Mental health, wellbeing, and mindfulness in schools

Schools, like the rest of society, are learning how to manage mental health, wellbeing, and mindfulness.

Mental health and mental wellbeing are synonyms to describe our current state of mind. Mindfulness describes our awareness of ourselves, and the world around us, in the present moment. Mindfulness techniques help our mental wellbeing.

Like most parents you’ll be aware of one of these terms. Maybe one of your children has had a mental health awareness lesson at school. Or you’ve heard results of academic research into mental health on the news. Perhaps you’ve wondered why so many minor celebrities reveal their mental health issues on social media.

Mental health awareness has only recently reached the mainstream. Perhaps only in the last five to ten years. Research and understanding are constantly evolving, with more charities receiving funding for research, and calling for action. We hear terms such as mental health, wellbeing, and mindfulness banded around and used interchangeably. Maybe it’s time for a little clarity.

So, this article has been written for parents to help them understand mental health, wellness, and mindfulness:

What they are.
Why they are important for your children, particularly now.
How schools are addressing them.
10 initiatives you might look for in your school

What is mental health?

The World Health Organisation (WHO) defined mental health in 2004 as;

“a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”¹.

So, what does that mean? Well, we all have mental health as well as physical health. If physical health is our state of body, mental health is our state of mind. Physical health is our ability to cope with physical challenges. Whereas mental health is our ability to cope with mental challenges.

If you were to greet someone (in the UK!) and ask them how they are, you’d normally get a response referring to their physical health. Implied and explicit. “I’m fine”. “I’m well”. “Feeling better”. “I can’t shift this cold”. “My back still aches”.

You’re unlikely to get an answer such as “I’m feeling stressed” or “I’m feeling anxious”. That is a comment on their mental health. And we don’t really do that in the UK.

So, the very act of defining mental health is valuable in recognizing its validity.

Another way of thinking about mental health is as a continuum between mental illness and mentally healthy². Under duress our mental health may move away from mentally healthy towards mental illness. A so-called ‘mental health issue’ if you like. Our ability to return to mentally healthy depends on our mental resilience and coping strategies. This dynamic in mental health can happen frequently during a day, just as physical tiredness and reinvigoration can.

What is the difference between mental health and mental illness?

At one end of the mental health continuum is mental illness. Mental illnesses are a range of medically diagnosed conditions that can’t be overcome by the patient. They have to be treated and managed with medical intervention.

They include addictive behaviour, anxiety, depression, eating disorders, mood/bipolar disorders, personality disorders, schizophrenia, and trauma disorders.

There is a difference between feeling anxious and medically diagnosed anxiety. Just as there is a difference between feeling depressed and medically diagnosed depression. One is a state of mental health, the other a mental illness. Mental health can be managed by the individual, given the right coping strategies.

What is the difference between mental health and wellbeing?

Now we are starting to get into less well-defined areas. The Oxford English Dictionary defines wellbeing as ‘the state of being comfortable, healthy, or happy.’

But most practitioners go well beyond that. For our purposes, wellbeing is an overarching and holistic concept of health and self-actualisation. Note how the WHO’s definition of mental health refers to wellbeing. Mental wellbeing is a constituent part of wellbeing and is synonymous with mental health.

Other constituents of wellbeing might be physical, spiritual, economic, social, and emotional. To experience wellbeing an individual must care for all six constituent parts.

Social and emotional wellbeing are often considered as part of mental wellbeing.

Why is mental health an issue now?

In 2007, the NHS published a survey that took a while to achieve public recognition. The survey³ suggested that one in four of us will experience a mental health problem at some time in our lives.

In 2016, a repeat of the survey⁴found that one in six of us experience a common mental health problem in any given week.

In many ways, the surveys confirm a generally held perception that life is becoming more stressful.

The surveys, and others like them, were important in bringing mental health to national consciousness. As were the 2015 Liberal Democrat election pledges, mental health charities surveys and campaigns, and a host of celebrity confessionals. They have also helped to begin to destigmatise mental health.

And it affects children too. According to the Report of the Chief Medical Officer 2013⁵ half of mental illness starts by age 15. And 75% of mental illnesses start by age 18.

How does mental health affect children?

