Promoting Mental Health in Schools Integrity the Foundation

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Outline Promoting Mental Health in Schools § Mental Health and Learning § Connecting Social and Emotional Learning with Mental Health § Addressing Misconceptions and Stigmatisation of Mental Illness § Encouraging Students to Develop Positive Coping Strategies § Roles of Schools and Teachers 2 Copyright © Ministry of Education, Singapore.

Why do we ignore the Emotional? Common beliefs, especially among Asians… § Emotional and behavioural problems reflect negatively on and bring shame to the family § Problems must stay within the family § A sign of weakness to ask for help § Emotional problems can be resolved by willpower and sheer determination Herrick & Brown (1998) 8 Copyright © Ministry of Education, Singapore.

We all have emotional needs § We want to be loved § We want to belong § We want to be accepted § We want to be appreciated Emotional needs Physical means 9 Copyright © Ministry of Education, Singapore.

Factors affecting Learning Teachers’ capacity to teach – Students’ capacity to learn – subject matter, appropriate pedagogies and assessment tools cognitive skills, linguistics skills 10 Copyright © Ministry of Education, Singapore.

The Learning Process An individual process requiring the ability of student to • understand how emotions affect him/her • manage challenging situations • persevere through challenges 11 Copyright © Ministry of Education, Singapore.

The Learning Process A social process requiring the ability of the student and his peers to v work in pairs and collaborative groups v avoid risky behaviours that distract or even prevent them, their classmates from learning, and their teachers from teaching 12 Copyright © Ministry of Education, Singapore.

Emotions and Learning Greenlagh (1994) stated that awkward, irritating and painful feelings can play a powerful role in getting in the way of learning. The realms of feelings, of our subjective experiences, can indeed both facilitate and inhibit growth, development and learning (p. 2). 13 Copyright © Ministry of Education, Singapore.

Factors affecting Learning Social and emotional factors § Students need to be able to attend to their needs and what they are experiencing § Teachers need to connect with students and their interests; find the right balance of challenge and support Becker & Luthar (2002), Cambourne (2002) 14 Copyright © Ministry of Education, Singapore.

School Ethos & Environment and Teaching Rutter, Maughan, Mortimore, Ouston and Smith (1979) observed …it was very much easier to be a good teacher in some schools than it was in others. The overall ethos of the school seemed to provide support and a context that facilitated good teaching. Teaching performance is a function of school environment as well as personal qualities (p. 39). 15 Copyright © Ministry of Education, Singapore.

Conditions for Learning § Safety – physical and emotional safety § Support – feeling of being cared about and treated well, sense of belonging, and acceptance by peers and adults in school § Challenge – high expectations for achievement and behaviour § Social and emotional capacities of individual students and other students in the student’s classes and the school Expert panel led by David Osher Best Practices in School Psychology Chap 78, Vol. 4 (2007) 16 Copyright © Ministry of Education, Singapore.

Conditions for Learning § Conditions for learning & teaching are Social-emotional conditions § Learning requires students to have Social and emotional capacities 17 Copyright © Ministry of Education, Singapore.

Mental Health As defined by WHO, it is a state of emotional and social wellbeing in which the individual § § realises his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community. Adolescent Health and Development. A WHO Regional Framework 2001 -2004. Regional Office for the Western Pacific, WHO. 19 Copyright © Ministry of Education, Singapore.

SEL FRAMEWORK CHARACTER Self Awareness Responsible Decision Values Making Relationship Management Self Management Social Awareness CITIZENSHIP Academic Achievement Personal Health Work Life Copyright © 23 2005. Ministry of Education. Republic of Singapore. Copyright © Ministry of Education, Singapore.

Mental Health and SEL Research shows that children and adolescents with well-developed social and emotional skills are more prosocial and display less aggression, disruptive behaviour and interpersonal violence as well as high-risk behaviour, resulting in better mental health and higher academic achievement. National Center for Mental Health and Youth Violence Prevention: Prevention Brief on Social and Emotional Learning. Retrieved from http: //www. promoteprevent. org/Publications/centerbriefs 24 Copyright © Ministry of Education, Singapore.

Fact or Myth? § People are born with a mental illness. § Mental illness is incurable and lifelong. § Mental illnesses are common. § Depression and anxiety are the most common mental illness. § Many people with a mental illness do not seek any professional help. § People with a mental illness should be isolated from the community. § People with a mental illness are usually dangerous or violent. 27 Copyright © Ministry of Education, Singapore.

A Thesaurus of Madness Extracts from ‘A Thesaurus of Madness (People must think I am crazy)’ by Sandy Jeffs Poems from the Madhouse published by Spinifix Press 29 Copyright © Ministry of Education, Singapore.

