Adolescent Mental Health

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Adolescent Mental Health
Developed by Karen Stafford, Program Manager,
Hunter Institute of Mental Health
Why address MH in schools? Key issues and
concepts Risk factors and warning
signs Wellbeing and resilience A whole-school
approach
April 2008
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Why address mental health in schools?

• Promoting mental health and wellbeing may
  contribute to better behaviour, better health
  outcomes and academic achievement.
• Adolescence is a key time for the onset of many
  mental health problems or disorders and these may
  persist into adulthood.
• Mental health difficulties can negatively impact
  on a students behaviour, relationships and
  academic performance.
• Around 14 of Australian children and young
  people experience significant mental health
  difficulties many dont receive help.
• Early identification and intervention can help to
  resolve mental health difficulties more
  effectively and minimise negative impacts.

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Student Activity

• Write down 10 to 15 words or phrases that come to
  mind when you hear the term Mental Health
• Share these with the person sitting next to you
  are there any common themes?
• Discuss emerging themes with the broader group.

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Key Concepts

• Mental Health OR Social and Emotional
  Wellbeing
• The positive capacity of people to interact with
  others in ways that promote wellbeing, positive
  development and the achievement of goals. Seen
  through thoughts, feelings, behaviour,
  relationships.
• Resilience the capacity to maintain or
  re-establish your wellbeing in the face of
  difficult circumstances or challenges.
• Mental Health Problem a temporary change in our
  thoughts, feelings, relationships, behaviour eg
  stress, difficult events, feeling upset about
  something (not an illness / disorder).
• Mental illness / disorder illness diagnosed by
  a doctor - more severe and long-lasting
  disruption of thoughts, feelings, relationships
  or behaviour specific symptoms, of a certain
  severity, over time - eg anorexia, schizophrenia.

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Mental Health Problem or Mental Illness?

• Anxiety / stress vs Anxiety disorders
• Depression / sadness / grief vs Depressive
  disorders
• Substance use vs Substance use disorders,
  abuse etc
• Could be a mental health problem OR a mental
  illness
• Difference is about severity, duration, level of
  impact on person
• Mental Illnesses
• Eating disorders anorexia nervosa, bulimia
  nervosa, and others
• Psychotic disorders delusions, hallucinations,
  schizophrenia
• Developmental disorders autism and related
  disorders
• Disorders of Attention eg ADHD
• Behavioural Disorders - eg conduct disorder

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Contributing Factors

• Biology and genetics
• eg brain chemistry and family history
• Individual factorseg differences in temperament,
  negative self-talk, difficulty managing stress or
  solving problems.
• Negative life experienceseg abuse, trauma,
  violence, loss or bereavement, chronic stress
• In most cases, there is probably a combination of
  factors
• Nature and nurture are both important

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Resilience

• The capacity to bounce back during difficult
  times, which helps to protect people from mental
  health problems.
• Resilient young people tend to have
• Confidence and communication skills
• Social skills, empathy and understanding
• Well developed problem-solving skills
• A sense of independence and self worth
• A sense of purpose, with goals for the future
• Factors that build resilience
• Caring and connection with others
• High but achievable expectations
• Opportunities for genuine contribution,
  participation

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Student Activity

• In small groups, discuss some simple ways in
  which a teacher could
• Promote caring and connectedness in the classroom
• Establish clear goals and expectations for
  behaviour and performance, while remaining
  supportive
• Provide opportunities for students to participate
  actively and contribute to classroom, school or
  community goals

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Possible Warning Signs and Risk Factors

• Feelings
• Persistent and/or severe negative feelings such
  as guilt, hopelessness, or sadness feeling
  irritable or anxious mood swings.
• Behaviour
• Behaviour changes frequent crying withdrawal
  decline in academic performance drug use
  aggression or irritability criminal or risky
  behaviour.

