Mental health and behaviour in schools 10-minute Briefing

Transcription

1 Mental health and behaviur in schls 10-minute Briefing

2 Frum Business Media 2014 Published by Frum Business Media Ltd, 3rd Flr Regal Huse, 70 Lndn Rad, Twickenham TW1 1QS. All rights reserved. N part f this publicatin may be reprduced, stred in a retrieval system, r transmitted, in any frm r by any means, electrnic, mechanical, phtcpying, recrding r therwise, withut the prir written permissin f Frum Business Media Ltd. Imprtant disclaimer Althugh every effrt has been made t ensure that the infrmatin cntained in this reprt is crrect at the time f publicatin, the publisher and the authr accept n respnsibility fr any errrs, text missins r advice given in this publicatin. Crwn cpyright material reprduced under licence C This reprt is intended t prvide a summary f key pints. Readers are advised that nt every aspect f the dcument is cntained in this reprt. T cntact Frum Business Media Ltd: Telephne: +44 (0) Fax: +44 (0) cs@frumbusinessmedia.c.uk Website: 2

3 Cntents Mental health and behaviur in schls... 4 Key pints... 4 Prmting psitive mental health... 5 Identificatin... 6 Interventins... 7 Referral and cmmissining... 7 Surces f supprt and infrmatin... 8 Table: hw t address the main types f mental health needs... 9 Handut: Mental health and behaviur in schls

4 Mental health and behaviur in schls This dcument prvides nn-statutry advice which clarifies the respnsibilities f schls and what can be dne t supprt children and yung peple whse behaviur might be related t unmet mental health needs. It aims t: Help schls prmte psitive mental health in their pupils Address thse with less severe prblems at an early stage and build their resilience Help schls identify and supprt pupils with mre severe needs Help schls make referrals t specialist agencies such as Child and Adlescent Mental Health Services (CAMHS). Mental health prblems referred t in the guidance include: Emtinal disrders, e.g. phbias, anxiety states and depressin Cnduct disrders, e.g. stealing, defiance, fire-setting, aggressin and anti-scial behaviur Hyperkinetic disrders, e.g. disturbance f activity and attentin Develpmental disrders, e.g. delay in acquiring certain skills such as speech, scial ability r bladder cntrl, primarily affecting children with autism and thse with pervasive develpmental disrders Attachment disrders, e.g. children wh are markedly distressed r scially impaired as a result f an extremely abnrmal pattern f attachment t parents r majr care givers Other mental health prblems including eating disrders, habit disrders, pst-traumatic stress syndrmes, smatic disrders, and psychtic disrders, e.g. schizphrenia and manic depressive disrder. The dcument in full Mental health and behaviur in schls: Departmental advice fr schl staff (Department fr Educatin, June 2014) can be fund in PDF frmat here: Key pints In rder t help their pupils succeed, schls have a rle t play in supprting them t be resilient and mentally healthy Where severe prblems ccur, schls shuld expect the child t get supprt elsewhere as well Schls shuld ensure that pupils and their families participate as fully as pssible in decisins 4

5 Schls can use the Strengths and Difficulties Questinnaire (SDQ) t help them judge whether individual pupils might be suffering frm a diagnsable mental health prblem MindEd is a useful free nline training tl There are little things that schls can d t intervene early and strengthen resilience Schls can influence the health services that are cmmissined lcally thrugh their lcal Health and Wellbeing Bard There are natinal rganisatins ffering materials, help and advice. Prmting psitive mental health There are prtective factrs that enable children t be resilient when they encunter prblems and challenges: A sense f self-esteem and cnfidence A belief in ne s wn self-efficacy and ability t deal with change and adaptatin A repertire f scial prblem-slving appraches. Risk factrs in schls include: Bullying Discriminatin Breakdwn in r lack f psitive friendships Deviant peer influences Peer pressure Pr pupil t teacher relatinships. Prtective factrs in schls include: Clear plicies n behaviur and bullying Open dr plicy fr children t raise prblems A whle-schl apprach t prmting gd mental health Psitive classrm management A sense f belnging Psitive peer influences. Difficult events such as lss r separatin can alter the balance between risk and prtective factrs fr pupils. Schls can prmte pupils mental health thrugh: A cmmitted senir management team Setting high expectatins f attainment fr all pupils and prviding cnsistent supprt 5

