Yesterday I was a speaker at ResearchEd Scotland and talked about the reasons why we need to teach and talk about mental health in schools. The text and slides from what I said are below. It being me, I went a little off text at times but I managed to say most of what I had planned. Where text is in brackets, it means that I did not get to say it due to time constraints.
Today I am going to talk about why I believe we need to teach and talk about mental health in schools. Some people like to argue that mental health education should be the remit of parents or health professionals or trained staff, but I would argue differently.
I think that there are 5 key reasons why talking and teaching about mental health must be part of our work in schools and they will be at the heart of what I talk about today.
To start, then, with the first.
This is the World Health Organisation definition of mental health and I really like this. When we look at this, we have to question why there is stigma around talking about mental health. How is this any different to the broadest aims for education that any of us would aspire to achieve?
And in fact, in spite of all the recent wranglings about the four capacities of Curriculum for Excellence, there is a huge resonance between the WHO definition and these capacities. I would not want to work in an education system that has anything else at its centre.
But just to return to this slide for a moment, although I love this, I do have a slight issue with one word here and that is the word “normal”:
When we talk about mental health we need to remember that there is no normal; my mental health is not necessarily yours. What is important is that each one of us understands what we need to do to keep mentally healthy.
But now to my second reason from my earlier slide:
For a long time now, we have been bombarded with press reports suggesting an unprecedented crisis in teenage mental health and calls to urgent action. But, is the crisis real?
Back in 2016 there was a report that basically told us that things were pretty bad for our teenagers.
If we weren’t feeling pessimistic before we read this, we probably would have been afterwards as it did not contain a great deal of good news.
My response to this and similar reporting in the Guardian on what they referred to as Generation K was to write a blog post where I argued that just maybe, things weren’t quite as bad as the reporting suggested.
It all got me thinking about a lesson that my dad once taught me. It wasn’t one of those life lessons that takes place over a camp fire and stays etched in your memory for ever but rather a literal lesson; my dad served a double purpose in my life for a while as father and economics teacher. I had a brief flirtation with economics in sixth form. I started off doing A Level EPA (economic and political affairs) but being hopeless at maths sent the economics the same way as both physics and a career in medicine had gone a year previously. I decided to settle with an O level in economics and went on to do straight A level politics. However, I remember that dad …or rather Mr Bell…talked in an economics lesson about the fact that within our lifetime we would experience a shift in working patterns as technology created efficiencies that would result in more leisure time. The leisure industry would grow and people would work less because tech and IT would make it possible to achieve tasks in less time.
I do remember wondering about the subtle difference between having more leisure time and being unemployed…..however, there was clearly an economic model underpinning the ideas.
So, where has the Generation Leisure, forecast in 1986, gone? Seemingly, instead having more time and leisure in which to have fun, we find that “British teenagers are among the most troubled in the world”: of the 42 nationalities surveyed in one report, only Macedonian and Polish teens were less happy with their lot.” It reported that we have teenagers crippled by anxiety; about debt, about terrorism, about social relationships. But in fact the article did then go on to give some hope, pointing out that teenagers generally also value authenticity, connection and friendship but it was hard to find this amongst the gloom.
There is no doubt that we live in a society that should have more free-time and where technology has created efficiency. Take a practical example. In 2016 I was studying for the Scottish ‘Into Headship’ course which required me to read a lot of academic literature. Twenty years ago, this would have probably required me driving to Glasgow (2 hours each way), going to a library, checking out each and every book and article (because they would have been the type that you could not take home), sitting and reading each one and taking copious notes. I cannot begin to calculate the time that this would have taken; time away from family, dead time travelling, time finding parking, time stuck in traffic. Today, I can click on a link in a virtual library and the book is here, on my laptop. I can read parts of it, go and put on a load of washing, come back to it, add notes electronically, spend an hour on a family walk, come back to it again.
Hours of my life have been saved in this way. I have hours more time that I can spend on leisure, with my friends and family, relaxing, meditating, right?
But actually, no. Because those hours that I have gained have somehow been hi-jacked by other things; learning Spanish, exercising, cleaning the house, trying once again to sort the finances. Doing, doing, doing……worrying, worrying, worrying.
Because the reality is that free time is SCARY. And space and quietness are times where the mind can ask those disturbing questions:
Who am I?
What is life all about?
Who do I want to be?
