Behaviour - Helping children with mental health issues

26th July 2013 at 01:00
Teachers should open students' eyes to these problems, recognise warning signs and ask for expert help if they think it is required

There is a myth within society today that mental health problems are an adult-only concern. In reality, children and young people are just as susceptible.

The evidence is persuasive. In the UK, the Prince's Trust interviewed more than 2,000 16- to 25-year-olds for its Youth Index 2013. The charity found that 27 per cent of the respondents who were in work felt down or depressed "always" or "often" and that this increased to almost half (48 per cent) of those who were not in education, employment or training (Neet).

And Keith Hawton and Anthony James, in the British Medical Journal article titled "ABC of Adolescence: suicide and deliberate self harm in young people", write of finding high levels of unhappiness, low self-esteem and self-harm among young people in Britain.

In the US, meanwhile, a report by the National Research Council and Institute of Medicine states that about one in five children in the country has a mental health issue. The Centers for Disease Control and Prevention also report that "millions of American children live with depression, anxiety, ADHD, autism spectrum disorders, Tourette's syndrome or a host of other mental health issues".

Some of these children are able to visit their school-based counsellor - a brilliant resource that can yield good results. Sadly, however, this isn't an option for many young people as counsellors are not always employed by their schools. In either case, teachers have a critical role to play in educating students about mental health, spotting signs of emerging mental health problems and helping their students to access the help they need. This is a big thing to ask of already overstretched professionals, but it is invaluable.

The first step is education. An understanding of mental health problems helps young people to recognise if they need support and lessens any associated stigma. However, teachers are rarely trained to educate students on this topic. To fill the gap, the British Association for Counselling and Psychotherapy is currently working with the Department of Health in the UK to develop a programme of e-learning modules designed to support the efforts of professionals to educate children about mental health. The programme will be universally available from March 2014. You can find out more on the Counselling MindEd website (

The second way in which teachers can play a crucial role is in spotting the signs of mental health issues. Studies have shown that early intervention makes a lasting difference to the lives of children so this is crucial.

It is often the case that teachers know their students well and can therefore spot the changes in behaviour that may indicate a mental health issue. Broadly speaking, children or young people can become withdrawn, quiet and generally disengaged from school and their peers. "Acting out" can be common, too. So, seeing a student become noisier, or more aggressive, defiant or confrontational can be a sign that they have problems that need to be addressed. Children in both these groups can often become prone to absenteeism.

When staff have these concerns, however small, they should discuss them first with a professional, whether internal or external. Best practice in this area - which works in many schools - is to have a well-established pastoral support team that includes a counsellor. This team can consider and implement the most appropriate intervention. For those without internal teams, teachers need to consider what other services may be available locally - for example, a local doctor or possibly a school nurse, who can refer the student to an external organisation. In the UK, for example, this might be the Child and Adolescent Mental Health Services.

As for informing parents, this has to be considered on a case-by-case basis - often they can be part of the problem. Seek advice from health professionals who have protocols for specific age groups and situations.

Teachers should be aware that things rarely move quickly when external bodies are brought in. In addition, once the child is involved with external organisations, information sharing with the school is often limited. In contrast, when the child or young person is accessing counselling support from a school-based service, the school counsellor, with the permission of the young person, is able to share appropriate information with teachers. This can be invaluable, helping staff to understand and be sensitive to the issues affecting the child.

Children's physical health issues are addressed effectively by educators, but their mental health is just as important and should have equal coverage. The sooner teachers are given as many tools to tackle the latter as the former, the better the situation will be for the millions of children affected worldwide.

Karen Cromarty is senior lead adviser on children and young people at the British Association for Counselling and Psychotherapy

What else?

How to talk to students about mental health and suicide.


A handy guide to spotting the signs of anxiety disorder and depression in students.



Hawton, K. and James, A. (2005) "ABC of Adolescence: suicide and deliberate self harm in young people", British Medical Journal, 330: 891- 894.

In short

  • Mental health problems are as much of an issue for children as they are for adults.
  • As such, teachers are key to helping the children in their care who are suffering.
  • The first task is education: demystifying mental health problems.
  • The second task is spotting when a child has problems. It is vital to discuss any concerns - no matter how small - with professionals.


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