Penelope Moon, author, and UKCP registered psychotherapist, is the founder of ‘A Quiet Place’ a team that provides evidence-based personal development programs, supporting the achievement of unique outcomes for all ages and abilities, focusing on future aspirations and dreams, while drawing upon a completely holistic approach. Developed and based in Liverpool, ‘A Quiet Place’ delivers services nationally and internationally. Working in education for the last 40 years, she developed the Early Years Behaviour Team for Liverpool City council that supported families of children with severe emotional and behavioral difficulties. She felt it essential to develop services that not only ‘worked’ for the needs of the service users but worked quickly to prevent exclusion. It was from this passion for offering effective and holistic support that ‘A Quiet Place’ was born.
Just exactly what do we mean by Mental Health? The WHO constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease of disease or infirmity”. An important consequence of this definition is that mental health is described as more than the absence of mental disorders or disabilities. Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and can contribute to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community. Thus, often simplified, these are the common 5 stages of Well-being according to the UK:
- Be Active
- Keep Learning
- Take Notice
While these are all very well, they can appear rather glib unless you are in the fortunate position to prevent problems arising. However, it is quite another thing when children/ people are in a difficult situation of their own making or one that has nothing to do with them whatsoever.
Stress level rise and, when they become chronic, can shift hormonal levels that may cause severe stress-related symptoms. Anxiety seems to be the common denominator underpinning all human issues. One of the symptoms is ‘inertia’. Mental health is a very complex issue that requires a baseline understanding and the difficulties of offering support or treatment. These standards, often developed in the West under the auspices of academic research based in Universities generally staffed by academics who are usually from a particular demographic, struggle with the reality on the ground with consequences to support and effective treatment that has to fit into their academic guidelines! Therefore, often services are developed for the providers rather than the service users.
To bring about a change that might have a chance of being sustainable, certain principles need to be evident and at ‘A Quiet Place’ we call it the ACE factor.
- Awareness that there is a problem
- Choice, there are other options
And if there is no energy left, the person is exhausted having been unable to move from an entrenched position or circumstance that has left them feeling hopeless and helpless. There is unlikely to be changed except through some random situation, which may be positive or negative. Basic survival comes in and there is little left for creative solutions
To conduce a change, one must also be mindful of the complexity like, ‘Cultural’, ‘Social’, ‘Belief’, and ‘Political’ systems. Here, ‘Social’ and ‘Cultural’ encompass race and ethnicity too. The broad spectrum of racial and ethnic minorities that come into contact at some point with our Western definitions of health inevitably bring a level of conflict with issues like Stigma, Definition, Treatment, and impact on outcomes with the limited understandings of the diverse acceptable norms.
In the West, treatment has gone through many historical approaches from the divine (exorcism) to the natural (lunacy), from pills to talking therapies, and now common self-diagnosis based on various questionnaires available through the internet.
In general, the DSM and similar tools were developed to help understand and label people who were already in institutions suffering from a variety of extreme symptoms. These diagnostic tools have now become an ever-increasing bible to define almost anything that seems to be out of the ‘norm’ and now has a label.
Unfortunately, while the increase in labels for mental health issues multiplies by the minute, innovative and effective treatment has not followed suit and we are left with an increasingly medicalized society, where terminology has spread through social media and everyone used these terms to insult directly or ‘kindly make suggestions for help!’.
Western science and medicine, which emphasizes scientific inquiry and objective evidence, has become the valued definition of treatment across the world. The politics and belief systems, however, still have an impact on the attitudes and treatment of individuals, especially where finances are very limited. This means that the UK, for example, which is my area of work, is now expecting teachers to become mental health workers, with only the briefest awareness of this increasingly complex field.
“A little knowledge is a dangerous thing”, especially when dealing with fragile and vulnerable children. Young people, when specific beliefs will inevitably lead to interpretation and judgment after powerful ‘therapeutic tools’ (that are now generally available through various self-help books), can open ‘cans of worms’, which the newly qualified weekend trained expert has no knowledge or experience of dealing with.
First, Do No Harm
Effective treatment while causing as little damage as possible is unlikely to ‘come out’ of existing clinical services, which are tied tightly into their clinical procedures. In ‘A Quiet Place’ we focus on safe programs that would bring about sustainable change in half term (6 weeks 3 times a week) while pupils are maintained in mainstream schools. Some of the tools that we utilize are:
- Evidenced-based preventions and interventions
- Holistic i.e., inclusive of all children, staff, families, and staff
- Quality assured training, (ongoing) and regular (weekly) supervision with a member of school trainee
- Joint training with all staff
- Transparency with confidentiality
- Value – do the techniques work? Do they develop independent human beings who are resilient despite life’s journey?
- Focus on underpinning issues common to being ‘human’
- Anxiety – tools to reduce anxiety that can be applied outside of school, which helps with good sleep an increasingly difficult problem ranging from ancient (Mindfulness) to the biofeedback software (HeartMath)
- Engagement and retention – the pupils must be motivated to take part in the programs
- Participation – pupil will have options of ‘medium’ through which they go through the 6-week program
- Focus on positive and realistic goals that have the most impact, the shortest time out of class for the best academic, behavioral and wellbeing outcomes
- Include parent, teacher, and child in identifying outcomes which in turn must fit into the school ails e.g. Personal development, managing behavior
Should pupils and teachers be aware of mental health issues? YES! YES! and YES! It should be a part of a truly holistic and balanced curriculum for personal development. However, because of the issues mentioned, we need to be very careful not to ‘frighten’ people with statistics, symptoms, and medicalization of what could be a natural phenomenon linked to bereavement or a traumatic circumstance. Using the knowledge and techniques that we have available, perhaps we need to be aware that ‘belief’ systems exist everywhere with various theories and those who came up with the ideas would have been developed by the initiator whereas their ‘followers’ can frequently develop a blind cult status without questioning and tend to ‘worship’ them on the altars of theories frozen in time.
So, let’s keep asking questions, using updated knowledge about our brains and finding ‘what works’ respectfully and kindly to our pupils and adults who are without a doubt suffering.