Welcome to series 2 of the Brighter Thinking Pod! In this episode, we’re discussing how teachers can help students look after their wellbeing and mental health.
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Introductions
Georgia: Hello, welcome to the Brighter Thinking Pod from Cambridge university press. I’m your host for today. Georgia Robinson. On this episode, we’re going to dive into student wellbeing and mental health, and we have two very exciting guests with us. Firstly, I’d like to introduce Ros McLellan. Ros is on the Faculty of Education at the University of Cambridge and is a researcher specialising in children’s wellbeing and motivation. Ros, welcome to the show.
Ros: Hello!
Georgia: And secondly, we have Tamsin Ford here with us. Tamsin is a Professor of Child and Adolescent Psychiatry, also from the University of Cambridge. Tamsin, it’s a pleasure to have you here today.
Tamsin: Thank you. Pleased to be here.
Georgia: Ros and Tamsin are here to answer some questions around student wellbeing that you can use in the classroom. If you want to have your say on this topic of wellbeing, you can get in touch with those on Twitter using the hashtag #BrighterPod or by tweeting us at CambridgeInt.
What is the best lesson you have ever had?
Georgia: So before we dive straight into student wellbeing, I thought it might be nice to get to know our guests a little more. Our ice breaker for this episode is what’s the best lesson you’ve ever had. Now this could be one you’ve taught yourself or one where you were the students, but we want to know what made it stand out for you. So let’s start with Ros. What’s your best lesson ever. And why?
Ros: I think the best lesson life has taught me is the realisation not everyone sees the world in the same way as you do. And it’s really important to try and put yourself in other people’s shoes.
So an early realisation of this came when I was in primary school, trying to help my friend who was struggling with the maths problem. And I just couldn’t understand why she couldn’t see it as I was seeing it. It led to tears and falling out, you can imagine – nightmare. And we ended up in completely different maths sets up to secondary school. So I could see that it also had real consequences for people in the real world.
So I think that’s what encouraged me eventually eventually to go into teaching. I’m still interested in maths. I’ve been doing research on maths anxiety as a phenomenon. So, yeah, it’s that importance of being able to see other people’s perspectives.
Georgia: Thank you, Ros. Tamsin, how about you?
Tamsin: I can think of a couple of examples, but probably the most relevant for this podcast is my amazing chemistry teacher who demonstrated to me the importance of encouragement.
I live in a family that’s full of amazingly talented people who are artists, photographers, thespians, and I can’t underline a heading straight or act my way out of a paper bag! It’s just not me and not surprisingly with this huge cultural influence, in secondary school, I was going to be a writer. I guess I am a bit of a writer in some ways.
But I quite enjoyed sciences and I was taught by the same chemistry teacher from year seven, right the way up to when I left school at age 18, she taught me A level. And she taught me A level because she took me aside when I was doing my O levels and I was beginning to think about, you know, what A levels I might be doing. She said, you’re really good at this.
Actually I ended up doing history, biology and chemistry, which really caused a stink in those days. So that conversation and that encouragement, that saying, ‘you can do this’, just opens so many doors and I try very much to do the same for the people that I work with.
Georgia: I think when you’re younger conversations like that can really shape your life in quite a big way. And it’s the kind of thing that you remember as you go through it. So that’s really great. Thank you both for sharing those.
Tamsin: Well, I’d like to thank Mrs. Wilson. And do you know I went back to school for the 30th anniversary of leaving a little while ago and she was there, which was fantastic! So I was able to go up and have a conversation with her. In fact, we had lunch together and I was able to say, you know, I’ve had this amazing career and I’m so grateful. It basically rests on the conversation that I had with you when I was 15 years old, which was just wonderful!
Georgia: Aw that’s so lovely.
In what ways could a teacher approach a student they suspect to be struggling with mental health?
Georgia: So now we’re going to move on to question one. What ways could a teacher approach a student they suspect to be struggling with mental health? Now I think this one is quite topical, especially with the impacts that COVID-19 has had on students and their wellbeing. And so Tamsin, shall we start with you on this one?
Tamsin: I think it’s a really good question. And it’s a question that I’ve had conversations with both in my professional life and socially with friends of mine who are teachers who contact me when they’re really worried about someone.
I think giving the young person an opportunity to speak if they want to is important. It depends on the level of urgency. There are times when perhaps you were so worried about the level of distress that you perhaps need to take someone aside and say, I really don’t think you’re okay. What what’s going on? If someone’s being very out of character.
