Thrive 2016 presentation: There is no health without mental health
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Presentation by Hunter Institute of Mental Health Projects Coordinator Ellen Newman for Thrive 2016, weaving wellness and wellbeing conference. This presentation is about mental health literacy and strategies for supporting children’s mental health and wellbeing.
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Thrive 2016 presentation: There is no health without mental health
- 1. There is no health without mental health Ellen Newman
- 2. What are we talking about? • What is mental health? • What does mental health in early childhood look like? • What can you do to support children’s mental health?
- 3. Key terms • Mental health • Mental illness • Neurodevelopmental disorders • Mental health difficulties • Social and emotional wellbeing
- 4. Mental health • Psychological, social and emotional wellbeing • Refers to our ability to manage thoughts, feelings and behaviour so that we can: – Experience satisfaction and happiness – Cope with stress and sadness – Achieve our goals and potential – Maintain positive connections with others • Changes over time
- 5. Piecing the puzzle together • Mental health mental illness • Mental health social and emotional wellbeing • Mental health wellbeing
- 6. Mental health in early childhood • Context of development • Capacity to: – Participate in physical and social environment – Form healthy and secure relationships – Experience, manage, understand and express emotions – Understand and manage behaviour – Interact appropriately with others, including peers – Develop a secure sense of self
- 7. Mental illness • Impact on thoughts, feelings and behaviour • Diagnosed by health professionals • E.g. Anxiety and depression • No single cause, combination of factors • Can be a single episode or ongoing • Common – 45% of the population
- 8. Neurodevelopmental disorders • Difference in the way the brain develops • Neurodevelopmental disorders: – Thoughts, feelings and behaviour – Diagnosed by health professional – No single cause, combination of factors • E.g. Autism, ADHD
- 9. Mental health difficulties • Difficulties with thoughts, feelings and behaviour • Emotional and behavioural difficulties • 100% of people experience mental health difficulties • Most will resolve in time • Additional support may be required
- 10. Mental health difficulties in children • Externalising behaviours – tantrums, defiance, aggression, impulsivity, overactivity • Internalising behaviours – fearfulness, anxiety, sadness, guilt, numbness, withdrawal
- 11. Activity
- 12. Brain architecture and development • The architecture of the brain is constructed through an ongoing process that begins before birth • Brain architecture is comprised of billions of connections between individual neurons across different areas of the brain • Simpler neural connections and skills form first, followed by more complex circuits and skills • The interactions of genes and experience shape the developing brain
- 14. Risk and protective factors • Risk factors – Individual – Family – Community • Protective factors – Enhance resilience, support positive development
- 15. The role of educators & allied health • Promote positive mental health • Prevent mental illness • Identify children needing extra support and linking families with services
- 16. Why is it important? • Early relationships, experiences and environments shape the developing brain • Brain development influences our future mental health, physical health, relationships, success at school and work • Up to 50% of mental health difficulties in adults can be prevented by supporting children and adolescents* * WA Mental Health Commission 2010
- 18. Creating safe and supportive environments for optimal wellbeing and development By providing opportunities to: • Build secure attachments • Establish and maintain respectful, trusting relationships • Develop a sense of belonging C H I L D
- 19. Helping children to learn social and emotional skills and manage their own behaviour By providing experiences and activities that offer opportunities to: • Understand emotions of self and others • Develop empathy and respond to others feelings appropriately • Learn effective social interaction with peers and pro-social skills. For example try Mindfulness and meditation: • Mindfulness of eating • A breathing meditation (focus on your breath) • Safe spaces for quiet time C H I L D
- 20. Identifying babies, children and families who may be in need of additional support Early childhood educators are skilled in observing children and can pick up early signs of difficulties, such as: • Not achieving developmental milestones • Challenging behaviour occurring in multiple settings and persisting overtime Key things to consider; severity, persistence over time, impact on functioning (reduced functioning or delay in achieving developmental milestones) and if this represents a significant change in behaviour for that child). C H I L D