A seminal Department of Health/NHS study⁶ in 2017 found that one in eight (12.8%) 5-19 year-olds had a mental illness. It is sometimes restated as ‘three children in every classroom has a mental illness’. Here’s some other examples of findings from the report:

2% of 5-19 year-olds had an anxiety illness and 2.1% a depressive illness. These are not included in any definition of special educational needs, as they aren’t. More pastoral, perhaps.
The incidence of mental illness increases with age. It’s 5.5% for 2-4 year-olds, 9.5% for 5-10 year-olds, 14.4% for 11-16 year-olds, and 16.9% for 17-19 year-olds.
17-19 year-old girls are a high-risk group. 23.9% had an anxiety or depressive illness. 5.6% had a body dysmorphic disorder.

The report also looked at demographics other than age:

9% of those who identified as LGBT had a mental illness.
2% of those living in ‘least healthy functioning families’ had a mental illness.
Those with a mental illness were three to five times more likely to try drugs. Twice as likely to be bullied. Eight times more likely to self-harm. And 12 times more likely to be excluded from school.

Contrary to popular perception, the survey also suggested that mental illness isn’t increasing significantly. There was a 1.5% increase in mental illness in 5-15 year-olds from 1999 to 2017.

What affects children’s mental health?

In 2017 the charity Place2Be⁷ found that two-thirds of primary school children say they worry all the time about at least one thing to do with their home life or school life.

There are probably three main sources of worry for children; domestic, world events, and school. Domestic worries include new siblings, moving house, money, divorce, and bereavement.

A 2018 survey by the Mental Health Foundation⁸ looked at some of the causes of anxiety among schoolchildren. It found, for example, that 26% of 10-15 year-olds were worried about their families not having enough money.

World events are significant. A further survey⁹ looked at the anxiety of 5-18 year-old schoolchildren with regard to world events.

41% of parents thought their children were anxious about the threat of terrorism,
23% about the threat of nuclear war,
33% about Donald Trump’s presidency,
And 32% about global warming and climate change.

As for school, exams are an obvious cause of stress. A 2016/17 survey by the Association of School & College Leaders¹⁰ found that;

90% of school leaders have reported an increase in the number of students experiencing stress in the last 5 years,
80% of pupils say that exam pressure has significantly impacted their mental health,
82% of teachers say that focus on exams is disproportionate to the overall wellbeing of their students.

The OECD has supported these findings. In 2018 the OECD¹¹ found that anxiety over exams, was higher in the UK than almost anywhere else in the world. 72% of pupils compared to a global average of 56%.

School worries can probably be summarised as follows:

Starting primary school, moving from primary to secondary, moving to university.
Changes in friendship groups.
Peer pressure and conformity.
Exams.
Puberty.
Sexual and gender identity.

How does social media affect mental health?

Social media is the elephant in the mental wellbeing room. The perceived decline in children’s mental health is popularly attributed to an increase in screen time and use of social media. Why?

More screen time is associated with more sedentary lifestyles. Which means less physical activity, fresh air, and exercise. Additionally, more screen time means more exposure to blue light, which suppresses the release of melatonin, the sleep hormone. Particularly if the screen is viewed late at night. Less sleep means tiredness during the day and lower attention span.

As for social media, there are benefits from engaging with friends, self-expression, and keeping informed. But the negatives¹² include cyberbullying, body image, fear of missing out, anxiety, depression, unsuitable content, and mindless passive scrolling.

There are so many statistics suggesting the harms of social media, in particular. Here’s a few from a 2018 survey of head teachers by the Association of School and College Leaders¹³:

40% of school leaders receive reports of bullying on social media daily or weekly.
Over 90% of heads said that students’ wellbeing had been negatively affected by social media in the past year.

Social media usage and mental health can create a vicious circle. Research finds that heavy social media users report worse mental health^14,15. And young people with a mental health problem are more likely to use social media^6,16.

Young people are aware of it too. 70% experience cyberbullying and 80% say that social media adversely affects their anxiety¹⁷.

So, what can be done? Most pupils already receive PSHE lessons and special sessions about safety online. But head teachers are starting to call out parents who are lax on rules for their children’s use of devices. Home is the new front on social media, devices, and mental health.