People must think I’m Crazy Being the madwoman, I am also: a lunatic, a maddy, a mental case, a bedlamite, a screwball, a nut, a loony, a madcap, a mad dog, a psychopath, a maniac, an hysteric, a psychotic, a manic depressive, a megalomaniac, a pyromaniac, a kleptomaniac, a crack-pot, an oddity, an idiot, a basketcase, demented, moonstruck, hazy, unhinged, dippy, loopy, distracted, pixy-led, a scatterbrain, certifiable, crazy, loco, psycho, a nutter, possessed, fevered, bonkers, obsessed, bedevilled, troppo, starkers, schizo, potty, nuts, daft, dilly, a crackbrain, a fruit-cake, touched. 30 Copyright © Ministry of Education, Singapore.

People must think I’m Crazy (cont’d) Being insane, I suffer from: mental illness, psychiatric illness, brain damage, unsoundness of mind, alienation, lunacy, madness, mental derangement, mental instability, abnormal psychology, loss of reason, intellectual unbalance, mental decay, a darkened mind, a troubled brain, a deranged intellect, nerves, imbecility, cretinism, morosis, feeblemindedness, queerness, having a screw loose, bats in the belfry, rats in the upper story, nervous breakdowns. 31 Copyright © Ministry of Education, Singapore.

People must think I’m Crazy (cont’d) Being as I am, mad that is, I must be: not in my right mind, bereft of reason, deprived of my wits, as mad as a snake, a tinnie short of a slab, diseased in the mind, as mad as a hatter, wildered in my wits, not the full quid, a brick short of a load, off my rocker, round the bend, a candidate for Bedlam, foaming at the mouth, as mad as a meat axe, up the pole, a sandwich short of a picnic, out of my tree, off my face, off my block, over the edge, off my saucer, a shilling short of the pound, as silly as a wheel, off my trolley, as mad as a two-bob watch, a shingle short and I have a kangaroo loose in the top paddock. 32 Copyright © Ministry of Education, Singapore.

People must think I’m Crazy (cont’d) Being wild and distraught, I live in a mad house, a mental home, a mental hospital, an asylum, an insane asylum, Bedlam, a booby hatch, a loonybin, a nut house, a bug house, a psychiatric hospital, the rat house, the giggle factory, the rat factory, the funny farm. I am many things, in many places. Fool that I may be, mad that I may be. I am, in all my precarious guises, The creation of a cruel mind. 33 Copyright © Ministry of Education, Singapore.

Labels. Labels are powerful… They § can define who we are, and how we see others § can be used to restrict what we think people are capable of But people are more than their mental illness… 34 Copyright © Ministry of Education, Singapore.

Labels. Why do people label? § The ‘odd’ behaviour in others might be thought of as something that • • We see as illogical, unusual that we want to explain We feel uneasy, perhaps frightened about We see as unpredictable We want to avoid § Yet the ‘odd’ behaviour might be easily explained if we understood the behaviour… 35 Copyright © Ministry of Education, Singapore.

What is Stigma? § Use of labels and stereotypes when describing someone § Means a mark of shame, disgrace or disapproval, of being shunned or rejected by others § Emerges when people feel uneasy or embarrassed to talk about behaviour they perceive as different 36 Copyright © Ministry of Education, Singapore.

People with mental illness are simply people who are unwell… It is slowly happening in many countries in the West. So why not here? Seeing a psychiatrist should be as readily accepted as seeing a doctor fever… 37 Copyright © Ministry of Education, Singapore.

What misconceptions and stigma can do… § Prevent many from discussing their health concerns with family, teachers or friends and seeking help early § Compel some to undertake the tough journey to recovery all alone § Block those who have recovered or whose symptoms are under control from finding friendship and love, and work Misconception and/or Stigma Discrimination 38 Copyright © Ministry of Education, Singapore.

How can schools help prevent misconceptions and stigmatisation of mental illnesses? § Address discrimination in every area of life within educational settings § Bring mental illness into the open and talk about it like other illnesses 39 Copyright © Ministry of Education, Singapore.

§ Communicate the healthy attitudes on mental health § Design lessons/activities that help students understand mental illnesses § Educate the community to overcome attitudes and beliefs based on misconceptions and stereotypes. 40 Copyright © Ministry of Education, Singapore.

Coping ‘Coping is what one does: it is the cognitive and behavioural strategies that are used to deal with the demands of everyday living. The thoughts, feelings and actions make up the coping strategies that are called on to varying extents in particular circumstances to manage concerns. Coping skills can be developed through previous experience, observing others, perceptions of one’s own biological disposition, social persuasion…’ Frydenberg, E. , Adolescent Coping, Theoretical and Research Perspectives, Routeledge, London, 1997 43 Copyright © Ministry of Education, Singapore.

Factors Affecting Coping § Individuals with strong coping mechanisms often - view self as competent - have a sense of control/mastery over one’s life - view others as willing and able to provide support 44 Copyright © Ministry of Education, Singapore.

Coping Style § People generally use a predominant style of coping. § It can become unproductive or detrimental when stress reaches overwhelming or traumatic levels. § More coping mechanisms should be developed to provide many coping responses. 45 Copyright © Ministry of Education, Singapore.