But actually, I would try and manufacture a situation where you weren’t necessarily sort of face-to-face with direct conversation unless you have that kind of relationship. Maybe ask them to tidy up the classroom with you at the end of the day, or give them some tasks where you’re alongside each other.
People who work in children’s homes quite often go on car drives because the young person is sitting behind them and it’s less intense and it’s amazing. And you know, it’s a technique I use with my own children. It’s less confrontational and things will just slip out.
But I think if you are really worried and that’s not working, and it is clear that this young person is struggling, perhaps try to find somewhere where you think they will feel safe and comfortable. Raise it in an indirect way that opens the door for them to say something that they want to, like ‘well some people have had a really awful time during lockdown’ or ‘some people are finding it really hard to come back into school. And I wonder what it’s like for you?’
And then you’re saying, I’m here. I want to listen. I want to know what you want to say. But you’re not saying you have to talk to me and you know that some people won’t.
And I think the other thing I’d like to get across to colleagues working in schools, is don’t beat yourself up if the young person doesn’t want to talk to you. Somebody else has said to me, some of the best counseling I’ve ever had, has just been sitting in silence.
You’re teachers, not counselors, you’re not expected to sort everybody’s problems. But just saying I’m here, I’m a bit worried. Talk to me if you want to. That’s fabulous, but don’t worry if the person doesn’t want to talk to you.
Georgia: I think you’re right. I think it’s a lot about trying to figure out what’s best for that child and how they want to respond to you. Definitely. Ros, do you have anything to add to this?
Ros: I totally agree with what what Tamsin is saying, that engineering of the opportunities for conversation is really important and often not doing that in a confrontational manner is really important.
So those walks down the corridor or asking them to help you get the books in that sort of thing. I appreciate now, in a COVID world, none of that will work quite in the same way! So I don’t quite know how we do it on Zoom and Teams, to be honest. If people have ideas perhaps they can write in?
But I also wanted to sort of make a distinction between wellbeing and mental health issues.
And of course, Tamsin is coming from the psychiatry world, but there are some distinctions between mental health and mental illness and wellbeing and flourishing as ideas. And actually I’ll pull out some statistics here just to share with you. There was a DFE state of the nation wellbeing report in 2019, obviously it predates COVID, but it indicates that:
84.9% of young people are relatively happy and only 5% relatively unhappy.
And similarly, there’s an annual report done by the Children’s Society called the Good Childhood Report, and they asked young people to comment on different domains in their life, including school, which obviously is of interest to this audience.
Again, on a 10 point scale, the average score young people gave about happiness in school was 7.1, which is pretty happy. With only 12% recording, low scores.
So the point I’m trying to make here is actually of course, everyone has their ups and downs, but overall, these figures seem to suggest the vast majority of young people are doing okay in school, they are happy.
But what do we mean, what is this thing wellbeing? I’d like to make a slight distinction between, what’s called hedonic wellbeing. This is the feeling happy, feeling things are going okay. And the eudaimonic wellbeing, which is this idea of self actualisation and functioning well.
And actually, perhaps we need to think a little bit more of the latter because the statistics that the government collect are more about the former. And we don’t actually have very much in the way of international or national data on that, though a European survey conducted a few years ago suggested only 16% of adults were flourishing.
We don’t have equivalent figures for young people. So, there are things to look at there. I think it’s complicated and this mental health, mental illness, needs to be somehow considered alongside wellbeing. I don’t know if Tamsin would like to add to that?
Tamsin: I would agree. I think they’re overlapping concepts, but actually you can have a chronic mental health condition and quite a high level of wellbeing and you can be mentally healthy and have quite a low level of wellbeing.
I think this idea of functioning as well as the internal feelings is really important. In terms of data on children, there aren’t many measures of functioning in children because it’s very different. The skills that you would expect a child to have change as they develop, but the strengths and difficulties questionnaire has an impact scale and it has five sub scales. We define thriving as being in the normal range, so in other words, scoring below the 90th percentile. So 90% of the ordinary population would score in this range.
We use the cut point that if you were scoring on all the sub-scales (so you didn’t have any behavior issues) – you didn’t really have any emotional issues, your peer relationships were good, your pro-social behaviors were high, and there wasn’t any evidence of any impact that you were thriving.