6 An effective strategic rle fr the qualified teacher wh acts as the special educatinal needs c-rdinatr Wrking with parents and carers as well as with the pupils themselves Cntinuus prfessinal develpment fr staff Clear systems and prcesses t help staff wh identify children and yung peple with pssible mental health prblems Wrking with thers t prvide interventins fr pupils with mental health prblems that use a graduated apprach t infrm a clear cycle. Identificatin Cnsistent disruptive r withdrawn behaviur can be an indicatin f an underlying mental health prblem. Only medical prfessinals shuld make a frmal diagnsis f a mental health cnditin. Schls can identify thse wh may be suffering frm a mental health prblem, r thse at risk f develping ne, thrugh: Effective use f data An effective pastral system with at least ne member f staff knwing every pupil well. Schls shuld als: Listen t parents cncerns Listen t pupils. Evidence might be gathered thrugh: Using the Strengths and Difficulties Questinnaire (SDQ) Assessing need using the Cmmn Assessment Framewrk (CAF). When t refer After using the Strengths and Difficulties Questinnaire, pupils shuld be referred t CAMHS fr a cmprehensive assessment if a cnduct disrder is suspected, r if the pupil has: Anther mental health prblem such as depressin A neurdevelpmental cnditin such as ADHD A learning difficulty r disability A substance misuse prblem. A pupil might be identified as having special educatinal needs (SEN) due t their mental health prblems and special prvisin might need t be made. This might include additinal supprt frm within the setting r require the invlvement f specialist staff r supprt services. There might be invlvement f the pupil s GP and schls might ask fr cnsent t share infrmatin with the GP. 6

7 Interventins Strategies t prmte psitive mental health These include: PSHE educatin which might fcus n develping children s resilience and cnfidence Psitive classrm management and small grup wrk, e.g. facilities fr children with emtinal needs such as a rainbw rm r asis Cunselling Child and adlescent psychiatrist either frm CAMHS r cmmissined directly Develping scial skills Wrking with parents Peer mentring. Children with mre cmplex prblems Additinal in-schl interventins fr pupils with cmplex prblems might include: Supprt t the pupil s teacher Additinal ne-t-ne educatinal supprt fr the pupil One-t-ne therapeutic wrk by a mental health specialist Medicatin Family supprt and/r therapy by a mental health prfessinal. Referral and cmmissining Schls are advised that they shuld invlve themselves in their lcal health and wellbeing bard t influence services such as CAMHS. Advice n making a referral t CAMHS includes: Using a clear prcess fr identifying children in need f further supprt, e.g. SDQ Dcumenting evidence f the symptms Encuraging the pupil and their parents t speak t their GP Wrking with lcal specialist CAMHS t make the referral prcess as quick and efficient as pssible Understanding the criteria that will be used by specialist CAMHS Having a clse wrking relatinship with lcal specialist CAMHS Cnsulting CAMHS abut the mst effective things the schl can d t supprt children. 7

8 Schls can cmmissin services directly frm CAMHS r elsewhere and are referred t the BOND prgramme which is available nline. Infrmatin abut services shuld als be published in the LA s Lcal Offer. Surces f supprt and infrmatin Cunselling MindEd e-learning t supprt the training f schl and yuth cunsellrs and supervisrs: HeadMeds website with infrmatin abut cmmn medicatin: MindEd free e-learning t help adults identify and understand children and yung peple with mental health issues: Yung Minds website aiming t imprve the emtinal wellbeing and mental health f children and yung peple: 8