I would argue (and I know that others have done it more eloquently) that these questions are particularly disturbing in our now largely secular society where God, the church and the state no longer provide the majority with answers to questions about the meaning of life.
And so instead of trying to provide secular answers to the meaning of life and self, we have created a religion of busyness.
And in my 2016 blog, I suggested that it was not just an issue in the world of young people and education. Read Ariana Huffington’s book ‘Thrive’. Read or watch ‘I Don’t Know How She Does It’ by Allison Pearson. And listen to John Lennon’ s ‘Beautiful Boy, written as long ago as 1981, where he said “Life is what happens to you while you’re busy making other plans.”
In my 2016 blog, I also went on to talk about the fact that what we may have come to label as a crisis of individual mental ill-health is perhaps in fact more of a societal dis-ease that education can help to play a part in addressing. Surely, as educators, parents and people, we need to encourage Generation Leisure to learn how to live and be happy in the life they have.
To know themselves and their minds.
To live with uncertainty and understand the things they can be certain of.
To embrace the best in social media and to reject the rubbish.
Back in 2016 there was a growing movement who were working hard to take this forward. They included the ‘#teacher5aday group, the #optimisticEd group, those who are fighting to raise the profile of PSHE (including Dr Pooky Knighstsmith @PookyH) and of course the man who now goes by the title ‘my favourite Doctor’, Dr Tim O’Brien and his book ‘Inner Story’; you can read my review here: http://staffrm.io/@lenabellina/LDzWUOXAjW.
My blog finished with a reference back to Mr Bell and economics. Another lesson led me to the work ‘Leviathan’, written by Thomas Hobbes in 1651 which referred to the state of mankind, when unregulated, as “solitary, poore, nasty, brutish, and short.”
Over 300 hundred years later and, even though we haven’t left the EU yet, our lives (at least in the Western world) are far from this. Yet, reading about Generation K and the crisis in teenage mental health in 2016, and we might have been led to believe that they are.
By 2017 we were still reading more of the same:
And this summer, we got this:
I don’t deny that provision in the UK for children and young people who are highly distressed, suicidal and suffering mental illness are woefully inadequate and I have been fairly relentless in my campaigning to improve things. It hasn’t always won me friends or helped my career prospects. But when I see austerity impacting on the wellbeing of children and leading to the deaths of children then I will not keep quiet.
Children with acute mental illness need specialist support an often they need it urgently, or they are at risk of death.
I don’t disagree with reports like this when they are evidence-based and if they help raise awareness that we need to talk. But I also think that we need to be clear what we are talking about. Teenagers have always suffered from emotional difficulty; it is part of being an adolescent and it is really important that we acknowledge that and talk about it as teachers and as parents/carers. For more on this, check out the pioneering research being done by neuroscientist Professor Sarah Jayne Blakemore and others in her field. We also need to ensure that we don’t create a crisis of “mental illness” or teenage depression by somehow turning normal emotions into something pathological. In perhaps the greatest and most popular study of teenagers ever, Shakespeare presents adolescence in all its terrible, emotional beauty; “Romeo and Juliet” deals with the issue of teenage suicide.
Last week we had this in the news. The slightly heart-breaking but also inspiring revelation that chirpy, positive Ruth Davidson suffered as a young person but hasn’t let it hold her back:
Now, not to labour the point, there was clearly some degree of teenage mental ill health back when Ruth was younger, a good 20 years ago when there was no social media and none of the associated pressures.
And back when this young university student was smiling on a German statue around 30 years ago there was also a lot of turmoil and mental distress under the smile:
Maybe more of her later…
If we look at the various articles I have referenced above or other sources to find suggestions as to the cause of the ‘crisis’ that we are facing, what do we find?
Well, social media gets apportioned a lot of the blame, that’s for sure (we hear about its alleged impact on body image fears, perfectionism and the fear of missing out) but actually what we know is that social media is still in its relative infancy in terms of robust and longitudinal research into its impact. Much as we THINK or FEEL that young people are more body conscious because of social media, we don’t KNOW.
In fact, if you follow the right you-tubers as a teenager on social media, you might, in fact, discover a whole tribe of like-minded individuals who make you feel better about yourself and your body, rather than worse.
What we DO know is that the ability of young people (and adults) to SWITCH OFF and have time away from connection with others is hugely reduced by social media and that this is likely to be affecting our thoughts, emotions and relationships.
