How to give a supportive, effective and proactive lesson on mental health without 'triggering'

As the number of pupils with mental health issues increases, we have an obligation to provide guidance – but how can teachers make sure they get it right? Mental health expert Natasha Devon shares her advice

Natasha Devon

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Logically, the school holidays are the time when education professionals are most likely to read and absorb my columns. For that reason, I’m going to ensure my remaining articles in August are really (for want of a better word) "tip-py". (Unless, of course, something massive and education-related happens like, I don’t know, Gove returns as secretary of state (shudder). In which case, I reserve the right to opine about that. And then possibly emigrate.)

I’m going to chuck as much solutions-based, proactive and practically applicable info as I can in your direction between now and September. In that spirit, below is my advice on having discussions or giving lessons on mental health without "triggering".

But first, what exactly is "triggering" and why is it important?

In the context of mental health, triggering is probably most relevant to discussions around eating disorders and self-harm, although it can also apply when exploring depression, anxiety, suicide and psychosis. The word is primarily used in one of two ways:

Firstly (and most commonly), it describes a situation where words, sounds or pictures can cause distress to someone with a pre-existing mental health condition. An example of this might be when an image of a person at an extremely low weight is shown to someone in recovery from anorexia. We know this can set them back by unearthing uncomfortable emotions and compulsions associated with their illness.

Secondly, people who are unwittingly encouraged into destructive behaviours might also say they have been "triggered". An example of this would be a teenager who is, let’s say, racked with anxiety about their forthcoming exams sitting in a lesson about self-harm and being given explicit instructions about the various methods self-harmers use, as well as being told that the act can provide a temporary relief from stress. In this instance, they might begin to think self-harm is a good idea.

The problem is, of course, we can’t simply avoid discussing these topics – not addressing issues doesn’t make them go away. Evidence collected by the Samaritans, for example, showed that discussing suicide euphemistically, alluding to it whilst not going into detail, can encourage "copycat" behaviours, whilst speaking about it directly and appropriately actively reduces suicide risk.

With mental health issues rising in prevalence, the chances are most children and young people know someone who is struggling, if they aren’t themselves. That’s before we even consider the prevalence of information online and in the media. This places an obligation to provide guidance, so how do we get it right?

1. Gauge the level of knowledge in the room

Always start by asking the class what they understand by a word – for example, "depression". Their answers will give you a good indication of where you need to roll up your sleeves and bust some myths and what you can afford to gloss over. If you can, try to guess in advance some of the things they might say, so you’re prepared.

I visit lots of different schools and, therefore, often address a year group without knowing the backgrounds of individual pupils. It’s useful, not to mention probably accurate, to assume that a couple in an average year have been recently bereaved, a good proportion have self-harmed and/or are currently experiencing anxiety, and that one or two have eating disorders.

2. Make sure you are clear in your own mind about boundaries and definitions

What is self-harm? If you can’t define it in a sentence or two, you’re going to flounder in front of your class. I usually say something like, "Self-harm is when someone is distressed in their mind and takes it out on their body by hurting themselves." I’m also quick to point out that self-harm isn’t necessarily the same as wanting to die, which is a common misconception.

3. Be ‘grass roots’

"Awareness-raising" often takes the form of the class being shown a testimonial from someone who has experienced severe mental illness. Whilst this can be a worthwhile exercise in a broader context, it also means the pupils probably won’t be able to relate it to themselves directly. After all, whilst the average onset age for mental illnesses is 14, they rarely start with someone being immediately in a state of mind where they need to be sectioned for their own safety. Think about where they are, as opposed to where they might end up.

4. Avoid before and after pictures

It’s unhelpful, in my opinion, to suggest that you can tell if someone is mentally ill by looking at them. With eating disorders, for example, it’s entirely possible to have one in conjunction with a "normal" BMI.

Additionally, explicit and distressing photos aren’t really enhancing pupils’ understanding. By all means, use visual aids but try to make them an anchor for their attention as opposed to something that’s going to reinforce stereotypes.

5. Focus on ‘whys’ not ‘hows’

If you approach each section of the lesson by asking yourself "why", rather than "how", you can’t go far wrong. "Why can people develop anxiety?", "Why do people self-harm?", "Why are mental health issues on the rise?" (you might want to chuck that one back at them for debate). That way, you move the conversation away from unhelpful clichés or misinformation and avoid getting bogged down in mechanics. "Whys" are also more universally relevant than "hows".

6. Build a safety net

Assume that the lesson will create a need for further support and advice. Your school might have a counsellor or peer-support service, in which case put up a slide at the end with information on it about how they can be contacted. You might choose to send an email to parents in advance, reassuring them that nothing in the lesson will be triggering but also advising them of the topics to be discussed so they are prepared for their children coming home and asking questions.

You might also like to find some online organisations which provide further, reliable information. Which brings me to…..

7. Warn against Googling

There are loads of people on the internet and most of them haven’t got the faintest clue what they’re talking about. Googling symptoms of mental illness almost always leads you into dangerous territory, whether that’s people trying to sell their services to the exclusion of all else; so-called "pro-eating disorder and self-harm" websites or dodgy chat rooms.

Find out in advance which charities and organisations provide agenda-free and safe information. For example, B-eat, the eating disorder charity, has a two-second delay in its chat forums so it can vet what users are saying. Point your pupils in the direction of somewhere you know they can trust.

8. Don’t forget the friends

One of your key aims, as well as making people with mental health problems feel comfortable and confident to speak about it, is to prepare their friends for that conversation. Remember to give tips on non-judgmental listening.

Most importantly, remind pupils that whilst they can provide support, it’s not their responsibility to "fix" their friends' issues. 

Natasha Devon MBE is the former government mental health champion. She is a writer and campaigner, and visits an average of three schools per week all over the UK. She tweets as @_natashadevon. Find out more about her work here

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Natasha Devon

Natasha Devon

Natasha Devon MBE is the former government mental health champion. She is a writer and campaigner and visits an average of three schools per week all over the UK.

Find me on Twitter @_natashadevon

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