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Melt downs and the hidden dangers of mental health

09/05/17

One of our bloggers, Ray, has written this entry for Mental Health Awareness Week from his personal experiences and point of view.

During Mental Health Week, we all ‘take stock’, reflect, re-group and decide on the best way to promote awareness of the warnings, the dangers and if possible, present some solutions to mental health issues within our lessons.

This subject is very close to my heart because not only did my son have two syndromes which affected his mental processes but I suffered a deep depression when he died six years later. Mental health covers so many aspects and is so vast and complex there can never be a ‘one fix for all’ approach. The more you are exposed to the range and depth of these complex issues, the more you realise how limited your help can be however that doesn’t take away from how vitally important even the smallest bit of help can be.

As teachers, we are expected to look out for signs of depression, anxiety and any other indicators that might lead to severe mental health problems. This is a difficult task as most of us are not medically qualified; we are given basic training on symptoms to look out for. Some depression and anxiety problems as a result of bullying or exam pressure can be addressed by the school and the pastoral teams who are a good place for the students to ‘talk out’ issues. These students can often have counselling sessions within their timetable.

During my time in teaching I have ‘flagged up’ a whole host of students needing help. In previous blogs I’ve mentioned ways in which I have helped students, such as the young man whose parents died the week of his GCSE final examinations and a young carer who was always given detentions for lateness while the school was unaware that his mum had Crohn’s syndrome. Although we, as teachers are constantly on the lookout for personality changes, mood swings or being withdrawn, often these can just be the result of puberty and the effects of chemical changes within the body. If I see that a usually animated and extrovert student is withdrawn, I would comment on the change to them and first ask them if there is anything wrong that I can help with. If they do not want to say, it could be a personal issue or simply something that they don’t want to discuss with a teacher. At this point, I would discreetly ask a known friend of theirs if they know what’s wrong.

There is a tremendous amount of care and support amongst friends and usually they will explain what they know to be troubling their friend and if they don’t, I give the student and their friend a few minutes to talk, away from the class and to report back to me. Both strategies work very well for minor ‘problems’, which could be anything from ‘so and so isn’t talking to me’ or ‘ I’m not going out with so and so’, although devastating for the individual, a simple chat after the lesson tends to lessen their pain.
The severe mental anguish problems that I have ‘flagged up’, have been about sexual abuse, violence at home, multiple bereavement and sometimes students who have a total disconnect from reality. These can only be dealt with by experts and although I have supported their schooling accordingly, (for example, a girl who I allowed to wear headphones during lessons because it calmed the voices in her head) I would take advice from her mental health team with regards to her care. We do need to liaise, negotiate, guide and be guided through a labyrinth of health and social care at times and sometimes, this means by outside agencies because of their different specialisms.

When a physical restriction presents itself, it can be an easy decision to report, like the time a Sixth Form student told me he did not want to tell his parents that he loses the use of his arm and hand every now and then for fear they’d stop him driving. However, when there is doubt about a student’s mental wellbeing and the decision is not so obvious, my advice would be to report anything that you are unsure of. Confusion, fantasy, lies and rambling can sometimes be the manifestation of underlying mental health issues, that is not to say that these are ‘markers’ because they can also be linked to some teenager’s growing up phases; more often than not, go with your gut. Does this feel right? When I look into the eyes of the student do they really believe what they say? Do they look, worried or frightened? Or, as with drug abuse, are they behaving ‘high’?

More recently I have taught a young boy who is on the severe end of the autistic spectrum and a girl who has tried to kill herself who both require intense 1:1 intervention but sometimes it is difficult to know in what form it should be given. The boy finds it difficult to articulate what makes him angry, mainly because of his autism but also because of his youth. His violent outbursts have escalated and he has become physical in all lessons, he views any help with suspicion and resistance and it is disheartening to watch a continual deterioration of his mental health despite so many different members of staff having tried a whole host of strategies with no positive effect. It seems that the mainstream school environment is not suited to his needs but I am no expert.

By contrast, I am in regular, close communication with parents who have boys with autism. They are very high achieving in certain subjects but they also have O.C.D (obsessive compulsive disorder) and their bodies have difficulty regulating body temperature combined with an over sensitivity to certain sounds, lights, or textures which can be severely distracting and uncomfortable. This combination of not being able to read visual cues correctly or interpret instructions literally, as well as the physical discomforts mentioned, causes distress and mental anguish that needs support.

The son of my friend would wash his hands constantly until they bled due to his O.C.D and his need for frequent toilet visits were deemed disruptive to his learning. However as he is high functioning with high attendance, it is extremely unlikely he will be awarded 1:1 support. A refusal to keep an extremely hot and uncomfortable item of clothing on (due to his autism) would result in punishment due to breach of the school’s uniform rules. It cannot be right that his mental anguish is ignored and his stress is made worse by a lack of empathy. When an ECHP (Education Care and Health (ECH) Plan) is not awarded, it is assumed by some schools that no support is needed, when they most certainly do, especially with their mental health!

The girl with suicidal tendencies presents no disruption within the lessons and yet when I speak with her, she tells me that she is concerned about not getting top grades in her GCSE exams and is virtually inactive with fear. Against school ethos, I suggested that we guide her towards achieving a lower grade than predicted because our subject is more labour intensive the higher the grade you pursue. My line manager agreed, the train of thought was twofold; firstly any pressure towards an unachievable grade (in her mind) would inevitably trigger a ‘melt down’, (there had already been two warning attacks) this would result in no grades across the board. It was suggested that she should aim for a ‘B’ grade and this did have the desired effect of alleviating her mental strain and yet still achieving a very good grade.

It’s always important to remember that mental health difficulties are often invisible and can affect anyone. I am wary of this and try hard not to apply pressure or fear tactics when reminding students of looming deadlines. I have witnessed many ‘melt downs’ due to exam stress in students who have no prior mental health issues; so when you are dealing with particularly vulnerable student, some tactics can have grave consequences. It can be a minefield for teachers, especially as they too are under extreme pressures but sometimes we really do need to apply the softly, softly approach.

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