MENTAL HEALTH

There’s no secret that the education sector has been facing overwhelming pressure and that the mental health and wellbeing of teaching staff and other educators has been stretched. News from the education world is often shrouded in negativity, and with the additional upheaval seen over the last two years, it can feel as if the negatives outweigh the positives. Around 9 in 10 teachers now say work-related stress has had a detrimental impact on their mental health, particularly over the course of the pandemic -  it can feel all too easy to become trapped in a cycle of despondency and pressure. 

The British Army has launched new Wellness and Mental Health resources for young people aged 11-16, which schools can use free-of-charge. These digital resources for Key Stages 3 and 4 focus on four topics: Coping with Stress, Managing Change, Healthy Minds and Support Networks.

WWT Wetland Centres will open their doors to school pupils from December 1.

School children across the UK will be filling up bird feeders, turning classrooms into bird hides and creating wildlife friendly bakes in preparation for watching and counting the birds in their school grounds for the 20th anniversary of the RSPB’s Big Schools’ Birdwatch. The Birdwatch – which takes place during the first half of the Spring term (5 January – 22 February) – is a chance for children to participate in a UK-wide citizen science project and generate real life data. The Birdwatch involves children watching and counting the birds that visit their outdoor space, before sending the results to the RSPB.

Now, more than ever before, young people are highly prone to experiencing a mental health disorder, a statement that was confirmed by a recent NHS digital report into the mental health of young people in the UK. Katharine Sadler, Director at the National Centre for Social Research and contributor to the report, has also commented on the prevalence of mental health challenges in youth, describing the statistics as “significant.”

In recent years we’ve seen a positive shift in attitudes towards mental health. It’s being talked about by everyone from the royal family to Justin Bieber: little by little, the taboo is being broken.

As I’ve only just dipped my toe into school leadership, I was surprised at just how difficult it has been this year. Simply managing your class, or leading a subject, is a full time, stressful job all year round. Throw the demands of leading a core subject - or the day-to-day demands of managing a school - into the mix, and ‘stressful’ doesn’t describe it. Thankfully, there’s a great, highly-accessible resource to hand: music.

How exactly can music can inspire leaders? To find out, we first need to discuss how it can make a difficult job easier. I am a musician and play a number of instruments. Playing an instrument, even when you have lots of experience, requires your full and complete concentration. Playing the piano, as I do, requires you to engage so many different elements of your body, both physical and mental that any other thought goes quickly out of the window.

That sheer level of concentration is how I destress. The only place where thoughts of school go fully out of my mind is sat at a piano stool. Any school leader, or teacher for that matter, needs something that completely frees their mind of school - be it exercise, meditation, and so on. This is definitely a vocation rather than a job; you simply can’t walk away at 3.30. However - and this is vital - you MUST be able to compartmentalise in order to survive.

The other way that music helps me with wellbeing is singing. I sing in a community choir once a week. Whilst the levels of concentration are different, this is another oasis in a busy week, one which frees my mind from thoughts of school. Music, and singing in particular, has so many physical and mental benefits.

A review by Chanda and Levitin (2013) highlighted the positive impact of simply listening to music in a variety of ways. The review showed that listening to music releases dopamine and oxytocin in the brain, whilst also increasing the body’s immunity by supporting the production of immunoglobulin A, an antibody that works through the mucous system. One of the studies reviewed also found that listening to music resulted in a decrease in cortisol, the ‘stress’ hormone.

Singing has also been found to have major physical impacts upon the body, particularly the respiratory system (Vickhoff, 2013). Singing, especially in a group, produces a coupling of heart rate variability to respiration, a process called respiratory sinus arrhythmia (RSA). Singing produces slow, regular and deep respiration, which in turn triggers RSA. RSA is a benefit of activities such as yoga and tai chi, so singing can be seen as an alternative to these, as well as having other physical and emotional benefits.

So music is good for you. Listening to music and singing along, whether in an organised way with a choir or simply in the shower, or in the car, on the way to work, can have a positive impact on your body - both mentally and physically. Music can provide a moment of calm in a busy, stressful day. It can help to clear your mind, allowing you to de-stress.

