Mentally healthy schools are schools that pay ongoing and dedicated attention to the emotional wellbeing of both students and staff and put in place policies and interventions to ensure that students and staff feel cared for, listened to, understand, nurtured and valued for what each of them, individually bring to the school community.
Teams at CCMH and TIS UK have seen some superb examples of mentally healthy cultures at the schools we have visited while judging our recently launched Mentally Healthy School awards. These awards, presented jointly by both organisations, aim to reward and acknowledge schools that are mental health informed and/or trauma-informed. I define mental health and trauma-informed schools as schools that are equipped to support children and teenagers who suffer from trauma or mental health problems and whose challenging behaviour disrupts learning.
I was inspired and moved by the examples of whole school communities collaborating to create mentally healthy cultures for all who study and work there. Although effective, these methods are realistic and achievable and can be implemented by any SLT hoping to turn their school into an environment that prioritises wellbeing.
One primary school our team visited provided a calm and happy space (in the form of moveable safe base hubs) for pupils to take a break in if they were finding the classroom overwhelmingly stressful and were unable to engage in learning. Built by the pupils themselves (with a little assistance), the hubs were designed for children who required some calming ‘me’ time.
At a secondary school our team visited, restorative conversations between peers and staff were used as a key part of behaviour management. Another school provided teaching assistants (TAs) trained in responding to moderate mental health problems. These TAs were able to engage with anxious and depressed teenagers in such a way that attendance soared – there was a change in attendance in just one term from 8%-88%.
We saw several schools in which senior leads were actively interested in staff wellbeing. This involved ensuring staff felt valued and respected with frequent feedback on what they were doing well, and not just with attaining good marks, but when they saw a teacher calming an angry child, being emotionally supportive to colleagues or managing a challenging class well. These schools enabled teachers who were emotionally dysregulated to step away from challenging situations without fear of criticism or shame and provided teachers opportunities to have breaks in calm and soothing environments.
Introduce a whole-school mentally healthy culture
We have health and safety policies for children’s bodies in our schools – so why don’t we have health and safety policies for children’s minds and brains too? The neuroscience research is now sufficiently advanced that we have all the evidence we need on the adult- child relationship experiences that cause mental health problems and those that heal.
Painful life experiences, particularly multiple ones, are in most cases, the cause of mental ill-health – especially when there has been no emotionally available adult to help the child / teenager make sense of what has happened. From research with over 17,000 people the evidence is overwhelming that Adverse childhood experiences (ACEs) are a leading determinant of mental and physical illness and early death. They include childhood events, such as living with parental separation and divorce, suffering a major loss or witnessing domestic violence. The more ACEs, without protective factors, a child has, the more vulnerable they are to developing a mental health problem. ACEs also trigger what is known as ‘toxic stress’, whichnegatively impacts on the developing brain, the immune system and the endocrine system.
However, with their protective factors, mentally healthy schools can do so much to bring down toxic stress and interrupt thetrajectory from adverse experiences to mental and physical ill-health.
If implemented, with appropriate training, as part of a whole-school culture, all of the following are evidence-based protective factors for children and teenagers:
- Feeling listened to
- Feeling understood
- Engaging in mental state talk with an empathic adult
- Helping children and teenagers to correctly label their feelings
- Emotion coaching (validating the feelings underneath the child’s behaviour, however challenging)
- Psycho-education (giving children and parents the facts about causes of mental health symptoms, about diagnoses and successful interventions)
Train school staff to become ‘emotionally-available adults’ for vulnerable children
- Having daily and easy access to at least one specific emotionally-available adult, and knowing when and where to find that adult is an effective way to bring down pupils’ toxic stress levels. If the child does not take to the designated adult, an alternative person should be found.
- School staff should be trained to adjust their expectations and practices around vulnerable children to correspond with their developmental capabilities and experience of traumatic stress and loss. This includes removing vulnerable children in a kind, non-judgmental way from situations they are not managing. For example, teachers could introduce a ‘calm and be happy space’ for children who, due to traumatic life experiences, keep triggering into aggressive behaviour in the playground.
