Transcript Document

Can Sport improve Mental Health and
Wellbeing of young people?
Stephen McLeod
Head of Specialist Children’s Services
NHS Greater Glasgow and Clyde
Contents
Definitions & Determinants
Glasgow’s School Children – active and healthy?
Young People’s development – what is normal?
Distress V Disorder
Resilience
Actions
Definition of health
“A state of complete physical, mental and social
wellbeing and not merely the absence of
disease or infirmity” (WHO 1948)
We need to reframe a definition for our time to
reflect the population age and the pattern of
illness changes
“The ability to adapt and self manage” in the face
of social, physical and emotional challenges.
(Huber et al BMJ 2011)
Positive mental health can be
promoted through
Physical activity-incorporating exercise
into everyday activities
Labour market activity-having
meaningful work and a daily routine
Social activity-being connected to
family, friends and our communities
The social determinants of mental health
Society
Community
Family
Individual
Equality of
opportunity
Safety and social
order
Family structures
and networks
Lifestyle (e.g. food,
exercise, alcohol
intake)
Employment
opportunities
Housing and
amenities
Family dynamics
(e.g. high/low
expressed emotion)
Attributional style
(i.e. how events are
understood) and
self efficacy
Social cohesion
Quality of physical
environment and
green space
Genetic
characteristics
Financial security
Educational
opportunities
Social connections
and networks
Intergenerational
relationships
Physical health
Health care
provision
External influence
and control
Parenting skills and
resources
Individual
relationships
• ‘Recovery capital.’… the things, the people, their resources, their
understanding and concern for the individual which can help
them have a sense of belonging and connection which helps
them to firstly help them consider, and then initiate change in
their lives. Sometimes this change is slow, but it can be
sustainable change, change that’s supported by others in a
meaningful and very personal way.
• My vision for a healthy Glasgow is one where people have a
common sense of hope and purpose in their lives”
Neil Hunter,
Chief Reporter to the Children’s Panel
“Many folk in Glasgow spend five or more hours a day watching
television – particularly commercial channels. My vision for a
mentally flourishing Greater Glasgow and Clyde is one where
people spend less time watching television and more on activities,
which support them socially and emotionally.
Carol Craig,
Director, Centre for Confidence and Wellbeing.
Screen time – computer games, surfing the net, social
networking, smart phone and TV
25% of secondary school pupils 12 or more hours of
screen time
•
One in four (25% 1,166 pupils) spent more than 12 hours a day on screen-based
activities on school days
Arts, culture and mental health
Contribute to effective health education
Contribute to therapeutic and relaxed environments in
health services
Develop creativity
Improve quality of life
Raise expectations of what is possible and desirable
…plausible link to mental health outcomes but more
research required
Benefits of Physical Activity
Environmental
Social
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• Encourages family/community
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connectedness
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• Improves social skills/networks
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• Prolongs independent living for
•
older people
• Reduces isolation, loneliness
• Enhances self-esteem,
confidence
Physical
Physical & mental
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Activity
Benefits
Improves quality of life
Manages weight
Reduces risk of chronic diseases
Improves sleep
Reduces stress, depression
Develops motor skills
Improves concentration, memory
& learning
Reduces traffic congestion
Reduces air pollution
Reduces greenhouse emissions
Reduces noise pollution
Creates safer places with
people out and about
Economic
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Creates employment
Draws tourism
Means of transport
Supports local businesses
Reduces absenteeism
Reduces crime
Reduces health savings
Glasgow Schools Survey
Sport, exercise and travel
• 4/5 report taking part in a
sports club out of school
• Swimming, football, dance are
most popular
• 51% used active travel
methods to journey to school
• ¾ report owning a bicycle
Travel to School
Level of walking remains high but trend towards greater car
use and less walking over past 20 years
Some examples of schools with high levels of active travel
despite pupils travelling longer that average distances
No difference by whether or not school has a travel plan
Cycling levels low – just over 2%- but ten times as many
secondary pupils would like to cycle than do currently
Best practice in planning for physical activity
(NICE)
Identify groups of children and young people
least likely to exercise at least 1 hour a day
Understand the factors that help or prevent
them getting involved
Involve them in design, planning and delivery
Mental health is important too
Widen awareness of mental health issues
Mental health promotion considered in all
plans and service designs
Promote value of positive environments and
activities
Stronger focus and leadership on physical
activity even in these times of austerity
The challenges to mental health and
wellbeing
High levels of child and family poverty
More likely to be admitted to hospital through assault
More likely to be reported to the Children’s Panel through
violence
Higher rates of looked after and accommodated children
Lower rates of referral to social services as a result of concerns
(public or professionals)
Worse school attendance
Higher proportion of 16-19s not in education, employment or
training
Erik Erickson’s Stages of Psychosocial
Development
Psychosocial Crisis Stage
Life Stage
Virtue
age range, other
descriptions
4. Industry v Inferiority
School Age
Competency
5-12 yrs, early
school
5. Identity v Role Confusion
Adolescence Fidelity
13-18 yrs, puberty,
teens*
6. Intimacy v Isolation
Young Adult
Love
18-40, courting,
early
parenthood
7. Generativity v Stagnation
Adulthood
Care
30-65, middle age,
parenting
8. Integrity v Despair
Mature Age
Wisdom
50+, old age,
grandparents
Developmental Goals (6 to 12)
Ages 6 to 12
To develop industry
Begins to learn the capacity to work
Develops imagination and creativity
Learns self-care skills
Develops a conscience
Learns to cooperate, play fairly, and follow social
rules
Normal Difficult Behavior
Ages 6 to 12
Arguments/Fights with Siblings and/or Peers
Curiosity about Body Parts of males and females
Testing Limits
Limited Attention Span
Worries about being accepted
Lying
Not Taking Responsibility for Behaviour
Cries for Help/More Serious Issues
Ages 6-12
Excessive Aggressiveness
Serious Injury to Self or Others
Excessive Fears
School Refusal/Phobia
Fire Fixation/Setting
Frequent Excessive or Extended Emotional
Reactions
Inability to Focus on Activity even for Five Minutes
Patterns of Problem behaviors eg property damage
Adolescence
Developmental Goals
Developing Identity-the child develops selfidentity and the capacity for intimacy
Continue mastery of skills
Accepting responsibility for behavior
Able to develop friendships
Able to follow social rules
Normal Difficult Behavior
Moodiness!
