairs. A recent study by the Office for National Statistics (ONS) found that 34% of people aged 52 and over felt lonely often or sometimes, with this figure reaching 46% for people aged 80 or over. Rather worryingly, a report by Age UK also suggested that over half of older people consider the television as their main source of company.

In many respects, these figures may not be too surprising, with some arguing that this is simply the by-product of changing societal attitudes. Conversely, it could also be said that these changes are a response to the demands of busy modern life. For example, a report published by the Royal Voluntary Service highlights that, because of uncertainty in the job market, many children have to move away from their parents for work reasons. The impact of this is that many older people are seeing their families less and less, with 48% of parents only seeing their children once every two to six months. Continue reading →

The quest to find young carers: Carers Week 2014

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Cooking Togetherby Steven McGinty

This week, throughout the UK, there will be a host of events in support of Carers Week 2014. For the first time, the UK-wide annual awareness campaign is launching the Carers Week Quest, a new initiative to encourage improved collaborative working in local communities to reach out to carers.  It will also be the first time that the valuable role of #youngcarers is recognised, with the introduction of Young Carers Awareness Day on Friday. The theme for this year is ‘identifying carers’.  It is hoped that this week of events can help carers access the support they need, when they need it.  In support of #carersweek, Idox has decided to review the literature on young carers. Continue reading →

Ending the stigma around anxiety: Mental Health Awareness Week 2014

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man crying

by Steven McGinty

Today marks the beginning of Mental Health Awareness week. The campaign started in 2000 with the aim of raising the awareness of a specific mental health issue. Previous issues have included alcohol, stigma and exercise and this year’s focus is the impact of anxiety. To highlight this event, the Knowledge Exchange has summarised some of the most recent literature on anxiety and mental health more generally. Continue reading →