Promoting student resilience and wellbeing/ responding to mental health needs

Liz Kemp Senior Project Officer Response Ability Initiative Hunter Institute of Mental Health Liz.Kemp@hnehealth.nsw.gov.au

Aims to promote the social and emotional wellbeing, or mental health, of children and young

people through supporting the pre-service training of school teachers and early childhood

educators.

www.responseability.org

Hunter Institute of Mental Health

A leading national organisation dedicated to reducing mental

illness and suicide and improving wellbeing for all

Australians.

www.himh.org.au

Response Ability

Overview

• What is mental health and mental ill-health • Mental ill-health in children and young people • What can teachers do?

– Promoting mental health and wellbeing and preventing mental ill-health

– CHILD framework – GRIP framework – Resilience – Looking after yourself

• Questions

What is mental health and mental ill-health? “…a state of well-being in which the individual realizes his or her own abilities, can

cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” (WHO, 2004, p. 12)

• Mental health = positive capacity = social and emotional wellbeing = behaviour, thoughts and emotions ≠ mental ill-health ≠ happiness

What does mental health look like?

Personal development

Positive and respectful relationships Identify, manage and

understand emotion

Communication Solve problems, make decisions,

take responsibility

Set goals

Why is mental health and wellbeing important?

• Healthier lifestyles • Better physical health • Improved recovery from

illness • Fewer limitations in daily

living • Higher educational

attainment

• Greater productivity • Greater employment and

earnings • Better relationships • Increased social cohesion • Improved quality of life.

Mental ill-health in children and young people

• 14% of children and young people (4-17 years) experience mental ill-health

• Highest prevalence in 12-17 years • Adolescents with mental ill-health report a higher rate of suicidal

thoughts and risk-related behaviour (Sawyer et al., 2000)

• 21.2% of 15-19 year olds met criteria for probable mental illness (Ivancic et al., 2014)

• Depression and anxiety are the most common forms of

mental illness

Mental ill-health in children and young people

Age of onset: • Approximately 50% of mental disorders occur prior to 14 years,

and 75% of mental disorders occur by 24 years . (Kessler et al., 2007)

In terms of support: • Only 25% (1 in 4) of young people with mental ill-health received

professional health care • For older children, care, was more likely to be received

through school-based counselling services (Sawyer et al., 2000)

Anxiety

• Everyone experiences stress and anxiousness at times – in moderation this can be beneficial

• Anxiety experienced in anxiety disorders differs from normal response via being: – More prolonged – Not subsiding when prompting event/threat passes – Occurring out of the blue without a particular reason – Can impair relationships, schooling and everyday functioning

• 15.4% 16-24 years olds have anxiety disorder 21.7% F, 9.3% M (Australian Bureau of Statistics, 2008).

Anxiety symptoms

• Nausea, perspiration and racing heart

• Persistent worry • Restlessness and irritability • Crying • Loss of temper • Procrastination • Disruption to sleep and eating

• Decline in academic performance

• Truancy • Increased use of alcohol /

drugs • Withdrawal • Obsessive thinking • Perfectionist behaviour

Depression • More than just a low mood, or feeling sad from time to time • Can impact on:

– Enjoyment of activities – Energy levels – Sleep – Concentration – Coping with day to day activities

• An estimated 6.3% of Australians aged 16 -24 experience depression in any year (Australian Bureau of Statistics, 2008).

Depression signs

• Frequently upset, sad, anxious or negative

• Irritable, angry or aggressive • Crying • Losing temper • Withdrawal and isolation • Risky or criminal behaviour

• Increased use of alcohol or other drugs

• Decline in energy • Lack of enjoyment • Decline in academic

performance • Self-harming behaviour or

suicide attempts.

Why address mental health promotion, mental ill-health prevention and early intervention?

Research suggests that mental ill-health is associated with:

• poorer health (including physical)

• reduced social functioning • behaviour problems • lower academic achievement • higher substance abuse.

Mental Health Promotion and Early Intervention can help:

• reduce risk factors • increase protective factors • improve future mental health

outcomes.

