ESRC SEMINAR SERIES

1
ESRC SEMINAR SERIES

• The school as a location for the promotion and
  support of mental health
• University of Aberdeen
• 6 November 2008

2
Cause for Hope or Despair?

• The scope and limitations of childrens rights
  discourses in relation to contemporary
  developments in promoting childrens mental
  health and wellbeing in schools
• Vicki Coppock
• Edge Hill University

3
Outline

• The problem with being critical
• The debate
• Cause for hope? Current policy and practice in
  CAMH and promoting wellbeing in schools
• Cause for concern? Conceptual, theoretical and
  evidential weaknesses
• Cause for despair? The State were in the
  limitations of childrens rights discourses for
  achieving a child centred approach to mental
  health and wellbeing

4
The problem with being critical

• Youre always the villain!
• Its easy to be negative
• Nobody likes a smart arse

5
Why its important to be critical

• The morally-active practitioner
• It opens the door to new ways of looking at,
  making sense of and responding to children and
  young people

6
Cause for Hope?

• Everybodys business
• Childrens mental health is the business of all
  the people, agencies and services in contact with
  children and young people
• Every Child Matters (DfES/DH, 2003)

7
Cause for Hope?

• Mainstreaming mental health
• Emphasis on mental health promotion / prevention
• Resources

8
The need for a response?

• Epidemiological estimates of diagnosable
  disorder in CYP
• 10 of those 5-15 in UK (Green et al, 2005)
• 20 of CYP in US (NAMH, 2006)
• 15-25 of CYP in Canada (Waddell et al, 2002)
• 14-20 of CYP in Australia (Sawyer et al, 2000)
• 2 million in the European region of WHO (WHO,
  2005)

9
The need for a response?

• Children in crisis
• Parents not parenting
• Communities not caring
• Rampant individualism and materialism

10
The response

• SEAL (DfES, 2005)
• Healthy Schools Programme (DfES, 2005)
• NICE Guidance (2008)
• School based mental health services reach
  children who do not receive help through other
  service routes
• with their captive audience and (almost)
  total population coverschools are the best
  placed institutions within which to centralize
  our holistic efforts
• Rothi et al (2006 p.10)

11
A Global Issue?

• Safe Schools Healthy Students Initiative (US)
• Take Action (Canada)
• MindMatters (Australia)
• Mentally Healthy Schools Mental Health
  Matters (New Zealand)
• European Network of Health Promoting Schools
• Teenscreen (US) Kidscreen (EU)

12
Cause for Concern?

• Is it an unequivocal good?
• Reflects linear thinking (context deprived)
• Is the public health/education model the most
  appropriate?
• Is the school really a natural setting?
• Purpose of education / schooling?
• Culture and ethos?
• Teachers concerns ignored

13
Theoretical coherence?

• Absence of serious debate / alternative
  perspectives
• Ignores contested nature of
• conceptualisations of childhood, family,
  mental health, wellbeing, disorder,
  illness, help, support
• Developmentalism
• Medicalisation

14
The evidence base?

• Unquestioned assumptions abound
• Re-framing of medicalising and psy discourses
  as wellbeing
• Selective hearing of evidence
• e.g. CAMHS Review (Interim Report 2008 SCIE
  Research Briefing on ADHD 2004)
• What counts as evidence and who decides?
• The deceit of ventriloquism (Hendrick, 2008)

15
What works in building resilience? (Newman, 2004)

• Key factors promoting resilience in children are
  support from family and/or peers, good
  educational experiences, a sense of agency, of
  self-efficacy and opportunities to contribute to
  family or community life by taking valued social
  roles
• Children and young people who have experienced
  difficulties report more often being helped by
  non-professional supporters (friends and family),
  rather than by professionals. Professionals
  should avoid weakening informal sources of
  support.

16
Cause for Despair?

• The idea that promoting children and young
  peoples mental health and wellbeing in schools
  is consistent with their rights is heavily
  problematic in New Labours Disciplinary State.

17
Cause for Despair?

• The Disciplinary State (Hendrick, 2008)
• Characterised by
• Early intervention
• Surveillance
• Discipline
• Punishment

18
Evidence of the disciplinary state?

• The Childrens Plan, December 2007
• the dispersal of discipline i.e. the
  universal approach
• the focus now on potential problems (as opposed
  to addressing structural issues! e.g. POVERTY)

19
Evidence of the disciplinary state?

• in a world of ontological insecurity, social
  anxiety and emotional disarray, governing
  children is made to seem preferable to feeling at
  the mercy of unseen and impenetrable forces risk
  in all its manifest forms
• Hendrick (2008)

20
The Disciplinary State

• What happens to
• children and young
• people has little to
• do with their actual
• emotions or behaviour
• and everything to do
• with the wider social,
• political and economic
• context they inhabit.

21
The Disciplinary State

• What a society judges as good or bad for its
  children depends on what it intends to make of
  them and the model to which it wants them to
  conformthus a nations politics becomes the
  childs everyday psychology
• Sami Timimi (2005 p.2)

22
The Disciplinary State

• The persistence of adult/professional power
  structures that militate against children and
  young peoples agency
• Adults prepared to tolerate an increasingly
  narrow band of behaviour from children and young
  people
• Resistance to adult control is not an option for
  children and young people

23
Scope for Childrens Rights? Rhetoric and Reality

• UNCRC Report, October 2008 the rhetoric of
  childrens rights in UK Govt Policy
• culturally, Britain just doesnt like children
  much
• Time Magazine 26 March 2008

24
Models of childrens rights in services and
welfare (Alderson, 2008)

• Provision and Protection Models of childrens
  rights dominate
• Tiers of management and inspection restrict
  professional and child autonomy.
• Children participate at various levels, BUT
  origins, meaning, purpose, context, grounding of
  participation is vague.

25
What about the other UNCRC rights?

• To freedom, privacy and autonomy?
• Objections include
• too much for incompetent dependent vulnerable
  children
• threaten childrens best interests

26
UNCRC Article 12.

• When does a child become capable
• of forming his or her own views
• of having the right to express those views
  freely in all matters affecting the child
• so that adults give due weight to childrens
  views in accordance with the age and maturity of
  the child
• of being main and sole decision makers (Gillick
  1985)?

27
The problem with rights (Alderson)

• are based on unreal Kantian concepts of pure
  reason, autonomy, decision-making,
  non-interference, ignoring social contexts and
  pressures
• are imperialist Western universal concepts,
  valuing physical and mental integrity, dignity
  and individuality over relationships and
  community
• pure autonomy - not totally realistic, realisable
  or desirable?
• all rights are qualified by respect for others,
  common interests, limited resources and, for
  children, by their best interests

28
Rights in discourse and rights in practice

• Nik Rose (1986)
• Rights-based strategies do not of themselves
  transform relations of dominance and
  subordination.
• Power structures must be brought into the open.

29
Tensions in childrens rights discourses in the
mental health context

• Paternalism
• adult professionally defined problems
• adult professionally driven services
• adult control

• Self-determination
• cyp defined problems and solutions
• ordinary sources of help and support for
  emotional wellbeing
• cyp control

30
Tensions in childrens rights discourses in the
mental health context

• The emotional distress and wellbeing of
  children and young people must be located in the
  structural reality of their experiences of
  exclusion and marginality

31
And Hope for the future?

• Mainstreaming truly child-centred approaches
• Challenging narrow medical model
• Dealing with the messy contradictions inherent in
  adult-child relationships

32
And Hope for the future?

• Academics / Practitioners who
• Ask questions
• Recognise inadequacies
• Challenge oppressive structures