How did the Covid lockdown affect mental health?

The full impact of the Coronavirus/Covid-19 pandemic on mental health and wellbeing is likely to be widespread. In June 2020, the Office for National Statistics¹⁸ reported a doubling to 20% of adults with depressive symptoms. Reasons included employment and financial insecurity, social separation, as well as sharing a confined space for a prolonged period.

Children are not immune to the same strains on wellbeing. In particular, isolation from friends and family, the routine of schooling, and boredom.

An Oxford University study¹⁹reported that 4-10 year-olds were particularly affected, one month into lockdown. These primary age children were experiencing an increase in emotional, behavioural, and restless/attentional difficulties.

In response, in August 2020, the government announced a £8M funding for training school staff in mental health and wellbeing.

With children returning to school in September 2020 it may be the case that lockdown related mental health will improve. Though restrictions on movement within school premises may delay recovery. The more likely detriment will be the inevitable reduction in sports, music, dance, and drama. And then there is the possibility of further local or national lockdowns.

We may start to hear more about tools such as mindfulness.

What is mindfulness in schools?

Mindfulness is the ability to be aware of, and engaged with, whatever is going on in the present moment. Mindfulness is a technique for managing mental health and wellbeing.

The practice is becoming popular in the workplace and school because the benefits include improved concentration and behaviour.

Being mindful is to be in the moment, not in what has happened, and not in what might happen. Focusing on the here and now enhances consciousness and relieves stress and anxiety. The Mental Health Foundation’s ‘Be Mindful’ course demonstrates a 40% reduction in participant stress, 63% reduction in depression, and a 58% reduction in anxiety.

The opposite of mindfulness is going through parts of your day on autopilot.

There are many activities that can improve mindfulness. Perhaps your child has attended a mindfulness colouring club. You might hear of mindful movement, mindful breathing, mindful listening, or even mindful eating.

But psychologists are keen to point out that mindfulness is not about escapism, relaxing, contemplative meditation, attaining different states of consciousness or Yoga. Mindfulness is being in the here and now.

Why teach mental health in schools?

There are many resources for parents to help their children with their mental wellbeing. MindEd for Families is one such example. Typically, they emphasise the need for quality time, honesty, and reassurance.

But a valid question is how much responsibility for children’s mental health rests with parents rather than schools. After all, isn’t a school is a place of learning? Are schools increasingly becoming a surrogate for social care?

Clearly, there are advantages of a school providing some form of mental health education as children spend their formative years there. And they are with peers experiencing similar issues at similar life stages. Teachers are also more likely to be aware of the youth zeitgeist than parents.

In 2014 Public Health England¹⁶ found that school programmes that directly improve social and emotional learning achieve an 11% boost in exam results.

7 year-old pupils with better emotional wellbeing were one term’s progress ahead of classmates with worse emotional wellbeing.
Whole school approaches to social and emotional learning correlate with higher attainment.

Furthermore, the study showed that higher levels of attainment are also associated with:

Pupils who are confident about their learning and have a ‘growth mindset’.
Pupils who can set goals, manage stress, and can organize their work; ie learning skills.
Pupils who can use problem solving skills to overcome obstacles.

And so, Growth Mindset, Learning Skills, Thinking Skills, and Problem Solving started to appear on school curricula.

What can schools do about children’s mental health?

‘Mental health is a priority at our school’.

You’ll hear this from many schools. But what does it mean?

It can be a response to what the health charity YoungMinds refers to as ‘the mental health crisis in our classrooms’.

Secondly, it might mean that mental health, wellbeing, and mindfulness are part of the Personal Social Health and Economic (PSHE) curriculum.

Thirdly, it might also mean that resources are available through other school initiatives. Initiatives such as extra-curricular activities, or the visitor programme, pastoral care, or theme days/weeks.

And finally, it might mean that the school adopts a ‘whole school’ approach to mental wellbeing.

There’s more detail to follow. But first, how do you know if a school is good at supporting your child’s mental health? Or if they do enough? Or simply better than the school down the road?

Please be aware that this is a hot area for debate among educators. The debate is a chicken-and-egg one; which comes first, on balance? Mental health or success?

The traditional argument is that children go to school, work hard, and get qualifications. Which leads to self-fulfillment, happiness, and health.