We do know that technology is likely to be having a worrying impact on the quality of people’ s sleep in the 21st century and that poor sleep hygiene and poor mental health are clearly interconnected. For more on this, look at the research of Dr Mike Farquhar, Consultant in Sleep Medicine at Great Ormond Street Hospital:
However, the causes behind the so-called crisis are not easy to define…because if they were, surely they would be easy to address.
Last summer I read a book by Matt Haig which I would highly recommend as an analysis of the possible reasons behind the societal dis-ease that is affecting many young people.
Notes on a Nervous Planet is brilliantly written as it tells Matt Haig’s personal story of anxiety, depression, existential doubts and literary genius but also draws on the ideas of other researchers and thinkers. Here, for example, he quotes Harari’s hugely influential book Sapiens…..and I don’t think this is a million miles away from what we talked about back in Mr Bell’s economics lessons.
Before we move on from the possible causes of any mental health crisis, I just want to mention this:
Because the world is confusing and hard to understand a lot of the time, not just for children, but for us adults too. And it’s only if we talk about it, that we will be able to manage it. I am not sure why this man is a role model. If I could, I’d ask him what he has to say about some of the mistakes from his past and debate whether he is actually the ultimate authentic role model who admits that he is flawed and has erred but is now repentant and looking to be forgiven so that he can work productively and fruitfully to make a contribution to his community. Maybe I would be able to forgive him and move on. But maybe some of the victims of his past would find it harder.
But to return to my first slide, whatever the reasons may be, a lot of young people would appear to be struggling and it seems logical that we, as people who are working to educate and support young people, should talk and teach about it.
The third reason behind my assertion is this.
In 2016 I did a poll on Twitter about staff mental health.
A friend who is a teacher in England and whom I really trust had said the phrase quoted to me.
I had heard of a school leader who had recently said that she had concerns over a prospective employee because she knows that she had suffered depression in the past.
I was aware that the virtual community of which I was a part at the time was something of an echo chamber. The amazing, positive, empathic, wonderful people whom I was engaging with through #teacher5day, “HealthyTeacherToolkit” and other forums did not, I feared, represent the whole of our profession. And that bothered me. I had written a lot on this matter and about how I think it SHOULD be in schools.
Of course, the poll was pretty unscientific and I am sure that the wonderful researchEd crew and Tom Bennett would have been pretty unimpressed:
For a start, there was no definition of what I meant by mental health.
I did not specify whether I wanted people with a medical diagnosis or the self-diagnosed to respond
And I did not ask the same question relating to physical health in order to make a comparison. I was hugely thankful to those who engaged with this and showed a shared passion to make things better.
The slide shows the final result:
Unscientfic or not, there was a message here. Thank goodness for that 65%. But 35% agreeing?
Many people also tweeted thoughts and several sent me longer direct messages.
And the real value of this exercise was in these responses and stories:
Some teachers and leaders answered with a definitive “I do not agree” and talked about schools where the mental wellbeing of staff is prioritised.
Others talked of having experienced terrible treatment in one school only to find a sympathetic approach in another so that they could continue successfully in their careers.
Some teachers talked of having been dismissed in defiance of equalities legislation but without the resilience or support to challenge this; the law is one thing but invisible prejudice that cannot be proven is another.
Others spoke of being forced into early retirement having shown vulnerability or having asked for support or reasonable adaptations.
And so on.
It seemed clear that there were some amazing schools out there doing an amazing job. There was a lot to be learned from them. But there were clearly also schools where there was room for improvement.
Some observations I made at the time
The education of our children is not something to be taken lightly.
Having someone who is able to be nurturing, calm, positive, realistically optimistic and caring for children is vital. If you aren’t those things, you probably need to do some reflection on whether now is the right time for you to be working with young people.
But that is not to say that you can’t be all of those things and suffering from mental health issues. There are teachers who put on the act during the day but struggle out of school with stress. There are functioning, thriving depressives. There are those who experience anxiety but manage it.
Let’s be honest. If someone is suffering from a bout of severe depression, they will probably be incapable of putting everything needed into teaching a class of thirty adolescents.
But then again, so would someone suffering severe back pain.
Teaching is stressful and maybe those who are not mentally resilient are not best suited to be in a classroom under intense pressures.
But there are other options. Teaching adults. Teaching part-time. A career break for recovery.
