Tackling children’s mental health issues in schools

Do you do something every day to look after your mental health? Do you often talk to your children about how they can best manage their thoughts and emotions?

The opening questions of Prof Deirdre Heenan at the Institute of Public Health Open Conference in Belfast in October certainly made us all feel like it's up to us to look after the mental health of our families and ourselves.

However, what happens if families are struggling with loss, trauma and stress in their own lives? Heenan, who is from the School of Social Policy at Ulster University, and Prof Siobhan O’Neill, from the School of Psychology at Ulster University, suggest schools are the ideal place to teach children how to be mentally healthy, just as they are now expected to keep children physically healthy.

“Schools are the hubs of our communities and children, parents, carers and teachers are crying out for help. We expect children to be mentally active for six hours a day and then don’t teach them how to manage stress,” says Heenan.

O’Neill says many students still don’t fully understand their emotions. “I was 30 before I learned about the fight or flight response [the body’s reaction to lash out physically or run away when stressed], and many secondary school students today still don’t fully understand their emotions.”

She believes we can teach children the skills to regulate their feelings and behaviours. “It’s very powerful to discover that your emotions and thoughts don’t define you and through mindfulness training, you can watch them float by. This is important for all children but it’s particularly important for the 20 per cent of children at risk of mental health problems,” says O’Neill.

Cultural change

According to Heenan, mental health and wellbeing shouldn’t be added on to a long list of things to do in schools.

“We need a cultural change from schools focusing on academic indicators to wellbeing indicators. Mental health awareness should be a natural part of every class. The whole ethos of schools should be based around a vision of wellbeing with supports for students and staff,” says Heenan, who is keen to develop a model for a wellbeing school.

O’Neill says that mental health is often only discussed when there is a teenage suicide or other tragedy linked to the school. “Suicide prevention is often too little, too late. The process can even be quite harmful as students reveal things and there isn’t any follow-up on it,” says O’Neill, who is also a suicidologist.

Many schools in the Republic have already introduced relaxation and mindfulness classes into the curriculum, but the two academics from Ulster University suggest an ethos of wellbeing requires much more.

“We need to teach children to programme their brains to self-regulate when faced with stressful situations. To do this, we need to teach them mindfulness and relaxation training, skills in relationship management and negotiation, how to deal with loss and trauma and then to have the self-esteem to know when to seek further help,” says O’Neill.

She says there is a strong evidence base for this preventative approach to mental illness. “We can see the signs of mental illness in children as young as eight. Girls develop phobias or social anxiety and boys tend to develop oppositional behaviours. Self-harm in teenagers is an attempt to get relief from a terrible state of mind.”

While she acknowledges that genetic, personality and family issues also play a part in the development of mental illnesses, she says training children to manage their mental health is a key to prevention.

“If we were able to teach these children how to regulate their thoughts and emotions, we can build emotional resilience in them to prevent alcohol or drug addictions, depression or anxiety from developing in early adulthood.”

With so many demands on teachers and current issues around assessment of the new Junior Certificate exams still unresolved in one major teachers' union, it seems unlikely that schools in Ireland will be willing to take even more responsibilities for students.

However, O’Neill says this work should be done at teacher training colleges. “It’s not the sort of work that requires psychiatric or even psychological training, it’s about teaching teachers to look out for signs, building these programmes into the curriculum and then having clear routes to specialist services for families that need them.”

The Institute of Public Health Open Conference

The all-Ireland Institute of Public Health (IPH) holds its free Open Conference every second year. The 2016 conference was held at the Titanic Centre in Belfast in October.

Those who register to attend get to choose the papers that are presented at the conference by voting from the abstracts that are submitted. In 2016, 300 people chose the 15 papers from 80 abstracts submitted for possible inclusion. In an innovative move, Prof Roger O’Sullivan, director of the IPH, invited delegates to stand rather than sit if they preferred, simply to highlight the health risks of sedentary behaviour.

The themes of presentations ranged from the benefits of a sugar tax to dance classes for older people. Research specifically related to children looked at how children who have more than two hours screen-time daily and less than 60 minutes’ physical activity are more likely to experience headaches, stomach aches, backache, general irritability, anxiety and low mood.

Another researcher outlined the benefits of free healthy lifestyle courses (with a focus on healthy eating, physical activity and emotional wellbeing) for families with young children at risk of obesity.

Another looked at the value of school-based smoking-prevention programmes targeted at 13- to 14-year-olds, the age that teenagers were deemed most likely to begin smoking.

iphopenconference.com