The contrarian recognises that mental unhealthiness is prevalent. Therefore, the school should address mental health and wellbeing to ensure a child’s good lifestyle. Which in turn enables the child to achieve their potential. Which then leads to qualifications and self-fulfillment.

We all know that the answer is a balance between the two. But knowing your child, and your position on the argument, will help you judge which school does best.

PSHE and mental health from September 2020

Many schools have a Personal Social Health and Economic (PSHE) curriculum. All the Schoolsmith schools do.

PHSE comes in many guises, covering a wide variety of different topics under a ‘life lessons’ umbrella. But as a ‘soft subject’ it was always vulnerable to being squeezed out of the curriculum. Except, that is, in independent schools where it is compulsory.

This changed in September 2020 when it became mandatory²⁰ for all English state schools to teach some PSHE topics. These compulsory topics are relationships, sex education (secondary schools only), and physical and mental health.

The aim of the law was to standardise provision and guarantee their coverage in the curriculum. Mental health is now part of every schools’ curriculum.

The proposed work schemes on mental wellbeing are, for now, a floor level provision. They address the importance of communication, respecting emotions, maintaining wellbeing, and recognising detractors to wellbeing.

Schools often use resources such as the PSHE Association and Mentally Healthy Schools for guidance on curriculum content and delivery.

But as a parent, you can be assured that your child will receive some form of mental wellbeing education. No matter which school you choose.

As an aside, here is an excerpt from the Department for Education’s introduction to the new statutory guidance. It makes quite clear where it thinks the responsibility for children’s mental wellness lies.

“We are clear that parents and carers are the prime educators for children on many of these matters. Schools complement and reinforce this role and have told us that they see building on what pupils learn at home as an important part of delivering a good education.”

10 school initiatives to promote mental wellbeing

Some schools have an expansive PSHE curriculum. But there are 10 other activities you may see a school doing to promote mental wellbeing.

1 Pastoral care

All schools have a pastoral care programme, and I’ve written more about it here. Pastoral care is a set of policies and procedures to ensure a child’s wellbeing at school. It often includes mental wellbeing, albeit in general terms. Good pastoral care ensures that there is always an observant eye and a sympathetic ear. And schools may refer to their pastoral care as a reassurance that they take mental health seriously.

They may be right. But evidence from recent surveys suggests that mental wellbeing needs a greater emphasis. Particularly because many pastoral care practices are mature, well understood, and well implemented. Mental health initiatives are new and developing.

2 Leaflets and posters

Leaflets and posters in the nurse’s office and around the school perhaps the simplest way of raising awareness. There are several charities that produce them. For example, YoungMinds publish, ‘Coping with pressure at school’, ‘Eating disorders and eating problems’ and ‘Mental illness in your family’.

The benefit of leaflets and posters is that they start a conversation and signal that help is available. But they also require pupils to be proactive.

3 Assemblies and Special Sessions

This is relatively common. An assembly is an occasion to inform large groups of pupils. Perhaps a special session gathers large groups of peers together for an age pertinent topic. Which might be on sexual health, drugs, safety online. It may equally be on mental wellbeing.

The mental health charity MIND offers information PowerPoint packs for large groups on mental health. Under the ‘Time to change pledge’ banner they include ‘Ask twice’ and ‘What is mental health?’.

Again, PowerPoints to a large group do a great job of informing, but they don’t necessarily facilitate pupil engagement.

4 Outside speakers

Schools invite external speakers to talk to pupils about many inspirational topics, including mental health. There are websites featuring dozens of speakers, usually with personal experience of mental health issues. Topics include depression, anxiety, suicide, stress, and adolescent development.

The benefit of an outside speaker’s experience may resonate with a pupil, more perhaps than with a member of staff. There is a cost (and quality) management issue with external speakers. Many schools limit the opportunity to one speaker per year. But they may be more effective as part of a series of visiting speakers, repeated annually to different year groups.

5 Extracurricular activities

A small number of schools include mindfulness, meditation, and Yoga on their curriculum. Many more run at least one of them as a lunchtime or after school club. Depending on how serious the sessions are, they are certainly worthwhile. But in isolation, the benefits are limited.

