Monday 17 August 2009

Mental health in schools: How teachers have the power to make a difference

We've had a lot of great feedback from our post on schools as the next frontier for mental health education.

We all know the problem. Mental disorders represent the most common and disabling condition affecting young people and therefore have major implications for students and for schools. In short, mental health problems affect a student’s emotional well-being, their ability to learn, are a factor in why some students drop out of school.

But too often we focus on the problems instead of the solutions. In a recent article entitled "Mental health in schools: how teachers have the power to make a difference" for Health and Learning Magazine, Dr. Kutcher, Leigh Meldrum and I outlined a three-pronged approach to address mental health problems in schools. 

Schools can be an important location for mental health promotion, early identification and intervention, combating stigma associated with mental illness and possibly providing interventions and ongoing care. But as a teacher, what can you do to make a difference in the mental well being of your students? The answer is not always easy, and requires cooperation at all levels of the education system and a positive collaboration with health care providers.

Using the classroom for stigma reduction
One of the largest obstacles facing youth with mental illness is the associated social stigma against people living with a mental disorder. While the scientific understanding and treatment of mental disorders, as well as the awareness of the importance of mental health in all aspects of life, has advanced considerably in the past decade, the public’s perception about people with mental illness has been much slower to change.

In the classroom, stigma associated with mental illness can affect how teachers, classmates, and peers treat the student living with a mental disorder. School-based anti-stigma activities present an opportunity to enhance understanding of mental illness and improve attitudes towards people living with mental illness. Furthermore, school-based anti-stigma activities reach people on all social levels, from teachers, principals and administrators to parents and community members to most importantly, the students themselves.

Identify and intervene!
Early identification and effective intervention for youth with mental disorders is critical. If left untreated, the symptoms of a mental illness may increase in severity, and its effects may become more serious and potentially life threatening. Educators and school personnel are in an ideal position to recognize behavioural or emotional changes, which may be symptomatic of the onset of mental illness.
By providing training related to youth mental health and mental disorders in young people that is specific to educators we will be better equipped to protect and promote the mental health of our youth. Educator-specific programs, such as Understanding Adolescent Depression and Suicide Education Training Program, addresses the signs and symptoms of depression, as well as risk factors for suicide, methods of identification and appropriate referral of high-risk youth. The basis of this innovative Canadian program is supported by documented evidence of effectiveness and has been demonstrated to improve mental health literacy in educators and health professionals.

School curriculum meets mental health promotion
A potential starting point for the integration of mental health care into existing school health systems is through the implementation of a gatekeeper model. A gatekeeper model provides training to teachers and student services personnel (such as social workers, guidance counseling, school psychologists) in the identification and support of young people at risk for or living with a mental disorder. It also links education professionals with health providers to allow for more detailed assessment and intervention when needed.

Schools can also address students’ mental health through the implementation of mental health promotion strategies through innovative curriculum initiatives. Improving mental health literacy through curriculum development and application could enhance knowledge and change attitudes in students and teachers alike, and embedding mental health as a component of health promoting activities could enhance mental health while decreasing stigma associated with mental disorders. Two examples of recently developed Canadian mental health curriculum for schools are: Healthy Minds, Healthy Body (Province of Nova Scotia) and the Secondary School Mental Health Curriculum (Canadian Mental Health Association).



~ David Venn

Tuesday 11 August 2009

Stigma associated with mental illness runs deep

Try playing this little game with a friend, parent or co-worker. Ask them to list three adjectives that describe a person with mental illness. Then ask them to list three adjectives that describe a person with breast cancer. Finally, ask them to list three adjectives that describe a friend.

More than likely the person will use words like "crazy", "sad", "depressed", "lonely", "patient", "consumer or victim", "scared", "down", "violent", etc. to describe someone with a mental illness. In describing someone with breast cancer they will likely use words such as "strong", "confident", "undeserving", "survivor", "thriving", "family connection", etc.

And in describing a friend the person will likely use words like "fun", "caring", "happy", "smart", "loyal", "honest", "responsible", etc. See the difference?

Whether you play this game with youth, parents, educators or even health professionals you get the same result - positive words to describe a friend or a physical health problem like breast cancer and negative words to describe a mental illness like Depression.



And what if the your friend had Anxiety Disorder or Depression? Would that change your perception of them as a fun, smart, caring, loyal person? Would they suddenly be relegated to being a crazy, lonely, scared patient? The stigma surrounding mental illness runs deep. It is embedded in our actions, our culture and our language. Imagine a time when we describe and perceive people living with mental illnesses the same way we describe and perceive our friends or people living with physical health problems!

Thursday 6 August 2009

Teens aware of marijuana harm and impact on mental health

According to a BBC article, a survey of of 27,000 teenagers found that "nearly one in two teenagers knows someone who has suffered from a mental health problem like paranoia after using cannabis."

The research, which was carried out on networking website Habbo Hotel, found 64% of young people were aware cannabis could cause panic attacks, 41% knew it could bring on paranoia and 38% thought it could result in memory loss.

Over 50% of teenagers associated cannabis use with losing motivation and doing badly at school or college.

While the survey is far from scientific - it does point to some interesting trends among teens and their perception of marijuana use and how it affects mental health. Recent research suggests that heavy use of cannabis may increase the risk of psychosis in some young people The website Psychosis Sucks maintains that:

Psychosis can be induced by drugs or can be "drug assisted". Some stimulating drugs, like amphetamines, can cause psychosis, while other drugs, including marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have "vulnerability". The risks associated with drug use for a person with psychosis include an increased risk of relapse, the development of more secondary problems (including depression, anxiety or memory problems), a slower recovery and more persistent psychotic symptoms.

The good news is that with early identification, treatment and support, people living with psychosis, substance abuse or a combination of these mental health problems can recover. Because people with psychosis may have interlinked problems with substance use problems, treatment that combines both mental health and addiction services into one program is best. ALSO - integrating treatment for psychosis and substance abuse into one program is an effective way to help both problems at the same time. Treatment programs include:
  • Improving quality of life including belief in the possibility of recovery.
  • Going beyond just eliminating symptoms of psychosis and substance use and emphasizing social and other supports.
  • Motivation support to help you set and accomplish your goals.
  • Taking medications as prescribed


Tuesday 4 August 2009

Kutcher Adolescent Depression Scale for the iPhone

Recently I wrote a post on mental health in the palm of your hand - exploring how technology and iPhone applications were being used to share medical and mental health information. Following that post I contacted Dr. Harvey Castro at Deep Pocket Series to ask him about Sad Scale - a self screening Depression test and iPhone application tool. Understanding the need for a Depression scale for children, Dr. Castro worked with our team to adapt the Kutcher Adolescent Depression Scale (KADS) for use on the Sad Scale application. 

The KADS, along with the Center for Epidemiological Studies Depression Scale for Children (CES-DC), are now available on the Sad Scale. These applications will give you a graph on your progress and will also allow you to email your health care provider the results of the test. The iPhone application is available now and can be downloaded for $0.99 from iTunes. We are now adapting the Kutcher Generalized Social Anxiety Disorder Scale for Adolescents (K-GSADS-A) ... stay tuned! (literally)

 ~ David Venn