Talk to the ResearchEd conference, 9th September 2017

Bristow, J.

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Canterbury Research and Theses Environment

IS IT TIME TO RESIST CALLS FOR MORE MENTAL HEALTH INTERVENTIONS IN EDUCATION?Dr Jennie BristowSenior Lecturer in Sociology, Canterbury Christ Church University jennie.bristow@canterbury.ac.ukResearchEd conference, 9 September 2017YES!• Won’t address serious mental health problems among children• Medicalises wider educational and existential problems• Displaces teachers and curriculum knowledge• Promotes a deficit model of students, and a generic culture of behavioural conformityRECENT POLICY CONTEXT• ‘Government puts £200k behind plan for mental health first-aiders in every secondary’ TES, 27 June 2017• The funding will be used to train 3,000 teachers and teaching assistants over the next three years. Teachers will receive practical advice on how to deal with mental health issues such as depression, anxiety, suicide and self-harm. The aim is to extend the programme to primary schools by the end of the current Parliament…• Training will be delivered in schools by social enterprise organisationMental Health First Aid England. Participants will be expected to educate other members of staff in their school about the best ways to handle mental health problems.• The programme was first announced by Theresa May in January. Today, she said: “Tackling poor mental health is a huge challenge, and we will keep our promises and meet that challenge with the comprehensive cross-society response that is required.”• Thousands of teenagers will receive additional support to improve their mental health as part of a new youth initiative, the Prime Minister announced on 17 August.• On A Level results day, Prime Minister Theresa May unveiled a new course is to be developed by National Citizen Service (NCS), to raise awareness of mental health among young people and improve their knowledge of how to get help…• The course will be developed with mental health experts and NCS graduates and be delivered as part of the organisation’sprogramme to prepare young people for the challenges of adult life and work.• The package of measures delivered by NCS will include:• a dedicated mental health awareness course for teenagers talking part in NCS• new mental health training for more than 10,000 frontline NCS staff to improve support to young people• a new network of young NCS graduates to champion mental health awarenessYoung people to benefit from new mental health awareness course. Prime Minister’s Office, 18 August 2017PRIOR POLICY CONTEXT• Policies designed to promote wellbeing and reduce mental health problems – eg Social and Emotional Aspects of Learning (SEAL)• ‘a comprehensive, whole-school approach to promoting the social and emotional skills that underpin effective learning, positive behaviour, regular attendance, staff effectiveness and the emotional health and well-being of all who learn and work in schools’• Introduced by New Labour government in mid-2000s at primary and secondary level • Part of development of generalised ‘therapeutic education’ (Ecclestone and Hayes 2008)WIDER CULTURAL CONTEXT• Increasing attention paid to the problem of young people’s mental (ill) health• Concern about behaviour, attendance, and inclusion• View of schools as ‘as ideal settings for reaching vulnerable and undiagnosed children and adolescents’ (Lendrum et al. 2013) • Generalised discourse of ‘vulnerability’ and ‘resilience’, within an overarching ‘therapy culture’WHAT’S THE PROBLEM?• Diagnosis of mental ill-health• Implementation of strategies to address the problemMENTAL HEALTH FIRST AID ENGLANDFACTSHEET FOR SCHOOLS. ACCESSED 4 SEPTEMBER 2017YOUGOV SURVEY, AUGUST 2016EXPANDING STATISTICS‘ I t  i s  not only the pressures of  school and exams, though that  is  in  the front of  our minds today, but also se l f -esteem issues ,  struggles with home l i fe  or  fr iendsh ips ,  and gett ing in to univers ity or f inding a job that can  a l l  a f fect mental  wel lbe ing . ’  Theresa May,  August 2017‘Perhaps unsurpris ing ly ’ ,  study is  the pr imary cause of  s tress  among students .  Seven in ten (71%) say that work from univers ity i s  one of  their main sources of  s tress . YouGov ,  August  2016EXPANDING EXPLANATIONSTHE MORE AWARENESS, THE GREATER THE SCALE OF THE PROBLEM• IPPR,                  2 September 2017CULTURAL SCRIPT OF FRAGILITY• Assumption that students and young people experience increasing mental health difficulties, requiring a particular (therapeutic) response• Construction of claims: ‘the meanings that people construct need to make sense of the world they inhabit’ (Best 2008, pp.11-12)• Not a ‘made-up’ problem • But is this how students and young people are encouraged to give meaning / explanation to existential distress?• Do therapeutic interventions work?PROBLEM OF IMPLEMENTATION• Evaluation of SEAL in secondary schools:• ‘In terms of impact, our analysis of pupil-level outcome data indicated that SEAL (as implemented by schools in our sample) failed to impact significantly upon pupils’ social and emotional skills, general mental health difficulties, pro-social behaviour or behaviour problems. • In relation to school-level outcome data, our analyses indicated that SEAL (as implemented by schools in our sample) failed to have a positive impact, although the results were less straightforward here. Analysis of school climate scores indicated significant reductions in pupils’ trust and respect for teachers, liking for school, and feelings of classroom and school supportiveness during SEAL implementation. Additionally, qualitative data around perceptions of impact indicated a feeling that SEAL had not produced the expected changes across schools. • However, school climate data also showed a significant increase in pupils’ feelings of autonomy and influence, and this was supplemented by anecdotal examples of positive changes in general outcomes (e.g. reductions in exclusion), as well as more specific improvements in behaviour, interpersonal skills and relationships.  (Humphrey et al. 2010)WHO’S IMPLEMENTING WHAT?• ‘Russell Hobby, general secretary of the NAHT headteachers’ union, pointed out that investment in mental health training in schools is only a first step: • “Schools may help in identifying problems, but if the mental health support services are not there, then this is only part of the solution. We know of the long waiting times for child and adolescent mental health services, which must be addressed to give children the support they need.”’ TES, 27 June 2017• Problem of ‘will and skill’ (Lendrum et al. 2013) – but what is right and reasonable to expect of teachers?OTHER AGENDAS…• Ecclestone and Lewis’s (2014): study of PAThS (Promoting Alternative Thinking Strategies programme) and other school-based interventions for building ‘resilience’ found a number of tensions in the view that ‘vulnerability defines many more people’s everyday experiences than in the past’, including:• 1. It draws in a growing range of mundane, everyday incidents and feelings as threats or risks to emotional well-being and mental health and presents them as needing professionally-led intervention. • 2. It encourages casual references to someone being vulnerable or at risk, or even whole categories of ‘the vulnerable’. In everyday educational settings, such categories and labels apply just as easily to someone facing very serious social and personal difficulties as they do to someone on the brink of a relationship crisis, someone stressed by tests or examinations, risking failure in a module assignment, seeking or being deemed to need ‘learning support’.• 3. A significant expansion of risks and ensuing vulnerabilities seen to need universal support or intervention diverts resources from targeted initiatives to address serious problems for a minority. • 4. Although policy interpretations and attempts to recast vulnerability in progressive ways acknowledge structural forms, they end up being preoccupied with vulnerability as predominantly psychological or emotional, and, from some perspectives, a cultural norm. • Furthermore:• ‘Although such interventions aim to help children formulate actions, thereby channellinganger and other ‘unhelpful’ responses in productive ways, the emphasis is on emotional regulation and control. Such programmes eschew the possibility of more ‘resistant’ types of resilience…• Following a Foucauldian argument, confessional and therapeutic strategies require participants to account for and manage themselves as part of new forms of governance that shape desirable citizens…• In an ethnographic study of SEAL in a primary school, Lisa Proctor illuminates the normative judgements that emerge amongst teachers and other children from one boy’s ‘anger management’ programme, where strategies for the right sort of behaviour are not only scripted but also made public whenever he displays ‘inappropriate’ anger… • PAThS trains children as peer counsellors or mediators to help peers with identifying and using problem-solving strategies that have been taught in dedicated sessions. An unanticipated outcome revealed by both these examples is the subtle, new forms of peer power and inequality that emerge, where children deemed to be emotionally competent, literate and confident not only gain new advantages but are also deployed to manage other children.... (Ecclestone and Lewis 2014)CONCLUDING THOUGHTS• Cultivation of a generalised sense of vulnerability, leading to therapeutic governance and management – and an ever-expanding ‘epidemic’• Defining everyday distress as a mental health problem can mean it is experienced as such – the ‘self-fulfilling prophecy’• Wider problems are presented as individual, pathological, in need of and susceptible medical intervention• Services for those in most need (eg SEN, mental health services) are over-burdened• (Over)emphasis on behaviour as a cause of harm and a site of regulation • Teachers distracted from core educational role and expected to behave as (unskilled) cliniciansREFERENCES• Best, J. (2008) Social Problems. New York: Aldine de Gruyter.• Ecclestone, K. and Hayes, D. (2008) The Dangerous Rise of Therapeutic Education. London: Routledge.• Ecclestone, K. and Lewis, L. (2014) ‘Interventions for resilience in educational settings: challenging policy discourses of risk and vulnerability.’ Journal of Education Policy 29(2): 195-216,• Furedi, F. (2003) Therapy Culture: Cultivating Vulnerability in an Uncertain Age. London: Routledge. • Humphrey, N., Lendrum, A., Wigelsworth, M. (2010) ‘Social and emotional aspects of learning (SEAL) programme in secondary schools: national evaluation.’ Research Brief. London: Department for Education. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/197925/DFE-RB049.pdf• Lendrum, A., Humphrey, N., Wigelsworth, M. (2013) ‘Social and emotional aspects of learning (SEAL) for secondary schools: implementation difficulties and their implications for school-based mental health promotion.’ Child and Adolescent Mental Health 18 (3): 158–164. 

Is it time to resist calls for more mental health interventions in education

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Is it time to resist calls for more mental health interventions in education

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