6 Focus days and weeks

World Mental Health Day is a global event designed to encourage conversation and decreasing stigma around mental health. Most schools organize events and activities to focus on just that.

Some schools go further and have a ‘wellbeing week’ or a ‘balance week’. The aim is to educate pupils on the need for work/life balance. Including, but not necessarily strictly focussed on, mental health, they encourage activities that aren’t offered in the normal school week. Activities such as Yoga or mindfulness.

But they can blur focus on mental wellbeing with other non-academic activities such as outdoor adventure. They acknowledge the importance of a broad curriculum which may be a luxury for many schools.

As good for general wellbeing as they may be, they aren’t a substitute for mental wellbeing education.

7 Counsellors

Many boarding schools have a visiting counsellor, whose role is to be an objective, non-partisan, ear for pupils. The facility is available regularly, on an individual basis, to all pupils.

More day schools are starting to use the service of counsellors, especially specialists in psychology and psychotherapy. But this facility is more sporadic and as an emergency response to specific pupils in crisis.

A National Association of Head Teachers²¹ survey found that 66% of schools commissioned counsellors in 2019, up from 36% in 2016.

Yes, the presence of a school counsellor recognises that teachers aren’t specialists in mental health, nor should they be. But it is more likely a sign that some children are not getting the support they need from community agencies. It is not necessarily an indication that all pupils are receiving mental health education.

8 Training and networks

Pupils aren’t involved in these networks, but they benefit indirectly from the training their teachers receive from them. An example is The Anna Freud National Centre for Children and Families. It runs an information sharing, training, and peer network for teachers, ‘Schools in Mind’.

9 Courses for individuals

A teacher may consider a pupil’s mental health to be at risk. In this situation the teacher may refer the pupils on to a course for individuals or small groups.

One example often used by schools is Mind Mechanics. It is a suite of tests, tools, plans, and workshops marketed as an ‘evidence-based wellbeing intervention’. The benefit to pupils is an understanding of what they are experiencing and some strategies for managing.

Universities have similar, if more complex, challenges with mental health among their students. They go one step further, offering individual mental health courses for anyone who needs it. For example, the University of Bath offers free online courses called ‘Drop the Struggle’, ‘Mindfulness Based Stress Reduction’ and ‘Anxiety Aid’.

10 Courses for large groups

The last school initiative you may see is a course for the whole school or, more likely, a year group. By involving a large group of pupils, a preventative, rather than remedial, scheme might increase peer-group discussion and adoption.

One example is the Actions for Happiness Scheme. A pupil writes down three things they are happy about at the start of each day. And this sets them up with a positive outlook for the rest of the day.

Another example is the Mindfulness in Schools Project. Mindfulness lessons are taught each week, with different age groups being taught different levels of mindfulness techniques. The aim is that constant reinforcement encourages a positive mindset, as well as skills to combat stress.

There are some primary school specific courses too. For example, Action Mental Health’s ‘Healthy Me’ programme aims to raise awareness of mental health in key stage 2 children. In particular, it helps prevent poor mental health and support the transition from primary to secondary school. Example topics include ‘What is health?’, ‘Healthy body, healthy mind’ and ‘Coping strategies and accessing help’.

What is a whole school approach to mental health?

A whole school approach to mental health and wellness is the current gold standard. It involves all members of a school community, is coordinated, proactive, and part of the school culture. The ideal is that everyone at the school helps each other with their mental health. It may include some or all of the 10 initiatives above, but in a strategic and coherent manner.

There is no mystery to what a whole school approach should look like. It’s similar to a school’s Special Educational Needs approach. Or those required for accreditation from Eco Schools, UNICEF Rights Respecting Schools, and many others.

Elements of a whole school approach

So here are the elements you might look for in a school with a whole school approach to mental health.