Less attention and affection towards parents
Extremely self involved
Peer conflicts
Worries and stress about relationships
Testing limits
Identity Searching/Exploring
Substance use experimentation
Preoccupation with sex
Cries for Help- Ages 13-18
Sexual promiscuity
Suicidal/homicidal ideation
Self-mutilation
Frequent displays of temper
Withdrawal from usual activities
Significant change in grades, attitude, hygiene, functioning,
sleeping, and/or eating habits
Delinquency
Excessive fighting and/or aggression (physical/verbal)
Inability to cope with day to day activities
Lots of somatic complaints (frequent flyers)
Discussion
How do you make the distinction
between the Concerning versus the
Unconcerning?
Prevalence Quiz…..
Prevalence Quiz
One in ten children between the ages of one and 15 has a
mental health disorder.
(The Office for National Statistics Mental health in children and young people in Great Britain, 2005)
Estimates vary, but research suggests that 20% of children have a
mental health problem in any given year, and about 10% at
any one time.
(Lifetime Impacts: Childhood and Adolescent Mental Health, Understanding The Lifetime Impacts, Mental
Health Foundation, 2005)
Rates of mental health problems among children increase as they reach
adolescence. Disorders affect 10.4% of boys aged 5-10, rising to 12.8% of
boys aged 11-15, and 5.9% of girls aged 5-10, rising to 9.65% of girls aged
11-15.
(Mental Disorder More Common In Boys, National Statistics Online, 2004)
Prevalence Quiz
One in two LAC children between the ages
of one and 15 has a mental health
disorder.
(The Office for National Statistics Mental health in children and young people
in Great Britain, 2005)
Distress V Disorder
Mental Health Distress
Mental Health Disorder
Mental Health Distress
Sadness
Anger
Worry
Common Mental Health Disorders
Behavioural Problems (e.g. ADHD)
Anxiety and/or Phobias
Depression
Suicidal Thoughts and/or Self Harm
Everything else (Psychosis, Eating Disorders etc)
Mental Health Distress
Distress is a normal human emotion and
reaction to sadness or suffering
Distress tends to disappear when the situation
is relieved or the stressor goes away
Mental Health Distress can
lead to a Disorder when:
The child has significant trouble with a stressful
situation and his/her response is not appropriate
Problems do not go away when the stressful
situation is resolved
The child cannot adapt to the stressful situation
Resilience
A child with a mental health disorder does not
necessarily have poor mental health.
When a child has strong character traits, they are able
to build resiliency.
Resiliency is the ability to overcome challenges and
stress in a way that promotes health and wellness.
Community Sources of Resilience
One Good Adult –dependable, mentoring, guiding,
befriending
Whole Team approach to mental health – ethos,
curriculum, positive behaviour, anti-bullying
Network of Youth Services – confident, skilled and able
to intervene
Community Sources of Resilience
Guide to the ‘Service Maze’ – a range of
supports and able to find quickly
Distress, Self Harm and Suicide Prevention –staff
are confident, able to help those in distress,
including self harm and risk of suicide
Peer Help and Social Media – young people who
share their problems enjoy better mental
health; use opportunities to use peer support
and social media.
Building Resilience
Focus on strengths
Identify what they are good at, recognise it, value it, celebrate it and build on it.
Promote connectedness
Positive impact of one supportive adult or one adult who a child knows is thinking
about them even when they are not there. For most children that will be a parent
or carer but for some it may be a coach or volunteer.
Become better observers
Observation is about noticing and reflecting on behaviour (the visible spectrum) in
order to understand what is going on in the areas of our experience that are
hidden from others. This includes, but is not confined to, observing children’s
behaviour.
Model emotional regulation
The last thing you need if you are a young person who feels out of control and
distressed is an adult who reacts to your high display of emotion with an equal
level of anxiety and distress.
Remember…
You are not there to be the mental ‘disorder’ expert
Your job is to support young people, not find labels
You are a young person expert
You can be a witness to fact – listen, observe, be the
dependable adult, advocate
Encourage help and support seeking
“Comparative studies have demonstrated
that exercise can be as effective
as medication or psychotherapy.”
Mental Health Foundation on depression (2010)
“Miracles are being achieved every day…
Football groups are saving lives.”
Participant in Time to Change focus group, for football
and mental health project attendees (2011)
"Working in football isn't always good for your
mental health, but being physically active
definitely is: that's why we're pleased to get
behind SAMH's Get Active campaign".
Danny Lennon, manager at St Mirren
“I worked in mental health for ten years… Out of all the
things that I did as a mental health worker, I found that the
benefits from football far outweighed anything else that I did.
I could see the progress that people made by being involved
in a physical activity.”
Rob Thomas, Mental Health Lead, Everton in the Community