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Mental Health for All Children and Youth


What is meant by “child and adolescent mental health”?

  • The term “child and adolescent mental health” refers to the social, emotional, and behavioural well-being of children and adolescents, and is considered an integral part of healthy development.

  • Just as with physical health, no one goes through life without some mental health problems. This is as true in childhood and adolescence as it is in adulthood.

  • Many such problems are a normal part of life. For the most part, we learn and grow from them.

  • For children and adolescents, however, adult awareness, sensitivity, and guidance often are very important to enable children and adolescents to learn and grow from such problems.

  • For some children and adolescents, the problems are serious enough that supports and guidance from the main adults in their lives (e.g., parents and teachers) are not sufficient, and specialized assistance is needed. Without such assistance, the problems can cause much stress and heartache to the children and adolescents, as well as to their families, their teachers, and the community. In addition, such problems can lead to even more serious mental health problems in adulthood.

What can teachers do?

  • The daily actions of effective teachers and their positive relationships with their students actively promote the mental health of students. 

  • Teachers’ roles and relationships reach through and beyond the substance of the curriculum to impact students’ feelings of self-worth, dignity, identity, and belonging. Through interactions with both students and their parents, teachers are in a unique position to strengthen these important elements of mental health.

  • Teachers also are in an excellent position to observe mood changes or behaviours that seem excessive or unusual, perhaps lasting longer than average, which could indicate a mental health problem requiring consultation and intervention.

  • “Sometimes you just can tell that something is not right.”

Guiding values and assumptions of this Resource.

  • The specific information and suggestions in this Resource are grounded in a set of values and assumptions about how we understand and relate to one another.
    • As a teacher, you are working to provide the students in your class with every possible opportunity to succeed and reach their full potential.
    • All persons (children, adolescents, and adults) are different and have unique needs, but:
      • We are all more alike than different
      • We are all of value, no matter what
      • We all need to be treated with respect and dignity, no matter what
      • We all have both strengths and limitations, and
      • We need one another.

  • One might think about children’s mental health as on a continuum ranging from developmentally normal, through problems that may be addressed in the everyday life of the classroom and the school, to problems that require expert assessment and intensive clinical interventions.

  • Depending on the student’s age and stage of development, and the temperament, social context and unique needs of a student, a particular behaviour or difficulty that a student is having may be part of normal development.

  • In this Resource, behaviours that are part of the normal development of a particular student are considered to be in the Green Light area.

  • If a behaviour goes somewhat beyond (e.g., in frequency or intensity) what would be considered a normal part of a particular student’s development, the behaviour is considered to be in the Yellow Light area. This is the type of behaviour that often causes teachers concern and that warrants further consideration.

  • How do you tell if a behaviour has moved into the Yellow Light area? The first general rule is to trust yourself. You know the students in your classroom. Trust what you hear and see.

  • In particular, it is important to watch for behaviour that changes, becomes more intense, or occurs more often than before. These can be signs that a behaviour is moving into the Yellow Light area.

  • Behaviour that interferes to a significant extent with a student’s functioning in school, or with normal development and normal pursuits, is considered to have moved into the Red Light area and to be serious enough to refer to a mental health specialist.

  • As with movement into the Yellow Light area, movement into the Red Light area often is indicated by an increase in a behaviour’s intensity, frequency, and/or duration.

  • Movement into the Red Light area also can be indicated by a lack of response to interventions in the classroom or home, with the behaviour continuing or intensifying, or with new concerning behaviours appearing, in spite of efforts to help.

  • Each chapter in the ABCs Resource presents a description of behaviours relevant to the title of the chapter as they might appear in the Green Light, Yellow Light, and Red Light areas, depending on the developmental stage of the student (Early Childhood, Middle Childhood, Early Adolescence, Adolescence).

  • When you observe a behaviour that is puzzling or worrisome, what might be behind it?

  • Our beliefs about what is behind a behaviour often determine whether or not we continue to worry about it and, if so, what Course to Follow might help.

  • There usually are several factors acting together that affect a student’s behaviour.

  • None of these influences should be seen as particularly positive or negative, good or bad on its own.

  • For example, no two families are alike, and particular family characteristics will influence a child or adolescent’s behaviour in particular ways (just as the child or adolescent’s behaviour will influence the family.) A particular characteristic in one family might be normal to the background and culture of the family, and have a positive influence on a child or adolescent’s mental health. The same characteristic in a family with a different background and culture could have a negative influence.

  • The purpose of exploring beliefs is to help teachers understand how those different influences work, but not to judge (for instance) a particular family or culture.

  • It also is important to resist the temptation to look for one-dimensional, simplistic explanations for behaviour, as the factors that underlie behaviour can be very complex.

  • Each chapter in this Resource for Teachers presents information about various factors that are known to influence the behaviour under discussion.

