Tackling student stress and depression

Written by: Pete Henshaw | Published:

Teachers are not trained mental health professionals, but schools can play a role in supporting students’ wellbeing. Dr Stephanie Thornton looks at the challenges and offers some ideas

A teenager drinks too much, or is high on cannabis most of the time. Another self-harms, slashing his arms with a razor. A third starves herself to a painful thinness. Another locks himself away in his bedroom, obsessively playing games on the internet.

What is going on here? We tend to label these teenagers in terms of their problem behaviour: alcohol abuse, drug addiction, self-harming, anorexia, gaming addiction and so on.

But scratch the surface, and very often it will turn out that these apparently dysfunctional behaviours are not so much the problem per se, as an effort to manage an otherwise overwhelming distress and anxiety. And in some ways, these strategies work.

Take the classic forms of self-harm, for example: there is good research evidence that pain reduces activity in brain centres associated with negative emotions, making it easier to manage distress. Equally, the chemical effects of alcohol and drugs blunt negative emotions.

An obsessional focus, whether on food or computer gaming, is a powerful distraction from other, less tractable stressors. So, in effect, the problem behaviours we see in adolescents are often strategies to self-medicate stress, albeit strategies that bring further problems.

Why do the young self-medicate their stress in ways which do further harm? The terrible truth is that often, the young know no better ways to cope, and these apparently dysfunctional strategies are better than nothing – and “nothing” in the way of support is exactly what many, many thousands of adolescents experiencing deep distress will otherwise have.

We do not know exactly how many of our young are suffering from severe stress. More than one in 10 had diagnosable mental illness 10 years ago, when the most recent research data were collected (and that figure was almost certainly an underestimate of the number suffering stress even then, as many affected teenagers would not manifest clinical symptoms).

Practitioners report increasing levels of distress over the past decade, and not just from the usual social groups, those suffering disadvantage of one kind and another. Today, a shocking number of bright, able teenagers from stable, affluent homes are turning up in GP and psychologists’ offices stressed and distressed.

Experts estimate that well over 40,000 adolescents seeking help for stress will be refused treatment every year. And of course, many youngsters suffering from serious stress through their teens never come to anyone’s attention, still less receive any help.

The lack of support for stressed teenagers is shocking. Research suggests that 50 per cent of mental health problems that will be manifest in adult life are already present by age 14; and 75 per cent of adult mental illness (excluding dementias) is manifest by age 18.

Early intervention offers the best chance of heading these problems off before they become entrenched. Far too few of the young receive that early support. Less than 10 per cent of NHS resources for mental health are presently targeted on teenagers. Nor is this situation likely to improve: services are presently being cut or withdrawn, making access to mental health professionals harder. Even the new funds of £1.25 billion promised for this sector are widely believed to be a drop in the ocean – nothing like what is needed to address the problem.

So schools are on the frontline. In an ideal world, there would be trained mental health professionals on hand in every school – but that is pie in the sky.

Teachers are not qualified to replace such help, and are too stretched to cope with the sheer numbers of distressed youth. We are doing pretty well if we can recognise such individuals, let alone manage them.

What is best practice, in this woeful situation? We cannot control the stress the young experience. All we can do is to help them find more constructive ways of managing that stress. And that is a matter of finding ways of shedding light on the issues, and opening new channels of communication.

Out in the open

Get the problem out in the open: strikingly, a number of bright, articulate university students report that as teenagers they did not realise that the stress they felt was not normal, still less did they understand that there was any sort of help, or any constructive self-help strategies that might be engaged.
Their misery seemed to them to be a reflection of private, personal inadequacy. So they struggled on in silence. Such ignorance and isolation is exactly what leads to the dysfunctional self-medications of drink, drugs, self-harm and so forth.
Explicit classroom discussion of mental health, and of the stresses and anxieties of adolescence can both relieve ignorance and reduce isolation, as individuals recognize a shared problem and gain a better understanding of themselves, others and discuss the possibilities of constructive interventions and healthy strategies for coping.
Safe to talk
Explicit discussion of stress and mental health issues can educate, and can help to take away the stigma of feeling one is not coping, and so can encourage troubled individuals to seek help early rather than going down the route of self-medicating with drugs, self-harm and so on. But group discussions are not the place for sensitive personal disclosures: for that students need individuals they trust, to confide in.
Sometimes that will be a teacher, and it is important that the young know that there are adults who are approachable, non-judgemental and nurturant.
But research shows that often, the first confidante the young choose is a peer – who they expect to understand their problem better than an adult would, and who is more an equal and so less threatening.
Such peer confidantes are potentially a major resource, particularly in the vital early identification of individuals who are beginning to struggle. Many experts believe that we should be fostering
this resource.
Some surveys suggest that around a third of secondary schools already have peer-mentoring programmes, primarily aimed at managing bullying, but also
in some cases moving toward a focus on attainment and wellbeing. The research suggests that, done well, peer-mentoring can have beneficial effects both for individuals and for the school community as a whole.
Could peer-mentoring be extended to offer a first port of call for students suffering stress? Obviously, there are limits on what it is appropriate to expect of a peer mentor in this context, both from an ethical and from a practical point of view.
Peer mentors cannot and should not be put in the position of counselling, nor should they be exposed to harrowing stories. But with the right training and clear boundaries, they might provide a useful resource as listeners, pointing the troubled to sources of help and alerting staff about worrisome individuals.
Setting up such a peer-mentoring scheme, training peer mentors appropriately and providing them with the practical and emotional support they will need obviously requires expert input, to avoid various pitfalls and dangers. Such help is on hand from charities such as ChildLine and the Mentoring and Befriending Foundation who can provide expert advice on the overall design and management of a scheme, and structured training programmes and models for on-going support for peer mentors.

Dr Stephanie Thornton is a chartered psychologist and former lecturer in psychology and child development.

Further information
ChildLine: www.childline.org.uk
The Mentoring and Befriending Foundation: www.mandbf.org


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