So where does the school leader inspiration come in? Well, if all the things above work, then you are better able to do your job. If your whole outlook has changed, if you are calmer and your body is tuned and able to function, then you will do your job better. I could write a whole article on how music inspires me and others, but first we need bodies and minds that are healthy and able to work. Listen to music, sing along (well or otherwise) and arrive at work with an opportunity to have a positive impact on the children in your care. This year, the doctor subscribes a burst of ABBA, Queen or Ed Sheeran on your journey into work (possibly not on public transport...).

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Did you know that horse riding offers tremendous benefits for pupils with severe learning difficulties? This article considers an innovative approach to widening education access to include more pupils, including those who struggle with a real-life horse, and those with profound and multiple learning difficulties (PMLD).

To begin with, it is useful to consider the benefits of horse riding. “The therapeutic benefits of riding are numerous and as well as the physical benefits of improving posture, becoming stronger and helping riders to become more supple, exercising with a horse is great fun! You can improve your awareness, communication, confidence and decision making, as well as enjoy activities with a community of like-minded people.” (RDA, 2018).

There is such a wide range of benefits to horse riding that it is easiest to provide some bullet points!

  • Relationship building - the pupil will benefit from the opportunity to build a relationship, and be able to trust a horse, as well as staff and peers in an alternative environment.
  • Activities of daily living - learning to groom the horse and look after its wellbeing. These skills can be transferred to the pupil’s own daily routines, helping them to develop their self-awareness and self-care.
  • Sensory experience - therapeutic riding and equine interaction provide a sensory experience which enables a broad range of new stimuli to be introduced, such as smells, sounds, textures, movement, pressure, rhythmical movement and perturbations to balance. The activity develops the sense of movement within joints and joint position, stimulating balance and spatial orientation systems.
  • Purposeful hand skills and fine motor coordination - riding requires specific hand skills, as well as the ability to change grasp and alter the purpose of hand movements - both unilaterally and bilaterally. For example, grasping for balance, holding reins and initiating steering, grooming, and touching the horse.
  • Balance and gross motor coordination - mounting and riding requires balance and gross motor control. The movement of the horse requires the body to reciprocally activate alternate muscles on both sides of the body to maintain balance. The trunk is forced to work continually to maintain and regain balance. This improves abdominal muscle strength, and is particularly helpful at promoting a symmetrical posture, coordinated movements and balance (very much like rebound therapy).
  • Communication - riding and equine interaction requires a broad range of communication skills and behaviours. Pupils will be enabled to develop their interactions with both the instructor and helpers, as well as learning how to ask the horse to move forwards, stop and change direction and speed.
  • Exercise as a leisure activity - riding promotes physical activity, and the use of muscles and light exertion, as part of a pleasant social activity. It enables pupils the opportunity to exercise in an alternative environment and take part in a peer group activity.
  • Behaviour – riding and associated activities, such as grooming, promote the understanding of body language, tone of voice, appropriate language and behaviour and encourages empathy and understanding of emotions in relation to themselves, the horse and others.

Outcomes

Within an educational setting, it is always important to consider the impact of an intervention, and this is no different.

In addition to providing cardiovascular benefits, decreased physiological stress is associated with animal interaction, contributing to better overall health.” - Pets Are Wonderful Support, 2007

With regards to the outcomes for pupils the photographs speak for themselves with reference to the therapeutic impact of horse riding “...offering stable work and riding to adolescents in an environment with a supportive adult and peers may benefit their psychological development.” - Hauge, H. Et al (2013).

A member of staff reflecting about one pupil commented that, “She benefitted by starting to overcome her fear of the horse. On the last visit she actually entered the sand school and was coaxed up to the horse to touch it. She has been desensitised”.

Riding also provides an additional opportunity for that all important increased physical activity to manage a pupils weight and therefore can be important part of a pupils PE package. There is also a more formal aspect to horse riding; the opportunity to gain some recognition for their achievements! Pupils have achieved a number of AQA Pre-Entry level awards that are available including:

  • Preparing to ride a horse.
  • Introduction to pony riding.
  • Horse riding: basic skills.
  • Horse riding skills.
  • Riding for the Disabled Association Unit 1 and Unit 2.
  • In 2015/16, five KS2 pupils had achieved the RDA Unit 1 award
  • In 2016/17, 21 pupils across the school achieved AQA unit awards, and six KS3 pupils had achieved the RDA Unit 1 award.