  • Most chapters discuss these factors under the following headings: (a) biological, congenital, and health; (b) family; (c) disabilities; (d) differences; (e) cultural and/or religion; and (f) trauma., loss, and/or turbulent environment.

  • However, cutting across all of these factors are the five concepts discussed below: normal development, temperament, social context, perception of “difference,” and risk factors and resilience.
Normal Development
  • Development during childhood and adolescence is generally understood to consist of several somewhat distinct stages, each with its own developmental tasks.

  • Developmental tasks are those abilities that are developed or that are expected to be developed during a particular developmental stage. The tasks involve particular physical abilities, cognitive development (i.e., thinking, remembering, understanding), social development, and emotional development.

  • Children and adolescents vary in the ease with which they accomplish these tasks, with some needing more support and practice than others. However, all children and adolescents experience bumps along the way.

  • For the four age ranges addressed in this Resource, some examples of major developmental tasks are as follows:
    • Early Childhood (3 to 5) – ability to use pencils and paintbrushes; elaboration of running, jumping, large motor movements; learning the letters of the alphabet; learning to count; developing the ability to verbally communicate needs and thoughts; learning basic problem-solving skills; developing the ability to sit still, listen, and follow directions; learning to share and take turns; developing sensitivity to other children’s feelings; developing a basic understanding of and regulation of own emotions.
    • Middle Childhood (6 to 12) – increased neuromuscular skills that allow playing team games; cognitive development that increases ability to reason and more sophisticated problem-solving skills; adjusting to changing body image, self-concept, and gender roles; becoming a more active family/group participant; becoming less dependent on family and gaining satisfaction from other adults and from peers; learning pro-social attitudes and skills; learning how to handle strong feelings and impulses appropriately.
    • Early Adolescence (13 to 14) – learning to handle the maturing body and to develop a variety of physical skills; learning to think analytically and abstractly; developing skills to relate to a variety of people, including those of the opposite sex; beginning independence from parents, while maintaining attachment and interdependence; learning to manage a wide range of sometimes intense emotions.
    • Adolescence (15 to 18) – learning to handle a mature body and developing a stable sexual identity; developing a personal worldview that includes ethical values and a philosophy of life; developing a sense of membership in a broader community of persons; preparing for personal and economic independence from parents; learning to take primary responsibility for own emotional and behavioural expression.
Temperament
  • Development during childhood and adolescence is generally understood to consist of several somewhat distinct stages, each with its own developmental tasks.

  • Temperament is another underlying factor that you will find discussed frequently in this Resource.

  • As a concept, temperament is closely related to the concept of personality; however, temperament is thought to be primarily biologically or genetically based, to be observable already in early infancy, to interact with the environmental experiences of the individual and, thus, provide the foundation for a person’s developing personality.

  • Babies have been found, from birth, to vary in their activity level, sensitivity to physical stimulation, emotional intensity, sociability, adaptability to change, and persistence.

  • Although parents report babies with some combinations of these temperament characteristics (e.g., high sociability and ready adaptability to change) to be “easy” to parent, and babies with other combinations (e.g., high activity level, high emotional intensity, and low adaptability to change) as “difficult” to parent, all combinations are considered to be “normal” and to present their own joys and challenges to healthy development.
Social Context
  • A child or adolescent’s social context also has a strong influence on his/her behaviour.

  • Behaviour that is appropriate in one social context could be an indication of a serious problem in another social context.

  • Social context includes such concepts as family structure, family circumstances (e.g., financial, health, location stability, losses, traumas), family religion and/or culture, and the community in which the family lives.

  • All social contexts have strengths and weaknesses.

  • With respect to family structure, it can be helpful to know whether the family is intact (both parents in the home), a single-parent home, or a blended family. It also can be helpful to know the number of children in the family, and whether extended family members or others are part of the family’s daily living.

  • With respect to family circumstances, it can be helpful to know: whether there are any major financial pressures or chronic or acute health problems in the parents or other family members: how often the family has moved; and whether the family has experienced any major disruptions, traumas, or losses, and how recent those might have been.

  • With respect to family religion and culture, it might be helpful to know what the family believes and values, and what religious and cultural practices they observe.
Individual Difference
  • In addition to having much in common, we also differ from one another and have unique individual needs.

  • Differences that produce unique needs include such factors as gender, our particular abilities/disabilities, genetics, and sexual orientation.

  • Some students have attributes or challenges that lead them to perceive themselves, or lead others to perceive them, as different from “the norm.”

  • The stress may have its origins in the student’s own concerns about the “difference,” or in how others treat the student as a result of their perceptions of the “difference.”

  • Regardless, they are factors to consider when one is trying to understand some of the behaviours students exhibit.
Risk Factors and Resilience
  • In the ABCs Resource, you will find frequent reference to the related concepts of “risk factors” and “resilience”.