A published policy. Just like all the other school policies. In 2018 only 4% of primaries and 2% of secondaries had one²².
Training for all staff, regularly updated. In June 2019, the Department for Education started a four-year programme to train one person per school. A train the trainer exercise, co-ordinated by the Anna Freud National Centre for Children and Families. How quickly a school goes from one trained member of staff to all might be a useful indicator.
A curriculum and extra curriculum exploring the different elements of mental wellbeing.
Established communication channels to encourage conversation about mental health. This may be in class groups, tutor groups or pastoral groups.
Clear communication channels for parents and staff for intervention.
A staff member responsible for mental health. A Head of Mental Health and Wellbeing. Equivalent to a SENCO. And a conduit to external agencies for specialist help.
A continuous assessment and monitoring programme leading to personalised intervention. Pupils might be tracked against nationally standardised data, such as GL Assessments’ Pupil Attitudes to Self and School (PASS).
Proactive interventions on a group-wide basis particularly in moments of heightened anxiety, such as exams.
Finally, an accreditation. There are several charities and school organisations offering awards and accreditations for efforts in mental wellbeing. At this early stage in the development of mental wellbeing in schools, they might be a positive endorsement.

How many schools have a whole school approach to mental wellbeing?

In 2019 a survey of school leaders by the Association of School & College Leaders²¹found that;

79% of schools have a whole school approach to positive mental health,
78% have a designated staff member responsible for mental wellbeing,
at 67% of schools, staff have undertaken mental health training, and
66% of school leaders said pupils feel confident to talk to staff about their mental wellbeing.

However, research by the Department for Education²² a year earlier contradicted this;

29% of primary schools and 18% of secondary schools had a coherent whole school approach to mental health,
27% of primaries and secondaries had some mental health initiatives,
44% of primaries and 56% of secondaries showed no evidence of support for mental health.

The reality is probably somewhere between the two.

Conclusion

When I started researching this article, I realised that many parents were slightly sceptical. Yes, they were aware of the significance of mental illness and the harm of neglect and abuse. Beyond that, most assumed that ‘well’ people just respond to stressful situations in different ways.

Without a doubt there’s a whiff of hyperbole and hubris about mental health. Maybe you believe that this is just another snowflake generation thing. Maybe you’re slightly jaded by the constant stream of attention-seeking celebrity confessionals.

But I think the point is that it’s the awareness of mental health that’s important. This generation of schoolchildren are probably experiencing the same degree of depression and anxiety as we did. Now we know how serious it is. One in four of us has, or will have, a mental illness.

Just as we know more about the importance of physical health than our parents did, so we now have the same opportunity with mental health. We can give our children coping strategies.

We can do something about mental wellbeing. And so can schools.

Sources

The World Health Organization: Promoting mental health; concepts, emerging evidence, practice, 2004
Mental Health Foundation: Mental Health at Work
National Centre for Social Research in collaboration with the University of Leicester: Adult Psychiatric Morbidity in England, Results of a household survey, 2007
National Centre for Social Research in collaboration with the University of Leicester: Adult Psychiatric Morbidity in England, Results of a household survey, 2016
Annual Report of the Chief Medical Officer 2013: Public Mental Health Priorities
Department of Health and Social Care/NHS: The Mental Health of Children and Young People Survey, 2017
PlacetoBe: Pupils share their views for Children’s Mental Health Week, 2017
Mental Health Foundation: Make it Count, 2018
Mental Health Foundation: How to talk to your children about scary world news, 2018
Association of School & College Leaders, & National Children’s Bureau, 2016
OECD: PISA 2018 Results Volume III: What school life means for students’ lives
Royal Society for Public Health/Young Health Movement: #Status of Mind, May 2017
Association of School & College Leaders, 2018
Glazzard and Stones: Social media and young people’s mental health, 2019
Sampasa-Kanyinga and Lewis, Mary Ann Liebert Inc: Frequent Use of Social Networking Sites Is Associated with Poor Psychological Functioning Among Children and Adolescents, July 2015
Public Health England: The link between pupil health and wellbeing and attainment, 2014
YoungMinds: Wise Up- Prioritising wellbeing in schools, 2018
Office for National Statistics: Coronavirus and depression in adults, Great Britain, June 2020
Oxford University: Co-SPACE (COVID-19 Supporting Parents, Adolescents, and Children in Epidemics) survey, June 2020
Department for Education: Relationships and Education, Relationships and Sex Education (RSE), and Health Education – Statutory Guidance 2019
Association of School & College Leaders, & National Children’s Bureau, 2019
Department for Education: Mental health and wellbeing provision in schools: Review of published policies and information, 2018

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