'Teachers aren't experts - they need tools to talk about mental health'
By Mike Armiger on 16 February 2019
Teachers should be given training on how to broach mental health issues with pupils, says one mental health expert
“Teachers should have mental health training.”
“Teachers should be trained in counselling.”
“Teachers should understand the signs of mental illness.”
The list of things teachers "should" be doing is endless. And more often than not, the suggestions miss the mark.
So how about this one?
“Teachers should be given the tools and language to have a conversation about a pupil’s levels of stress, distress, pain or overwhelm.”
*Newsflash*: it’s the nuanced answers that are often missing from the debate.
Are you expected to counsel someone through their depression? No.
Should we have to become experts in mental illness? No.
Can we have conversations with a pupil about stress? Overwhelm? Distress? Worry? Yes.
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Too often, we are forced to see mental health through a clinical lens. Take depression, for example: historically, we’ve been told that it’s a "chemical imbalance".
Neurotransmitters, AKA "brain chemicals", do play their part. But many causes of depression are situation – and this detail is, once again, absent from many conversations.
I work a lot in suicide prevention. And so much of what people think they know around this highly complex issue simply isn’t true. It isn’t true to say that all people experiencing suicidal thoughts are disordered or ill.
Teachers can't 'fix' mental ill-health
The fact is that suicidal thought or thoughts of self-harm are more often symptoms of distress.
I meet young people every week who have lost someone, experienced trauma, just come out of a relationship and who face financial hardship. The reality is that at any given time, we may find ourselves in a place of immense distress that we are unable to tolerate or process.
Educational provisions must play a role in supporting young people’s mental health. I’m yet to find one that doesn’t want to. It’s the resources and funding that remains the issue.
I often work with young people who need a bed in a psychiatric intensive care unit. Sometimes, there isn’t one within 150 miles and, in the worse cases, not a single one in the whole UK.
Child and adolescent mental health services are stretched – they can’t meet the demand. Early help is rarely available in many areas, and appropriate therapeutic treatment for children with high/active arousal states is difficult to access. The lack of provision is absolutely criminal and we should continue to voice our concerns as a profession.
So where’s the hope?
Any clinician will tell you that often an effective care pathway has to contain a mixture of clinical and social resource. It’s within this social element that teachers can play a part in supporting our young people’s mental health and wellbeing.
People often mistake mental health for mental ill health. In fact, we rarely separate the two and in much of my work across provisions, I use this scale/continuum to highlight this point:
Of course, there are detailed stages in between, very many exceptions and just as effective continuums out there. But this one is useful in our role, as it demonstrates clearly that our mental health is not fixed. We move across the scale daily and our baseline can, of course, shift. It also helps us to understand why we need to separate mental health and wellbeing and mental ill health.
I see and understand the apprehension of educational staff when it comes to discussing mental health with their students, as a result of these lines being blurred. It’s up to leaders within provisions to take a nuanced and sensible approach to conversations in school around mental health.
Let’s be explicit in stating that, in the first instance, staff are often responding to stress or distress. We want our staff to foster good relationships with our students and so it is no surprise that young people seek out adults they trust and have a relationship with. Our systems and thought processes can sometimes forget this.
We must equip those staff with the necessary tools. It’s completely normal for teachers to feel apprehensive about this and feel as if they’re not sure what to say through fear of making things worse.
Listening can be good support
Let’s give them the language and emphasise that listening and empathising rarely does any harm. We don’t need to fix anything, often simply holding the space and allowing someone to be heard effectively is the first step people need.
What can staff say when they have these conversations? What might the content of the conversations include? I suggest the following:
- Use humanising adjectives such as "heavy", "overwhelmed" and "saturated".
- Let’s use emotion theory to remind us that we don’t experience emotion singularly. Often I hear staff ask, "How are you feeling?" and then allow one response. Emotion theory tells us that we don't feel emotions singularly and that our body enters an arousal state way before we label emotions. That process is confusing and certainly not straightforward for many young people. We need to allow more time to think on this, and say things like, “Let me know later today or tomorrow what you think.”
- Explain that brains can catastrophise quite easily.
- Explore self-talk.
- Discuss vulnerability.
- Describe ways of coping with stress.
- Explain about low mood not necessarily being depression. It is possible to not be depressed and still suffer from low mood.
- There is a difference between being anxious and being nervous. There are many different levels – feeling nervous doesn’t mean you have an anxiety condition.
- Hope: let’s use this word and go after the hopelessness that many may feel.
- Never underestimate the phrase “I’m so glad you came and spoke to me”. It can lead to, “Can I support you in talking to someone about this?”
- Ensure appropriate staff members know how to co-produce a safety plan. A safety plan provides a practical and certain plan for someone when they experience suicidal thoughts or thoughts of self-harm. It can be completed by anyone and is often used by educators, parents, GPs, friends or family members to help get someone through the next few hours or days whilst a referral takes shape. Colleagues, students, family members and I all have one. I recommend that everyone do it. For more information on safety plans, click here.
I’m not suggesting that conversations are the only way tackle the levels of distress we are seeing daily in our schools and I’m certainly no fan of the simplistic narrative around "just talk".
We also need the resources and tools that allow us to have those conversations and be able to support pupils therapeutically.
But we can ensure that we start in a better place. I’ve had many of these conversations with staff members and students over the years and I can assure you that an authentic and human conversation is often a very good place for people to begin the support process.
Together let’s humanise mental health.
Mike Armiger is an education and mental health adviser