Developing our 'senses' for better mental health

Schools are increasingly looking to develop the social and emotional skills of students. Brian Graetz and Jeanie Sheffield investigate how teachers and parents can support students who are experiencing health difficulties, such as depression and anxiety.

Students with better social and emotional skills are more able to cope with the stressors of daily life, have better relationships with parents, teachers, and peers, and do better academically.

It is estimated that, at any one point in time, approximately 120,000 or 3 per cent of young Australians have severe or 'clinical' depression with many more (about 15%) experiencing periods of prolonged sadness leaving them at risk for 'clinical' depression. Other than the extreme distress that depression causes a young person (and the adults and friends who care for them), it can profoundly diminish their capacity for schooling, relationships and community participation.

Although depression has serious consequences, including being a well-recognised risk factor for suicidal behaviour, only a minority of young people with depression receive professional help (estimates in Australia suggest less than one in three). While access to specialist mental health services—particularly in some areas of Australia—is an issue, it is often the case that young people experiencing problems do not seek help even when it is available. Often this is out of concern about what others will think or in the mistaken belief that nothing or no one can help.

Awareness at the school level

Over the past decade, schools have become increasingly aware of the impact that mental health problems, such as anxiety and depression, have on students and the broader school community. It is evident that many staff want to know more about these problems and how they can support students who are experiencing difficulties. While professional development opportunities may be limited, there are websites that provide useful information and resources on supporting young people with mental health issues. Since 2000, beyondblue: the national depression initiative has taken a leading role in raising community awareness about depression, anxiety, and related disorders and has information and resources about the impact of these problems on young people than can be accessed through its website (www.beyondblue.org.au).

In addition to supporting students experiencing mental health difficulties, increasingly schools are adopting the view that they should play an active role in supporting the social and emotional development of all their students. Schools have been doing this implicitly for years through practices, such as pastoral care groups and the conscious role modelling of teachers, however, this is now being extended to formal curriculum approaches with the introduction of programs ranging from the broad-based (e.g. resiliency) to the more specific skill sets (e.g. managing exam stress).

Enhancing the social and emotional skills of students has some important pay offs for the whole school community. Students with better social and emotional skills are more able to cope with the stressors of daily life, have better relationships with parents, teachers, and peers, and do better academically. Such skills also make it less likely that a student will experience a significant mental health problem in the future.

Partnering with teachers

When beyondblue began in 2000, one of its major priorities was to develop a curriculum program for junior secondary school students that would teach skills for managing the ongoing challenges of life. The program was to target the skills and capacities that research indicated were 'protective' or made students less vulnerable to depression. A team from the University of Queensland's School of Psychology was contracted to develop the program because of their expertise in developing large-scale school-based prevention programs. With input from other health and education professionals, they developed the beyondblue Classroom Program, a comprehensive 30-session curriculum program delivered to students over a three-year period beginning in year 8.

The Classroom Program was based on cognitive-behavioural principles. Cognitive approaches to mental health regard thoughts as playing a central role in influencing feelings and consequent behaviour. Specifically, when an event happens to us, it is our thoughts and interpretations of that event, and not the event itself, that leads us to feel certain emotions and act in particular ways. Teachers will likely witness this first hand many times in a school year. One of the more obvious examples occurs when students receive exactly the same scores on an exam but have completely different emotional reactions.

A crooked lens

Research indicates that thinking 'styles' do contribute to a person's vulnerability to experiencing depression and the extent to which it is maintained. Specifically, young people with negative cognitions about their selves, the world and their future are more vulnerable. The beyondblue Classroom Program was developed with the view to enhancing students' thinking around their selves, their world and future though the development of six key senses. These are:

1. Sense of Self-worth (knowledge of and belief in one's strengths, skills, and abilities—an acceptance of one's inherent value)
2. Sense of Belonging (feeling valued, needed and accepted—being connected meaningfully to a social network)
3. Sense of Control (belief that one has the skills and ability to cope with life challenges and to manage one's own emotions)
4. Sense of Purpose (capacity to make sense of the world and to perceive some meaning in one's life)
5. Sense of Future (hopefulness about the future enabling us to act purposely and positively)
6. Sense of Humour (being able to see the lighter and 'funnier' side of life—including ones own foibles).

Underpinning the development of these six senses is a number of core 'thinking' skills, such as emotion recognition and regulation, effective communication, conflict resolution, helpful thinking, challenging unhelpful thoughts, setting realistic expectations, life problem solving and decision making, planning, time management, scheduling pleasant events, recognition and understanding of mental health issues, and readiness and capacity to seek help for self and others. These were built in to the program and delivered in a hierarchical fashion over the three years.

The key themes and major topics covered by the beyondblue Classroom Program are shown in the table.

Support for a new focus

The beyondblue Classroom Program was originally trialled across 50 schools in three states as part a larger research project. For evaluation purposes, teachers were asked to deliver the program in a standardised manner and were provided with detailed teacher manuals, student workbooks and DVD materials. Upon the completion of the trial in early 2006, beyondblue has made these materials freely available to schools through its website. Demand for the materials has steadily grown over this time supporting the view that schools are increasingly looking to develop the social and emotional skills of students. The feedback we have received from schools suggests that they are looking for clear guidelines for delivering social and emotional curriculum but want a range of strategies and materials to engage their students.

Over the next 18 months, beyondblue will update and repackage their Classroom Program as distinct modules (with accompanying online materials) each focusing on one of the six key senses with an additional school community module that will provide teachers and parents with information on supporting students experiencing mental health difficulties, such as depression and anxiety. beyondblue has a strong commitment to enhancing the mental health of young people and regards the further development of the materials as an opportunity to support schools in their quest to enhance the social and emotional skills of their students. It is intended to provide these resources to the wider school community and beyondblue welcomes comments about the proposed approach.

Brian Graetz is senior program manager of Public Health at beyondblue.

Jeanie Sheffield is lecturer in clinical psychology and research fellow in the School of Psychology at the University of Queensland.

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