Not many days go by without the media raising concerns about mental health in children and young people. It has been reported in July 2019 that 3 out of 5 secondary school students have experienced mental health problems themselves or are close to someone who has. That could be as many as 18 in a class of 30, who could be suffering with anxiety, depression or other mental health issues.
Mental health issues can affect any child or young person but there is evidence to suggest that the likelihood of experiencing these problems is not evenly spread across the population.
The charity Mental Health Foundation reveals that children and adults living in households in the lowest 20% income bracket in Great Britain are two to three times more likely to develop mental health problems than those in the highest.
Adverse childhood experiences (ACEs) also increase the risk of mental ill health: the World Health Organization estimates that 30% of adult mental illness in 21 countries could be attributed to ACEs.
The presence of ACEs can increase self-harm and suicide among children and young people, with the national study in Wales found that students who had experienced four or more ACEs were 10 times more likely to have had suicidal thoughts or self-harmed.
We also know that there are factors that are protective and compensatory – things that build resilience among children and young people but sadly it is often the most vulnerable who have problems accessing these; things like feeling valued and having a sense of belonging; the opportunity to take part in sports and leisure activities and to build trusted relationships with adults outside of the home.
Children who have experienced adversity are likely to have experienced trauma and issues with attachment so if schools understand the impact of these on the brain and behaviour of children and young people, they will be better placed to support mental well-being for all students.
The impact of trauma
When children grow up in situations where trauma is repeated, they experience toxic stress, the prolonged activation of the stress response without protective relationships. This can prevent healthy brain development particularly their response to stress.
Such children may perceive all sorts of situations as threatening and their brain will launch them into a ‘survival instinct’ stress response, fight flight or freeze. This may have kept them safe in the past, in domestic violence situations for example, but may lead them to behave in ways which seem unpredictable and disproportionate in a school setting.
As adults we must remember that feeling safe is not the same as being safe and these students will not be able to tell the difference between the very real threat of a violent adult in the home or the feeling of threat that may accompany being ‘told off’ by a teacher, or being asked to do work that feels too challenging.
Such students are not choosing to misbehave; they are responding to a very primitive drive to keep themselves safe. Sadly, these children have not had the benefit of an adult consistently providing that safety.
If staff working with students understand this they can help the child feel safe and co-regulate with them so they learn to manage the feelings of anxiety and panic that can cause these responses, eventually reaching a point where they learn to regulate themselves or at least have strategies they can use to help them calm, and know there are trusted adults who can help.
Babies have strong instincts to help them survive, and behaviours that are designed to attract an adult who will take care of them. When this happens, a baby expresses its needs, in a state of high arousal, (red in the face, tense, screaming, heart rate high) and a caring adult will meet their needs and soothe them.When this adult response is consistent an attachment develops and these early relationships help the baby realise the world is a safe place, that they can rely on adults to meet their needs and be nurture them. This forms the basis for all future relationships and shapes the child’s view of the world and themselves. If these needs are not consistently met the attachments are insecure and as succinctly stated by John Bowlby: ‘We are as needy as our unmet needs’.
In schools these children are constantly seeking to have those needs met by the adults who are around them. The Dan Siegel Model is helpful to think about they need to be seen, safe, soothed and secure. Unless they experience this in school, they will not only find it hard to manage relationships and learn but they will be driven each day to make sure their needs for safety and security are met.
Small changes big impact
Being trauma-informed and attachment aware may not mean wholesale change of school policies and practices, but it does mean creating a culture where adults are curious about the cause of behaviour and acknowledge that not all students ‘choose’ the way they behave.
Students may feel anxious about situations, sometimes going into panic or survival mode where aggression or running away will be the ‘best option’ of their activated stress response. Students whose attachment needs were not met when they were young may still have those needs, allowing time to develop relationships will benefit rather than detract from learning and will enable the student eventually to feel safe enough to learn.
Promoting positive relationships for students, with both staff and peers, will support the mental health and well-being of all students. Understanding that trauma and poor early attachments may mean these most vulnerable of students will find relationships and self-regulation particularly difficult. This is often what lies behind the behaviour that may be challenging and may ultimately lead to further isolation and adversity for these students.
Schools who understand the impact of trauma and insecure attachments can develop policies and practices that meet the needs of these students and support mental well-being, improve learning outcomes and create a more positive, collaborative culture in which staff students can thrive. Surely that is the aspiration of all schools.