“MAD,” someone writes in capital letters on the whiteboard.

“CRAZY. PSYCHO. BASKET CASE,” someone writes next to it. A third person contributes “CAN SHORT OF A SIX PACK”. A fourth person adds an exclamation mark to this last one.

The people writing on the whiteboard are not boundary-testing teenagers. In fact, they are not pupils at all: they are a group of teachers and teaching assistants from several Suffolk schools, gathered in a classroom for a day’s training in mental health first aid.

Last week, Theresa May announced that the government would be paying £200,000 to fund the first year of a three-year programme to provide every secondary school with a member of staff trained in mental health first aid.

The government says that the programme will train 3,000 teachers and teaching assistants (although there are actually 3,401 state-funded secondaries in England), with the intention that it will later be extended to cover primary schools as well.

“Schools already have safeguarding policies,” says Caroline Hounsell, who leads the school programme at Mental Health First Aid England, the social-enterprise organisation paid by the government to deliver the programme.

“But mental health first aid is about crisis response. It’s about first response. We’re not training people to be therapists or psychiatrists - we’re giving them the skills to respond in a crisis.

“If teachers are able to intervene and take appropriate action when a young person is in emotional distress, they can stop it from getting worse. And that can aid recovery in the long term.”

Opening up conversations

The programme has been largely welcomed by schools, teaching unions and mental health specialists. However, many are concerned that access to child and adolescent mental health services remains difficult.

The British Psychological Society warns that “providing teachers with training in mental health first aid alone will not address the scale of need”, although it sees the programme as a useful “first step”.

Anita Malster, who is delivering the course today, has split participants into two groups. One group has been asked to write down as many unacceptable mental health terms as they can (“Crackpot!”, someone says. “Unhinged”). The other group has the harder task of writing down acceptable terms for mental ill-health.

The point is to illustrate the way that even words that should be neutral - “mental”, for example - tend to have negative connotations.

Malster then shows participants a short clip in which a neuroscientist discusses what happens to the brain during adolescence. “If someone is in an environment where they feel understood, then that’s good for their self-esteem,” the neuroscientist says.

This, Malster believes, is a key point. “Part of the role of a mental health champion is being able to open up those conversations and listen effectively,” she says. “A lot of the time, young people are looking for that.

“It’s about being seen, being heard, and having your emotions acknowledged. So we’re teaching people to listen, in a non-judgemental way.

“That’s the fundamental thing that comes out of this course: the importance of opening up a conversation and listening to what young people have to say. For a lot of young people, being listened to can be enormously helpful.”

Next, Malster illustrates the effect that stress can have on vulnerable pupils, using a bucket, a flowerpot and a sack of purple plastic balls. The larger and more sturdy the bucket, the more balls of stress it can hold. A smaller, flimsier flowerpot - representing a vulnerable pupil - overflows more easily.

What mental health first-aiders need to do, therefore, is to help vulnerable pupils reduce the number of balls in their bucket, one by one. “It’s that old adage,” says Malster. “How do you eat an elephant? You eat it bit by bit.”

The group then breaks for sandwiches. “Part of the purpose of today is to give us reassurance that the things we’re doing are right,” says Richard Pope, director of learning at Claydon High School. “And, on the whole, we are. There’s a reasonable amount of it that comes down to common sense.”

Graham Tait, head of year in the sixth form at Farlingaye High School, agrees. He has already come across many of the problems being discussed. “So many students have mental health issues,” he says. “And we’re at the front line.

“There’s no question that more and more students are finding it difficult to deal with anxiety and stress, because there’s lots of pressure on them all.

“We’re not counsellors; we’re not being trained as counsellors. But we do provide counsel to our students. We want staff to be able to know how to deal with what’s presented by young people.”

After the break, the tone of the training changes. Malster offers a succession of briefing sessions on various mental health problems teachers might encounter: suicidal thoughts, depression, anxiety, self-harm.

They begin with suicide. “It’s an emotive topic,” Malster says, “so feel free to take some time out, if you need it.”

Direct questions

The recommendation is that, if teachers suspect a pupil might be feeling suicidal, they ask them the question directly: are you contemplating suicide?

“I’m not sure I feel emotionally equipped,” one teacher says. Another cuts in: “But however bad we feel, it’s not as bad as they feel. It’s giving them that opportunity to talk about it.”

Others are worried about what comes next: if a pupil admits to considering suicide, how should a teacher respond?

At this point, Richard Pope interjects. No matter how well teachers respond, he says, they are only a stop-gap measure. The problem comes when suicidal pupils have to wait weeks - or months - to access professional help.

“Ultimately, what we need is someone to sit down and listen and follow through with the stuff they’ve said they’ll do,” he says. “But that’s getting harder and harder.”

This has been a concern for teaching unions, too. While they have welcomed the decision to provide training for teachers, they also point out that it is not enough: many children need specialist help. And child and adolescent mental health services remain underfunded, often with months-long waiting lists.

Malster acknowledges that mental health first aid is not a panacea. Still, she hopes that its impact will be felt far beyond the classroom in which the group is currently sitting.

“Hopefully, once one teacher has been on the course, they will recognise the benefits of having a whole-school strategy and a whole-school approach,” she says.

“This is the first step, really; it’s the first point on the ladder of training people.”