9 Table: hw t address the main types f mental health needs Descriptin Cnduct disrders Defiance, aggressin, anti-scial behaviur, stealing and fire-setting Anxiety Generalised anxiety disrder (GAD) Panic disrder Obsessive-cmpulsive disrder (OCD) Specific phbias (such as schl phbia) Separatin anxiety disrder (SAD) Primary interventins Interventins Teaching scial and emtinal skills in cmbinatin with parents Small grup sessins t develp cgnitive skills and psitive scial behaviur Parent training prgrammes t prmte prblem-slving skills Nurture grups Play-based appraches Classrm management techniques Secndary interventins Therapeutic appraches that invlve wrking with the family Multi-systemic therapy Multi-cmpnent schl-based preventin prgrammes Specialist fster placement with prfessinal supprt Regular targeted wrk with small grups f children Additinal wrk with parents Therapeutic appraches fcusing n cgnitin and behaviur Training in scial skills Play-based appraches Psychanalytic family psychtherapy Depressin Majr depressive disrder (MDD) Dysthymic disrder (DD) (depressed md fr at least 2 years) Hyperkinetic disrders Disturbance f activity and attentin such as Attentin Deficit Hyperactivity Disrder (ADHD) Attachment disrders Lack f an affectinate bnd with special peple Eating disrders Anrexia nervsa, bulimia nervsa Substance misuse Yung peple wh are at risk f lngterm dependency Deliberate self-harm Overdsing, hitting, cutting r burning, pulling hair r picking skin, selfstrangulatin. Can als include taking illegal drugs and excessive amunts f alchl Pst-traumatic stress Fllwing witnessing smething deeply shcking r disturbing Regular wrk with small grups f children fcusing n cgnitin and behaviur Therapeutic appraches, including family therapy Psychanalytic child psychtherapy Nn-directive supprtive cunselling Use f medicatin Parent educatin prgrammes and individual behaviural therapy Psychscial treatments by medical prfessinals Training fr teachers Vide feedback interventins with a fcus n enhancing maternal sensitivity Using play t develp mre psitive child parent relatinships Therapeutic wrk with the family Individual therapeutic wrk Therapeutic appraches invlving the family Multi-systemic therapy, multi-dimensinal family therapy Develping skills that enhance resilience Brief interventin engaging the child and invlving the family Assessment fr psychlgical disturbance r mental health prblems Individual psychdynamic therapies and behaviural treatments Therapeutic supprt fcused n the trauma 9

10 Handut: Mental health and behaviur in schls Backgrund This is nn-statutry advice which clarifies the respnsibilities f schls and what can be dne t supprt children and yung peple whse behaviur might be related t unmet mental health needs. It aims t: help schls prmte psitive mental health in their pupils address thse with less severe prblems at an early stage and build their resilience help schls identify and supprt pupils with mre severe needs help schls make referrals t specialist agencies such as Child and Adlescent Mental Health Services (CAMHS). Mental health prblems referred t in the guidance include: emtinal disrders e.g. phbias, anxiety states and depressin cnduct disrders e.g. stealing, defiance, fire-setting, aggressin and anti-scial behaviur hyperkinetic disrders e.g. disturbance f activity and attentin develpmental disrders e.g. delay in acquiring certain skills such as speech, scial ability r bladder cntrl, primarily affecting children with autism and thse with pervasive develpmental disrders attachment disrders e.g. children wh are markedly distressed r scially impaired as a result f an extremely abnrmal pattern f attachment t parents r majr care givers ther mental health prblems including eating disrders, habit disrders, pst-traumatic stress syndrmes, smatic disrders; and psychtic disrders e.g. schizphrenia and manic depressive disrder. The dcument in full The Mental health and behaviur in schls: Departmental advice fr schl staff (Department fr Educatin, June 2014) can be fund in PDF frmat here: Key pints In rder t help their pupils succeed, schls have a rle t play in supprting them t be resilient and mentally healthy, e.g. thrugh develping prtective factrs by having clear plicies n behaviur and bullying Where severe prblems ccur schls shuld expect the child t get supprt elsewhere as well schls can cmmissin directly frm CAMHS r anther apprved prvider Schls shuld ensure that pupils and their families participate as fully as pssible in decisins 10

11 Schls can use the Strengths and Difficulties Questinnaire (SDQ) t help them judge whether individual pupils might be suffering frm a diagnsable mental health prblem MindEd is a free nline training tl There are little things that schls can d t intervene early and strengthen resilience such as: PSHE educatin Psitive classrm management and small grup wrk Cunselling Prviding a child and adlescent psychiatrist Develping scial skills Wrking with parents Peer mentring Where a child has mre cmplex prblems a schl might need t prvide: Supprt fr the pupil s teacher Additinal educatinal ne t ne supprt fr the pupil One t ne therapeutic wrk by a mental health specialist Family supprt and/ r therapy by a mental health prfessinal Schls can influence the health services that are cmmissined lcally thrugh their lcal Health and Wellbeing Bard There are natinal rganisatins ffering materials, help and advice 11

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