Absence in school through any type of illness is hard to manage. Getting quality supply can be difficult and absence can impact on teaching and learning. But school leaders can minimise absence through awareness of their staff members’ wellbeing, early intervention and by creating a culture where it is ok to ask for help.
The individual school context and ethos are key. If ethos is not right, it is this in itself that may lead to a person suffering from mental ill health even if they had no issues previously.
If you hit me with a stick, I will suffer physical injury and distress. If you shout at me, bully me, exclude me, undermine me, I will suffer mental injury and distress.
(In the long term, I (and others) would like to see the following implemented in order to ensure that moving forward, all schools are happy, healthy environments:
The inclusion in all leadership and headship development courses of modules on staff wellbeing management.
The inclusion in all initial teacher training courses of modules on managing emotional health and wellbeing in a high-challenge profession.
Awareness raising around equalities legislation that tells us that it is illegal to discriminate against someone who has mental health issues (current or past).
The development of education-specific occupational health teams.)
In the short term, here’s what I suggested that people could do, whether they were a head teacher or a dinner lady:
- Be reflective about your own assumptions and prejudices and learn about mental health, what it is and what it is not. Do a mental health first aid course or look at website like this: https://www.scottishrecovery.net/.
- Engage in all those behaviours and kindnesses that you teach your pupils about.
- Challenge gossip and rumour about others.
- Challenge bullying behaviour and cliques.
- Avoid repeating certain clichéd phrases – for example “she’s off her head”, “he’s a psychopath”.
- Watch out for each other and ask people how they are. Listen to the answer.
- Challenge stigma.
- Ask for help when you need it.
- Celebrate the wonderful diversity of your colleagues and embrace them for all they are, vulnerabilities and strengths.
- Love the ones you’re with. You never know when they may not be there.
Back for a moment to this book; I really like the way that Matt Haig talks about stigma here:
If as adults, we stuggle to talk, how on earth are children going to manage?
But hopefully, things are changing.
And this brings me on to my next reason.
We need to create cultures in schools where pupils meet with adults who care about them and show them unconditional positive regard.
What this means is adults who see them as lovable and full of potential and able to learn, even when sometimes they can’t act loveably or learn for the moment. Who show them that they respect and have time for them even when they sometimes have difficult things going on in their heads and make poor choices.
Who don’t judge them because they sometimes act out because they are feeling so bad.
Who don’t shame or punish them for their behaviours but allow them to get it wrong in the hope that with good teaching and support they will learn to get it right.
Who don’t punish precisely those pupils who are living the hardest lives and deserve more support than others.
These are the teachers and adults who make a difference to children who are struggling to make good choices and are therefore mentally unhealthy.
Chris Kilkenny is a care-experienced speaker in his early twenties who grew up in poverty, in care and in addiction services because of the addictions that had been passed on to him in utero. I am honoured to call Chris my friend. He talks about the very poor experiences he had in school when there were no adults willing to see beyond his behaviour and take the time to see that he was struggling. No-one who asked how he was. No-one who was there, day-in, day-out. Chris now goes into schools and talks about the difference that just one adult can make to the life of a child by doing the simplest things. If you want to hear Chris talk about this, find last week’s Ricky Ross Show from Sunday morning on STV catch-up. Or watch out for him on the STV Appeal this coming Tuesday, 25th September at 7.30pm. Chris is also part of the ACE Aware Nation movement in Scotland which is driven by the fundamental belief that adults working together can mitigate against the damage of trauma that children may experience in their lives.
(The movement has been responsible for bringing screenings of the film Resilience to Scotland under the passionate leadership of Dr Suzanne Zeedyk who is is a research scientist fascinated by the connections between our emotional and physical health. More information can be found here.
Suzanne’s core aspiration is to strengthen awareness of the decisions we take about caring for our children — because those choices are integrally connected to our vision for the kind of society we wish to build.
Her team have been working for some time to bring awareness to the UK and Scotland around what have come to be known as Adverse Childhood Experiences and which are the subject of the film.
The Scottish Tour took place between 29th April and 1st July 2017. Over that nine week period, 28 screenings of the film were hosted, all over the country. Almost all of them sold out. Twenty-five were community screenings, held as far north as Shetland and as far south as Dumfries. The remaining three were additions: the Premiere, a screening for the business community, and a screening for Scottish Government civil servants. In total 2,435 people came.