- 21. Linking families with support and information services for mental health and wellbeing Children’s services and early childhood educators can do this by having: • Knowledge of local support services • Effective partnerships with parents, children and other agencies in the community • Referring children and families to other agencies for further assessment, treatment and support when required. C H I L D
- 22. Developing broader organisational and community strategies that support wellbeing Children’s services and early childhood educators can also contribute to broader wellbeing strategies through: • Develop policies and procedures for wellbeing • A service goal or philosophy • Documents, procedures and daily practices • Staff orientation and training to key policies. C H I L D
- 23. Monitoring children’s wellbeing • Observing and documenting development and wellbeing • Being aware of what’s happening in a child’s life. Communicating openly with their family • Identifying when there is an issue • Discussing concerns with other staff and the child’s family
- 24. What to keep in mind • Normal part of child development • Influenced by temperament, culture, relationships, health, their family situation etc. • Some mental health difficulties are temporary and have no major long-term impacts
- 25. Early intervention for mental health • Occurs in early stage of mental health difficulties, illness or disorder • Aims to prevent mental illness or reduce its impact • Early intervention for mental health can occur at any age
- 27. Talking with families • Challenging but critical • Allows educators, families and other professionals to work together • Achieve the best possible outcomes for the child and family
- 28. Preparing for the conversation • Discuss situation with supervisor or colleague • Role play the discussion in advance • Make an appointment with the family • Organise for an interpreter • Find a private area for discussion • Put together a list of websites etc.
- 29. Talking with families • Explain purpose of meeting • Talk about specific behaviours or changes • Explain why this behaviour is a concern • Share support strategies • Recommend a family makes contact with support services • Agree on next steps • Maintain professional boundaries
- 30. Role play: Family discussion
- 31. There’s nothing wrong! • Continue to record observations • Inform your supervisor • Raise concerns again at a later date • How can you support the child?
- 32. Support within service • What is the behaviour needing guidance? • What influences this behaviour? • Thoughts and emotions? • Influencing relationships with others? • What strategies could be used to support the child within the service? • Developing a plan in partnership with parent/caregiver
- 33. Case study: Annika • How could Annika be supported in your service? Consider: – What is the behaviour needing guidance? – What influences this behaviour? – Thoughts and emotions? – Influencing relationships with others? – What strategies could be used to support the child within the service? – Developing a plan in partnership with parent/caregiver
- 34. Activity: child wellbeing plan
- 35. Examples… • Group strategies: – Relaxation activities – Read funny books or tell jokes – Talk about emotions and behaviours – Maintain predictable routines • One on one strategies: – Provide physical and verbal reassurance – Allow children to observe group activities rather than participate – Give children choices instead of demands – Reward positive behaviour when you see it
- 36. When is it more serious? • Extreme behaviour • Ongoing • Unchanged despite guidance • Across multiple settings • Interfering with development, learning or progress
- 37. Who can help? • GP • Paediatrician • Psychiatrist • Psychologist • Social worker • Other health and welfare professionals
- 38. How can they help? • Assessment and diagnosis • Developing support plans • Implementing support plans • Talking with children • Providing medication
- 39. Self-care • Reflect on the situation • Debrief with others (maintain confidentiality) • Be kind to yourself
- 40. Questions Ellen Newman Projects Coordinator Email: ellen.newman@hnehealth.nsw.gov.au Website: www.himh.org.au Phone: 02 4924 6900
Notas do Editor
- Acknowledgement of country. Introduce HIMH Introduce Self Ask people to introduce themselves and background.
- Before we talk about the mental health and wellbeing of early childhood educators, I’ll like to make sure we are all on the same page with our terminology. Take a few minutes to write down what mental health means to you. What do you think mental health is? What does it look like in early childhood? What can educators do to support the children in their care to thrive in their wellbeing and prevent mental illness? Don’t worry, no one will see your answers, it is just an exercise to get you thinking.
- There are a number of terms people use when talking about mental health and wellbeing. Some of the terms I will be using today are mental health, mental illness, neurodevelopmental disorders, mental health difficulties and social and emotional wellbeing. People use a number of terms to talk about the same concepts because they have different beliefs and understandings of mental health based on their culture, education and life experiences. I’d like to talk about what I mean by these terms before we talk about how they apply to babies and young children.