And in fact, it was about 50% of the population (general household population sample), but only about 10% of children who were looked after, which you would expect, you know, they’re in care because, they’ve come from very disadvantaged circumstances and their parents weren’t coping. But it was 50% of the general school age population, which I think is very encouraging actually.
Georgia: Yes, absolutely. I think it will be really interesting to see the effect COVID-19 has on quite a lot of these statistics today as we go forward. But yes, really interesting points. Thank you both so much for sharing those today.
How to spot the signs a child might be struggling
Georgia: So that leads us nicely onto question two. We know student well-being is an important topic right now and that some struggling students will ask a teacher for help. But I wanted to discuss how to spot the signs that a child might be struggling because there may be some students who aren’t very comfortable talking about their feelings as we’ve already touched on. And Ros, do you have any suggestions for this?
Ros: Well, this is a tricky one, isn’t it? Tamsin’s already mentioned the strengths and difficulties questionnaire and the idea of different types of behaviors that are assessed with that. And it’s the kind of externalising behavior – the end of the conduct problems – that teachers immediately notice because generally they disrupt learning.
It’s the quiet, withdrawn students that are more difficult to spot. Mind has a really helpful checklist of symptoms for common problems, such as depression and anxiety, and while it’s targeted at adults, it’s still quite useful for teachers to look at for students.
But it is quite difficult because it could be the student is either gaining weight or not gaining weight or sleeping too much or sleeping too little. So it’s very difficult to spot the symptoms. I think what’s key, and I’m sure Tamsin will say more, is whether you notice a slight difference in a child’s behavior. And it can be very small, you know, you might find they’ve stopped talking to their friends, or they may just be slightly doing something in a different way and it’s not immediately apparent.
Because the teacher is likely to be spending time with that young person and will know them quite well, they’re probably quite well-placed actually to spot a small difference. But you have to tune into it. It’s almost like you have to do a mental audit of the kids in front of you and think:
oh, are they different? Am I worried about any of them? Have they changed in any sort of way?
And then try and have that sort of conversation with them to see if they want to talk to you. But as Tamsin said, they may not want to.
Georgia: Yes, absolutely. Tamsin, do you have anything to add on that?
Tamsin: I totally agree with everything that Ros has said. I think she’s made some really important points and I would encourage teachers to have confidence in their intuitions because they will know their pupils.
I think there are some things that schools could use systematically, such as data that’s collected anyway. So a change in attendance pattern, for example. Poor attendance at school is associated with both anxiety and depression. And particularly if you had a child who has attended fairly well and suddenly they’re missing odd lessons or days, that’s something that might get you thinking anxiety and depression, or eating disorders also affect your ability to concentrate.
If a child who’s previously been attentive, suddenly doesn’t quite seem to be on the ball, or the quality of work suddenly changes, those are things that teachers will be tuned into. They will get you thinking well, okay, what’s going on here? What, what might explain these changes?
Behavior can be a communication – depression and anxiety, both lead to irritability. So you have a child who’s suddenly talking back or grumpy or suddenly seems to be falling out with all their friends all the time. You know, what’s going on.
Ros: It’s worth adding about the paper from your ex-colleagues at Exeter that was recently published. It was about whether teachers noticed a concern and whether that did link to a student’s symptoms. Teacher’s judgment was moderately predictive and sensitive.
Tamsin: Yeah, absolutely. And I think the thing to say about that is teachers were really, really good at spotting the kids that were doing okay.
To give the context, this was a national survey where we had nearly 8,000 school aged young people. And again, it was a strengths and difficulties questionnaire. The impact supplement has a question that essentially says, ‘do you think this child has a mental health problem?’ And we split the answers into no, minor (meaning nothing significant) and definite and severe (the teacher is really quite worried about that young person).
In the same study, there was a very detailed, diagnostic assessment, which involved a 45 minute interview with parents and a similar interview with youngsters if they were 11 or over. And I think it was fewer than 2 or 3% of children who would have had clinically impairing mental health condition, according to the systematic assessment.
Where teachers were less accurate, was whether a concern translated into a clinical level of problem. But that’s not a teacher’s job, so I don’t think that matters. I think teachers should be very confident in their gut instincts.
If you think a young person is doing okay, 99 times out of a 100, they will be. And if you’re worried, whether it’s a wellbeing, minor, transient issue, there is still something going on.
