The importance of emotional health


The importance of the links between thinking patterns, emotions and behaviour cannot be underestimated. Child psychologist Karen Sullivan reports on a healthy lifestyles programme and the lessons it can teach UK educators.

Last September, a fascinating study was published in The American Journal of Preventative Medicine. Researchers from Ohio State University College of Nursing found that implementing an emotional health component to school-based health education programmes enhanced healthy behaviours, reduced depression and improved grades.

For the study, researchers recruited 779 secondary-school students between the ages of 14 and 16. Half attended a control class that covered standard health topics such as road safety, dental care and immunisation. The others were enrolled in the COPE healthy lifestyles programme. 

This programme involves weekly 50-minute cognitive behavioural therapy sessions with an emphasis on skills-building, interspersed with nutrition information and physical activity. In the latter, 15 to 20 minutes of physical activity are incorporated into the sessions, not just to improve physical health but to build beliefs and confidence in teens that they can engage in and sustain some level of physical activity on a regular basis (it is important to note that exercise has been shown to improve emotional health in people of all ages).

The impact of the programme was astonishing. Participants had a lower average body mass index, better social behaviours (co-operation, assertion and academic competence), higher grades, and drank less alcohol than did teenagers in a class with standard health lessons. Symptoms in teens who were severely depressed also dropped to normal levels at the end of the semester compared to the control group, whose symptoms remained elevated. The impact of the programme was sustained for six months.

This is an important message here in the UK too, where 30 per cent of teenagers are overweight or obese, and some 85 per cent of girls and 73 per cent of boys aged 13 do not do the recommended one hour of physical activity per day. 

According to YoungMinds, mental health problems remain a critical issue for British children: one in 10 aged five to 16 suffer from a diagnosable mental health disorder (around three children in every class); one in every 12 young people deliberately self-harm and hospital admissions have increased by 68 per cent in the past 10 years; nearly 80,000 young people suffer from severe depression; and over half of adults with mental health problems were diagnosed in childhood, with less than half treated appropriately at the time.

With a spate of teen suicides, 194,000 young people with diagnosed anxiety disorders, 294,000 British children with conduct disorders, and a startling increase in self-harm and anorexia, something needs to be done and fast. 

Mental health issues in teens are increasing faster than any single health problem, including obesity, and are grounds for great concern.

COPE emphasises the link between thinking patterns, emotions and behaviour as well as the ABCs of cognitive behavioural skills-building. The researchers found: “This training acknowledges that activator events can trigger negative thoughts, the negative beliefs teens may have about themselves based on the triggering event, and the consequences of feeling bad and engaging in negative behaviour as a result.

“We teach kids how to monitor for activator events and show them that instead of embracing a negative belief, they can turn that around to a positive belief about themselves. Schools are great at teaching math and social studies, but we aren’t giving teens the life-skills they need to successfully deal with stress, how to problem-solve, how to set goals, and those are key elements in this healthy lifestyle intervention.”

  • Karen Sullivan is a best-selling author, psychologist and childcare expert. Email


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