- The term mental health refers to a person’s psychological, social and emotional wellbeing. It relates to our ability to manage thoughts, feelings and behaviour so that we can: Experience satisfaction and happiness in our life; Cope with stress and sadness; Achieve our goals and potential; and Maintain positive connections with others. Like physical health, the level or quality of our mental health and wellbeing can change over time, depending on what is happening in our lives.
- So what you’ll notice from our definition of mental health is that it is not the same as mental illness. Often times people use the term ‘mental health’ when they are really talking about a mental illness such as depression, anxiety or schizophrenia. One of the confusing things is that mental health services in hospitals and communities provide treatment for people experiencing a mental illness. Really they should be called mental illness services. When we are talking about mental health and wellbeing, some people are much more comfortable using the term ‘social and emotional wellbeing,’ especially those working in early childhood education and care. This is because there is a lot less stigma attached to the term ‘social and emotional wellbeing’ and it is less easily confused with mental illness. Social and emotional wellbeing is also the preferred term of many Aboriginal and Torres Strait Islander communities. And lastly, wellbeing is also a term that’s used often these days to describe concepts relating to mental health. Wellbeing also has less stigma attached and means more to people than just mental illness.
- Mental health in early childhood is a little bit different to mental health in adulthood. It is still related to thoughts, feelings and behaviour; however it has to be viewed within the context of development. The human brain and body are developing rapidly during this time; and children’s feelings, behaviour and ability to do things, will vary depending on their stage of development. So we define mental health in early childhood to be the capacity of a young child – within the context of their development, family, environment, care settings and culture – to; Participate in the physical and social environment Form healthy and secure relationships Experience, manage, understand and express emotions Understand and manage their behaviour Interact appropriately with others, including peers; and Develop a secure sense of self.
- Mental illnesses are conditions that impact upon a person’s thoughts, feelings and behaviour. A person is diagnosed with a mental illness if they fulfil specific criteria on assessment by a health professional. There are many different types of mental illness that a person can experience and a range of treatments for each condition. Mental illnesses that can be diagnosed in early childhood include: Anxiety and related disorders Depression and related disorders There is no single cause, but occurs because of a combination of biological, psychological, environmental and social factors. It is a complex process and everyone’s situation is unique. The condition may be ongoing, for example, bipolar or schizophrenia, or it can come and go in a series of episodes, such as depression or anxiety. And mental illness is really common. It affects people of all ages, educational and income levels and cultures. Nearly half of the population will experience a mental illness at some stage in their lives.
- A neurodevelopmental disorder is a condition where the brain develops in a slightly different way, and this can impact on a person’s thoughts, feelings and behaviour. Like mental illness, neurodevelopmental disorders are diagnosed by health professionals and there is no single cause, but rather a combination of factors. Neurodevelopmental disorders that can be diagnosed in childhood include: Autism spectrum disorders; and Attention Deficit Hyperactivity Disorder or ADHD.
- So then what are mental health difficulties? Mental health difficulties are the troubles we all experience with our thoughts, feelings and behaviour. They can include: Long periods of feeling sad, worried or angry; Behaving aggressively; Withdrawing from others; or Not coping with day-to-day tasks. The term emotional and behavioural difficulties is often used to describe mental health difficulties in children. 100% of people experience difficulties at times with their mental health and most will resolve with time. When the difficulties don’t resolve in time or they are really severe then there may be a mental illness involved and it is important the person receives assessment and support from a health professional.
- Children often express mental health difficulties through challenging behaviour or through changes in their behaviour, rather than talking about their thoughts or feelings. This is particularly true for younger children. Mental health difficulties in childhood are generally divided into two categories: externalising behaviours and internalising behaviours. Externalising behaviours include a range of under-controlled behaviours associated with difficulty in self-regulating feelings, behaviour and attention. Externalising behaviours include tantrums, defiance, aggression, impulsivity, overactivity and difficulty following instructions or making transitions. Sometimes these behaviours are associated with ADHD or an autism spectrum disorder. Internalising behaviours relate to over-controlled behaviour and self-regulation, resulting in distress that is turned inward, such as fearfulness, anxiety, sadness, guilt, numbness and social withdrawal. Anxiety disorders are one of the most common childhood emotional disorders, and include separation anxiety, generalised anxiety and specific phobias. Depression is another internalising disorder and even young children can develop clinical depression.