Differences between Positive and Negative Coping Mechanisms Positive coping mechanism Negative coping mechanism Enables one to restore emotional balance Does not restore emotional balance Helps one to feel better Can be harmful to self, others and/or property Helps one to solve the problem Does not solve the problem and may create additional problems 46 Copyright © Ministry of Education, Singapore.

Positive Coping Mechanisms § Positive coping mechanisms help to - reduce anxiety - lessen other distressing reactions - improve the situation in a way that does not harm the individual further, not only today but tomorrow and in future 47 Copyright © Ministry of Education, Singapore.

Negative Coping Mechanisms § Negative coping mechanisms may - perpetuate problems - reduce the distress immediately but may be addictive § Early reliance on these behaviours often persists into adulthood and may result in associated health problems 48 Copyright © Ministry of Education, Singapore.

Positive Coping Mechanisms Negative Coping Mechanisms - Learning about stress and how it affects people - Talking to another person for support - Practise relaxation techniques - Increasing positive distracting activities - Consulting a medical doctor or mental health professional - Taking prescribed medications - Use of alcohol or drugs - Social isolation - Anger or violent behaviour - Avoidance - Overeating - Excessive online activity - Other types of selfdestructive behaviour (e. g. self-mutilation, attempted suicide) 49 Copyright © Ministry of Education, Singapore.

How can teachers promote mental health? § Enhancing students’ emotional well-being through caring relationships, and creating a safe, positive learning environment § Building students’ social and emotional competencies and lifeskills as well as positive coping mechanisms § Recognising students with mental health difficulties and need additional support - referral 51 Copyright © Ministry of Education, Singapore.

How can schools promote mental health? § Enhancing students’ emotional well-being by creating safe learning environments and build a sense of connectedness and community § Educating students in social and emotional competencies and lifeskills and run prevention programmes § Connecting students with mental health difficulties and their parents with professional help 52 Copyright © Ministry of Education, Singapore.

4 -Tier Model of Service Tier 1 involves non-specialists, like teachers, who have direct day-today contact with children and youth, who have a key role in the promotion of mental health and prevention of mental health problems Teacher’s role is one of providing info towards assessment of child/youth with mental health problems Tier 2 involves school counsellors who network with other professionals and non-specialists; they offer intervention, assessment and access to more specialist services, as well as training and consultation to Tier 1 Tier 3 provides specialists who provide services for children and youth with more severe, complex and persistent mental health problems Teacher’s role is one of point of contact and facilitating continuity of education Tier 4 provides highly specialised and intensive interventions, such as residential psychiatric treatment, for those who are severely mentally ill Adapted from Child and Adolescent Mental Health Services (CAMHS), UK (1995) 53 Copyright © Ministry of Education, Singapore.

RECOGNISE the warning signs in the child/youth REACH out to the child/youth NO Does the child/youth require additional support? Monitor the situation and continue with the support for the child/youth YES REFER the child/youth to the school counsellor RESPONSE Flowchart RENDER support to the child/youth REFLECT on your own needs 54 Copyright © Ministry of Education, Singapore.

WARNING Signs brupt Changes cademic Disengagement nguished Behaviour voidant Behaviour nti-social Behaviour Negative Neglect of ffect ppearance Substance buse 55 Copyright © Ministry of Education, Singapore.

Fact or Myth? § People are born with a mental illness. Myth The causes of mental illnesses are unclear. Many factors can contribute to the onset of a mental illness in people with a predisposition. 56 Copyright © Ministry of Education, Singapore.

Fact or Myth? § Mental illness is incurable and lifelong. Myth When treated appropriately and early, most people recover fully. Some people have only one episode and recover completely. 57 Copyright © Ministry of Education, Singapore.

Fact or Myth? § Mental illnesses are common. Fact A mental health community survey done in Singapore showed that 1 in 6 adults will suffer from some form of common mental health disorder in our lifetime. 58 Copyright © Ministry of Education, Singapore.

Fact or Myth? § Depression and anxiety are the most common mental illness. Fact In Singapore, the 2 most common mental illnesses are depression and anxiety disorders. 59 Copyright © Ministry of Education, Singapore.

Fact or Myth? § Many people with a mental illness do not seek any professional help. Fact A national survey conducted in Singapore in 1996 revealed that only 37% of the participants interviewed would seek professional help if they had serious mental illness. 60 Copyright © Ministry of Education, Singapore.

Fact or Myth? § People with a mental illness should be isolated from the community. Myth Most people with a mental illness recover quickly and do not need hospital care. 61 Copyright © Ministry of Education, Singapore.

Fact or Myth? § People with a mental illness are usually dangerous or violent. Myth People with a mental illness are seldom dangerous or violent. Even people with the most severe mental illness are rarely dangerous when receiving appropriate treatment. 62 Copyright © Ministry of Education, Singapore.