By Ella Higgs (Education Mental Health Practitioner from the West London Mental Health Support Team at HFEH Mind)
I have worked for three years as an Education Mental Health Practitioner at Mind, but before that, I was a 1:1 special needs assistant in a school. When I worked in the school, I remember wishing there was more training, advice and attention given to how I could support the mental health of the young people I worked with. Looking back now, with the training and experiences I have had, there is so much I wish I knew and there are things I definitely would have done differently. As school staff, you might be the only adult in some students lives who notices how they are feeling. Whilst this can of course feel like a daunting responsibility, it is also the most wonderful opportunity to make a difference. What I hope to do in this blog post is to provide some practical tips for supporting young people, and to empower you to feel confident using them. This sits alongside the variety of experience and diversity of backgrounds you have as a staff team and of course the natural skill and human instinct you all have when supporting young people.
When I discuss mental health in this post, I am defining it as a state of wellbeing that we all have and I invite you to consider your interactions with all young people, not just those who might have a diagnosed mental health condition.
What to look out for:
- The first thing to say here is that a need for support can present itself differently in everyone. One of the key things I want to discuss, which I feel is often misunderstood, is how ‘challenging behaviour’ is almost always an expression of an unmet need or a way of seeking safety. Picture a child who struggles to focus in class, one who appears defensive, rude and talks back when told off, and one who is always acting the class clown to get attention. Each of these behaviours have something in common, they can be part of a ‘survival response’. But what next? If a child is breaking rules and disrupting class, there have to be consequences? How do we support their mental health at the same time? – see the second tip below.
- As well as challenging behaviour, which we would call externalising, some young people turn more inward when they are struggling with their mental health, known as internalising. Signs of this may include withdrawing, avoiding, tearfulness, irritability. Sometimes young people may not have the language to tell you how they are feeling and might say, “I’m fine, I’m just tired”. I encourage you to trust your instincts if you suspect there is more to it – no harm can come from offering a conversation or letting someone know you are looking out for them.
Top tips, techniques and strategies
1. Emotion regulation
- When in distress, or ‘survival mode’, the brain is adapted to focus on keeping safe and deprioritises other functions such as being able to think and plan rationally. We can all relate to having the feeling of not being able to think clearly when we are super stressed, anxious or angry and perhaps doing or saying something we later regret.
- An important first step before we try to reason with young people or discuss their feelings, is to help then ‘turn down the heat’ on their emotions. This involves taking the time to help them relax a little. You could spend some time discussing their interests or something in their comfort zone, or you could guide them to use a calming technique such as deep breathing or grounding. See the resources and signposting section below for some ideas.
- Dr Bruce Perry, a neuroscientist, has shown us that to help a child to learn, think and reflect, we need to intervene in a simple sequence known as “The Three R’s”: Regulate, Relate, Reason. See the resources section below for more information on this approach.
2. Separate the behaviour from the young person
- If we know challenging behaviour is an indicator of something deeper, try this simple but highly effective strategy: separate the behaviour from the young person. This allows you to hold all boundaries and stick to school policies, but crucially also allows you to support the young person to feel seen, heard and safe.
- This might look like: “Your behaviour was not acceptable today and there will have to be a consequence, but I really want to hear about how you are feeling and what happened for you.” – then you can follow with some of the tips about having a conversation below.
- This communicates to the young person: you are not your behaviour. You can make a mistake and I still like you and ‘see’ you as a person.
- We are not providing permission for negative behaviour; we are acknowledging the underlying cause. We can hold the key assumption that all behaviours make sense – they always indicate an unmet need or are a way of seeking safety. This allows us more curiosity and empathy to explore what this might be for each individual young person
3. Having a conversation
- When young people are really distressed, sometimes the uncomfortableness of this can drive us - the adult - to want to fix, change or offer solutions. Whilst this can be very useful, there are other times where the most helpful thing is simply to listen and validate – “oh yes, that really is hard isn’t it”, “I understand why you feel so [angry, upset, scared] about that”. This communicates to the young person that you are a safe ‘container’ for their emotions, you are not overwhelmed by them, you accept them. Over time, this kind of validation and safe holding of overwhelming feelings will allow the young person to do the same for themselves – building their tolerance for uncomfortable emotions. Sometimes you are doing more by ‘doing’ less.
- As well as validating and showing empathy, some young people may not have language for their experience, especially if emotions are avoided or not spoken about. We can support young people to give language to their experience by modelling language about emotions and making suggestions – but being sure to allow them to accept or reject them. E.g., “I think I would feel pretty anxious if that happened to me, is that how you’re feeling?”
- Phrases to avoid: “Don’t worry about that”, “You’re okay”, “everything will be fine” – these are phrases we commonly use to try to comfort others and sometimes they can be comforting. However, more often than not, what they actually communicate is “I’m not hearing or acknowledging how this actually feels for you”, this can lead people to feel confused and alone with their feelings: “my body is telling me this is terrifying, yet this person is telling me everything is fine”.
4.Looking after yourself
- Supporting distressed young people can be mentally exhausting and this can make it difficult to be nurturing and attuned all the time. The key here is to be kind to yourself and make sure you are listening to your own needs just as much as you are to those you support.