- Key staff should be trained in reflective conversations to enable vulnerable children to address ‘incoherent narratives’ they have about their lives and negative self-referencing (e.g. ‘my mother’s depression is my fault’) Pupils should be helped to process, talk through and make sense of painful life events when they want to, with someone trained to provide an empathic, compassionate response. This provision can enable vulnerable children to move from ‘behaving’ their trauma/painful life experiences, to reflecting on those experiences.
Implement a ‘relationship policy’ for staff
Author Paul Dix in, When the Adults Change, Everything Changes advocates for a relationship policy. Such a policy should include whole-school training on the physiology and neurochemistry of angry, threatened behaviour in children and the physiology of calm, engaged behaviour.
When we are consistently open and engaging with a child in a warm and respectful manner, the physiological social engagement system (Porges 2017) and pro-social neurochemical systems, in particular opioids and oxytocin (CARE system, Panksepp and Biven 2012), are optimally activated. These trigger anti-aggression and anti-anxiety brain chemicals.
This is why interventions such as ’meet and greet’ are key. Meet and greet in primary schools involve the teacher addressing each child individually by name, with a warm open expression, at the school entrance, and in secondary schools at the classroom door. This one intervention not only calms children and settles them to learn but has also been found to dramatically increase attendance figures (Dix 2017). One school found that saying goodbye to each child in turn and by name as they got on the school bus at the end of the day led to far calmer bus journeys home.
Introduce interventions that bring down pupils’ toxic stress levels to tolerable stress
Many children arrive at school in an emotional state not conducive to learning. There are many neuroscience research backed interventions designed to bring down stress levels in vulnerable children from toxic to tolerable. These arebest implementedat the beginning of the school day and include:
- Accompanied drumming
- Tai chi
- Sensory play
- Time with animals or time outside
All these interventions support learning and protect against toxic stress-induced physical and mental illness.
Use discipline that actively teaches pro-social skills
Research shows that punishment, such as isolation, sensory deprivation and feeling shamed is detrimental to the mental and physical health of students (Dickerson et al 2004). In contrast, the use of restorative conversations in schools has been found to be highly effective in both decreasing behaviour problems and exclusions and developing pro-social skills and life-long ability to manage stress well.
Implement a teacher well-being policy for senior leads
This is to ensure that the school is a mentally healthy culture for staff too.
- Carrying out a duty of care to staff toprevent burn-out, absence or leaving the profession through stress-related illness
- Being aware of high stress states in staff and providing those staff with sufficient emotional regulation, such as a ‘reflect and restore room’ or sensory zone staff-only spaces (with time built into the timetable) A quick chat in the corridor before the teacher’s next lesson is not sufficient to reduce toxic stress levels and activate optimal levels of oxytocin in the brain.
- Providing on-the-spot empathic support, not just advice giving, for moments of crisis and a forum for school staff to talk in confidence about their feelings and particular stress triggers from their work, e.g. providing timetabled time for psychologist-led supervision and and/or facilitated group talk- time.
Create a policy around testing and exam stress
Mentally healthy schools will promote and value the development of the whole child to ensure that pupils understand that their self-worth, and the worth of others, cannot be measured simply by tests and exams.
Finally and most importantly, if schools are to become mentally healthy places for both teachers and students, the value of wellbeing has to start at the very top, with organisations such as Department For Education, Ofsted and the Regional Schools Commissioners balancing the scales between outcomes (test scores) and emotional wellbeing. There needs to be national recognition of the importance of monitoring the wellbeing of schools, and governing bodies, trust boards and directors need to make staff wellbeing as well as pupil wellbeing a key performance indicator for our schools.
Author: Dr Margot Sunderland, Director of the Centre for Child Mental Health (CCMH) – a non-profit organisation that provides mental health training in schools and Co-Director of Trauma Informed Schools UK (TIS UK) – discusses some of key components of a mentally healthy school and explores measures that senior leadership teams can implement to improve the wellbeing and mental health of both students and staff.