MENTAL HEALTH AWARENESS WORKSHOP

VIDEO CLIP

WORKSHOP OBJECTIVES

To provide a understanding of common child and youth mental health difficulties.

To improve the capacity of teachers to identify and respond early to indicators of mental health difficulties in children and youth

To provide opportunities to share information and enhance working relationships

NOT OBJECTIVES

To turn participants into mental health professionals

To cover every mental health and/or learning concern

To include comprehensive discussions of mental health concerns

It is not to be interpreted as specific advice on a specific situation

WHO USUALLY NOTICES A PROBLEM?

Parents/Caregivers

Teachers

Often the first to notice a mental health difficulty

In a classroom of 30 students, about 5 to 6 will be facing a mental health problem

Early intervention is the most effective way to prevent future problems.

POSSIBLE SIGNS OF MENTAL HEALTH PROBLEMS

Behaviours

Fight (aggression), Flight (avoidance or withdrawal)

Problems functioning at home, school, work

Hyperactivity / Passivity

Inattention/distractibility

Emotions/Feelings Sadness, depression, anxiety

Irritability, anger

Thoughts Low self-esteem, thoughts of life isn’t worth living

Behaviours

Thoughts

Feelings

CHILDREN/YOUTH ARE LIKE ICEBERGS

Image by Uwe Kils

ANXIETY DISORDERS

ANXIETY

Healthy

Just enough anxiety is helpful because it keeps us cautious and safe

Unhealthy

When it interferes with the child’s function, and/or causes distress

SIGNS/SYMPTOMS OF ANXIETY

Behaviours

Avoidance of feared situations, e.g. school

Feelings

Worry, anxiety

Physical symptoms

Thoughts

“The world is a scary place”, and/or

“I am not competent”

TYPES OF ANXIETY DISORDERS

Generalized Anxiety Disorder Panic Disorder Obsessive Compulsive Disorder (OCD) Social Anxiety Disorder Post Traumatic Stress Disorder (PTSD)

WHAT ANXIETY CAN LOOK LIKE

Refusal or reluctance to attend school

Excessive worrying

Fear of new situations

Physical complaints not attributable to health problem

Social isolation/withdrawal from peers

Tiredness, fatigue, difficulty getting through the day, frequent bouts of tears

Anger, opposition, defiance, aggression

Obsessions (consuming thoughts and worries)

Compulsions (behaviour rituals)

WHAT CAN ANXIETY LOOK LIKEWHAT ANXIETY CAN LOOK LIKE

Experimentation with drugs and alcohol

Suicidal thoughts

Anxiety may co-exist with other disorders

WHAT CAN ANXIETY LOOK LIKEWHAT ANXIETY CAN LOOK LIKE

POST TRAUMATIC STRESS DISORDER

(INCLUDING POST TRAUMATIn vulnerable individuals, exposure to trauma can result in lasting symptoms

Trauma = event that involves actual or threatened death or injury

Violence/aggression such as bullying; domestic abuse at home; abuse/neglect

POST TRAUMATIC STRESS DISORDER

(INCLUDING POST Symptoms

Re-experiencing the event over and over again (e.g. flashbacks)

Hyper-vigilance

Avoidance/numbing

Loss of function

MOOD DISORDERS

MOOD PROBLEMS: A CONTINUUM

Normal moods

Mood problems

Mood disorders

MOOD DISORDERS

Healthy

Sadness can be an appropriate response to life stressors

Sadness signals to us that there is something wrong

Unhealthy

When sadness and depression start interfering with life

SIGNS/SYMPTOMS OF MOOD DISORDER

Behaviours

Social withdrawal, avoidance

Feelings

Sadness, depression, irritability, anger

Physical symptoms

Thoughts

“I am not loved” / “Nobody cares”

“I am powerless” / “I am not competent”

TYPES OF MOOD DISORDERS

Major Depression

Dysthymic Disorder

Adjustment Disorder

Bipolar Disorder

GENERAL INTERVENTIONS

PROFESSIONAL MENTAL HEALTH HELP

Start by speaking with families about concern

Encourage families to see a physician or paediatrician

Can help rule out medical conditions

Can help with referrals to other services

WHERE MIGHT YOU FIND HELP?

Child/Youth/Family

Schools / Education

Sector

Friends, Family, Colleagues

Addictions Sector

Justice /Policing Sector

Child WelfareSector

Hospital, Mental Health

Agencies

Self-Help, Mutual Aid,

Peer Supports

Private Practitioners

(e.g. Psychologists,Counsellors)

UNIVERSAL INTERVENTIONS FOR MOOD/ANXIETY

Lifestyle strategies

Exercise

Healthy nutrition

Getting enough sleep

UNIVERSAL INTERVENTIONS FOR MOOD/ANXIETY

Reduce risk factors / stressors

Identify stresses at school, work or home

Reduce stresses or problem-solve to help deal with them

UNIVERSAL INTERVENTIONS FOR MOOD/ANXIETY

Improve resiliency factors / strengths

Improve connections to supportive, nurturing adults

Ensure parents know how to listen and support the child

Ensure that the child can turn to parents for support

COMMON TYPES OF COUNSELING/PSYCHOTHERAPY

Cognitive behavioural therapy (CBT)

Interpersonal and attachment-based psychotherapies

Solution-focused psychotherapy

Collaborative problem solving (CPS)

WHEN SHOULD MEDICATIONS BE USED?