Risk and protective factors

Risk factors: • Increase the likelihood of a mental health problem or illness • Do not cause illness • Have a cumulative effect

Protective factors

• Decrease the chances of mental health difficulties • Promote mental health

Risk factors for mental ill-health Child

• Overly fearful or anxious • Argumentative and non-

compliant • Learning difficulties • Poor attachment

Family • Inconsistent supervision • Lack of warmth and affection • Parental health problems /

substance abuse • Family violence or conflict

Social • Bullying others / Being bullied • Peer rejection • Being withdrawn • Socioeconomic disadvantage

School or Centre • Inadequate behaviour

management or supervision • Learning difficulties or

academic failure • Poor attachment to

school or centre

Protective factors Child

• Secure relationships • Positive expectations of self • Hopefulness • Autonomy • Problem-solving skills • Social skills • Self-regulation

Environment • Warm environment at home • Supportive environment in

childcare or school • Consistency with firm limits

and boundaries • Opportunities for

participation

Role of teacher

• The capacity to promote mental health is essential to every aspect of teaching and every teacher.

• ‘Every teacher is a teacher for wellbeing’ MindMatters.

Teachers make a difference

Creating safe and supportive environments for optimal wellbeing and development

• Care and respect • Behavioural guidelines • High but achievable expectations • With discipline focus on behaviour • Acknowledge strengths and abilities

C

• Model effective social and emotional skills • Set tasks needing problem-solving and negotiation skills • Build emotional literacy and empathy • Teach coping skills

Helping children to learn social and emotional skills and manage their own behaviour

H

Identifying babies, children and families who may be in need of additional support

What should I look for? • Feelings • Thoughts • Behaviour • Situations

I

Identifying those in need of support

Feelings • Anxiety, guilt, sadness • Swinging between positive and negative • Feeling bad about themselves

Thoughts

• Negative or worrying thoughts • Problems concentrating or making decisions • Rapid thoughts or ideas

Identifying those in need of support Behaviour • Withdrawn and avoiding social contact • Crying easily • Irritation or aggressiveness • Decline in academic performance • Being lethargic • Talking or writing about things that do not make sense • Neglecting personal appearance • Changes to sleeping and eating • Extreme behaviours such as aggression or self-harm

Identifying those in need of support

Situations • Being bullied, teased or ostracised • Family conflict • Breakdown of relationships and

friendships • Concerns over sexuality • Having a parent or carer with a mental illness • Surviving a traumatic event • Having a serious chronic illness

Identifying those in need of support

• A minor or short-term change, or an isolated incident, may not be a problem.

• Look for severity, persistence over time, and several problems occurring together

Remember: • It is not the teacher’s role to diagnose or treat mental health

problems • Teacher’s role is observe, identify and refer.

Linking children, young people and families with support and information services for mental health and wellbeing

Teacher’s and early childhood educators can do this by: • Having knowledge of local support services • Effective partnerships • Referral

L

Linking children, young people and families with support

• The school counsellor, or support workers through district offices • Local GPs • Youth centres and services • Youth health / mental health services (part of local government health

services) such as Headspace: www.headspace.org.au • Your local hospital (child and adolescent services; emergency services) • Lesbian, gay, bisexual, transgender, intersex or queer support groups • Drug and alcohol support groups • Psychologists or counsellors • Psychiatrists • Lifeline (13 11 14) • Kids Help Line for ages 5 - 25 (1800 55 1800)

Developing broader organisational and community strategies that support wellbeing

• Support policies and practices • Participate in programs to

support mental health • Professional development • Work in partnership

D

Resilience

• Capacity to maintain or re-establish our mental health and wellbeing in the face of significant changes or challenges.

• Resilience impacts our thoughts, emotions, behaviours and social interactions.

Some of the characteristics associated with resilience include:

• Effective communication skills • Assertiveness, asking for help • Self-efficacy • Problem-solving and decision-making abilities • Flexibility • Trust in others • Sense of hope for the future • High expectations

(For other examples see Earvolino-Ramirez, 2007).

The characteristics associated with resilience can lead to:

• Greater academic achievement • Positive relationships • Socially appropriate behaviour • Reduced risk of mental health problems

Drama piece – Deep breaths

When watching the play think about: • How Katie demonstrates

resilience? • The role each character

has in supporting Katie and promoting resilience (eg her teacher, principal, best friend, boyfriend, and mother).