- Think of it like the instructions for using oxygen masks on an aeroplane – you must put your own mask on before helping others. Understanding and managing your own emotional responses is not selfish, it is quite the opposite. When your own mental health is cared for, you will be far more resourced to be there for others. You can also provide a good role model for what it looks like to understand and respond to your emotions in a healthy way.
- Just as I am inviting you to validate the feelings of the young people, I am inviting you to validate your own feelings too – it is ok if you sometimes feel angry/frustrated, hopeless/helpless, sad, worried, ineffective, guilty, ashamed, to name a few common and understandable reactions to supporting distressed young people.
- It is important to stay aware of your own feelings and triggers It is always good to have some ‘go to’ strategies or activities to use to support your emotional wellbeing.
Thank you for taking the time to read this blog post. I really hope it can be useful to you. I want to leave you with a little take-home message – never underestimate the power of showing an interest in the young people you work with and taking time to build your relationship with them. This can be as simple as remembering (or writing down to remember!) something they talked about the last time you spoke and asking them about it. Warm, consistent and respectful relationships are the foundation for any kind of mental health/wellbeing support.
Resources/References:
Beacon House: https://beaconhouse.org.uk/?section=welcome-to-beacon-house
ARC Framework: https://arcframework.org/what-is-arc/
Signposting and further support:
If you are concerned about your or your student’s mental health, please speak to your GP or invite their parent to.
For Yourself:
- IAPT Services through NHS choices: https://www.england.nhs.uk/mental-health/adults/iapt/
- To find a private therapist:
- BACP: http://www.bacp.co.uk/
- UKCP: https://www.psychotherapy.org.uk/find-a-therapist/
- Mind Info Line: provides an information and signposting service. Open 9am to 6pm, Monday to Friday (except for bank holidays) 0300 123 3393. Ask about: mental health problems, where to get help near you, treatment options, advocacy services
- Samaritans: Free phoneline: 116 123, alternatively you can email at jo@samaritans.org
- YoungMinds Parent Line: detailed advice, emotional support and signposting about a child or young person up to the age of 25. Call for free on 0808 802 5544 from 9:30am to 4pm, Monday to Friday. https://youngminds.org.uk
- Anxiety UK Infoline: Helpline 03444 775 774 is available from 9.30am – 5.30pm Monday to Friday, or you can email support@anxietyuk.org.uk
- Helplines Partnership: For more options, visit the Helplines Partnership website for a directory of UK helplines https://helplines.org/helplines/
- Hub of Hope: The Hub of Hope is the UK’s leading mental health support database. It is provided by national mental health charity, Chasing the Stigma, and brings local, national, peer, community, charity, private and NHS mental health support and services together in one place for the first time.
- Mental Health Support Team (MHST) telephone drop-in service for staff - to support their own wellbeing. We are providing drop-in telephone sessions to support staff with their own mental health and wellbeing. This is a confidential space away from the school where staff can get a listening ear, wellbeing guidance, signposting support, and resources. Each phone call lasts for up to 20 minutes and you can request up to 6 calls – please note this is not a counselling service. To sign-up, use the following link: https://hfehmind.jotform.com/21052318690295
For Your Students:
- Anxiety UK Infoline: Helpline is available from 9.30am – 5.30pm Monday to Friday, 03444 775 774 or you can email support@anxietyuk.org.uk
- BEAT: eating disorder charity. Information on types of eating disorders, recovery information, support information including helplines & downloadable resources. www.beateatingdisorders.org.uk Helpline: 0808 801 0677, Studentline: 0808 801 0811, Youthline: 0808 801 0711
- CAMHS: is the name for the NHS services that assess and treat young people with emotional, behavioural or mental health difficulties. Most local CAMHS teams have a website where you can look up how to get access to their service.
- Hope Again: support for children and young people experiencing grief and bereavement. Helpline. www.hopeagain.org.uk, 0808 808 1677
- Kooth: free online counselling support for under 25s. www.kooth.com or download the Kooth app
- Mind: A-Z information for mental health, including treatment options, self-care, information for family & friends, & useful contacts www.mind.org.uk
- The Mix: information & support about mental health for under 25s. Professional and young person blogs and advice over a wide range of topics. Helpline, crisis messenger, 121 chat, email. www.themix.org.uk, 0808 808 4994
- NSPCC: charity fighting to end child abuse. Information, resources and further support, stories. www.nspcc.org.uk, 0808 800 5000
- No Panic: offers advice, support, recovery programs and help for people living with phobias, OCD and any other anxiety-based disorders. https://nopanic.org.uk, 0844 967 4848
- Papyrus: charity to prevent and help young people thinking about suicide. Information & support, hopeline for under 35s. www.papyrus-uk.org/hopelineuk, 0800 068 4141
- Samaritans: 24/7, free helpline for anyone. 116 123, www.samaritans.org.uk
- YoungMinds: mental health charity for children and young people. Information and resources for young people & parents, including parents’ helpline and young people crisis messenger and helpline. https://youngminds.org.uk, Text the YoungMinds Crisis Messenger for free 24/7 support across the UK if you are experiencing a mental health crisis. If you need urgent help text YM to 85258.