  • Risk factors are individual, family, and community circumstances that increase the probability of mental health problems developing.

  • Known risk factors include having a “difficult” temperament, poverty, and exposure to violence.

  • However, it is important to remember that teachers find that many of the students who live with identified “risk factors” actually perform just fine in school and live lives that are primarily positive, without the development of significant mental health problems.

  • Students who exhibit the most challenging behaviour in school often live with more than one risk factor, and it’s the cumulative effect of the risk factors that becomes the major problem.

  • However, even with many risk factors in their circumstances, some children and adolescents thrive and do not develop mental health problems. These children and adolescents are said to be resilient.

  • Why some children and adolescents are resilient and others are less so is not well understood. However, it is thought that in addition to risk factors there are “protective factors” in the environments of resilient children and adolescents that can protect those living with multiple risk factors.

  • Prevention programs often focus on increasing children and adolescents’ resilience to risk factors by emphasizing the importance of adding protective factors into the child or adolescent’s daily environment.

  • Protective factors include such things as having caring adults in the family or school, developing meaningful relationships with other adults, having opportunities for positive group involvement and contribution, and receiving praise and recognition for accomplishments.

In General
  • Although many students cope well as they grow older and move from grade to grade, others need extra supports in order to progress academically, socially, emotionally, and behaviourally.

  • Effective educators already are providing, or helping students find, the supports they need for their growth process, though they may not be thinking of these in terms of children’s mental health.

  • In dealing with mental health problems in school, a good general guideline for Courses to Follow is “the earlier the intervention, the better the outcome.”

  • Preventing problems from developing in the first place is an excellent beginning strategy.

  • Similarly, being aware of the first sign of trouble in order to prevent a problem from developing further should be the philosophy that underpins any course of action by the teacher.

  • The classroom environment, including the classroom program, has a major role to play in preventing problems from developing or from increasing in seriousness. This is especially true for behaviours in the Green Light and Yellow Light areas.

  • In addition to the classroom, working with an individual student and with the student’s parents often can be very important to reducing the likelihood of actions moving further along the seriousness continuum toward the Red Light area.

  • In some circumstances, the teacher will find that formal school and/or community supports and resources also are needed. This is especially true when a behaviour has moved into the Red Light area.

  • In developing a Course to Follow with regard to a student’s worrisome behaviour, it often is helpful to document the behaviour. Such documentation:
    • demonstrates that you are aware that there is a problem
    • provides a clear and concrete description of the problem for yourself and others
    • creates a tool for sharing the problem with parents, school personnel, and community supports helping with the problem
    • provides a framework for planning appropriate interventions for the student
    • supports you in your role as a teacher.

  • For behaviours that are more serious, an important rule is to avoid labelling the behaviour or the student, especially with diagnostic terms (e.g., “depression”).

  • In the ABCs Resource, this is known as the “No Diagnosis Zone,” which is indicated by its own icon [insert icon].

  • Your training, knowledge and experience make you an expert in teaching, but no one expects you to have expertise related to mental health, nor would it be appropriate to your role.

  • Even if a diagnosis is eventually made by a trained mental health professional, it is important to refrain from labelling, as there may be many variables about which you are not aware, such as family circumstances.

  • Premature or inaccurate diagnoses can be harmful to the student and to the parent-teacher relationship.

  • Another important rule when deciding on a Course to Follow is that crises situations (e.g., child abuse, threats of suicide, serious physical threats to others) need to be responded to immediately in order to prevent serious harm from occurring. Although a longer-term Course to Follow may need to be developed to help the student, whatever needs to be done to prevent immediate serious harm needs to be carried out as soon as possible.

  • Although there are many joys and satisfactions in teaching (the very reasons you became an educator), teaching can be at times difficult and worrisome. Therefore, a permanent Course to Follow is the ongoing availability of personal support, such as a circle of colleagues for informal mutual advice and encouragement.
The Classroom
  • A positive classroom climate has been found to be one of the most important factors in promoting good children’s mental health, whether in the prevention of the occurrence of mental health problems, in preventing mental health problems from getting worse, or in reducing the impact of mental health problems on a student’s everyday life and ability to learn.

  • What is a “positive classroom climate?” Generally, it is what you strive to provide in your classroom every day, and includes:
    • an underlying philosophy of respect (between teacher and student, and between the students themselves), which helps provide the protective factors of:
      • support
      • caring relationships
      • respectful interactions
      • acceptance of differences
      • opportunities for success, involvement, and contribution, and
      • recognition
    • clear expectations and predictable routines;
    • modelling of:
      • optimism
      • positive behaviour
      • understanding and acceptance of feelings
      • regulation of emotion, and
      • constructive conflict resolution
    • creation of an environment that helps students take pleasure and interest in school activities.