Since the tour, there have been numerous screenings and the film has had huge impact in moving forward Scottish society’s understanding of what needs to happen to help children thrive.
Interestingly, Vincent Felitti, one of the doctors who appears in the film was here in Scotland 10 years ago and spoke about the issues– but there was no revolution then.
The power of this film seems to be that it has sparked what Suzanne calls a revolution in kindness to children.
Revolution happens because individuals want it to happen.
One of the key messages of the film is that to be resilient role models to children, we have to first acknowledge our own uncomfortable feelings and take ownership of any bad things that have happened to us so that we can move on from them.
Jack P Shonkoff MD speaks about the fact that children who are born with a poor start in life are not doomed. The science shows otherwise. He speaks about the term toxic stress stress which is the chronic activation a stress reaction with no support to manage that stress.
Resilience (the ability to survive and thrive in spite of trauma) is learnt but you cannot learn it if you are living in a culture of fear. A child cannot learn conflict resolution if his parents are constantly fighting.
A child cannot plan for the future if she lives in a culture of fear where the future seems frightening. A child cannot learn to delay gratification if she is constantly mixing with friends who do drugs. The key to learning resilience is the presence of stable and caring adults. In order for adults to be caring and stable they need to acknowledge their own early experiences and transform their own lives. Adults need to build their own capabilities in planning, monitoring, and impulse control. This is about more than just reading to kids.
It’s crucial that those involved with the children are trauma informed. We should not talk about what is wrong with children. We should talk about what has happened to children.
– Some teachers may feel that they are not qualified to do this work as they are not therapists But this is not about therapy. It is about life. It is about us adults being honest about the ups and downs of life but showing up and being role models.
– And no matter how jaded we feel, we can’t give up.)
Just for a moment, I would like to return to the idea of us being role models. It is important that, as role models to young people, we show our own vulnerabilities as well as our strengths. Even though I am the head teacher in my school, all my pupils knew a year ago that my dad was not well with cancer and that I was struggling a bit because I talked about it ins assemblies..but they also saw me come out the other side of it and manage the emotions around this difficult situation.
They also know that I struggled with anxiety and perfectionism when I was in my early 20s because I have told them; I want them to learn from where I went wrong. I fell into some very helpful at the time (but damaging in the long term) coping mechanisms that have taken me years to unpick and are still hard to shake.
They don’t know the full details but I can tell you that it was a pretty dire time for me and that I fought some really difficult battles to stay mentally healthy. I am 100% certain that if someone at school had talked to me about mental health I wouldn’t have had such a difficult time. When we do talk and learn about it we can feel better and children need to know that. More on this type of experience from a friend here, if are interested, though it does not make for easy reading.
Even Mrs Smiley, positive Carter goes through difficult patches and that is ok. In my opinion, children need to see that. My own two children need to see that too.
Perhaps it is better to say that children are at risk of death when we don’t teach them to be mentally healthy. Let’s not fall into the press tendency to over-dramatise.
But there is no expressing what you go through, as a teacher, when a young person in your care commits suicide.
And of course, adults who have not been taught to be mentally health are at risk too.
So. What can we do, in practical terms, if we want to talk and teach about mental health?
Just start. Use the WHO definition of mental health and start a conversation.
Look at the Action for Happiness website. It is a fantastic resource, full of free to use material and fully backed up by robust research from great thinkers like Lord Layard and the Dalai Lama:
Although we need to talk about mental health, talking is not always easy.
We started this campaign in our school a couple of years back and it worked well in many cases, but not for all pupils.
One of the things that has upset me the most recently is hearing professionals from CAMHS say that they can’t do anything for a child because the child won’t engage, by which they mean, talk.
Who has a teenage child in the room?
And how chatty are they?
We KNOW that teenagers often lose the power of verbal communication and revert to monosyllabism when they hit adolescence so why would anyone expect them to talk to a therapist or counsellor about feelings?! We need to do better than that and offer something else.
For me, that is often simply hello and eye contact at the morning bus drop off. Or just offering a smile every day in class. Or maybe writing a postcard to say something positive. Or organising a lunchtime club.
You don’t need to be CAMHS trained to do these things. But they DO make a difference.
We can talk to children about some of the difficult issues in life and we can create a culture where we use assemblies and lessons to model openness and honesty. But they may not always want or be ready to talk back and therefore we must never push it.
Thanks for listening. I hope that some of this may be of some use.