- Dual Continua model
- Nurturing environments from birth, are essential for healthy brain development. Very early childhood experiences impact on the way that genes are expressed in the developing brain and the way the brain is organised Our ability to understand language, solve problems, and getting along with others is influenced by these experiences as an infant and young child
- Watch video: http://www.albertafamilywellness.org/resources/video/how-brains-are-built-core-story-brain-development Facilitator: Questions – discussion on the video: What did you think of the concepts discussed – do you agree with the analogy of brain development like architecture/building a house?
- What supports positive social and emotional development, and brain development Individual: physical health problems, genetic factors, difficult temperament or insecure attachment Family: drug and alcohol dependence, parents/siblings with a mental illness, family conflict, death of a pet, divorce Community: the environment where the child lives e.g. poverty, discrimination, crime or violence
- What supports positive social and emotional development, and brain development Individual: physical health problems, genetic factors, difficult temperament or insecure attachment Family: drug and alcohol dependence, parents/siblings with a mental illness, family conflict, death of a pet, divorce Community: the environment where the child lives e.g. poverty, discrimination, crime or violence Protective factors Enhance resilience even with the presence of risk factors, and support positive development: Nurturing and secure relationships with adults Positive temperament Good communication & problem solving skills Identify emotions and manage & express them appropriately Positive and supportive friendships Role of educators Educators may not be able to control the risk factors in a child’s life, but they can work to increase protective factors: Monitor risk and protective factors Create a safe and inclusive environment Communicate clearly and openly with families & children Provide reassurance, be supportive and accepting Offer warm and consistent care
- And why is it so important to support children’s mental health and wellbeing in early childhood? Well research into early childhood development has grown rapidly over the past 20 years. We now understand that the relationships and experiences we have as a baby or young child, and the environments in which we live and grow, can affect how the brain develops. And how the brain develops influences a whole range of things in our adolescence and adulthood including our mental health, physical health, relationships, and success at school and work. Those who experience positive wellbeing in childhood are more likely to go on to experience good mental and physical health as adults; form healthy and satisfying relationships; and succeed at school and work. And it is estimated that up to half of mental health problems in adulthood can be prevented by supporting social and emotional wellbeing in childhood and adolescence.
- There are a number of ECEC practices that support the mental health and wellbeing of young children. These are represented in the CHILD framework, created by the Response Ability team. They include: Creating a safe and supportive environments for optimal wellbeing and development Helping children to learn social and emotional skills and manage their own behaviour Identifying babies, children and families who may be in need of additional support Linking families with support and information services for mental health and wellbeing Developed broader organisation and community strategies that support wellbeing These practices are particularly important when a child is experiencing difficulties associated with their family environment and their physical, social and emotional needs are not being met at home. I’ll spend the rest of my presentation looking at I and L: Identifying babies, children and families who may be in need of additional support & linking families with support and information services for mental health and wellbeing.
- For each of the CHILD elements I am just providing an overview as we do not have time today to go through all the detail – BUT – see our website for more! So for C - Creating safe and supportive environments for optimal wellbeing and development… Early childhood educators can promote children’s mental health and wellbeing by: Providing opportunities for children to build secure attachments; establish and maintain respectful, trusting relationships and develop a sense of belonging. Helping children to feel safe by excluding fear and having a trusted adult available And respecting all children as individuals and acknowledging their diversity, culture, temperament and preferences 45 sec OTHER: Feeling safe, secure and supported is known to contribute positively to children’s wellbeing. When children feel safe they are more likely to take reasonable risks to explore their environment, particularly if they know that they have a secure base such as a parent or carer to return to when they feel unsafe. Secure and safe environments also help to develop children’s confidence and autonomy, which contributes to their overall social and emotional development. In a safe and supportive environment early childhood educators care for children in ways that build positive relationships and secure attachment (really important for developing social and emotional skills). They understand children’s cues and are caring and consistent in their response. This means meeting children’s needs physically, during play or rest, social interaction and for emotional comfort.
