Transcript Supporting young people’s mental health in school

Supporting young people’s
mental health in school
Jenny Spratt
Kate Philip
The Rowan Group
University of Aberdeen
(Co-authors Janet Shucksmith, University of Teesside,
Cate Watson University of Aberdeen)
The extent of the problem
• It has only recently become clear that mental ill
health among children and adolescents us not
confined to only a small proportion of young
people but is surprisingly common. (WHO
2004a)
MHF estimates that 20% of children and
and adolescents are experiencing
psychological problems at any time
Implications for school
behaviour
Whether a child “acts out” or “acts in” they may
have barriers to learning which require to be
addressed. Children “acting out” may be
aggressive, threatening, disruptive and
demanding of attention….Children “acting in”
may have emotional difficulties which can result
in unresponsive or even self-damaging
behaviour
Better Behaviour Better Learning (SEED 2001)
A role for the voluntary sector?
• New Labour’s “third way” sees the voluntary sector as a
partner to the state in service delivery
• Particularly well placed to offer local interventions
responsive to local need
• Health promoting schools need to work in partnership
with the communities in which they are located and
voluntary sector organisations can help form these links
• Child welfare or specialist mental health organisations
can offer expertise which can support schools develop
their capacity to address these issues.
Investigating the links between mental
health and behaviour in schools – a
research study
• SEED funded, Scotland wide study
• Examined the responses (both proactive and
reactive) of education authorities, schools and
their partners in the health and voluntary sectors
to challenging behaviour thought to be triggered
by poor mental health
Methods
• Literature review
• Telephone survey
– All education authorities
– All health boards
– Relevant voluntary sector organsiations
• 6 case studies of good or innovative
practice (3 involving voluntary sector organisations)
– Observation, scrutiny of documents, interviews with
range of stakeholders including parents pupils,
teachers , managers and interagency staff
Case study 1- The Place2Be
• National organisation offering targeted
therapeutic support for identified children, self
referral drop in, and support for staff.
• Small units based in primary schools
• Franchise – same organisational structure and
support in all locations – contractually agreed
Case Study 2: North Glasgow Stress Centre
• Small local voluntary sector organisation
• Underpinned by framework of emotional literacy
• School based group work and individual counselling, and
community based initiatives
• Works in two secondary schools, both in areas of
deprivation, on with high asylum seeker intake
• Flexible approach – operates differently in each school
• Offers multi-disciplinary training courses for
professionals
Case Study 3: RAMH Youth counsellor
seconded to Integrated Community School
• Full time post – seen as full member of ICS team
• Individual counselling is main focus, also group
work and professional support
• Teacher referral and self referral systems
Findings: An overview
• New thinking
• Schools and education authorities unfamiliar with
language of mental health
• Mental health touched on in a range of policy areas –
e.g. anti-bullying, health promotion, inclusion, behaviour
support
• Hence falls into range of departments and funding
streams with little co-ordination
• National picture is patchy, with pockets of very good
provision.
• Partnership with parents and other agencies is critical to
success in this area
A health promoting school:
• Analysis of data based on WHO definition
of a health promoting school report:
– inclusive curriculum
– ethos and environment
– partnership working
• This presentation focuses on partnership
working
Partnership working:
3 models
• Export problems
– Refer troubled children to expert services elsewhere
or into containment schemes
• Import skills
– Import skills into schools to solve problems but
devolve authority to another agency
• Retain ownership
– Use personnel in integrated teams to develop new
approaches embedded in school life
Exporting problems
• Both LAs and Health Boards worked hard
to stop schools shipping problems off site
• Barriers erected to prevent schools “firing”
problems “ into external agencies”
• For some children with severe / enduring
problems access to specialist help always
necessary
Importing skills
• Two discernible models
– Buy in – parallel structure, focussed on
“fixing” the problem children, no learning, no
integration
– Buy in – integrated structure, painful lessons,
slow learning, new thinking embedded into
school structures and functioning
• The first was the most common parallel
working not true partnership
What does “ownership” mean?
• Schools (and individual teachers) …
– Accept professional responsibility for children’s
mental well-being
– Accept that some discipline problems are associated
with poor mental health
– Acknowledge that schools may contribute in some
cases to poor mental health
– Undertake to review all aspects of schools ethos and
functioning to minimise negative impact and improve
the positive
– Work with other agencies and parents to develop
capacity to achieve this
In conclusion
• The drawing into schools of other professional
groups offers the chance
– To build capacity on this issue within the teaching staff
– To provide young people with additional and different
services to what teacher can offer
• An overview would indicate that we have the
latter but not the former in most instances.
Additionality has been achieved, but it may take
time to build capacity in this way
Challenges: Building capacity through
interagency working…..
• What roles can be successfully
undertaken by voluntary sector workers in
schools?
• What are the challenges to the voluntary
sector in schools working in this area?
• How can we work to effect culture change
around attitudes to mental health? Does
inter-agency working lead to cross
fertilisation of ideas?
….and more challenges
• Does the presence of interagency workers
in schools allow teaching staff to
relinquish responsibility for mental health?
How can we avoid this?
Part 2. Voluntary sector in schools:
Working in partnership?
• Referring to relationship between the state
and the voluntary sector Morrison (2000)
commented:
In short, there is a space here where issues of
power are being worked out
Equal partners?
• In practice, in schools, the voluntary sector
organisations are hampered by their relative lack
of power:
– Access to schools depends upon goodwill of head
teacher
– Short term funding, depends on schools opinion
– Referral of children often mediated by school
– School traditions are long held, professionalised and
protected, challenges are fiercely contested
– Voluntary sector presence in schools are small units
in much larger institutions
Embedded or separate?
• “We never forget that we are hosted by the
school and in a sense we have guest status no
matter how integrated we are. Because of the
therapeutic confidentiality we have to have
enough separateness to be separate but enough
integration to be working closely with the staff
team”
Voluntary sector worker
Whose agenda?
• VSOs and schools may have different
understanding of children’s rights
• Schools institution orientated priorities e.g.
discipline, curriculum delivery educational
outcomes, may come into conflict with needs of
individuals
• VSOs concerned exclusively with well being of
pupils
• Yet success may be judged in terms of enabling
children to “fit” into the system
That was almost the test, you know, fix these kids,
because there is…..an expectation that we will fix them.
And that is an interesting thing that we are looking at , in
terms of evaluation, is people’s perception of significant
change. What the person may deem as being significant
to them may not, in fact, affect their classroom
behaviour, so therefore the teacher sees a different
change or no change at all. So therefore has the
counselling in fact failed?
Voluntary sector worker
Capacity building
• All VSOs in case studies aimed to raise staff awareness
and build their capacity to support mental well-being
• In reality education staff viewed VSOs as an add-on to
the main business of school
• Little evidence of the level of integration required to
support staff development
• Presence of interagency staff could be counterproductive to building capacity in main body of staff
• Some evidence of active resistance to developing
shared understandings.
Evaluation
• VSO’s maintenance of position in school
depends on demonstrating their success to
schools and education authorities
• Much time and effort put into producing
comprehensive self evaluations
• Little incentive to honestly appraise
shortcomings
• Awareness of informal evaluation by school staff
leads to defensiveness of position
Innovation
• Leadbeater (1997) suggests that voluntary
sector organisations can act as “a kind of
research and development wing to the welfare
system, innovating new solutions to intractable
problems”
• Q: How can that flexible approach be fostered to
support mental health in the school environment