Mental health

Promoting children's mental health within early years and school settings (0112/2001)

Summary

The government has issued good practice guidance on 'promoting children's mental health within early years and school settings' as part of a wider government strategy to raise educational standards for all children, to tackle the causes of social inclusion and to transform children's services.

What causes mental health problems in children and young people?
Whole school approaches to promoting children's mental health
Early years settings
Schools
What are mental health problems in children and young people?
Interventions to support individual children who are experiencing difficulties
Early interventions in pre-schools settings
Early intervention in primary and secondary schools

What causes mental health problems in children and young people?

There are a range of factors in chidren and young people's lives which can result in them being at increased risk of developing mental health difficulties.

risk factors in the child - for example, children with specific learning difficulties, communication difficulties and specific developmental delays are more at risk than their peers
risk factors in the family - for example, overt parental conflict, family breakdown and where children experience inconsistent or unclear discipline
risk factors in the community - for example, children who experience socio-economic disadvantage, homelessness or discrimination are at increased risk

An important key to promoting children's mental health is also an understanding of the protective factors that enable children to be resilient.

resilience factors in the child - these include having secure early relationships, a positive attitude, a problem solving approach and good communication skills
resilience factors in the family - includes at least one good parent-child relationship, affection and clear, firm and consistent discipline
resilience factors in the community - includes having a wider supportive network, a high morale school with positive policies for behaviour, attitudes and anti-bullying and strong academic and non-academic opportunities

top

Whole school approaches to promoting children's mental health

Promoting children's mental health within schools has important educational payoffs, resulting in improved academic attainments for all children.

top

Early years settings

Characteristics of early years settings that actively promote the emotional well-being of children. These include:

stable child care arrangements so that children interact with just a few primary care givers in any one day
low staff turnover so that children are cared for by the same individuals over several years
good staff training in child development
adequate staff to child ratios
positive behaviour management

top

Schools

Key characteristics of schools that promote their children and young people's mental health share:

a committed senior management team, creating a culture within the school in which the importance of trust, integrity, democracy, equality of opportunity and each child being valued regardless of their ability is seen as being vital
a culture within the school which values teachers, lunchtime supervisors and all those engaged in the care and supervision of chilren
clear policies on vital issues such as behaviour and bullying - 'whole school behaviour' policies which set out the range of acceptable behaviour for children, what is and what is not acceptable
the range of sanctions that will result and the acceptance and implementation of the policies throughout the school
high professional standards (efficient planning, setting, marking, punctuality)
skillful teaching which arouses pupil interest and motivates
proactive work with parents

top

What are mental health problems in children and young people?

Mental health professionals have defined these as:

emotional disorders, eg phobias, anxiety states and depression
conduct disorders, eg stealing, defiance, fire-setting, agression and anti-social behaviour
hyperkinetic disorders eg disturbance of activity and attention
developmental disorders eg delay in acquiring certain skills such as speech, social ability or bladder control, primarily affecting children with autism and those with pervasive developmental disorders
attachment disorders, eg children who are markedly distressed or socially impaired as a result of an extremely abnormal pattern of attachment to parents or major care givers
other mental health disorders including eating disorders, post-traumatic stress syndromes, somatic disorders and psychotic disorders eg schizophrenia and manic depressions disorder

Many of these problems will be experienced as being mild and transitory nuisances to the child and their families, whereas others will have serious and longer lasting effects. When a problem is particularly severe or persistent over time, or when a number of these difficulties are experienced at the same time, children are often described as having mental health disorders.

top

Interventions to support individual children who are experiencing difficulties

School staff need to understand a child's needs to decide what help and support might be most useful. Questions to consider when thinking about the help that children and young people might need include:

what sort of problem is the child presenting with?
what is the impact of the child's problem?
hyperkinetic disorders eg disturbance of activity and attention
risks - what factors have initiated and maintained the problem?
strengths - what aspects are there to work with?
are there wider perspectives?

School staff will already have experience of these issues. The code of practice for special educational needs has clear guidance for meeting children's needs, including those children who have emotional and behavioural difficulties and mental health problems. In contributing to the assessment of children's needs under the children act, schools should also be working with the framework for the addessment of children in need and their families. (Copies of the framework are available on www.doh.gov.uk).

top

Early interventions in pre-schools settings

In early years settings some practices are particularly important for children who are at risk of developing emotional and behaviour problems. These include:

home visiting, parent 'drop ins', courses run for parents in such areas as literacy and computing skills
parenting classes which enable parents to build on their strengths and learn new ways of engaging with small children
work with small groups of vulnerable children or vulnerable children individually around strategies to promote positive behaviour, social development and self-esteem
teaching interpersonal problem solving skills to young children
compensatory nurturing experiences for vulnerable children

top

Early intervention in primary and secondary schools

Some simple but important strategies that all teachers can use to support children with mental health problems are:

in the classroom - evidence has shown the effectiveness of positive classroom management techniques at a whole class level, alongside work with small groups of chidren or individual
in the playground - a range of interventions - circle of friends, play assistants and Pyramid Trust type schemes can help children at these potentially difficult times
out of school through effective links with parents - evidence shows that if parents can also be supported to better manage their children's behaviour, alongside work being carried out with the child at the school - there is a much greater likelihood of success in reducing the child's problems, and in supporting their academic and emotional development

For children with more complex problems, interventions in schools may include:

support to the child's teacher, to help them manage the child's behaviour within the classroom, taking into account the needs of the whole class
additional educational one to one support for the child - to help them cope better with the classroom
one to one theraputic work with the child, delivered by mental health specialists outside or sometimes inside school. This may take the form of cognitive behavioural therapy, behaviour modification or counselling approaches
medication may be recommended by mental health professionals (school staff should be aware of the medication that children are taking)
family support and/or therapy could also be considered by mental health professionals - to help the child and his/her family better understand and manage his/her behaviour

top