Mental Health and Well-being: Depression, Anxiety, and Self-harm

The Covid-19 Pandemic has negatively affected the mental health and wellbeing of students and staff alike. We expect to see further issues associated with the pandemic surfacing for months if not years to come.

In response, we created a series of wellbeing webinars to help provide you with the knowledge and tools you need to support your students during these uncertain times. The webinars, which are available to watch again using the link at the bottom of the page, provide practical advice and guidance to help you create outstanding pastoral care in your setting. The webinars are beneficial to all teaching staff as well as safeguarding leads. 

How to Spot the Signs a Child or Young Person is Struggling.

According to Brathay.org.uk Teenage rates of depression and anxiety have increased by 70% in the past 25 years. These statistics have been further impacted by Covid-19 and the multiple lockdowns and increasing restrictions students and staff face.

Worryingly, World Health Organization statistics show that half of all mental health conditions start by 14 years of age, but most cases are undetected and untreated.

Some symptoms of anxiety and depression in teenagers can include but are not limited to;

• Lack of energy
• Fatigue
• Low self-esteem
• Trouble concentrating
• The inability to feel pressure
• Sleeping too much or too little
• Lack of emotion
• Mood swings
• Self-harm

The teenage years are a time of tremendous change where attachments between the child and the rest of their family become strained. All items on this list can be viewed as normal forms of development; however, once you look at them together it can be possible to see patterns. Therefore, it is extremely important for teaching staff to record low-level concerns, so connections can be made as patterns emerge.

Are there things that increase the risk of anxiety and depression in Children and Young People?

Often depression and/or anxiety can be triggered by a single difficult event, such as a loss in the family, parents separating or problems at school academically or with other students. A decline in a young person’s mental wellbeing can also be caused by a combination of things, for example, a difficult recent event such as the pandemic or family bereavement.

Other factors can include family difficulties, bullying in person or online, severe obesity, experiencing or witnessing physical, emotional or sexual abuse or a family history of depression or other mental health problems.

Many of these issues have been further aggravated by Covid-19 including a rise of online bullying. Distanced learning has impacted the attachments some children have made to their homes and families which adds to their anxiety at the thought of returning to classroom learning. It is important to note that each child/young person will respond to each situation in a unique way, some children are more resilient which means when they do start to suffer teaching staff may not notice.

Again, the importance of reporting what may be considered as ‘low-level’ concerns is highlighted here as, by doing so it becomes possible to identify patterns and trends as they emerge. This could be across year groups or with individual students.

What happens when a student experiences stress?

When stressful or unpleasant events occur, a feeling is triggered within the individual, from that feeling a child or young person will respond with action and over time this action will become an automatic response whenever they feel overwhelmed or anxious. Reactions could present as disruptive behaviour, outbursts, being angry/oppositional and defiant even withdrawn.

Sometimes children and young people will exhibit fight or flight as an acute stress response, these responses can be from real or imaginary threats. Things to look out for would be dilated pupils, pale or sweaty skin, rapid breathing and trembling, the sensations would be eerily similar to the symptoms of a heart attack.

It is vital to help children and young people break this connection and to increase the control they have over their reactions, to progress from an automatic reaction to a level-headed response.

It is also extremely important to note that stress is not always a negative thing to experience. For example, when a student experiences stress over an upcoming exam or test can be used as a reminder to study, to that students recognize the importance of being prepared. Positive stress - called eustress - can boost motivation and decision-making, helping students achieve goals.

Practical Suggestions to improve mental health for pupils.

The immediate way to help is to distract and reduce the power of these automatic responses by offering the child or young person a list of choices to help them cope with their feelings. From that list they can select one that works for them, helping them to feel in control of the situation.

For longer-term wellbeing, we want to decrease the frequency of that feeling occurring and also the intensity of that feeling. We want to look at the overall picture and give that child or young person the tools to help them cope.

What is Self-harm?

Self-harm is when a person intentionally damages or injures their body. Some forms of self-harm can include self-cutting, burning, scratching, biting, hair pulling and eyelash plucking, headbanging, excessive use of alcohol or drugs and even over-exercising.

Some common signs and symptoms of self-harm can include but are not limited to;

• Substance abuse or eating disorders,
• Changes in behaviour, demeanour and/or, appearance,
• Changes in academic achievement, or attendance.
• Reluctance to participate in group activities, sports or to remove layers of clothing, for example refusing to remove jumpers and sweatshirts in hot weather.
• Isolation and withdrawn behaviours,
• Patches of missing hair and changes in skin condition.

Often self-harm occurs when a person does not know how to express certain emotions in a certain way. People have described self-harm in a number of ways; as a way to reduce overwhelming emotional thoughts, turn their emotional feelings into physical pain, to create a sense of control, as punishment or a way of expression and even as escapism from traumatic events. It can also be a form of communication; in which case, we need to help them find more effective ways of communicating and a healthier way to approach their feelings.

Self-harm is part of a brutal cycle in which negatives emotions leads to a build-up of tension which results in an act of self-harm. Endorphins are released but are soon replaced by guilt and shame which results in more negative emotions. The relief is temporary because the underlying issues remain.

For teaching staff it is essential to always record and report these issues, include other professionals, and make referrals when appropriate. It is important to offer support and help while understanding your own professional boundaries and referring to your school’s policies and procedures when moving forward. Make professional judgements when deciding to bring in other staff members or the child’s parents, if alerting a parent will help the child’s wellbeing then tell them, alternatively if a child expresses a concern but asks you not to inform their parents figure out what the root of the problem is. What is the fear that the child is harbouring? Give the child the option so they feel in control of the situation. We stress that you should not hesitate to contact 999 if you feel there is an emergency occurring.

What you can do to support a student who you believe is self-harming

Never be afraid to talk to the child or young adult you are concerned about, address your observations in a matter of fact, non-judgmental way but do not get drawn into the promise of keeping anything a secret. It is important to reassure the individual that they are not in trouble and support will be offered to help them. Let them be in control of their feelings and decisions, remind them of their positive qualities and things they do well, reinforce that positivity and honest communication. Be aware of your own feelings and how you may communicate them through tone or nonverbal cues. Encourage the other teaching staff to always report low-level concerns.

Another way to help is to raise awareness through workshops and discussions. Invite guest speakers and specialists to discuss mental health and wellbeing, nominate a wellbeing champion in your establishment. Another great way to help support children and young adults is by offering safe spaces to share their feelings and experiences and get them involved in conversations about mental health. These can be safe spaces where they can chat openly or even after school activities that allow students the space to exercise, write, create, and express themselves in whatever mediums they desire.

Ways to support a child or young person’s mental health through distanced learning.

While more limited than identifying issues through face-to-face conversations there are still ways to identify if a child is struggling with their mental health and wellbeing. Some include the unwillingness to turn on their cameras during classes (if that is the norm), not taking part in discussions, being absent from multiple classes or meetings.

We suggest making time to allow children the opportunities to talk and express themselves. This can happen either in one-on-one meetings, group calls or short presentations on certain topics. Offering short 10–15-minute sessions on managing anxiety and stress, promoting wellbeing, top tips to stay active during lockdown will get children thinking and engaged, encouraging them to reach out if they are struggling.