A tsunami of mental health problems… or a surge of resilience?

 How can we make a difference to the outcome?

Last month the Royal College of Psychiatrists warned of a tsunami of mental illness after lockdown, followed last week by press reports that school closures will trigger UK child mental health crisis. One proposed solution is that ‘every school should be assigned a child mental health counsellor’who can work directly with children who need specialist mental health support, but whose responsibility would also include working on whole-school approaches to improving the mental health of all children”. I am sure that schools would welcome the provision of mental health counsellors. However, this suggestion illustrates the fact that the world outside education appears unaware that schools have been on the frontline of mental health support for children and their families for many years, just as they have been on the frontline of social care for far too long – another fact that has come to the fore in the current crisis. Behind the inspirational stories of headteachers that have made media headlines in the past 3 months are many thousands of educational professionals who have been working hard, throughout the period of partial school closure, to support children’s health and well-being as well as their learning.

 

Knowing this context well and knowing that school leaders are profoundly aware of the mental health concerns that were so prevalent for some children even before the health crisis, I worried that these alarmist headlines would lead to further anxiety and dent the resilience of school staff. I was pleased, therefore, to see this tweet from a fellow educational psychologist which has provided inspiration for this week’s newsletter:

Preparing for the surge

Puzzling about the implications of a possible ‘tsunami’ of mental health problems led me to look up advice about how to prepare for and survive an actual tsunami. It was quite instructive and surprisingly helpful. The advice includes this 4-point plan:

  • Protect yourself
  • Prepare yourself
  • Stay informed
  • Stay calm and alert, including “communicate and share information” and ‘Don’t panic”

This is a resilience plan. Applied to our current situation in education it offers a plan within which we can work towards a surge in resilience, reduce the negative impact of the pandemic on children’s well-being and mitigate potential long term ill-effects.

To translate the tsunami resilience plan into a set of actions that schools can plan for, I have used the framework of the Sandwell Wellbeing Charter which is itself based on the Public Health England document, Promoting children and young people’s health and well-being. The framework considers the following principles essential to a whole-school approach to mental well-being: Leadership; Ethos and Environment; Curriculum, Teaching and Learning; Pupil Voice; Staff Development; Identifying needs and monitoring impact; Working with parents/carers; Targeted support and appropriate referrals. Each is addressed below:

Leadership

Many schools already have, or are working towards developing, the role of senior lead for mental health as recommended in the green paper, Transforming Children and Young People’s Mental Health Provision.

If you don’t already have a senior leader with this role, you will need one for the coming year. If you are already the Mental Health Lead but are also the Safeguarding Lead, SENDCO and Assistant/Deputy Head, you are going to need some help.

Planning now to ensure that there is enough capacity in your support team will be essential to both protect yourself and to prepare yourself. Take some time now to think about the implications for your role and your team of an increase in mental health needs. Can you expand you team? Can you get some admin support? Do you need an assistant or deputy who can make some of the phone calls or chair some of your meetings? If there is extra funding to support mental health in schools, how would you use it to strengthen your team?

Ethos and Environment

We know that many eligible children are not currently attending school because their parents are fearful and anxious about the virus. The ways in which information and messages are presented can either increase anxiety or provide reassurance. Compare these two approaches:

 

 

 

 

Reassurance will reduce fear and anxiety, reducing the likelihood of mental health issues in the longer term.

Think about how to create a nurturing environment as children return to school in September. Educational Psychologist Dr Chris Moore has generously shared this infographic A-Z of a nurturing environment, with further ideas and explanations in his blog here.

Curriculum, Teaching and Learning

Many schools in Manchester are already using elements of the Recovery Curriculum 

 

 

This approach, or something similar is likely to be required over the coming 12 months. There is much focus on the importance of ‘catch up’ in terms of the curriculum, but all children will need to have their ‘recovery’ needs addressed before they can learn effectively. The timescale for this will vary from child to child, so a flexible approach to maintaining the recovery approaches in the medium to long term will be important.

Pupil Voice

We know that children and young people have had very different experiences in this period of “lockdown” and in the aftermath. It is likely to be some months before the full impact is known. It is important to remember that for many children this period will have been an unusual but not unwelcome period out of school. Most children will skip back into school without too much concern. It is important to give children opportunities to talk about what has happened and to listen to their stories and their lived experiences. This period of listening may need to continue over several months. It would be a mistake to assume that September will be ‘back to normal’.

Staff Development

Providing opportunities for staff development specifically related to the emotional and well-being aspects of the pandemic will be at least as important as the teaching and learning aspects of the return to school, if not more so.

Some staff have accessed online training via webinars during the partial school closure, but others have been fully occupied in school. It will be important to allocate some time to bringing your school teams together again and sharing their collective experience as you plan for the year ahead.

If there is indeed to be a large increase in mental health concerns, it will be important that every member of your school team feels confident and well-informed about what they can do to help and support young people, what the core school support systems are and how to access these. As we prepare for the September return, no teacher should feel that mental health is ‘somebody else’s business’.

Identifying needs and monitoring impact

Amongst your school populations there will be many children who fall into potential “at risk” groups. It is important to be aware of who is at potential risk, but this does not mean that these children and young people will necessarily go on to develop mental health problems. Each child and family will have their own risk and resilience factors. It is important to identify and build on the resilient elements as well as being alert to risk factors.

We would recommend a ‘watchful waiting’ approach to children and young people who are living with: special educational needs; long-term illness; disabilities; conditions such as autism and ADHD; Looked After Children; children who are adopted; international new arrivals; children from black, Asian and minority ethnic backgrounds; children who are learning English as an additional language; children on free school meals or with other indicators of poverty and deprivation. For many of our schools in Manchester this list encompasses the majority of the school population. This is exactly why every teacher will need to have as much confidence in supporting children’s well-being as they have in teaching the curriculum.

Working with parents/carers

Whilst it goes without saying that the return to school should include working with parents, it will be particularly important to gather knowledge about the experience of families during the pandemic and lockdown. This has been an intense period for families. Some parents have had the opportunity to get to know their children much better and will want to share their new knowledge and insights with schools. Some families have experienced life changing circumstances such as bereavement or job losses. All must be understood if children are to thrive.

Targeted support and appropriate referrals

If the above points are embedded in your ‘return to school’ plan, with a commitment to resource school-based approaches for a good amount of time, the number of children and young people requiring specialist support should be a small percentage of your overall school population. Those who do require specialist services will gain enhanced benefit from belonging to a school or college that has a strong baseline of support for mental health and well-being. Well-informed staff, able to incorporate well-being principles into their Quality First Teaching/universal provision, will be better able to identify those young people in need of specialist support. Referrals from schools with strong provision for well-being are more likely to be accepted by specialist services, and there will be greater impact from the specialist interventions available.

Ultimately, if we can move in this direction, specialist services will not be overwhelmed by a ‘tsunami’ but will be able to work in partnership with schools and colleges to support the surge of resilience.

If you only read one thing this week…

This week’s resource is highly recommended: Compassionate transitions: reconnecting school communities

Have a look in particular at Appendix 5:Nurturing principles: reconnection and recovery.

In short, this document provides an educational psychology-informed evidence base to support your planning for the surge in resilience. Your school's educational psychologist will be happy to offer support in translating these principles into practice.

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