• Thoughts
• Negative or worrying thoughts thoughts about
  suicide or self-harm difficulty concentrating or
  making decisions bizarre thoughts not shared by
  others.
• Difficult situations
• Stress worry about school or work being
  bullied family conflict physical, sexual or
  emotional abuse relationship breakdown loss and
  grief.

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How should I respond to a troubled student ?

• Gather information eg by observation or by
  asking others, look for signs and risk factors,
  decide if there is a risk and if more support is
  needed
• Respond Talk and listen to young person,
  show empathy, ask open ended questions - avoid
  taking on role of counsellor / psychologist
• Involve others Refer to school counsellor or
  other professional talk to parents if
  appropriate report suspected abuse stay in
  touch and review progress
• Promote positive school environment for that
  student and all students - tolerance, positive
  feedback, supportive classroom environment,
  consistent discipline styles etc

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But what would I actually say?

• Ask open ended questions how are you feeling,
  how are things going with ? Try a few times.
• Be approachable offer to talk another time or
  to help them access support if they need it.

• Suggest someone else if you did have
  something on your mind, is there someone you
  could talk to?
• Use active listening show empathy, and use
  reflection I can understand that you feel
  upset, when your parents are fighting.
• Talk about confidentiality In general, I
  wont pass on things you tell me in confidence.
  But if I think someones going to get hurt, Ill
  have to tell someone else about it, so we can
  help.

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• Dont try to become a counsellor yourself if in
  doubt, refer the student to someone else. Try to
  explain this in a helpful way, offer to introduce
  them or go with them
• I think name or position eg school counsellor
  might be able to help. Would you be able to tell
  him/her what you told me? I can come with you if
  you like - OR I can introduce you to him/her.
  
• Maintain a connection, even if someone else has
  taken over the main task of trying to help. If
  it doesnt work out, encourage them to keep
  trying
• I know that must be frustrating but maybe this
  will take a while to work out. Will you keep
  working on it with ? - OR It might help to talk
  to someone else (suggest another person or
  somewhere to look for help)

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When you go to a new school, find out

• Is there a school counsellor or welfare officer?
  Who can refer to him / her? Can students
  self-refer?
• Are there any youth centres available close to
  the school, and if so do they offer counselling?
  Is this a drop-in service or by referral? What
  else do they offer?
• Are there other services close to the school that
  might be of interest to students? General
  practitioners, psychologists or counsellors,
  youth health services, drug and alcohol services,
  support groups, same-sex attraction support, etc
• Does the school have any formal policies or
  procedures in regard to assisting students with
  personal problems or mental health issues? What
  do other staff recommend?

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Ethos and Environment
A whole-school approach
Curriculum, Teaching and Learning
Partnerships and Services
Involves everyone in the school community
staff, students, parents, etc Not just for those
staff who perceive they have a special role in
health, eg not just health/PE teachers, welfare
staff, school counsellors or nurses Backed up
by formal policies and procedures by school
leadership
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Student Activity
Ethos and Environment
Curriculum, Teaching and Learning

Partnerships and Services
Visualising a whole-school approach
Imagine you are coming into a school that has an
effective whole-school approach to managing and
promoting cultural diversity. What would you
expect to see, hear and feel around you? What
would you notice in the office? The classroom?
The playground?
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Wellbeing Tips for Teachers
Teach about mental health, social and emotional
issues eg in the health curriculum, pastoral
care, social studies, stories and drama, etc
Identify and refer young people who may be in
need of additional support for personal problems
or mental health issues. Teach everyone in a
way that promotes wellbeing development of
social skills, problem-solving and communication
interactive teaching methods positive and
inclusive classroom recognition of achievements.

Actively participate in programs adopted by your
school, such as MindMatters, KidsMatter,
etc. Advocate for a school environment, policies
and procedures that are supportive of wellbeing,
including the wellbeing of staff.
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Follow up -

• Children and Young Peoples Wellbeing An
  Educators Guide (brochure or download)

www.responseability.org
www.curriculum.edu.au/mindmatters
www.kidsmatter.edu.au