- Read slide 45 sec OTHER: Social and emotional skills help children to learn to manage themselves, relate to others, resolve conflict and feel positive about themselves and the world around them. Helping children to develop their social and emotional skills will support children’s mental health and wellbeing. Early childhood educators can do this by helping children to engage in experiences that offer opportunities for understanding emotions, developing empathy and responding to the feeling of others appropriately and learning effective social interaction. Providing experiences and activities that include an element of social interaction and opportunities for talking about feelings and emotions have been found to facilitate social understanding, contributing to the development of important social and emotional skills. Children learn how to manage their feelings and behaviour by watching others, trying out things and through the feedback that they receive. Also, caring for children in a way that promotes secure attachment will further enhance the best possible social and emotional development.
- Read slide 1min OTHER: Children or families may need extra support when social or emotional difficulties arise. Research indicates that intervention early in children’s lives can be effective in both preventing and improving emotional and behavioural difficulties in children. However, before this can occur, children and their families who are experiencing difficulties need to be appropriately identified. Fortunately, children’s services and early childhood educators are well positioned to do this in their daily practices through observation and comparison of children in a range of situations and tasks. Of course, not all behaviour shown by children is problematic, therefore it is important to recognise when behaviours may just be transient or when they may be reflecting deeper social-emotional challenges. Best practice highlights that it is important to consider a number of points in deciding whether a child and their family may be in need further support to address behavioural difficulties. This may be the case if the child’s parent has expressed a concern regarding a particular behaviour and / or the behaviour shown by the child meets certain criteria. This might include not achieving developmental milestones, occurring in multiple settings and persisting over time. For example in an early childhood setting behaviour that might signal the need for additional support might include: Children who are not playing with others; Repetitive activities and play; and Not talking or communicating appropriately for their age and stage. Being aware of changes in children’s behaviour is important for early identification of children and families who may need further support.
- Read slide 45 sec OTHER: When a child has been identified as having a possible emotional or behavioural problem, children’s services and early childhood educators can assist by referring these children and their families to another agency or professional for further review. Linking children and families in this way can help to get children and families the appropriate treatment and support that they need. In order to effectively link children and families to support services, early childhood educators need to have awareness of local services and supports for children and families in their area. In addition to this effective partnerships with families will also be important in the event that a child has been identified as having additional needs, or concerns raised about their wellbeing or development. Effective partnerships will make it easier for early childhood educators to talk with families about the way forward. Key sources of support that early childhood educators might consider when linking children and families include: Parenting programs (run by community health centres, family support agencies etc) Family support programs (that provide support in the areas of housing, finances, violence) Child and Youth mental health services (such as specialist mental health services for those children identified as having social-emotional problems).
- Read slide 1 min OTHER: As has already been highlighted, children’s services and early childhood educators have an important role in supporting the social and emotional wellbeing children. As we have seen this can be achieved by: Providing environments that support children’s optimal development, especially their social and emotional development, and Identifying children or families with additional support needs and helping them to access other professionals and agencies as required. Promoting optimal social and emotional wellbeing and supporting early intervention for those with additional needs is consistent with the principles of quality early childhood care and education. What’s more, this is also consistent with the current reforms to early childhood development and education in Australia that are being implemented through the: National Quality Framework for Early Childhood Education and Care, The Early Years Framework for Australia (Belonging, Being and Becoming); and The National Early Childhood Development Strategy (Investing in the Early Years). Therefore, implementing a service-based approach to mental health and wellbeing, that includes the strategies listed on the slide, is important for promoting the best possible mental health outcomes for children. If policies and procedures based on mental health and wellbeing are to bring about change, there needs to be support and participation across all levels of the children’s service setting. This means that there is a role and responsibility for service directors, managers and individual staff members. These roles are in actively developing and implementing effective and appropriate mental health promotion-based policies and procedures. At the individual level, early childhood educators can act as important agents of change when they advocate for service-based policies that promote positive mental health and wellbeing outcomes for the children in their care. This could mean working toward the development and implementation of policies around partnerships with families; supporting and guiding children’s behaviour; helping children manage transitions, ideas about networking with other community organisations and reflecting the life and culture of the local community within their service and daily practice. So, a service-based approach to mental health and wellbeing is really fundamental to supporting the overall social and emotional wellbeing of children in the early years.
