Best Practice

Mental health, wellbeing and PSHE

PSHE Pupil wellbeing Mental health
PSHE has a key role to play when teaching young people about their mental health and wellbeing. Expert Jenny Barksfield explores how a well-planned and delivered PSHE education programme can support pupils’ mental health and emotional wellbeing

Children and young people’s mental health and emotional wellbeing is cause for concern, with increasing numbers reporting mental health issues and seeking support from organisations such as Childline. The government has announced measures to help address this, including an imminent Green Paper on mental health.

There are important decisions to be made about the extent to which schools will be expected to provide support. However, teaching about and promoting mental health and emotional wellbeing as part of a planned PSHE curriculum can play a vital role in keeping pupils safe and healthy, as part of a whole-school approach. Such complex issues need complex solutions, and PSHE should be considered within the wider range of support schools can offer.

PSHE education can promote pupils’ wellbeing by developing healthy coping strategies, by developing pupils’ understanding of their own and others’ emotions, and by providing an opportunity to talk openly about these issues (which helps to break down associated stigma). Additionally, such lessons can be a vehicle for providing pupils who do develop difficulties with strategies to access the support they need, as well as helping pupils to recognise and support friends who are facing challenges.

While the content of lessons will be determined by the specific needs of the group you are teaching, there should always be an emphasis on enabling pupils of any age to promote and maintain their own emotional wellbeing as well as develop the skills, knowledge, understanding, language and confidence to seek help, as needed, for themselves or others.

You can help them to understand when this help might be needed, what help is available, and the likely outcome of seeking support.

Teaching about mental health and emotional wellbeing raises significant challenges for teachers, however. We know that schools want to cover these issues and recognise the imperative to do so, but without sufficient subject knowledge teachers can find it daunting.

Our freely available Department for Education-funded guidance and companion lesson plans aim to help schools prepare to teach about mental health and emotional wellbeing sensitively through PSHE education, and we offer a taster here of a few key points from this guidance.

The guidance is clear that schools must access training and support before teaching the more challenging and sensitive areas of mental health and emotional wellbeing. Teachers must be supported by their colleagues and must work on the basis that in any lesson at least one pupil will be affected by the issues being addressed. With this in mind, schools should work on the principle “first do no harm”, explored below and in detail in the guidance itself.

A planned PSHE programme

Mental health and emotional wellbeing should not be viewed as a “topic” that can be delivered in isolation in a lesson or series of lessons. The skills, language and understanding needed to promote positive mental health should underpin much of what you teach in PSHE.

Your PSHE programme should aim to develop the relevant knowledge, understanding, skills and attributes progressively in an age and stage-appropriate way from early years onwards. Build on appropriate earlier learning so that it forms part of a developmental, spiral curriculum, rather than a patchwork quilt of unrelated issues. This will sometimes take the form of discrete lessons with a focus on mental health or emotional wellbeing, but it will also form part of wider PSHE teaching.

The PSHE Association Programme of Study for PSHE education covers key stages 1 to 5 and is based on three core themes:

  • Health and wellbeing.
  • Relationships.
  • Living in the wider world.

Mental health and emotional wellbeing runs through all the core themes, especially health and wellbeing and relationships. In planning, it is important to consider not only where mental health is mentioned explicitly but also where there is implicit learning.

What to teach and when

Our Programme of Study for PSHE outlines the skills, knowledge and understanding to develop at each key stage in relation to mental health and emotional wellbeing. It is, however, very important to be flexible in your curriculum development and delivery, and adapt your PSHE programme to meet the specific needs of your own pupils, in your own schools.

For example, while we do see self-harm and mental health issues in younger children, young people become increasingly vulnerable from about age 12, with a peak in onset of issues such as self-harm and eating disorders at about age 14 or 15. Therefore it is important not to leave this learning too late. You could begin to explore issues related to mental health and wellbeing more explicitly (in an age and stage-appropriate way) once children enter secondary school.