 

Barriers

The majority of these awards were achieved by pupils with severe learning difficulties. Very few pupils with PMLD were able to access the horse riding, and for some pupils the prospect of engaging with a live animal was a step too far (though there were some who conquered their fears over a few weeks, and this had been their target). Barriers for pupils with PMLD included the inability to hoist pupils, the limited physical support available from the saddles, and the less controlled environment that provided specific risks for some pupils.

Many studies have indicated the beneficial effects in the rehabilitation of patients with diverse disabilities… The combination of a horse riding simulator and the concept of hippotherapy led to a new form of rehabilitation.” - Baillet, H. Et al, (2016).

The idea of buying a mechanical horse simulator was born. This would be indoors in a more controlled environment (and with hoisting available), would provide an introduction to horse riding to those who had a fear of the live animals, and would enable the school to find ways of providing access to pupils with more complex needs. There was a problem, though: horse simulators, used by professional horse riders, are rather expensive. A fundraising initiative - ’Tonto’ - was born, and the riding simulator along with a horse riding instructor were all set up to hit the floor galloping for the start of the 2017/18 academic year.

Tonto

There are now in place a number of AQA Pre-Entry level awards for a horse simulator, including:

  • Horse simulator skills.
  • Preparing to ride a horse simulator.
  • Introduction to riding a horse simulator.
  • Riding a horse simulator with physical prompts.
  • Riding a horse simulator without prompts.

Here is an example of one of these awards:

To achieve the introduction to riding a horse simulator, the pupil will have demonstrated the ability to:

1. Cooperate with putting on a riding hat.
2. Get onto the horse simulator from the riding block or ramp with verbal or physical prompts.
3. Hold onto the saddle with both hands.
4. Ride independently on level ground, on uneven ground, uphill or downhill, on three occasions.
Experienced:
5. Trotting with minimal physical support.

Impact 

Improved access. The horse riding sessions continue, but in addition there are now at least 30 pupils accessing weekly riding lessons with a qualified riding instructor on the simulator. These pupils are now able to access many of the benefits considered at the start of this article. Some of them will progress to the real horse riding lessons.

Increased accreditation. In addition to the awards achieved through horse riding, at the time of writing pupils are working towards the awards relating to the horse simulator.

Therapeutic benefits. With regards to the outcomes for pupils the photographs speak for themselves with reference to the therapeutic impact of the simulator. Anecdotal evidence, however, includes comments from staff, parents and pupils, including:

When he first got on Tonto he was very nervous, and did not want me to let go of his hands and back. By end of first session, he was riding independently. He had a further four sessions and wanted to try a faster walk. This lasted about 20 seconds, then he asked to go back to a slower walk. Then he went off-site horse riding, and actually rode the horse for the whole session, with only the horse leader for verbal support. These were great achievement in such a short space of time.

This was especially impressive as during the home visit, his mum said that he was scared of horses. The family own a horse, and he had fallen off of the trap and refused to go near the horse or ride again!

For two pupils, “it helped them to be focussed and calm upon returning to class. Attention and focus has improved over the course of the term within the riding lessons. All of them now remain on for the whole lesson, developing their riding skills, and also their focus and ability to follow verbal instructions.”.

Bibliography

Effect of Therapeutic Horseback Riding on Posture in Children with Cerebral Palsy. Paper presented at the 6th International Therapeutic Riding Congress,Toronto, Canada, 23-27 August. Bowlby, J. (1969).

Energy expenditure of horse riding. European Journal of applied psychology, 82, 499-503. DCMS (2007)

Equine-assisted activities and the impact on perceived social support, self-esteem and self-efficacy among adolescents – an intervention study, Hilde Hauge, Ingela L. Kvalem, Bente Berget, Marie-José Enders-Slegers & Bjarne O. Braastad (2013)

The health benefits of companion animals. Pets Are Wonderful Support, 2007

The health benefits of horse riding in the UK. The British Horse Society, 2010

Human Energy Expenditure and Postural Coordination on the Mechanical Horse, Journal of Motor Behavior, Héloïse Baillet, Régis Thouvarecq, Eric Vérin, Claire Tourny, Nicolas Benguigui, John Komar, & David Leroy (2016)

Riding, http://www.rda.org.uk/taking-part/riding/ accessed from RDA website, February 2018.

