How teachers can keep an eye on their students’ mental health

John Nichols

John Nichols has worked in education for his entire career, first as a teacher in a challenging school on the Teach First programme, in an educational charity placing PhD students into schools to widen university access and then as a private tutor working with some of the best tuition agencies in London. John has a passion for solving educational problems. His ambition is to dramatically improve the life chances of young people in the UK by promoting mental health and cognitive development.

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There is a lot of media attention on the mental health of young people. Barely a week goes past without a new article about the mental health crisis. The issue of child and adolescent mental health is of major concern for three reasons. Firstly, although we know that about 10% of young people have a mental health disorder, it is by no means obvious which young people are in that 10%, much less who the 15% who are at higher risk of developing a mental disorder in future (Ibid).

 

"An additional 15% of young people are at increased risk of developing a mental health disorder."

Secondly, poor mental health and wellbeing can have profound influences on a young person’s education. Lastly, mental health problems in later life tend to begin in childhood. 50% of adult mental illness begins before the age of 15, and mental health issues tend to be more disabling than physical health problems, costing England more than £105bn per annum. Here I will try to explain the issue and what teachers and school leaders can do to identify and tackle mental health issues in school.

Everybody, of any age, has mental health. There is a continuum between being exceptionally healthy, either physically or mentally, and being very unhealthy. When people are very unhealthy we often try to categorise what is wrong with them in order to treat it, and this is often termed as a disease or a disorder. It is very important to realise that we should not think of there being two groups, those with mental health disorders and those without. Not having a disorder doesn’t mean that someone is necessarily ‘mentally healthy’.

When we say that 10% of young people have a diagnosable mental health disorder, what we mean is that 10% of young people have particularly poor mental health. An additional 15% of young people are at increased risk of developing a mental health disorder; their mental health is not particularly good perhaps and if it were to worsen then they would fit the criteria for a mental health disorder. These statistics should be treated similarly to childhood obesity. In 2013/14, 19.1% of Year 6 children were obese whilst a further 14.4% were overweight, which means that although they may not have a more substantial medical issue yet, they are certainly at risk of developing one if their diet and exercise levels don’t improve. These statistics also tell us nothing about the diet, exercise levels and physical health of the remaining pupils who don’t class as being overweight, just as we don’t know how mentally healthy the other 75% of pupils without mental health disorders or increased risk are. However, unlike obesity, mental health problems are often difficult to spot.

There are warning signs which may give teachers or other school staff cause for concern. These include being excessively withdrawn or quiet, evidence or suspicion of self-harm, suicidal remarks, persistently negative comments about themselves or recurrent inappropriate behaviour. However, it is important that teachers do not take it upon themselves to attempt to diagnose such disorders; a diagnosis should only be undertaken by qualified mental health professionals.

It would be even less helpful to encourage pupils to self-assess themselves or each other. Awareness of mental health issues among pupils is important, but this does not mean trying to publicly identify pupils with mental health disorders within a class. If you are concerned about individual pupils or even groups, then you need to talk to the management of the school to obtain appropriate additional support from either child and adolescent mental health services (CAMHS) or other private / third sector organisations that employ appropriately trained and experienced professionals. They will be able to give you an accurate idea of which pupils may have mental health issues, what issues they might have and what measures you could take to address them.

Why should you deal with mental health issues in school, anyway? It would be entirely understandable to take the view that teachers are already excessively overworked, and we have already acknowledged that they are not appropriately qualified to diagnose or treat mental health disorders. Nonetheless, teachers can be an integral part of the solution without needing to increase their workload at all.

"75% of students with mental health issues receive no specialist help before they’re 18."

Teachers already flag up pupils as a cause for concern, and schools already have systems in place to deal with inappropriate behaviour. Just this data alone could give a clear indication as to some of the individuals who may have issues; 75% of students with mental health issues receive no specialist help before they’re 18, so this really could make a difference. Additionally, teachers and schools could profit substantially from dealing with mental health issues; interventions that are designed to effectively improve pupils’ mental health are implicated in a whole range of tangible benefits including improved attendance, fewer exclusions, better behaviour, better attitudes to school work and ultimately improved academic outcomes.

Therefore, even a relatively small initial investment into early identification and intervention in mental health issues can pay dividends further down the line. Interventions into this area can be free (if provided by the local authority or NHS, this is sometimes the case) but are relatively cheap to buy in. School leaders should be sure to check the qualifications of the individuals who will be delivering the therapy; therapy delivered primarily by trainee counsellors will be less effective than that delivered by more experienced professionals.

What can teachers do in the classroom? As a former teacher myself, I know the onerous workload that teachers have to face. I do not think it would be helpful to place responsibility for another major issue on teachers’ shoulders. In any case, the best teaching practice often promotes positive emotional wellbeing anyway, such as creating a consistent and safe environment. The most useful things that teachers can do are to learn about some of the most common mental health disorders and to try and understand the issues facing their pupils. There may be some subtle adjustments to the seating plan that will put pupils more at ease, or repeatedly make it clear to pupils that failure and adversity are completely normal and can be overcome with support from peers and staff. If pupils know where they can get support on a day to day basis and teachers have someone to turn to if they have more substantive concerns, then this is a good start.

How do you deal with student mental health in your school? Let us know in the comments.

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