When non-medication options (e.g. counseling/therapy) have already been tried, but have not been successful

Common medications include

Anxiety / depression SSRIs

ADHD ADHD medication

Psychosis/Schizophrenia Antipsychotic medication

SCHOOL INTERVENTIONS

SUPPORTING STUDENTS WITH ANXIETY/DEPRESSION

Inform the school when a child has mental health needs so if faced with behaviours, the school can be supportive

Foster a relationship between the student and the school

Ensure that key educators make a point of building a connection with the child

SUPPORTING STUDENTS WITH ANXIETY/DEPRESSION

Regularly communicate with the child about:1) how things are going

2) any stresses and possible solutions

3) positives

Develop a system so the child can let teachers know when s/he is overwhelmed, in order to have a break in a resource room or library

SUPPORTING STUDENTS WITH ANXIETY/DEPRESSION

Provide positive feedback on positive behaviours as well as academics

For negative behaviours, help the student to see mistakes are a necessary part of the learning process

Reduce expectations if possible

BEHAVIOUR DISORDERS

BEHAVIOUR DISORDERS

Healthy

Most children/youth misbehave at some point

May indicate confidence, persistence and other positive traits

Unhealthy

Behaviour disorders can severely impair function at home, school and elsewhere

TYPES OF BEHAVIOUR DISORDERS

Oppositional Defiant Disorder (ODD)

Conduct Disorder (CD)

OPPOSITIONAL DEFIANT DISORDER

Oppositional Defiant Disorder (ODD)

Seen in younger children

Child is oppositional towards rules and authority

Child has frequent temper tantrums

CONDUCT DISORDER

Conduct Disorder (CD)

Seen in older children

Child violates rights of others through:

Physical aggression

Stealing

Bullying

Deceit

IMPACT ON SUCCESS

Likely to fare poorly at school

May also have learning problems

Behaviours can alienate other children and result in isolation

May miss class time, teacher instruction, and school work

May affect their ability to commit to school/life

APPROACH TO BEHAVIOUR PROBLEMS

Many approaches to behaviour problems

Collaborative problem-solving (CPS)

Children do well if they can; they want to please their parents, and want to do well at school

If they cannot do well, then there is some other issue, stress or problem that is getting in the way

BASIC STRATEGIES TO HELP CHILDREN WITH BEHAVIOUR PROBLEMS

Provide consistency, structure, and clear consequences

Use positive behavioural expectations (describe desirable behaviour)

Praise child (in subtle ways) when they respond positively

ATTENTION DEFICIT HYPERACTIVITY

DISORDER (ADHD)

RECOGNIZING ADHD

Inattention

Problems paying attention, e.g. parents/teachers need to repeat themselves

Hyperactivity

Needs to move or fidget

RECOGNIZING ADHD

Impulsivity

May blurt out things

Say inappropriate things without thinking

Difficulty waiting for their turn

Low frustration tolerance

RECOGNIZING ADHD

High need for stimulation and excitement

Difficulty playing quietly

Gets bored easily; likes stimulating/exciting activities

STRATEGIES FOR ADHD

Distractibility

Reduce distractions

Move child closer to the front of the class and away from windows

Talk with the child when there are less distractions

STRATEGIES FOR ADHD: HYPERACTIVITY

Hyperactivity

Give appropriate ways for the child to move in the classroom

E.g. mobile seats like ball seats, wedge cushions, disc-o-sit, etc.

STRATEGIES FOR ADHD: HYPERACTIVITY

Ideally have physical activity prior to difficult academic or mental tasks

Allow use of ‘fidgets’ in the classroom, with appropriately agreed upon rules

STRATEGIES FOR ADHD: ATTENTION

Break large tasks into smaller ones

E.g. Asking child to clean their room would become:

Task 1: Place dirty clothes in laundry basket

Task 2: Place toys in toy box

Task 3: Make bed

Task 4: Vacuum floor

Etc….

STRATEGIES FOR ADHD: ATTENTION

Give shorter sets of instructions both orally and visually.

Use visual teaching strategies, as well as visual strategies for daily routine

Show or demonstrate what you want the child to do, and then have the child do it

STRATEGIES FOR ADHD

Medications

It is preferred that you use a combination of behaviour management and medication but….

Studies show that if you only use one strategy for ADHD, then medications alone are more powerful than behavioural management alone

TALKING WITH CHILD/YOUTHABOUT MENTAL HEALTH

Use everyday language that students can understand

Let them know there are limits to what you can keep confidential

Privacy is important for talking about sensitive topics; find a quiet meeting room

TALKING WITH CHILD/YOUTH ABOUT MENTAL HEALTH

Focus on the behaviour you have noticed; ask student whether they have this problem in other settings

If child/youth acknowledges a problem, involve other adults who are involved in the child’s life

TALKING WITH PARENTSABOUT MENTAL HEALTH PROBLEMS

Start with the things that the student is doing well; these positives can build trust

Focus on a specific behaviour you’ve observed, without making a judgement about the cause

TALKING WITH PARENTSABOUT MENTAL HEALTH

At the meeting: “First, I want to let you know how much I’ve liked getting to know your son this year. I really like the way he _____”

“I’ve noticed ______, and I think it causes him difficulties. Your son is not alone; we see a lot of students struggle with these types of issues. The good news, is that help is out there.”

“I’m wondering what you think.”

CASE STUDY

REFLECTION AND WORKSHOP FEEDBACK

EVALUATION

THANK YOU!