Our classroom teachers and Learning Support Assistants see our students on a daily basis.  They know them well and are well placed to spot changes in behaviour that might indicate a problem. Our school aims to offer support to students at such times, intervening well before mental health problems develop.

Where children experience a range of emotional and behavioural problems that are outside the normal range for their age, they might be described as experiencing mental health problems or disorders. Mental health professionals have classified these as:

• emotional disorders, for example phobias, anxiety states and depression.
• conduct disorders, for example stealing, defiance, fire-setting, aggression, and anti-social behaviour.
• hyperkinetic disorders, for example disturbance of activity and attention.
• developmental disorders, for example delay in acquiring certain skills such as speech, social ability, or bladder control, primarily affecting children with autism and those with pervasive developmental disorders.
• attachment disorders, for example children who are markedly distressed or socially impaired as a result of an extremely abnormal pattern of attachment to parents or major care givers.
• Trauma disorders, such as post-traumatic stress disorder, as a result of traumatic experiences or persistent periods of abuse and neglect; and
• other mental health problems including eating disorders, habit disorders, somatic disorders; and psychotic disorders such as schizophrenia and manic-depressive disorder.

Only appropriately trained mental health professionals should attempt to make a diagnosis of a mental health problem. However, as a school, we will observe our students daily to identify those whose behaviour suggests that they may be experiencing a mental health problem or at risk of developing one.

Certain individuals and groups are more at risk of developing mental health problems than others. These risks can relate to the child themselves, to their family, or to their community or life events. The DfE ‘Mental health and behaviour in schools 2018’ highlights the risk and protective factors that are believed to be associated with mental health outcomes in the table below:

	Risk factors	Protective factors
In the child	•   Genetic influences •   Low IQ and learning disabilities •   Specific development delay or neurodiversity •   Communication difficulties •   Difficult temperament •   Physical illness •   Academic failure •   Low self-esteem	•  Secure attachment experience •  Outgoing temperament as an infant •  Good communication skills, sociability •  Being a planner and having a belief in control •  Humour •  A positive attitude •  Experiences of success and achievement •  Faith or spirituality •  Capacity to reflect
In the family	•  Overt parental conflict including domestic violence •  Family breakdown (including where children are taken into care or adopted) •  Inconsistent or unclear discipline •  Hostile and rejecting relationships •  Failure to adapt to a child’s changing needs •  Physical, sexual, emotional abuse, or neglect •  Parental psychiatric illness •  Parental criminality, alcoholism, or personality disorder •  Death and loss – including loss of friendship	•  At least one good parent-child relationship (or one supportive adult) •  Affection •  Clear, consistent discipline •  Support for education •  Supportive long-term relationship or the absence of severe discord

 

The balance between the risk and protective factors is most likely to be disrupted when difficult events happen in students’ lives.

These include:

• loss or separation – resulting from death, parental separation, divorce, hospitalisation, loss of friendships (especially in adolescence), family conflict or breakdown that results in the child having to live elsewhere, being taken into care, or adopted, deployment of parents in armed forces families.
• life changes – such as the birth of a sibling, moving house or changing schools or during transition from primary to secondary school, or secondary school to sixth form.
• traumatic experiences such as abuse, neglect, domestic violence, bullying, violence, accidents, or injuries; and
• other traumatic incidents such as a natural disaster or terrorist attack. Some groups could be susceptible to such incidents, even if not directly affected.

As a school, we work incredibly hard to provide support to our students and their families at such times, including those who are not presenting any obvious issues.

Identifying children with possible mental health problems- Information for Parents and Carers

Behavioural difficulties do not necessarily mean that a child or young person has a possible mental health problem or a special education need (SEND).  Consistent disruptive or withdrawn behaviours can, however, be an indication of an underlying problem.  Our school is well-placed to observe students day-to-day and identify those whose behaviour suggests that they may be suffering from a mental health problem or be at risk of developing one.  This may include withdrawn pupils whose needs may otherwise go unrecognised.

Self-Harm

Self-harm encompasses a wide range of issues including eating disorders, self-injury and drug/alcohol misuse.  As a school, we focus primarily on the preventative measures and supportive steps against self-injury. We understand that this can be distressing for families and we will always work positively to support families who need it.

Self-Injury

Self-injury is a coping mechanism.  A student may harm their physical self to deal with emotional pain or to break feelings of numbness by arousing sensation.  Self-injury is defined as any “deliberate, non-suicidal behaviour that inflicts physical harm on your body and is aimed at relieving emotional distress“.  Physical pain is often easier to deal with than emotional pain because it causes ‘real’ feelings.  Injuries can prove to an individual that their emotional pain is real and valid.  Self-injurious behaviour may calm or awaken a person, but it only provides temporary relief; it does not deal with the underlying issues.  Self-injury can become a natural response to the stresses of day-to-day life and can escalate in frequency and severity.

Self-injury can include but is not limited to, cutting, burning, banging, and bruising, non-suicidal overdosing and even deliberate bone breaking.  Self-injury is often habitual, chronic, and repetitive self-injury tends to affect people for months and years.  People who self-injure usually make a great effort to hide their injuries and scars and are often uncomfortable about discussing their emotional inner or physical outer pain.  It can be difficult for young people to seek help from the NHS or from those in positions of authority, perhaps due to the stigma associated with seeking help for mental health issues.  Self-injury is usually private and personal, and it is often hidden from family and friends.   People who do show their scars may do so as a reaction to the incredible secrecy, and one should not assume that they are ‘inflicting’ their scars on others to seek attention, although attention may well be needed.  Risk factors include, but are not limited to:

• Low self-esteem.
• Mental health issues such as depression and anxiety
• The onset of a more complicated mental illness such as schizophrenia, bi-polar disorder or a personality disorder.
• Problems at home or school.
• Physical, emotional, or sexual abuse.

It is important to recognise that none of these risk factors may appear to be present.  Sometimes it is the outwardly happy, high-achieving person with a stable background who is suffering internally and hurting themselves in order to cope.  As noted above, there may be no warning signs, but some of the things below might indicate that a student is suffering internally which may lead to self-injury.

• Drug and / or alcohol misuse or risk-taking behaviour.
• Negativity and lack of self-esteem.
• Out of character behaviour.
• Bullying other pupils.
• A sudden change in friends or withdrawn from a group.
• Physical signs that self-injury may be occurring.
• Obvious cuts, scratches or burns that do not appear of an accidental nature.
• Frequent ‘accidents’ that cause physical injury.
• Regularly bandaged arms and/or wrists.
• Reluctance to take part in physical exercise or other activities that require a change of clothes.
• Wearing long sleeves and trousers even during hot weather.

Suicide

Although self-injury is non-suicidal behaviour and relied on as an attempt to cope and manage, it must be recognised that the emotional distress that leads to self-injury can also lead to suicidal thoughts and actions.  It is therefore of the utmost importance that any concerns or particular incidents of self-injury are taken seriously and reported in accordance with our School Safeguarding Policy to allow for the underlying issues to be thoroughly investigated and the necessary emotional support given, in order to minimise any greater risk.  If you have any concerns or worries about your child, please get in touch immediately so that we can offer you the appropriate support. Should you be concerned that your child is at risk of immediate harm, you must either phone 999 or take your child to the nearest A and E.