Helping schools to support young people with mental health needs.

24th October 2014Oakwood House – John Wiggin Room

Focus on:• Context

• Main areas of need

• Risk and Protective Factors

• What to do

• What works

• The opportunity

Mental health and behaviour in schools- Departmental advice for school staff.

Department for Education - June 2014

Context

• One in ten children and young people aged 5 -16 have a clinically diagnosed mental health disorder

• A further 15% (i.e 1 in 7) have less severe problems that put them at increasing risk of developing mental health problems in the future

10% of children and young people with a diagnosed mental health disorder

• 5.8% of all children have a conduct disorder.

(This is twice as common among boys as girls)

• 3.7% have emotional disorders

• 1.5% have hyperkinetic disorders.

• 1.3% have disorders such as ASD, tic disorders, eating disorders, mutism

• 2.0% of all children are diagnosed with more than one of the main categories of mental disorder.

Main Areas of Need

• Conduct disorder (defiance, aggression, anti –social behaviour, stealing and fire setting)

• Anxiety ( worries about things that are happening at home or school or due to a traumatic event)

• Depression (where feeling low or sad dominates or interferes with a persons life)

• Hyperkinetic disorders – such as ADHD involving inattention, hyperactivity and impulsivity. Core symptoms present before 7 years and evident in two or more settings

Main Areas of Need

• Attachment disorders: The affectionate bond children have with special people in their lives. An important protective factor for mental health and the absence of this as a risk factor for the development of behaviour problems.

• Eating disorders: Anorexia nervosa and bulimia nervosa

• Substance misuse : Can result in physical or emotional harm

• Deliberate Self Harm : e.g. hitting, cutting, burning, inflicting punishment on oneself

 

Video Interaction Guidance and Attachment

• Strong evidence supports video feedback based interventions.

• http://www.edukent.co.uk/our_services/service/educational_psychology/

Understanding the risk and protective factors for child and adolescent mental health ( examples) – In

the Child

Risk Factors

• Communication Difficulties

• Difficult temperament• Academic failure • Low Self esteem

Protective Factors

• Secure attachment experience

• Good communication skills, sociability

• Humour • Being a planner and

having a belief in control• Problem solving skills and

a positive attitude• Capacity to reflect

Understanding the risk and protective factors for child and adolescent mental health ( examples) – In

the Family

Risk Factors

• Overt parental conflict• Inconsistent or unclear

discipline• Hostile or rejecting

relationships• Failure to adapt to a

child’s changing needs• Death and loss- including

loss of friendship

Protective Factors• At least one good parent-

child relationship ( or one supportive adult)

• Affection• Clear consistent discipline• Support for education• Supportive long term

relationship or the absence of severe discord.

Understanding the risk and protective factors for child and adolescent mental health

( examples) – In the School

Risk Factors

• Bullying• Discrimination• Poor pupil to teacher

relationships• Lack of positive

friendships• Peer pressure

Protective Factors

• Clear policies on behaviour and bullying

• Positive classroom management

• A sense of belonging• Positive peer influences.

The balance between risk and projective factors is most likely to be disrupted by difficult events in pupil’s lives:

• Loss or separation ( e.g. death, parental separation, divorce, hospitalisation, loss of friendships , family conflict of breakdown)

• Life changes ( e.g. birth of a sibling , moving house or changing schools)

• Traumatic events ( e.g. abuse, domestic violence, bullying etc)

Resilience

• “Resilience seems to involve several related elements. Firstly, a sense of self esteem and confidence; secondly a belief in one’s own self-efficacy and ability to deal with change and adaptation; thirdly , a repertoire of social problem solving approaches”- Rutter M (1985)

 

Resilience

• Big Lottery define’s resilience as:

“ The opportunity for and capacity of young people – in the context of adversity- to negotiate for an navigate their own way to resources that sustain their mental health”

• Young people in Kent define resilience as:

“The ability to be mentally strong enough to bounce back from the problems of life”.

What to do…..

• Cultures

• Policies

• Practices

Culture

• A committed Senior Management Team- values all pupils, promotes a sense of belonging, enables talking about problems in a non-stigmatising way.

• An ethos of high expectations and consistently applied support- clear policies on behaviour and bullying, clear responsibilities of all in the school, a range of acceptable and unacceptable behaviour for children. Understood by all and consistently applied.

• An effective strategic role for the qualified teacher who has the role of SENCO-ensuring that all adults understand their responsibilities to children with SEND. This includes those with persistant health difficulties and therefore require SEN provision. Liaising with external SEND professionals.

Policies

• Clear Systems and processes – schools working closely with other professionals to have a range of support services that can be put into place to meet identified need.

• Should be set out clearly in the schools published SEND policy.

• Having ongoing CPD for school staff that empowers and enables them all to be responsible in promoting good mental health

Practice

Using a graduated approach to inform a clear cycle of support through a plan do and review cycle to achieve good outcomes.

•Assessment- Analysis to understand pupils needs.

•Plan – To set out how the pupil will be supported

•Do – Action to provide the support

•Review- To assess the effectiveness of the provision/ intervention and lead to changes where necessary.

An Educational Psychology Contribution- What works.

• Video feedback based interventions with mothers of pre school children with attachment problems ( e.g. Video Interaction Guidance- ViG)

• Video Enhanced Reflective Practice

• Cognitive Behavioural Approaches

• Solution Focused Approaches

• Solihull Approach

• Mindfulness

• Crisis Support

Solihull Approach in Kent

The aim of this stream of work is to ensure that the wider children and young peoples’ workforce:

 – Have an increased knowledge of children and young people’s mental health to

be able to identify those who need help.– Increase their capacity to give advice and support to those with minor problems

with relating to psychological health and emotional well being. – Understanding the role that parenting plays in the psychological development of

children. – Refer appropriately when necessary.

 

The approach is a highly practical way of working with families within a robust theoretical structure.  

Mindfulness Bases Approaches for Working with Children and Young People

• A particular way of paying attention to everyday experiences.

• Forms the basis of an evidence based intervention (MBCT) recommended in NICE guidelines for depression

• Can form part of universal preventative interventions or be used to support targeted groups of vulnerable youngsters

• Can support positive well being, including improved attention, concentration and resilience.

HeadStart Project

• KCC has been awarded £500K to trial a range of activities the support resilience and emotional well being amongst 10 -14 years

Six new locality bases An Opportunity to:

Provide support for pupils with mental health needs through having:

•The right information

•Identifying, providing and co-ordinating the right support

•Delivering in the right place at the right time