How do schools treat children with mental health difficulties?

Last year I wrote the below article.  As our children go back to school this question is even more relevant.  What plans do schools have to help children going back to school after this huge disruption to their lives?  Are there adequate resources, support, and understanding?

The elephant in the room - what do we do with students with mental health difficulties?  
 
I want to start my saying that my mother was  school teacher, and I grew up with a lot of respect for the good teachers, the ones who worked hard to understand and then educate their students. 
 
And I still believe that the vast majority of teachers have the best intentions, and just like our students, they do well if they can.  
 
Over the last 10 years as an independent child and adolescent psychologist I have witnessed school and teachers who do not know what to do when a student has acute and/or chronic mental health difficulties.  When we look at understanding why a child is not learning well in the classroom it is not enough to look at cognitive abilities the emotional wellbeing of a student must be taken into account.  In our school system there are both systemic gaps, knowledge gaps and understanding gaps.
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The World Health Organisation states that half of all mental health conditions start by 14 years of age and “most cases are undetected and untreated”.  And “globally, depression is one of the leading causes of illness and disability among adolescents” https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.
 
About 10-20% of adolescents experience mental health problems.  In a classroom of 30 children that means 3-6 on average.  In a school of 1200 that is 240 students.  This is not an elephant that should be ignored and dealt with on an ad hoc basis.
 
We may be increasing the number of counsellors and psychologists in schools, but is that helping?  How far is it going?  Do schools think that because a student has an appointment a session a week or a fortnight, or is seeing an outside psychologist that that is enough.
 
I am asking these questions to school leaders, parents, teachers, mental health professionals.  These are aimed at encouraging conversation.  Possible answers and/or best practices to some of these topics will be addressed in future articles.  For now consider the following.
 
Knowledge and Understanding

• Do teachers understand the impact that mental health has on the ability of a child to focus and learn?
• Do teachers understand the range of reasons that may be behind a student sitting in class and not doing work?
• Is a student told they should be doing better?  Or are there conversations had around what is getting in the way of their learning.  Do teachers know how to carry out these conversations?
• What are teachers fears or mental health, and how does that impact on the way they manage situations?

 
Systemic

• Does your school have a mental health policy?
  • Who created it?
  • Does it have student buy-in?
  • Are parents aware of it?

 

• When do you tell a parent their child is self-harming?  Do you ever tell parents their child isn’t attending the counselling sessions that were initiated with parent consent?
• What is the process if a student has an anxiety attack in class?  When a student leaves the room due to distress?  When they can’t focus in class because of obsessive thoughts, or lack of sleep due to depression or ongoing trauma?
• What is your procedure when a child is absent?  Is there any investigation as to the reasons behind abseentism?
• Who looks after students with mental health concerns when there are excursions, camps, school events?
• Is the value of a good teacher-student relationship understood, encouraged and supported by the school?
• When English text books are decided upon – is the school choosing literature that is uplifting?
• How is the school managing student peer groups who indulge in rumination?
• What is the policy for students who self-harm and have visible marks?
• Are there emotional management plans in place for students with identified mental health concerns?
• Are there coordinated and formal meetings with parents?

 
These and many other questions need to be answered.
 
Let’s carry on the conversation.  Whether you are a principal, a teacher, a parent or a school psychologist/counsellor/welfare worker – what is your school doing?  Let’s share, what is working, what isn’t, where are the gaps in understanding, knowledge and systems.