The transformation of mental health support places increased emphasis upon Schools and Academies, what support they currently offer and lays out plans to develop this further.
Recent research suggests...
The most recent research conducted into the mental health and well being of children and young people suggests that 10% of children ages 5-16 years have a diagnosable mental health condition¹, with 20% of young people experiencing mental health difficulties in any given year².
In addition, the research states that poor mental health is established in 50% of children & young people as young as 14³.
If this is not addressed, mental health difficulties including depression and anxiety, self-harm, suicide ideation and many more difficulties, cannot only impact future life chances and potential achievements but the immediate future can quickly lead to poor attendance & motivation, lack of engagement and ultimately the child or young person becoming a school refuser.
Anxiety is an issue
Often the development of mental health difficulties are due to anxiety. This can be general deep rooted worries and concerns, general anxiety, or more specifically applied to school and education.
A child or young person may have general anxieties around a number of things including international or local events for example terrorism or more and more, personal concerns and events such as transitions, moving house or the death of a loved one.
It may also simply be that the child or young person is anxious, without a reason. What must be remembered is that the anxiety is all consuming for the child and over and above a ‘normal’ reaction.
Further pressures for pupils
More specific anxiety and depression around school and education can stem from performance anxiety:
- Their abilities to complete work
- The judgment of staff, friends and other students
- A specific event that has taken place in school such as bullying
- Younger children may develop separation anxiety
- Have a fear surrounding moving schools or making transitions.
Depression or low mood can also be signified by increased absence or complete school refusal. The child or young person may present for example as tired, lethargic, lacking motivation or interest in their school work, there may be examples of risk-taking behaviour, going missing for periods of time, and low moods.
There may also be examples of self-harm and suicide ideation, but both anxiety and depression may also be seen together. Whatever the symptoms, it is important that the child or young person's voice is not lost in the attempt to bring them back into school.
School phobia or school refusal does not happen in one day, but develops and grows over a period of time due to a number of reasons. Schools and school staff are in a prime position to identify the early warning signs of growing anxiety and depression in children and young people, and are central to ensuring that support is instigated as soon as possible.
Important emotional signs
The warning signs that a child is experiencing emotional and mental health difficulties may include recurring absences where a specific reason is not or cannot be given, in older children where they bring themselves to school, punctuality may become an issue – dawdling and frequent late arrival, regular requests to call home, to call a parent or to be sent home due to illness.
There is also the manifestation of physical symptoms - dizziness, sickness, aches and pains.
There may be emotional signs where the child displays low mood, is very obviously tired and irritable – due to changes in sleep patterns or lack of sleep, a change in behaviour – from lively and engaging to low motivation or becoming withdrawn.
What can we do? How can we support?
- Be supportive: use positive reinforcement rather than negative consequences for school refusal.
- Be patient: it is hard, but you cannot force a child to come to school whatever their age. This can be referred to as “Flooding”. In simple terms this is forcing a child to confront their fears and may result in having the opposite effect. Remember that the child is not just being poorly behaved or ‘naughty’ there are genuine mental health concerns as the basis of all school refusers.
- Maintaining boundaries: it is important to observe existing behaviour management processes.
- Knowing when specialist support is required: making a referral to specialist services can be frustrating especially in a climate of reduced funding for schools and oversubscribed services, however persistence is key.
- Does the child have a specific condition which may be central to any anxiety or mental health? How could you support a child with autism who suffers from mental health difficulties or anxiety to come into school?
- Remember that truancy is different from school refusal or school phobia: forcing or disciplining a child for school refusal will simply reinforce the fear and anxiety and place further emphasis on the negative experience.
- Do you have a whole school approach to supporting mental health: it important to keep the conversation going at both an individual level as well as a whole school.
It is essential that we all continue to work hard to remove the stigma around mental health in any form.
Want to learn more about how you and your school can help to support young people who may be struggling with school and/or home life?
You are invited to attend our Safeguarding Conference on 8th February 2019 which brings together national leaders and experts in safeguarding and child protection.
Hear from Professor Dame Sue Bailey (champion of young people's mental health) who is one of the keynote speakers at the conference.
¹ Green,H., Mcginnity, A., Meltzer, Ford, T., Goodman,R. 2005 Mental Health of Children and Young People in Great Britain: 2004. Office for National Statistics.
² Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62 (6) pp. 593-602. doi:10.1001/archpsyc.62.6.593.
³ Op. Cit.