Ros: Absolutely. I agree. And I think it’s good for teachers to know this because perhaps they’re worrying about this, but their professional judgment seems to be quite sound according to that evidence.
What does good mental health or wellbeing planning look like?
Georgia: I’m going to move us onto question three now. We have a lot of teachers on our teacher panel talking about student wellbeing and Nick, who is a science teacher from the UK asks, ‘what does good mental health or wellbeing planning look like? Should this be taught as a separate subject or integrated into all lessons where appropriate?’ Tamsin, do you want to start us off on this one?
Tamsin: Well, as somebody who is not only a psychiatrist, but my research and now my career is about public mental health, I would, of course say both.
I think good health, physical and mental, is intrinsic to success, both in school and afterwards. And if we can integrate ways of problem-solving, emotional regulation, working in teams – all of that provides you with the skills to keep yourself mentally healthy.
But I do think as part of PHSE that some of those things can be taught as skills. For example, the understanding that we all need to sleep. You may be lucky and only need three or four hours a night, or you may be someone who needs 12 hours, but you need sleep and you need it regularly. You need to eat, you need to eat well. And the better the fuel you’re putting in your engine, the better your performance and the better your body will be.
You need to keep yourself physically healthy and you need to keep yourself mentally healthy. And that means having good relationships with people, trying to keep away from people you really clash with, and learning how to resolve conflicts in a positive way.
It’s important to learn that all of us will have things that we find really stressful and all of us will have things that actually we can cope well. Get to know your own personal set of triggers and what makes you anxious, or what makes you stressed, and work out ways to manage that so you don’t get overwhelmed.
All of these are really useful life skills that would stand people in good stead in the job market. There’s not a GCSE or IGCSE in it, and I don’t think there should be, but actually they are essential life skills that we should be teaching people.
I think we should also be teaching everyone first aid as well, which isn’t necessarily on all school curriculum. And we should teach people how to swim. Two things that might save your life or somebody else’s life, but actually keeping yourself healthy is right up there among useful skills to have.
Georgia: What do you think, Ros?
Ros: I would agree with what Tamsin said, but I’d go further. On the one hand, these are really important skills that need to be taught and the PSHE curriculum is clearly a good place for that to happen. However, just to see it as a bolt-on would be a real mistake.
I think if we want good mental health and wellbeing, we need to plan for that at the whole school level, it needs to be a whole community thing. There is a network called Schools for Health in Europe, and they have quite an interesting website that the listeners might be interested later in looking at, but they talk about five core values that underpin planning a whole school approach for those.
So these are equity, sustainability, inclusion, empowerment, and democracy. And I think those core values are things we should be taking into account. When we think about the school as a complete ecosystem embedded within the broader education system and within that, they talk very strongly about you need a whole school approach. So you need to be looking at your policies. You need to be looking at individual teachers in all subject areas and what messages they’re promoting in the curriculum relative to their area. So just having it in PSHE alone, I don’t think will work.
Tamsin: I’m not an educator and I don’t know a huge amount about school cultures, but I’d say it’s important to actually have somebody designated to look out for children who have special educational needs or for children who are in care. Maybe there needs to be a dedicated role within school, backed up, and with time to deliver on that role. I totally agree, Ros.
Ros: I know Wellington college has tried this over the years and it was quite a well known private school in the UK. They have a curriculum for wellbeing. It was quite high profile a few years ago and people talked about that, but it’s actually embedded within a broader school approach. And I think that’s why it works, not because of the happiness curriculum that was talked about in the media.
There are various schools across the world – take the famous school in Australia – where they take a positive psychology approach to the curriculum, but again, it’s not an individualised little thing within a small area of the school. It has to be seen across the school, which is why these core values have to underpin what physical things the school does. And actually the Schools for Health in Europe network has case studies on its website. So if teachers are interested, they might find it useful to look that up.
Georgia: I suspect as well, a lot of teachers listening will be thinking, how do I find time to integrate this into an already hectic schedule? So I think you’re right, there does need to be one person or a group of people who take ownership, but ultimately it needs to be embedded in the whole school, definitely.
Tamsin: It needs to come from the top. The senior leadership in the school have to be behind this idea and give it some time.
Ros: Absolutely. And it can’t be something that you’re trying to shove in. It needs to be second nature within the whole school approach and then backed up with assemblies and things like that. But actually, it just becomes something that is how we do it in the school. It’s sort of embedded so you almost can’t see it. And it doesn’t feel like an extra thing that you’re trying to do, it’s just the way we do things here. I agree.