  • Each of the chapters in this Resource will include, in discussions of Course to Follow, suggestions for classroom climate and, in particular, specific classroom activities of particular relevance to the behaviours discussed in the chapter.
The Student
  • Sometimes in developing or implementing a Course to Follow, it is important to speak with and work with the student directly.

  • When speaking to a student about a problem, it is important to keep the following general points in mind:
    • Take it slowly. When you are first trying to find out what may be happening, a student may not know how to express it or may not be comfortable in sharing the specific details.
    • Avoid being judgmental, either verbally or non-verbally. Avoid blaming or admonishing the student. Students are more likely to open up if they know you will not be judging them.
    • Conveying interest, verbal and non-verbal reassurance, eye contact can help indicate to the student that he or she is understood and not being judged.
    • Listen, listen, and listen!
    • Convey sensitivity to the student’s problem and show empathy for what the student might be going through.
    • Treat what the student tells you as confidential. With the exception of needing to prevent the student or someone else from being seriously harmed (e.g., disclosure of physical abuse), it is important to ask the student’s permission to discuss what the student has told you with someone else who might help with the problem.
    • Never speak to the class about private matters related to the student.
    • Provide an atmosphere of acceptance to the student so that he or she feels welcome and valued. Such an atmosphere provides a positive learning environment and an excellent example for all of the students in the classroom.

  • Each of the chapters in this Resource will include, in its discussion of Course to Follow, suggestions for talking to and working with students that are specifically related to the behaviours being discussed in the chapter.
The Parents
  • Research indicates that a strong partnership between the school and family helps children and adolescents to thrive in both environments.

  • Conversely, lack of communication between home and school can have a negative effect on a child or adolescent’s mental health.

  • Therefore, maintaining regular and open communication with parents and encouraging them to participate in school activities is critical to the well-being of every student in the classroom.

  • Parents are an excellent source of valuable information about the student and about factors in the student’s life that might be affecting the student’s behaviour in school.

  • Much sensitivity may be needed when communicating with parents about behaviour that is of concern to you.

  • Some general points to keep in mind are the following:
    • It is important to remember to start with their child’s strengths and accomplishments, and not focus only on the behaviours of concern.
    • It also is important not to blame parents and make them feel they are responsible for their child’s behaviour. The emphasis should be on exploring the situation and on developing an acceptable Course to Follow.
    • Ask the parents whether they see the same behaviour at home.
    • If so, ask the parents how they respond to this behaviour when it emerges at home. Are there responses that make it better or worse?
    • Be sensitive to what parents are already doing for the child or adolescent, and to the fact that they may be struggling with many challenges related either to their child/adolescent or to other life circumstances, or both.
    • Explore with the parents their opinions about the behaviour and whether they would like to see something different.
    • Avoid coming across as “the expert,” telling parents what to do. Rather, form a partnership with them in trying to solve any identified problems.
    • Respect parents’ cultural and religious background. They may understand their child or adolescent’s problems and reactions very differently from you. Stay open to different views!
    • Learn along with the parents in finding a way to help their child or adolescent.

  • Each of the chapters in this Resource will include, in its discussion of Course to Follow, suggestions for talking to and working with a student’s parents that are specifically related to the behaviours being discussed in the chapter.
The School
  • On an ongoing basis, it is often helpful to have a network of colleagues (formal or informal) with whom you can consult, sharing ideas and strategies for preventing or dealing with mildly to moderately concerning behaviours.

  • However, behaviours in the Red Light area almost always require formal supports and interventions that go beyond what you can do in the classroom, or directly with the student or parents, or with consultation alone.

  • As school resources can be structured differently from one school or school region to another, it is important to know both the specific resources and relevant policies/procedures of your school and/or school region.

  • With respect to resources, the following (or their equivalents) might be available to you:
    • Principal
    • Vice Principal
    • School social worker
    • School psychologist
    • Guidance counsellor
    • School support team

  • Each of the above (or similar persons available in your school) may be part of your formal or informal network, but also generally fulfills a specific role with respect to students with behaviours in the Red Light area.

  • For instance, mental health professionals available within a school often are involved in helping with assessment of the seriousness of the situation, with referrals to specialized community resources if needed, and with providing you with ideas for assisting the student in the school environment while the child or adolescent is receiving specialized services.

  • With respect to policies and procedures, it is particularly important to familiarize yourself with those related to mandatory reporting (e.g., of suspected child abuse) and management of crises (e.g., suicidal gestures, emergencies).

  • Above all, remember not to be afraid to ask for help if you sense that something is wrong!

  • Each of the chapters in this Resource will include, in its discussion of Course to Follow, suggestions about when to take a situation to the formal school resources level.