How Katie demonstrates resilience

• “The first step to recovery is admitting you have a problem” (self-awareness)

• “Catch up on all that worked you’ve missed out on” (do the best you can) • “Make amends with those who you’ve hurt” (re-connect with friends) • “If you need help, just say so” (reach out to those who care) • “If you’ve got fears you’ve got to face them head on” (tackle your

problems rather than avoiding them) • “Stay positive and know that you’ll get through it” (use your internal

strength and skills to cope)

Other characters

The other characters helped promote Katie’s resilience: • Katie’s teacher and principal had high but realistic

expectations • Her boyfriend and friend were open to talking • Her mother encouraged her to seek professional help.

Specific techniques to promote resilience in students

• Using praise and rewards • Clear class rules and values • Collaborative group work • Giving students a sense of mastery • Individual attention • Asking about students extra-curricular activities • Teaching problem solving, coping skills and help-seeking • Allowing students to express a wide range of emotions • Modelling appropriate responses to situations • Showing respect to all students: this includes reducing stigma

toward mental illness

Additional resources - resilience For more information on resilience including general ideas for how to promote and support resilience in classrooms and schools see the “Resilience” fact sheet at www.responseability.org or visit: • Resilience Net resilnet.uiuc.edu • Kids Helpline www.kidshelp.com.au/teens/get-info/hot-

topics/being-resilient.php • MindMatters www.mindmatters.edu.au • Keeping Cool www.keepingcool.edu.au/node/97 • Aussie Optimism

healthsciences.curtin.edu.au/teaching/psych_aussie_optimism.cfm • Open Doors opendoors.com.au/studentA.htm

More info • Social and Emotional Wellbeing:

A Teacher’s Guide • Fact sheets and podcasts on

www.responseability.org

• What might I actually say? Responding to mental health problems fact sheet/podcast

Physically: • Healthy diet, regular exercise and adequate sleep • Monitor and manage your stress in positive ways • Make time for relaxation and fun • Limit the use of alcohol and other substances

Relationships: • Foster and maintain your personal relationships • Strive for balance between your study/work and your personal life

Work/study: • Develop interests and friendships outside of your work/study

environment Spirituality:

• If you have spiritual beliefs, make time for regular spiritual practice, or relationships with others who share your philosophy.

Wellbeing and self-care factsheet www.responseability.org

Looking after yourself

It’s ok to ask for help Reach out for support when you need it:

• Friends • Family • GP • Psychologist • Student counselling service • Lifeline, a 24-hour telephone

counselling service (13 11 14).

Additional resources

• Response Ability: www.responseability.org • MindMatters: www.mindmatters.edu.au • Health Direct Australia: www.healthdirect.gov.au • HeadStrong: www.headstrong.org.au • SANE Australia: www.sane.org • ReachOut.com: www.reachout.com • beyondblue: www.beyondblue.org.au • headspace: www.headspace.org.au

References Australian Bureau of Statistics (2008). 2007 National Survey of Mental Health and Wellbeing:

Summary of results (4326.0). Canberra: ABS Earvolino-Ramirez, M. (2007). Resilience: A concept analysis. Nursing Forum. 42(2), 73-82. Ivancic, L., Perrens, B., Fildes, J., Perry, Y. and Christensen, H. 2014, Youth Mental Health

Report, June 2014, Mission Australia and Black Dog Institute. Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S. & Ustun, T. B. (2007).

Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359-364.

Sawyer, M., Arney, F. M., Baghurst, P. A., Clark, J. J., Graetz, B.W., Kosky, R.J., Nurcombe, B., Patton, G.C., Prior, M. R., Raphael, B., Rey, J., Whaites, L. C., & Zubrick. (2000). The Mental Health of Young People in Australia. Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care.

World Health Organisation. (2004). Promoting Mental Health: Concepts, emerging evidence, practice: Summary report. Geneva: World Health Organisation. Accessed April 12, 2012 from http://whqlibdoc.who.int/publications/2004/9241591595.pdf

Contact Details Liz Kemp Senior Project Officer Liz.Kemp@hnehealth.nsw.gov.au Response Ability email: HNELHD-Education@hnehealth.nsw.gov.au

Websites: www.responseability.org www.himh.org.au

Phone: 02 4924 6900