Georgia: Great. Thank you both for your thoughts there.
How can teachers manage the mental health of students and parents?
Georgia: And finally, I have one last question for you. This one is from Lindsay, a teacher in Malaysia, and she asks, ‘how can we manage the mental health of students and parents? Parental stress often impacts heavily on students, their study, and even the career choices.’ Shall we start with Ros here on this one?
Ros: I would totally agree with Lindsay’s comment that parental stress does impact upon young people in school. There’s quite a well-known model of development, taught by a guy called Bronfenbrenner who talks about ecological systems. So you have the individual with micro systems.
The school, the parents, and then these systems are all embedded within broader systems linked to society. So clearly, if someone loses their job and then comes back and takes it out on the child, then the child is going to internalise and have a problem with that potentially.
So I absolutely agree that that will happen. The way to think about that, if we think from a Bronfenbrenner kind of systems perspective, is you need to work out with the community to some extent, to at least help parents to understand how their world impacts upon their children’s world in terms of learning.
But again, I appreciate that sounds a bit wooly. It’s quite difficult to do, but if you go with this sort of health promoting schools idea of it being a community and working with community and having initiatives to have the community in work with the school, I think there can be ways to make that happen.
In Cambridge, the idea of community schools and village colleges was premised on that very idea of working out with the community. So that’s one side of it. But the other side of that is, particularly as children get a bit older, it’s not just a family that impacts upon young people, actually peers and teachers are also strong influences on what young people do.
So you were thinking about, for instance, career choices and whether parental stress might impact on that – well, yes. But also teachers and peers make a big difference to the sort of choices young people make.
So again, to go back to these values from the schools network, this idea of empowering people and giving them a sense of agency so they can make their own choices, I think is really important.
And schools can do quite a lot to facilitate that through role models. I mean, we started this episode with Tamsin telling us about a really influential chemistry teacher, so to get back to that, I think teachers can do quite a lot, even within the situation of parental stress and particularly with COVID impacting upon young people.
Tamsin: I think you’ve just made a really important point, Ros, which is that teachers should not underestimate just how much they can support young people with a kind word or with interest.
There’s a very famous seminal study by Michael Rutter and David Quinton of young women from the East End of London who’d grown up in children’s homes. These youngsters had come from very deprived backgrounds and had ended up in the care system, but if they could name one person who’d taken interest in them when they were a child – and it was very often for many of these young people that person was a teacher – that was one of the things that predicted them coping.
The other thing was, coming back to peer influence, was whether they chose a partner who was supportive or recreated their often domestic violence type backgrounds. And I think with schools that function as a community, one of the things that predicts young people’s mental health problems is parental poor mental health.
It’s not just young people that have been having a tough time during COVID, it’s families as well. I don’t think that’s necessarily a role for the teacher, but you know, most schools have somebody who has a pastoral care role.
Some schools have parents support advisors who actually have that particular role and actually encouraging parents to go and seek help if they are anxious and depressed, whether it’s talking therapy or it’s antidepressant therapy, or both actually is very likely to have spillover effects on the child.
And the final element of this, which we haven’t yet considered, is the impact of child mental health on the parent. And it’s really interesting.
There’s lots of studies about the impact of poor parental mental health and very little going back the other way. Of course, to have a child who has any significant health problem is hugely stressful and anxiety provoking. And when it’s stigmatising and they can’t get into school or maybe it’s really impairing with their ability to access the curriculum, that is hugely stressful.
And actually having those conversations about how are you finding this? Do you have enough support? Not necessarily that the school should provide support, but maybe they can sign post parents to places where they could get some support, either as a family or individually for the parents themselves. But we shouldn’t underestimate how stressful it is for parents if their child is struggling.
Outro
Georgia: Well, that’s all of our questions. We’ve had an excellent discussion today. I’d like to take a moment to thank our guests, Ros and Tamsin for being here with us. It’s been really great to get some insights into the world of student wellbeing. And you provided lots of valuable advice, which I’m sure our listeners will really appreciate. Where can people find out more about you?
Ross McLellan
Twitter @RosMcLellan
Tamsin Ford
Twitter @Tamsin_J_Ford
Join us again for another episode of the Brighter Thinking Pod!