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School children are constantly engaging with their peers on digital technology and social networking sites such as Instagram, Snapchat and Musical.ly. While it is sometimes harmful - reports of cyberbullying cases are increasingly commonplace - digital technology also comes with considerable benefits. Below are some of the top e-health tools that enable pupils, and those supporting them, to access mental health and wellbeing advice at the click of a button.

1. Chat Health

This school nurse text messaging service was developed by the Southern Health NHS Foundation Trust. ChatHealth is a confidential text messaging service which enables school children aged 11-19 to connect with their school nurse for help and advice on health and wellbeing issues, such as depression and anxiety, bullying, self-harm, alcohol, sex, drugs and body issues. Students will generally receive an instant confirmation message followed by a full response within one working day.

Find it at: www.southernhealth.nhs.uk/services/childrens-services/school-nursing/chathealth

2. SAM

This is an anxiety management app created by the University of the West of England, Bristol. SAM helps users understand the causes of anxiety, monitor their anxious thoughts and behaviour, and manage their anxiety through self-help exercises and reflection. The app also allows users to share their experiences with the SAM community, and fellow anxiety sufferers, through a ‘social cloud’ feature.

Find it at: www.sam-app.org.uk

3. Worrinots

Created for Primary school children dealing with anxiety and worry, this app allows children to send a written or recorded message to one of four Worrinot characters: Chomp, Shakey, Rip and Stomp. The pupil’s message is then forwarded to a designated person at the school. The app can also be used by teachers as a tool to monitor their pupils’ wellbeing and provide early intervention where necessary. Worrinots was developed with the help of child psychologists, school staff and counsellors, and is Ofsted compliant.

4. WellHappy

An app for London-based 12-25-year-olds, this guidance and information resource contains details for accessing more than 1,000 local support services for mental health, sexual health, drugs, alcohol and smoking. Through the app, young people can also blog about their own experiences, read FAQs, jargon busters and information about rights and advocacy.

Find it at: mentalhealthpartnerships.com/resource/well-happy-app

5. TooToot

This platform and app, which offers ‘a voice for your students’, is an alternative way for students to report incidents of bullying, cyberbullying, racism, radicalisation, sexism, mental health and self-harm straight to their school, when they are unable to do so face-to-face. The app can be used by students (to report concerns directly to teachers), by school staff (to record incidents and behavioural concerns) and by parents (to report any concerns to school staff) Tootoot provides students with 24-hour support.

Find it at: www.tootoot.co.uk

6. ForMe

Developed with Childline by teenagers, this wellbeing app is aimed at children and young people, up to 19. Features include: access to self-help articles and videos on topics such as body issues, exam stress, emotions, bullying, abuse, mental health and self-harm issues. There is a message board where children can chat to others about what’s on their mind. Children can keep track of their daily mood through the app and tailor content that’s relevant to how they are feeling. If a child needs more support, the app will content them with a Childline counsellor for a phone or email conversation.

Find it at: www.childline.org.uk/toolbox/for-me

The year for progress

With teachers’ workloads persistently increasing, technology will continue to play an important role in enabling schools to screen for, and monitor, the mental health and wellbeing of their pupils. Apps and websites are essential in making effective use of teachers’ busy schedules and maximising their time with children: allowing face-to-face contact to be as targeted and beneficial as possible.

Access to digital mental health support also comes with an array of benefits for children, such as the ease, cost-effectiveness and swiftness in which these services can be tapped into. Additionally, digital technology provides an opportunity for pupils to share experiences with a group of like-minded people, fostering a sense of community and camaraderie.

While professional face-to-face services are still an essential part of supporting young people with mental health and wellbeing issues, digital support may be able to reach children who are unlikely to engage with mental health services. According to a 2016 Centre for Mental Health report, entitled Missed Opportunities, children are waiting on average 10 years for effective mental health treatment. Lastly, digital technology brings with it a level of privacy and anonymity - key for young people who are not comfortable to voice their concerns in person.

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