MHAW: 8 – 14 May 2017
Mental Health Awareness Week (MHAW) is a fantastic opportunity for schools to consider how they support emotional wellbeing of their pupils, and how ironic it is that it falls in SATs week!
Increasing awareness is one important factor as it provides opportunities to de-stigmatise mental health issues which affect a staggering number of individuals across all levels of our society. Studies have found that a third of all GP appointments are about mental health concerns, with one in four people suffering with them during their lives.
The new report on the state of mental health in the UK published by the Mental Health Foundation looks in detail at the current levels of psychological well-being throughout the population, framed by the theme: are we thriving or surviving?
What do we mean by thrive?
The concept is tricky to define and the report takes its definition of ‘thriving’ from a helpful description that was used by the Public Health Agency of Canada. They outline what constitutes a positive state of mental health:
Canadian Institute for Health Information, 2009
"The capacity of each of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity."
Using this benchmark description, for us to be considered ‘thriving’ we need to be free of emotional and psychological problems, but also engaged in the process of growing. To thrive is essentially to develop rapidly in positive ways; to flourish amidst our environment. MHAW is inviting us all to reflect on this point and consider if we are currently achieving this and – if not – then to consider how might we begin to do so? How might we all begin to thrive?
Measuring mental health
In order to tackle this problem effectively, we must first consider how well we are managing our wellbeing. We have access to a host of standardised assessment tools, however, at times these functional, quantifiable approaches can feel impersonal or prescriptive. When considered with children, these methods can feel counter-intuitive to our instinctive ways of working. It is undeniable, however, that there is a clear benefit in some kind of standardised measurement of these issues.
Are there any other methods more child-friendly that we can adopt to monitor assessments and interventions? It is useful at this point to consider the Five Ways to Wellbeing, developed by the New Economics Foundation (NEF) from evidence gathered in the UK government’s Foresight Project on Mental Capital and Wellbeing (Neweconomics.org, 2008). The research looked at mental capital and wellbeing through life and the NEF developed the Five Ways to Wellbeing to communicate its key findings.
Five ways to wellbeing
Complex research studies were compared and carefully distilled into five recommendations. The strategies outlined in this wellbeing guidance are simple, cost-effective and easy to apply, used successfully in a variety of environments such as: health organisations, schools, community projects and work places, to help people take proactive steps towards improving their levels of wellbeing. The five suggestions made by the NEF from its extensive evidence-based research review are seen in the image below:
Professionals in education can use these bitesize wellbeing prompts to encourage promotion of positive mental health in the children they work with. The streamlined nature of these five concepts allow them to be used as an holistic method of considering outcomes and change in those receiving interventions.
Within the Emotional & Trauma Support service (ETS) at One Education, our therapists have used these ideas to create a method of assessment for use with children receiving creative expressive therapies. By examining each of these five aspects within the therapeutic work, fully qualified therapists and children are able to use them as a broad set of guidelines through which to analyse progress and growth.
Case study – Dramatherapy and assessing wellbeing
An One Education Dramatherapist used the five ways to wellbeing in her work with a highly traumatised eight year old boy. He was known to social services who had placed a child protection order on him, legislation which illustrates the fact that he has lived through challenging circumstances and rightly was in receipt of psychological support. This young boy struggled to talk at school and was very withdrawn and isolated. He was exhibiting high levels of anxiety and additionally he appeared to be having difficulty forming relationships and making friends. He began attending Dramatherapy sessions once a week which offered him a consistent space in which to think about his feelings and his circumstances.
Initially the work focused on building the therapeutic relationship, which he managed to form successfully with the Dramatherapist. Once this was established, he began feeling calm and less anxious in the therapeutic space. He grew more confident over time and was able to talk more freely. At this stage the therapist began to use the five ways to wellbeing to think about the child’s experience of school.
She asked him if he could assess himself in relation to each topic, on a scale from one to ten (with one being not at all and ten being a lot). With the use of this newly developed self-scoring system, his information was used to start reflective discussion around his self-assessment, with the therapist asking questions about his rationale for the scoring.
After an interval of a few weeks, the therapist returned to the self-assessment tool once again and asked the child to reconsider these things and rescore himself. Where this little boy had once found it very hard to score himself highly in certain areas, he now showed progress. To illustrate this progression, one topic - ‘giving’ - had previously ranked very low, potentially due to his difficulties communicating with others. Upon being asked again, he was able to score himself much more easily, providing detail to the therapist about how he had given a sweet, a pencil and a hug to other children since the last session – a distinct and marked improvement in his self-scoring was seen as a result.
By taking each of the five topics and using a scaled self-assessment system, the therapist utilised some of the powerful benefits of a therapeutic relationship to assist this child. As she did not have any expectations about his numeric progression, the child felt free from pressures experienced in the classroom environment. She was able to help him to explore the experience of a positive, containing relationship and his own innate ability to make progress. This child transitioned from a place of survival to a place where he was able to begin to thrive, with the help of therapeutic support in his school.
Small change = big win
Sometimes in a class of many children, it can be challenging for teachers to notice small differences which are indicators of a child achieving positive growth – especially in regard to qualities as described by the five ways to wellbeing. When working with a therapist, the one-to-one ratio fosters a relationship which is uniquely attentive to the tiniest changes, allowing small events to feel like big developments for the child and their personal growth.
For children to thrive in education, there is a real need for staff to be attuned to the wider social circumstances and resulting emotional needs of their students. This can be hard to achieve as teachers typically have to work within strict, curriculum guidelines and attainment focused policies. Perhaps during Mental Health Awareness Week, time can be spent reflecting on the broader experience of children, outside of testing, attainment and curriculum. Readers may recognise the concerns of an educator in this position:
“…students were expected to “thrive”, regardless of the glaring social factors affecting their wellbeing and communities… I was always aware as a vice-principal when changes had been made to the benefits system…changes to benefits for us meant a rapid drop in attendance, lack of uniform, increase in behavioural issues, more referrals to the school counsellor, more social service referrals” (Stewart-Hall, C. 2017).
Mental health is impacted by a wide variety of factors including issues such as gender, age, location size of household and household income. Problems such as anxiety and depression are diagnosable in one in ten children – that’s three in each class – between the ages of five and sixteen, with many more having experience of mental health challenges which go without clinical attention (ONS, 2015). As one headteacher, president of the school leader’s union and NAHT concluded:
“Unless the child is in the right place emotionally and mentally, learning will not take place, however good the teaching and leadership in the school” (Draper, 2017).
Mental Health Awareness Week offers us a practical chance to be mindful about the many and complex factors at play when it comes to the emotional wellbeing of children and calls us to strategize ways in which we can support their mental health from our privileged position as educators.
Also, don't miss our Advanced Mental Health Training session on 25 May, looking at mental disorders and what you can do in schools.