When considering mental health and wellbeing, it’s impossible to ignore the role of contemporary society, particularly the influence of the plethora of social media platforms available. Social media can play a considerable role, and consume an enormous amount of time, in a young person’s life and the reach of this impact often sees young people being bombarded with a never-ending stream of images, posts, and messages about the ‘perfect’ life. This often contributes to insecurities, feelings of isolation, and self-doubt. Ms Sadler further echoed this sentiment, saying, “young people with a mental disorder were more likely to agree they compared themselves to others; that likes, comments and shares impacted their mood; that they spent more time online than they meant to; and that they couldn’t be honest with their feelings.”
There is significant discourse on how to address these challenges and best support our young people, however, irrespective of the approach, my experience has shown that maintaining a sense of individuality and personal experience at the forefront is key. What’s more, given the influence of the school environment on young people’s lives, I also think it is important that discussions happen within the school community. The School and Public Health Nurses Association (SAPHNA) are also advocates for a proactive approach to supporting the mental wellbeing of young people in schools as teachers, head teachers, and pastoral carers can play a significant role in enhancing students’ mental wellbeing.
As is the case when providing effective support of any nature, a sound knowledge base of the issues at hand lays the foundation for greater understanding and empathy and provides practical pathways that will help overcome the challenges being managed.
Anxiety, one of the most commonly diagnosed mental health disorders, is a feeling of worry, fear, or unease and is thought to affect five percent of the UK population (NHS, 2018). According to YoungMinds, one in six young people will experience anxiety at some point. Put this in the context of school and it means that a significant number of students, at any one time, may be feeling pressure and angst from this mix of emotions.
There are countless situations that can trigger anxiety, but there are a variety of physical and psychological signs which can help educators and school staff identify when a student is feeling anxious. These can include nausea, tension, increased heart rate, a sense of dread, and fearing the worst. These symptoms can also extend to physical manifestations including increased crying; a lack of appetite; becoming angry or easily agitated; difficulty concentrating; or a clinginess to particular friends, family, or members of staff.
Importantly, once you identify a student who may be burdened with anxiety, it’s crucial to make sure they feel supported and take the necessary steps to distance themselves from the angst. This may involve inviting them to practice controlled breathing, or physically changing location and finding a space that is more calming. It’s also important to initiate a conversation to try and understand their feelings – something that is usually mutually beneficial to the staff offering support and the student experiencing the anxiety. In addition to these approaches, SAPHNA also recommends that teachers and staff offer self-help strategies such as regular physical exercise, healthy eating, listening to music, journaling, confiding in someone they trust, distraction techniques and mindfulness exercises so that they are empowered and better prepared should another episode of anxiety occur.
While significant progress can be made with these tactics, it’s vital to note that if staff notice continued anxiety with a student, they should feel comfortable discussing this with pastoral support staff or informing the child’s parents/carers.
Many children and young people will encounter a low mood at some point. Depleted moods cause people to feel sad, anxious, or worried however, these feelings tend to be alleviated after a short period of time. If a low mood persists for longer than a few months, this could be a sign of depression. In its milder form, students may experience a low spirit and energy however, more severe depression can lead to greater threats including suicide.
The symptoms and warning signs of low mood and depression are often similar, making it one of the more difficult mental health challenges to monitor. With this in mind, teachers should keep an eye out for students who exhibit sadness; anxiety; low self-esteem; social isolation; tiredness; and a lack of, and inability to concentrate, for extended periods of time and maintain records or notes that can be useful for informing future support.
Subsequently, if staff suspect a student has low mood or depression, it’s important to reach out and offer support as soon as possible. Encourage them to talk about how they are feeling, offer reassurance, and make sure a non-judgemental environment is being provided. Additionally, teachers can also suggest some practical tips that can support and improve young people’s mental wellbeing including a healthy diet, regular exercise, and adequate sleep. Again, however, given the impact of low mood and depression, should students symptoms persist it is imperative that concerns are referred to the appropriate support in school, for example, pastoral care staff, or a school nurse so that further assistance can be sought.
Self-harm is when somebody damages or injures themselves intentionally, often using physical pain as a way of distracting themselves from emotional distress and providing temporary relief. Self-harm is also sometimes seen as an indicator of suicidal intent however, many people who self-harm do not share this intent but are instead using it as a coping mechanism. Importantly, self-harm should not be dismissed as attention-seeking behaviour or something that is limited to a particular age-group or gender - it does not discriminate and should be taken seriously as soon as warning signs emerge.
Although self-harming can affect people at any age, it is most prominent in children and teenagers, with the BBC recently reporting that in 2018, almost 1,600 young people in London went to hospital with self-harm related injuries. The NHS Digital report also found that a quarter of 11 to 16-year-olds with a mental health disorder had self-harmed or attempted suicide.
Given these statistics, educators should take steps towards safeguarding against self-harm by looking for any of the following warning signs: unexplained cuts, bruises, or cigarette burns; keeping the body covered at all times; signs of low mood or depression; exhibiting self-loathing; unexplained hair loss; or becoming withdrawn.
As is the case with many mental health problems, if these signs are displayed by a student, teachers should feel confident in delicately approaching the topic with the pupil. This can help shed some light on the motivation behind the self-harm but also provides the opportunity to share some strategies and coping mechanisms that can be used. For example, students can squeeze ice cubes or snap an elastic band against their wrist. Each of these activities are sensory and importantly provide a safer distraction from the emotional turmoil that has triggered the self-harm. Students should also be encouraged and helped to create a safety plan which covers who they can speak to if they are feeling the impulse to self-harm, or what to do if they have already self-harmed and require assistance. Importantly, teachers should also ensure they are up-to-date with their first aid training should they need to administer medical assistance urgently.
The statistics surrounding young people and mental health need to be addressed. What’s more, as advised by SAPHNA, schools have a responsibility to not only equip their pupils with academic attainment but also the knowledge and resilience to help improve and manage their mental wellbeing.
Teachers and staff should also be aware that it is not unusual for pupils to find it difficult to speak openly about their issues, despite offers of support. Overcoming this challenge, some school nursing services offer regular drop-in sessions or provide virtual methods of support, like ChatHealth, which some pupils find a more acceptable approach. This is, of course, worth bearing in mind however, training remains an important factor for staff. Empowering staff through relevant training so that they understand the threats posed by anxiety, self-harm, and depression are not only key to addressing the knowledge deficit surrounding mental wellbeing but also create a school community that has an open dialogue about these challenges, is aware of the warning signs, and is armed with the toolkit to provide effective support.
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