If you are in communication with your feeder primary schools about PSHE provision, they may inform you of specific issues among the pupil population or in the local context that they/you feel a need to address. Otherwise, the primary school years can be most usefully spent developing protective skills, knowledge and understanding as outlined above.

A focus on healthy coping strategies, stress management and help-seeking can be especially useful in years 6 and 7 as children make the transition from primary to secondary school.

Do no harm

There can be a particular anxiety about teaching lessons which explore topics such as self-harm, eating disorders or suicide for fear they may do more harm than good. While our primary focus should be on promoting positive mental health, we should not avoid talking about these topics as these lessons provide an important opportunity to aid understanding, reduce harm and signpost young people to support for themselves or their friends.

However, we need to be careful about the types of things we say and the information we share, and again it comes back to teachers being adequately trained and prepared to cover these often difficult areas of PSHE.

It is extremely important for instance not to provide information on detailed methods when it comes to issues such as self-harm, weight loss/purging or suicide, or ways people can hide the harm they are doing to themselves, as this could prove instructional to a vulnerable young person.

It is also important to be factual rather than dramatic, avoiding use of over-emotive language. Pupils learn best and most safely when presented with facts and given the opportunity to discuss and explore them within safe boundaries.

Using words, images or videos designed to dramatise or sensationalise issues such as self-harm, suicide and eating disorders can often trigger harmful thoughts, feelings and behaviours in vulnerable pupils.

Portrayals of extreme thinness for example are often incorporated into teaching resources with the mistaken belief that they will horrify and shock pupils and therefore prevent them from developing disordered eating, when in fact they can be inspirational for vulnerable young people, providing a role-model or goal to aim for.

For these reasons it is also imperative that we don’t ask pupils to research issues such as eating disorders or self-harm online, as they will very easily find forums and websites that support and promote unhealthy coping strategies, which again could trigger, inspire or instruct vulnerable pupils.

Creating a safe learning environment is a central principle of best practice in PSHE education. This includes using ground rules to establish and maintain a positive context for discussing difficult issues. Learning should also be “distanced” to ensure young people are not vulnerable as a result of sharing personal experiences (teach the lesson assuming there are one or more vulnerable pupils in the room).

This can be achieved by using fictional characters, case studies and scenarios, visual images, stories and language that avoids personalising the learning (taking care not to provide negative instruction or inspiration as mentioned above). For example, pupils could be asked to consider what “someone their age who lives near them and goes to a school just like theirs” might think, do or feel.


Signpost sources of support


Though PSHE focuses on preventative and supportive learning through the taught curriculum, we must always take care to signpost sources of support, and we must take extra care to do so when touching on self-harm, suicide or eating disorders. Ensure that young people understand the importance of seeking help for themselves or a friend if they have concerns, and that the ramifications of preventing this help-seeking can be very serious, and at best will mean that their friend is facing these difficulties alone for longer.

We need to make it clear to pupils how to seek help and what will happen when they do – this means being upfront about issues related to confidentiality. As well as recommending in-school sources of support, also specifically highlight sources of anonymous support – such as Childline or the Samaritans – which can act as a good stepping stone for a young person who is not yet ready to have a face-to-face conversation.

Conclusion

PSHE is effective in supporting mental health and emotional wellbeing as it not only directly focuses on related issues, but develops the underlying skills, attributes and knowledge across the whole of the subject. PSHE can also help address contributory factors that can affect mental health, such as unhealthy relationships, pressures exacerbated by social media, peer pressure, bullying (online and offline), body image and substance misuse.

I hope that this article provides a useful overview, but I also recommend that before attempting to teach such topics you consult our guidance and receive extra training or support for yourself and/or colleagues if needs be.

  • Jenny Barksfield is deputy CEO and senior subject specialist at the PSHE Association, a national body for PSHE education. A charity and membership organisation, the association provides teachers and schools with resources, training and support to improve their PSHE provision. Visit www.pshe-association.org.uk

Further information

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