- Early childhood educators, in particular, are well placed to monitor the mental health and wellbeing of children, and identify those who are experiencing difficulties. As part of everyday practice, educators should observe and document the development and wellbeing of all the children who attend their service. This makes it easier to tell when any concerns come up about a child’s mental health. Allied health professionals can also monitor children’s wellbeing, as long as they spend enough time with the child to really get to know them and notice when there is a change in their behaviour. As part of monitoring their mental health, it is important to be aware of what’s happening in a child’s life, as these things impact upon their wellbeing. For example, a child whose parents are separating will be facing challenges at home and will require additional support from the adults around them. To be aware of what’s happening at home, it’s important to maintain open communication with all families so that they feel comfortable talking about their needs and the needs of their child. Lastly, as part of monitoring children’s mental health and wellbeing, educators and allied health professionals should be aware of the early signs of mental health difficulties and speak with their supervisor or team members, as well as the child’s family, when they have concerns.
- However, before deciding that a child is experiencing mental health difficulties, it is important to keep a few things in mind. Firstly, almost all children show difficulties in managing their feelings and behaviour at times, particularly during certain stages of development. Learning how to manage feelings and cope in positive ways is an important part of child development and takes time. A child’s feelings and behaviours are also influenced by a number of factors including their temperament, culture, relationships, health, family circumstances, or experiences of early childhood education and care. For example, many children may behave differently when they are unwell or tired. It is also important to remember that some mental health difficulties are mild or temporary and don’t have major long-term impacts. These can often be addressed successfully as the child develops further and is provided with guidance and support from family and carers.
- However if a child is experiencing mental health difficulties, then it is important that early intervention for mental health is provided by the adults in their life. Early intervention for mental health is not the same as early childhood intervention. Early intervention for mental health occurs in the early stage of a mental illness or neurodevelopmental disorder. It aims to prevent the issue from becoming more serious. It can also aim to reduce the impact of an illness or disorder on a person’s life and their family. As such early intervention for mental health is not just for children but can occur at any age.
- * Split into pairs Annika is three years old and has been attending your service for one year. She always actively engages in play with her friends. She especially loves listening to music and dancing. However for the past week, Annika has been spending inside activity time in the book corner and not interacting with the other children or educators. During this week’s intentional teaching time, Annika has been sitting with the other children but not contributing. This is out of character for her. You try to talk to Bianca, Annika’s mother, one afternoon, but she is in a rush to pick up Annika’s older sister from school and can’t stay. Answer question 1
- Having difficult conversations with families about a child’s mental health and wellbeing can be really challenging; however it is also very important. For children experiencing mental health difficulties, identifying the difficulty and discussing how best to support a child allows everyone to work together to achieve the best possible outcomes for the child, in terms of their wellbeing and development.
- There are a number of things educators or allied health professionals can do to prepare for a difficult conversation with a family member including: Discussing with your director, supervisor or coordinator the best way of approaching the family and raising your concerns; Considering how the family member might respond to your concerns; role playing the discussion with your supervisor in advance; Making an appointment with families so they have time to talk with you and aren’t rushing home after work; If needed, organising for an interpreter to attend the meeting so the family will fully understand what you’re saying; Finding somewhere private to talk where you won’t be overheard or interrupted by others, including the child you’re discussing; and Putting together a list of books, pamphlets or websites to visit for more information.
- When speaking with families, start by introducing yourself and explaining the purpose of the meeting. Next it’s important to talk about specific behaviours or changes you’ve observed and why this a concern for the child. In doing this, it’s best to avoid suggesting a particular problem or diagnosis. Ask whether the family has noticed anything similar at home. After talking about the behaviour or issue, discuss strategies for supporting the child with their parent or caregiver. Talk about what seems to be most effective, so you can develop a strategy together for use at home and at the service. Let the family know if you think it would be beneficial for the child to see a health professional, and provide them with information about where they might go for help. If possible, reach an agreement about the next steps that is realistic and measurable, for example, suggest having another meeting after they’ve had a chance to see their GP. And while it is helpful to listen to families and provide them with advice and support, it is also important to remember that it is not up to you to provide counselling or treatment. There are trained mental health professionals who can assist families or children who have personal concerns or mental health difficulties.
- Split into pairs Complete part 2 of the case study.
- But after all your preparation and careful discussion, families may not be ready to listen to what you have to say straightaway, especially if you are raising a concern about their child’s development or mental health and wellbeing. Sensitive discussions like these can be overwhelming for many people and they may need time to come to terms with the information being provided to them. If a family member is not open to discussing these issues, continue to record your observations, make sure your supervisor is aware of the situation and consider raising your concerns again with the family at a later date. In the meantime, think about what you can do to support the child within your service.
- Early intervention for less serious problems may only require additional support from within the ECEC service. In deciding what this additional support from the service might be, it’s helpful to consider a few questions such as: What is the behaviour that needs attention or guidance? What influences this behaviour? Is something happening at home or in the service that might make this behaviour worse? What could this child be thinking and feeling? How is the behaviour influencing the child’s relationships with others? What strategies could be used to support the child within the service? Wherever possible, these questions should be considered with the child’s parent or caregiver, and strategies developed in partnership for use in the service and at home.
- Ask group to briefly answer these questions together re: Annika. Complete individually using the child wellbeing plan
- Some of the strategies educators can use to support children experiencing mental health difficulties can benefit the other children in their care as well. These strategies are useful as they encourage inclusion, reduce stigma and don’t single out one particular child. They can include: Relaxation activities, eg lying on the floor and listening to classical music, a story or practising yoga; Reading funny books, or telling jokes or funny stories. Encouraging children to share their own funny jokes or stories; Discussing behaviours and emotions by role playing with dolls, other equipment, educators or other children; and Maintaining predictable routines and schedules, so that children experiencing mental health difficulties feel safe and secure. Some strategies focus solely on the child who has mental health difficulties. Examples of one on one strategies include: Providing physical and verbal reassurance to a child who may be struggling to settle, eg let them sit on your lap during reading time; If children do not want to participate in group experiences, allowing them the space to observe rather than insisting they join in; Giving children choices instead of demands; and Rewarding positive behaviour when you see it.
- But what if it is more serious? Assessment by a health professional or support agency would generally be recommended if: The behaviour seems extreme when compared with other children at a similar stage; The difficulty is ongoing and has been observed over several weeks or months; The behaviour is not changing despite efforts of adults to guide or support the child; It happens across more than one setting (eg at home, service, the park); and It is interfering with the child’s ongoing development, learning or progress in certain areas, for example there may be concerns about school readiness.
- There are a number of professionals that can help a child and family experiencing mental health difficulties. These include a: General Practitioner; Paediatrician; Psychiatrist; Psychologist; Social Worker; and Other health and welfare professionals. Often, a family’s local GP is the best place to start. GPs can provide assessment and advice, or they can refer children on to a specialist for further assessment and management.
- Professionals or support agencies can help by: Assessing children showing signs of mental health difficulties and providing a diagnosis if appropriate; Developing a support plan for children regardless of whether they have an existing diagnosis or not; Working with educators and families to implement the support plan; If appropriate, talking with children about their thoughts and feelings, and working with them to develop problem solving skills and helpful ways of coping; and In some situations, providing the child with medication.
- And lastly don’t forget to look after yourself! Talking about these issues with families is really difficult. After your discussion, reflect on your own thoughts and emotions. How are you feeling? Are you ok? Debrief with others. Share your feelings and thoughts about the situation with someone you trust. Ideally this will be your supervisor, or otherwise a colleague. Make sure you maintain confidentiality and don’t share unnecessary details. And then be kind to yourself; do something you like to do. Forget the dishes for a night and take a nice bath instead. Go out for dinner with a friend. Go to bed early with a book. Do the things you know will help you recharge your batteries.